Occupational safety and health in networked organisations · Management of OSH in networked systems...

Occupational safety and health in networked organisationsManagement of OSH in networked systems

of production or service delivery: studies

in healthcare, construction and logistics

Alistair Gibb, Aoife Finneran, Alistair Cheyne, Andrew Dainty,

Jane Glover, Jennie Morgan, Mike Fray, Patrick Waterson,

Phil Bust, Roger Haslam, Ruth Hartley, Sarah Pink

Loughborough University

www.iosh.co.uk/networkedsystems Research Report

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www.iosh.co.uk/networkedsystems Research Report

Occupational safety and health in networked organisationsManagement of OSH in networked systems

of production or service delivery: studies

in healthcare, construction and logistics

Alistair Gibb, Aoife Finneran, Alistair Cheyne, Andrew Dainty,

Jane Glover, Jennie Morgan, Mike Fray, Patrick Waterson,

Phil Bust, Roger Haslam, Ruth Hartley, Sarah Pink

Loughborough University

I

OCCUPATIONALSAFETYANDHEALTHINNETWORKEDORGANISATIONS:

ManagementofOSHinnetworkedsystemsofproductionorservicedelivery:Studiesinconstruction,healthcareandlogistics

ABSTRACTHowdoemployeesinlarge,networkedorganisationsknowhowtoworkinasafeandhealthymanner?Does

occupationalsafetyandhealth(OSH)knowledgeflow,and,ifso,how?Thisreportpresentsfindingsfromour

research project entitled: Management of OSH in networked systems of production or service delivery:

comparisonsbetweenhealthcare,constructionandlogistics, fundedbytheInstitutionofOccupationalSafety

andHealth(IOSH)andformingpartoftheIOSHresearchprogrammeHealthandSafetyinaChangingWorld.

We introduce the main concepts of OSH knowledge and organisational networks along with the

interdisciplinary theoretical approaches from human factors, safety science, ethnography and organisation

studiesusedaslensestostudythetopic.OurfindingscoversourcesandformsofOSHinformation;channels

ofcommunication;structureandflowacrossthenetwork;filtersormembranesaffectingthetranslationofthe

OSH messages. We deal with conflicts, barriers and enablers for OSH messages, internal translation and

enactment. We discuss the ethnographic lens in some detail. We develop a ‘Third Way’ model to aid

understandingofthecombinationof,andinteractionbetween,thebottom-upandtop-downapproaches.We

proposeresponsestotherealityofOSHasenactedalongwithOSHfutures.WeproposeaPerson-CentricOSH

Knowledge (P-COK) flowmodel to improve understanding of how people take-in, translate and enact both

explicitandtacitOSHmessagesfromanetworkcontext. Afurther,practitioner-facingoutput isplannedfor

thenearfuture.

II



EXECUTIVESUMMARYOURAIMS,APPROACHANDMETHODS

This research report presents our findings from the project entitled: Management of OSH in networked

systemsofproductionorservicedelivery:comparisonsbetweenhealthcare,constructionand logistics. This

projectwasfundedbytheInstitutionofOccupationalSafetyandHealth(IOSH)andformedpartoftheIOSH

research programme Health and Safety in a ChangingWorld. Networked organisations are large, complex

organisationswheresignificantrelationshipsandconnectionsexistacrosstraditionalhierarchical,businessor

functionalboundaries.

Weaimed to identify the typesofOSHknowledgeandevidence that circulateandwork in relation toeach

other in organisations involved in networked delivery systems, how local actors in organisations interpret

information and, in turn, the influences on OSH. In sharing good practice and insights from and across

differentsectors,organisationscanlearnmoreaboutthewaysinwhichsafeandhealthyworkingisachieved

inpractice,aswellaswaysofimprovingtheirOSHknowledgeflow,makingitabetterworkingenvironmentfor

allstaff.

We used an interdisciplinary research approach through the lenses of human factors, safety science,

ethnographyandorganisationstudiesdomains. Thesevencasestudyorganisationsthatformedthebasisof

our study were from construction (2), healthcare (2) and logistics (3) as they all operated in complex

organisationalcontextsbutyetcoveredaspectrumoftaskandorganisationalenvironments.Wehad150face

to face interactions in twophases through interviewsand focusgroups,developingdata flowdiagramsand

usingcriticalincidencetechniquestofocusintervieweesonpracticalrealities.Emergentthemesfromphase1

were then investigated further at phase 2 and through qualitative ethnographic methods at case-study

organisations from across the sectors, spending fiveweeks at each organisationworkingwith and a broad

communityofpractitioners(linemanagersandworkers)-‘keyinformants’:16healthcare,7constructionand

10logistics.

We selectivelydeploy thedataandouranalyses in complementaryways toanswer the researchquestions,

mobilisingaspectsofthedatainconcerttoillustratethecomplexwaysinwhichtacitandexplicitknowledge

combine in both expected and unexpected ways. We also dedicate a standalone section to discuss

ethnographicfindingstoavoidprivilegingoneperspectiveovertheother,andtoputourdatasetsindialogue

with each other (both directly and indirectly) to present amore complete understanding of OSH practices

withinnetworkedorganisationalandsupplychainsettings.

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We have used complementary but distinctive methodological, theoretical, and interpretive approaches to

explorethecomplexecologyofOSH-knowinginlargeorganisations.Byrevealinginsightsandgoodpractices

from across different sectors, and using these as opportunities to learn more about how safe working is

actuallyachievedinpractice,theresearchhasgeneratedasetofappliedconclusionstoassistorganisationsto

improveOSH-knowledgeflows.

We position our findings against contemporary debates and emerging theoretical thinking, interpreting the

findings fromour fieldwork, drawingonourdifferentdisciplinaryperspectives. Weuse this to formulate a

pragmatic,person-centricaccountofknowledgeandinformationflow,applicableto individuals inanetwork

and thenetworks themselves. Wehighlightwhatwebelieve tobekey implications for theOSHprofession

arisingfromtheresearch.

CONTRIBUTIONTOTHEOSHRESEARCHFIELD-SUMMARYOFMAINFINDINGS

OSH-knowledge at the case study organisationswas generated from varied sources including both internal

(e.g., responding to incidents) and external (e.g. HSE, governing bodies, other companies). Managers and

supervisorsperceivedthemselvestoplayakeyrole in ‘flowing’–orselecting, translating,anddistributing–

OSH-knowledge to the workforce. Multiple communication channels were used, including textual, visual,

digital, and electronic, but a preference for verbal ‘face-to-face’ communicationwas emphasised due to its

perceivedeffectivenessforassistingtheuptakeofmessages.

CommonacrossthesectorswasanemphasisontransmittingOSH-knowledgethroughtheformalisedspaces

oftraining(induction)andthemechanismsofinstruction(policy,guidelines).Workerswereperceivedtolearn

safe practice from a one-way ‘flow’ of knowledge between individuals (e.g. trainer to trainee); however

initiativesacross the sectors suchas feedback card systems in constructiondidattempt to facilitategreater

workerengagementinsafetymanagementandpractice.

Despite novel approaches to greater worker engagement, an emphasis on formalised OSH-knowledge

transmissionmayoverlooktheotherwaysthatworkerslearnaboutandcommunicatesafetyintheworkplace,

and may not recognise the safe practices that workers have already developed in response to the

contingenciesofparticularworkplacescenariosandcontexts.Workerswerefoundtolearnandcommunicate

OSH-knowledgeininformal,subtle,andlessdirectways.Awiderangeofroutine,taken-for-granted,or‘quiet

safety’practicesweredevisedbyworkerstoensuretheirownandother’ssafety.Theseweredevelopedfrom

working with, talking to, and watching others, but also the embodied, sensory experience of undertaking

practicaltasksinspecificorganisational,social,materialandtemporalworkplaceenvironments.

By developing skills and abilities to anticipate and plan approaches toworking safely, workers used varied

sources of knowledge including personal and informal ways of knowing gained from non-work contexts.

Embodied,sensory,affective, intuitive,andexperientialwaysofknowingwerecrucial tohowworkersmade

OSH ‘feel right’or ‘work inpractice’. Thesewerenotantagonistic to,butwerebrought togetherwith (and

usedtosupplement)institutional-OSH.

IV

External agents - including patients (healthcare) or customers (logistics) - were also crucial sources of

informationthatworkersusedinordertoanticipate,plan,andmanageapproachestosafeworkingandthus

activelyinvolvedintheco-productionofOSH-knowledge.

Learninghowtoworksafelywasthusshowntobeanincrementalandongoingprocess,asapproacheswere

developedinresponsetospecificfeaturesofworkplaceenvironments. Inparticular,thedynamicproperties

ofdiverseworkplaces(buildingsites,organisationalbases,andcustomer/patienthomes)wereforegrounded

asworkerswerefoundtoberespondingtotheuncertainandongoinglychangingfeaturesofthesecontextsby

adapting,improvising,andinnovatingOSHknowledgeandpractice.OSHwasfoundtobecontingentlysituated

andenactedinwaysthatwereorganisationally,individually,culturally,andsociallyappropriate.

OURMOREDETAILEDFINDINGS

Knowledgecreation

Bothour interviewsandethnography suggested thatOSHknowledge is co-createdand interpreted socially,

bothininformallyandformally,oftenleadingtoworkers‘pickingup’knowledgeeitherexplicitlyortacitly.Our

ethnography also revealed that knowledge is not static but is, at least partially, socially constructed in and

through practice. Workers placed value of ‘learning by doing’ and more informal clusters of knowledge.

Knowledge isproducedbothtop-downandconstructedby individualsandsocialnetworks fromthebottom

up.

Participants stated that they used both formal (in accordance with convention or standard practice in the

organisation)andinformal(amorerelaxed,unofficialstyle)OSHknowledgetodotheirjobsafely.Theextent

towhich individualsrelyonformaland informalknowledgecanbeafunctionofexperience, familiaritywith

theworkenvironmentandinstructionfromtheirorganisation.Dynamicworkenvironmentsrequirealevelof

flexibility in the interpretation of formal information aswell as the use ofmore individually and/or socially

constructed practices. These two types of knowledge are often used together to develop an approach

appropriatefor‘inthefield’operations.

Knowledgesources

OSHinformationcamefromanumberofsourcesacrossallofthestudyorganisationsandtookseveralforms.

However,more generally, sourcesmay be described as external (coming from outside the organisation) or

internal(comingfrominsidetheorganisation)andarebothformalandinformal.Thereisalotof“knowwhat”

rather than“knowhow” topreventionof injuryand ill healthatwork. There is alsoaneed to identify the

qualityandtrustworthinessofthesource.

FormalexternalsourcesareusedbymanagersandOSHprofessionals,butalsomanyinternalsourcesplayed

anactivepartinknowledgeproduction.Externalsourcesincludedprofessionaleducation;HealthandSafety

Executive (HSE); other regulatory bodies ; insurers; professional bodies such as Institution of Occupational

Safety & Health (IOSH); professional magazines; equipment / product suppliers; the media (news about

workplace accidents etc); and personal networks. Sources Internal to the organisation were also crucial

V

sourcesofinformationusedtoanticipate,plan,andmanageapproachestosafeworking-theyincludedOSH

committees; OSHmangers; line managers; colleagues; and champions (keenies) – both acknowledged and

unacknowledged.

Many respondents relied on social networks and colleagues as sources of information, alluding to the

prevalenceofstrongsocialhierarchiesinmanyworkorganisationsandthenaturaldevelopmentof‘arenas’for

sharedlearning.

Tacit, informal, and ‘alternative’ (i.e. non-organisational) ‘ways of knowing’ play a significant role in

maintaining worker health and safety. We provide empirical support for these statements and develop

differentperspectivesfromthosedominantinsafetyresearchbyexploringhowworkerOSH,theenvironment,

perception, and practice interact to produce safe working. Informal knowledge tended to be socially

constructedviacolleagues,championsandexternalagents(includingpatientsorcustomers).

KnowledgeChannels

Achanneldescribesthewayinformationistransmittedfromthesourcetothereceivers. Over40different

channels were identified including: training; verbal; meetings; internet (www); intranet (company-specific);

emails; internet forums; notice boards; leaflets; posters; TV/Radio; newspapers/magazines; and real-life

examples.Trainingincludededucationatcollege,schoolanduniversity;professionaltradetraining;newsite

or location induction; and on-going CPD/Tool-box talks. Verbal communicationwas cited across the three

sectorsasoneofthemostefficientandeffectivemeansofconveyingOSHmessages.

Electronic communication has revolutionised society, with most people in the UK owning a smart phone

capable of phone calls, emails and internet browsing. These technologies have also affected theway that

business is done but such methods are currently problematic as many companies outlaw, or at least

discourage access to the internet. Emails provide time-effective means of communication but can create

significantbacklogsifnotcarefullymanagedandalsonecessitateaccesstoITaswellassuggestinganeedfor

an immediate responsewhich is not always necessary or helpful. Many industrial contexts ban the use of

mobilephonesonsafetygroundsandmanysmallerworklocationsdonotprovideaccesstoworkcomputers.

However,thisisanareathatmustbeaddressesbyindustrytomaximisethebenefitsavailable.

SeveralfeedbackchannelswereidentifiedincludingOSHcommitteesandinitiativessuchas‘closecall’or‘near

miss’reportingorworkersuggestionboxes.

Itwasconsideredimportanttousevariousalternativechannelsappropriatetotheneedsandcircumstancesof

thereceivers,especiallythoseworkingindynamicenvironments.

KnowledgeFlow

OSHknowledgedoesnotonly(oralways)‘flow’,butsometimesemergesthroughpractice.Wearguethatitis

notonlystatic,predefined ‘knowledge’ that isaddedtoactionandthenmovesaroundanorganisation,but

that‘waysofknowing’emergeincrementallyfromandthroughthepractical,situatedactionsofworkers.We

have found thatOSHknowledge is shapedand reshaped through theprocessof enactment; at timesbeing

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appropriated,atotherstimesbeingaugmentedthroughitssituatedapplicationandre-applicationelsewhere

inthenetwork.Knowledgeiscontinuallymutatingasitmovesthroughtimeandspace.

Thecomplexityofthenetworkswithinandacrosswhichknowledgetravelsandthenatureofthehazardand

regulatory environments affect how formal and informalOSH knowledge interact and shapeoneother. At

timesformalknowledgewillcollecttacitpracticesasittravels,growinginscaleandcomplexity;atothertimes

it will remain largely intact, shaping and determining processes and behaviours. The challenge for OSH

practitioners is to comprehend the institutional context’s role in shaping this knowledge pathway, learning

when toaccept localisedcontingentpracticeasequally valid to formalisedknowledge;and learninghow to

harness the power of emergent practices alongside a more codified approach to achieve positive OSH

outcomes.

Notwithstanding, it is clear that something flows around the network and that this something can be

translatedintoknowledgeleadingtoenactmentatagroupor individual level. However, largenetworkscan

be challenging, creating long complex communication paths and the knowledge was determined, to some

extent,bythestructureandcharacteristicsoftheworkplace.Allthecasestudieshadsomesortofhierarchical

flowstructuredespitetheirnetworkednature. DataFlowDiagramshavebeendevelopedforOSHmessages

forthecasestudiesinallthreesectors.

Temporary,agencyorbankworkerswereusedineachofthesectorsandtheflowofOSHmessagestothese

workerswasfoundtobelackingonanumberofoccasions.Therewasconsiderablevariationintraining

dependingonwhetherworkerswereemployedbythemainorganisationinthenetworkorbyasubcontractor

orsupplier.

The ‘OSH hub’ (an OSH manager, consultant or keen worker) was a key success factor for effective OSH

messageflow.Asa‘politicalreflectivenavigator’,whetheracknowledgedformallyornot,pursuesanagenda

inacomplexnetworktemperingotheragendassuchasproductivity,economicsandquality.TheOSHhubis

political inpursuingaworkenvironmentagenda;and is reflective inbeingable toswitchbetweendifferent

rolesandmobilizedifferenttypesofknowledge. TheOSHhubisanavigatorbyknowinghowtonavigate in

thecomplexnetworksurroundingthetechnologicalchangeprocess.

KnowledgeFilters-Enablersandobstructions

Inasimple, idealworld, theOSHmessagewouldbetransmittedfromareliablesourcethroughaneffective

channel toareceptivereceiverwhowouldaccuratelyprocess itandenact itappropriately. However, there

aremanyotheraspectsthataffecthowthereceiverprocessesthemaintask-specificOSHmessagealongwith

all theother related ‘messages’. Wedescribe these as filters, ormembranes, throughwhich themessages

must pass and which will affect how the messages are translated and processed and eventually enacted.

However, their intangiblenaturemaybebetterdescribedasa ‘fog’, rather thana filter, throughwhich the

messagesmustnavigate.

These filters can be ‘OSH-philic’ (enhancing OSH messages) or ‘OSH-phobic’ (limiting or restricting OSH

messages). Restricting filters include lack of stability (of structure or workforce make-up), varying work

VII

environments,project-basedstructures,contractoragencyworkers,timepressures,priorities,socialgroups,

or sub-cultures within organisations, bureaucracy, conflicting messages from different sources and the

interfacebetweenorganisationaldepartments.Enablingconditionsthatfacilitatedknowledgeflowincluded:

stabilityandstructurewithinorganisations,aswellas thecreationofacultureof individualOSHownership

andresponsibility.

Wealsoaddressedthetensionsbetweenapparentlyconflictinggoalssuchaspatientsafetyandoccupational

safety in healthcare or productivity and worker occupational safety in construction or logistics. These are

caused or strongly influenced by either the situation or the individual and have implications for OSH

enactment and behaviour. As such, all of them are, to some extent, personalised and internalised by the

individual,eitherconsciouslyorsubconsciously.

Notwithstanding theseexternalbarriersandenablers, the responsibilityof individuals to listen,appropriate,

translate and enact OSH carefully, effectively and appropriately was also stressed. The culture and

environment created in the networks and the individual workplaces was significant in encouraging or

discouragingthis.

Knowledgetranslationandenactment

Oncethroughthefog,orfilters,theOSHmessagemustbetranslatedinternallybytheindividualwhichrelies

on their internal cognitive and intellectual abilities and the appropriateness of themessage channel. This

internalprocessisoutsideofthescopeofourresearch.Theenactmentbymostindividualsinthenetworkis

topassthemessageontootherindividualsorgroups,oftenafterchangingthechanneltoimprovethechance

of itbeingeffectivelyunderstoodandacceptedbythenext layerofreceivers. Theultimateenactment isat

theendofthenetwork,bythepeoplewhoaredoingthetasksandaremostlikelytobehurtifsomethinggoes

wrong.TheenactmentofOSHmessagesisrarelycompletelyinlinewiththeintentionoftheoriginalsource.

Partialenactmentmaybebecausetheindividualdoesnotunderstandthemessage;orbecausetheyconsider,

rightlyorinadvisably,thattheconditionsandenvironmentthattheyfacemakesthemessageinappropriate;or

becausetheindividualdecides,consciouslyorsubconsciously,nottofollowtheguidanceorinstructionofthe

message. Across all these categories is the reality where, to a lesser or greater extent, enactment is

determined, based on contingent knowledge, created by the individual or group concerned. Different

responsesarerequiredforeachofthesepartialenactmentcategories.

DynamicRiskAssessmentsandWorkarounds

Weknowthatdynamicriskassessmentsandworkaroundsarecontentioustopics,atleastintheOSHdomain.

Weacknowledgethatthereisaclearneedtoproperlyconsideralltasksandtoestablishappropriate,safeand

healthy methods to complete them. It is also important to ensure, as far as possible, that all tasks are

completedinasafeandhealthymanner.

For high risk tasks, great care should be taken to avoid inappropriate alteration of the agreed method,

although, indynamichigh-risksituations, it isessential thatthose involvedareabletoassesstherisk ‘inthe

VIII

field’ and to take appropriate action. Many contemporary OSHmanagement systems stress the need for

workerstobeempoweredtostopanytaskorprocessthattheyconsiderisnotsafe.

Wealsoacknowledgethat, forasmallnumberofsituationsortasks, therecouldbeaneedforactiontobe

takenimmediatelytopreventacatastrophe.Wheresuchtasksareenvisaged,individualsshouldbeproperly

trainedtobeabletomakegooddecisionsunderextremepressure,forexampleusingscenario-basedtraining.

Notwithstanding,inthemajorityofcases,particularlyforlower-risktasks,althoughsafeworkingmethodsmay

have been agreed, theremay be several alternativemethods to do the task safely. Furthermore, the task

environmentmaychangesuchthat thepreviouslyplannedmethod is inappropriate. It is insuchcases that

acknowledging that the enactment of OSHmessages is rarely completely in line with the intention of the

originalsourcecanactuallyimproveOSHmanagementandincreasethelikelihoodofunwantedconsequences.

Our research found that dynamic risk assessments were a common response to partial enactment of the

message because the individual considers, rightly or inadvisably, that the conditions and environment that

theyfacemakesthemessageinappropriate.Therewasadifferencebetweentheenvironmentsfacedinstatic,

relatively unchanging work environments and those where the situation was constantly changing or more

unpredictable.

Wheretheworksituationwassuchthatitwouldregularlychangebeyondtheboundariesenvisagedwhenthe

task was planned, alternative ways of establishing agreed methods and appropriate training are required.

Respondents considered that dynamic risk assessments where inevitable and successful, at least where

management systems acknowledged them andmanaged the process, particularly by ensuring that a team

decisionwasmaderatherthanjustanindividualone.However,insituassessmentofriskshouldnotbeused

asanexcusenottoplanorassesstheriskinadvance.

Scenario-orsimulation-basedtraining(e.g.inhealthcare)wasconsideredtobeaneffectivewayofequipping

individualsandteamstoappropriatelyaccessriskinthefield.Improvingworkers’andworkteam’sabilitiesto

adequatelyassessriskastheyfacetasksinthefieldisanessentialaspectofimprovingtheirOSHcompetence.

Therearesometasksthathavelegallyprescribedrestrictionsbutwesuggestthatmanagersareadvisednotto

try tocontrol things thatdon’tneedtobecontrolled. Ourevidencesuggests thebestsolutionwouldbeto

minimisethesituationswheremanagerstrytocontrol theriskbysettingprescriptiverulesandtomaximise

trainingbasedoncontingent,scenario-basedapproacheswherepossible.

Dynamicriskassessmentsoftenleadto‘workarounds’andthereisanassumptionbysomethatworkarounds

are always wrong and always less safe than the prescribed method. The term ‘shortcut’ was also used

frequently,althoughofteninamorenegativeway,suggestingthattheshortcutwaslesssafethantheofficial

method. Thereasonswhypeopleusedworkaroundsorshortcuts includedlackofnecessaryequipment,the

situationbeingdifferenttotheoneassumedintheinstruction/methodstatementorperceivedtimepressure.

Sometimes itwasseenastheonlyway inordertodothe jobandwasdeemedthesafestwayto ‘bendthe

rules’,thusmitigatingtherisk.

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Our findings suggest thatmanagers could bemore sophisticated inmanaging these insitu assessments and

workarounds.Thereisnota‘onesizefitsall’approachforallsectors,allnetworktypes,allindividualsandall

situations.Peoplewillassesstheriskforthemselvesandmakedecisionsonthatbasisbutstillneedtobeheld

accountablefortheirdecisionsandactions.Thissituationneedstobemanagedratherthanignored,hopingit

will go away. We need to stimulate people to understand the consequences of their actions, both for

themselvesandothers.Ifwetakeanarrow,directive,proceduralapproachweshouldnotbesurprisedwhen

itdoesnotwork–peoplewilladaptandstretchtheboundaries–weneedtounderstandthisandmanageit

accordingly.

ThereisadifferencebetweenOSHasimaginedandOSHasactuallydone.

OURMODELS

TheThirdWayContinuum

Inourdiscussion,wehavedevelopedanumberofmodelstoimprovetheunderstandingofhowknowledgeis

createdandtransferredthroughcomplexnetworks.

Themaintypesofknowledgewefoundaremodel1(formal,top-down)andmodel2(social,bottom-up)(after

Hale&Borys(2013). These interactandcombinewithsocialknowledgeasthenetworkbecomesmoreand

morecomplex.Weproposeathirdwaycontinuumwithmodel1andmodel2attheextremesandamodel3

alternativeinclusiveperspectivethroughwhicheachsituationcanbebetterunderstood.

We have found this continuum to be a helpful way to increase understanding of the contingent interplay

betweentheindividual,thetaskandtheenvironment.Furthermore,itwasadesiretoexplorethisinterplay

between individual decision-making, practice and environmental features that informed and united the

distinctdisciplinaryperspectivesframingourresearch.

TheThirdWayContinuum

A more experienced and competent individual would tend to be able to operate in a more flexible way

towards model 2 and be better able to make appropriate dynamic assessments of the risks and required

behaviour. A less experienced or less competent individual would tend towards model 1, needing more

certaintyandclarityoftherules.Theyarelikelytobelessabletoassessrisksinsituorknowtheappropriate

behaviouralresponse.Anexperiencedpersonwhohasnotbeenwelltrainedmayveertowardsmodel2which

Mod

el1

Model2

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couldbeproblematicifthemissedtrainingisgermanetothemessageandtask,unlesstheyhadfoundasafer

ormoreappropriatewayofdoingthetaskintheparticularcircumstancesthantherulessuggest.

Amorecontrolledandconsistentenvironmentwouldenableamorerule-basedapproach towork,whereas

the more varied and unpredictable the environment the more contingent the necessary behaviour to

maximiseOSH and a successful task. Where the negative consequences of an incident are very significant

appropriatebehaviourshouldtendtowardsmodel1.Thecriticalityofpreciseandaccuratecompletionofthe

taskislikelytoencourageprotocolstendingtowardsmodel1.However,wherethetaskisverycomplexthen

model2behaviourmaybenecessarytoachieveapositiveoutcome.

Wealsorecognisethattheremayalsobesituationswhereamodel3approachwouldbeappropriate.People

canaddtheirownpracticetorulestocreatenewwaysofworking.Inthiscasethesearenotworkaroundsor

compromises,butrule-informed,practice-basedwaysofknowing.

ThePerson-CentreOSHKnowledgeFlow(P-COK)Model

WealsoproposethePerson-CentricOSHKnowledge(P-COK)Flowmodel, interpretingour findings fromthe

perspective of each individual in the network. This should be considered in tandem with the Third-Way

Continuumwhichprovidesmoreofaholisticperspective.

This idealisedmodelconsiderseach individualandthespecifictask-relatedmessagethattheyreceive,along

withthemanyotherexplicitandtacit inputsthatarepresentedtothem.Thewaythatthesituation,orthe

person’s individual characteristics, eitherhelporhinder them interpreting theOSHmessagealongwith the

other‘noise’aredescribedasfilters.Theindividualthentranslatesthemessageinternallytoformknowledge

whichisaffectedconsiderablybytheircognitiveandotherpersonalskillsandcompetencies.Theenactment

thenmay be the passing on of themessage to the next person or group in the network or, in the case of

frontlineworkers,theirbehaviourindoingthetask.

ThePerson-CentricOSHKnowledge(P-COK)FlowModel

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ACKNOWLEDGEMENTS

We acknowledge the funding and support provided by The Institution of Occupational Safety and Health

(IOSH),withoutwhich this studywould not have been possible. In particularwewould like to convey our

thanks to the guidance and feedback provided by JaneWhite and Robert Dingwall. Wewould also like to

expressour sincere thanks for the in-kindsupportprovidedby themanyorganisationsand thehundredsof

individuals who gave up their time to participate in our research and talk to us about their approach to

occupationalsafetyandhealthintheirworkplaces.

We also acknowledge the guidance from our Scientific Consultation Panel (SCP) who offered constructive

feedbackona regularbasis encouragingand challengingwhereappropriate. Inparticularwewould like to

thankthefollowing:

• JoanneCrawford-SectionHeadErgonomicsandHumanFactors,InstituteofOccupationalMedicine• PeterFisher-HealthandSafetyDirector,Costain• PaulHaxell-GroupHealth,SafetyandEnvironmentDirector,BovisHomes• ChrisJerman-CorporateSafetyManager,JohnLewisPartnership• DavideNicolini-ProfessorandCoDirectorofIKON,UniversityofWarwick• JamesStapleton-FMHealth,SafetyandRiskManager,LoughboroughUniversity• NeilStephens-PrincipalInspector/TeamLeader,HealthandSafetyExecutive• DylanTutt-LecturerinWorkforceStudiesinConstruction,UniversityofReading

• LawrenceWaterman-DirectorofHealthandSafety,BatterseaPowerStationdevelopment

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Contents1 INTRODUCTION AND BACKGROUND ...................................................................................... 1

1.1 Introduction into the programme and project .......................................................................................... 1

1.2 Introduction to the main concepts .............................................................................................................. 2

1.2.1 Networks and Supply chains ................................................................................................................ 2

1.2.2 Knowledge ............................................................................................................................................ 4

1.3 Interdisciplinary theoretical basis for our research .................................................................................. 7

1.3.1Human factors and ergonomics (HFE) ................................................................................................. 9

1.3.2 Organisation studies ............................................................................................................................ 10

1.3.3 Anthropology and Ethnography ......................................................................................................... 11

1.3.4 Safety Science ..................................................................................................................................... 11

1.3.5 Mapping and Applying Knowledge .................................................................................................... 12

1.4 The case study sectors: healthcare, logistics and construction .............................................................. 13

1.4.1. Construction ........................................................................................................................................ 14

1.4.2 Healthcare ........................................................................................................................................... 16

1.4.3 Logistics .............................................................................................................................................. 20

1.5 Models and concepts used in this research .............................................................................................. 25

1.5.1 The ‘third way’ continuum ................................................................................................................. 25

1.5.2 Model 3 rule- and practice-based knowledge ..................................................................................... 26

1.5.3 The Person-Centre OSH Knowledge Flow (P-COK) Model ............................................................. 26

2 METHODOLOGY ........................................................................................................................ 28

2.1 Study Design and Methodology ................................................................................................................ 28

2.1.1 Research Overview and points for investigation ................................................................................ 28

2.1.2 Methodology and study design – Framework .................................................................................... 29

2.2 Non-Ethnographic data collection ............................................................................................................ 30

2.2.1 Data collection techniques .................................................................................................................. 30

2.2.2 Face to Face interactions .................................................................................................................... 31

2.2.3 Critical Incident Technique ................................................................................................................ 32

XIII

2.2.4 Quality, Reliability and Validity – Non-Ethnographic work .............................................................. 32

2.2.5 Bias and internal validity – Non-Ethnographic work ......................................................................... 33

2.2.6 Interim analysis (Non-Ethnographic data) .......................................................................................... 34

2.3 Ethnographic research ............................................................................................................................... 34

2.4 Presentation of the results ......................................................................................................................... 36

3 FINDINGS ................................................................................................................................... 37

3.1 Introduction ................................................................................................................................................ 37

3.2 Sources and forms of OSH information ................................................................................................... 37

3.2.1 Sources External to the Organisation (both formal and informal) ..................................................... 38

3.2.2 Sources Internal to the Organisation ................................................................................................... 40

3.2.3 Unknown Sources – ‘picking up knowledge’ – Socially constructed knowledge .............................. 43

3.3 Channels to communicate OSH ................................................................................................................ 44

3.3.1 Training ............................................................................................................................................... 45

3.3.2 Verbal communication ........................................................................................................................ 48

3.3.3 Meetings ............................................................................................................................................. 49

3.3.4 Electronic information & communication (intranet, internet and emails) .......................................... 50

3.3.5 Initiatives and campaigns ................................................................................................................... 52

3.3.6 Notices and notice boards ................................................................................................................... 53

3.3.7 Feedback ............................................................................................................................................. 54

3.4 Structure and Flow ..................................................................................................................................... 54

3.4.1 Formal Flow ........................................................................................................................................ 55

3.4.2 OSH message flow diagrams .............................................................................................................. 57

3.4.3 Informal Flow ..................................................................................................................................... 66

3.4.4 Flow to temporary/contract workers ................................................................................................... 67

3.5 Influencing Filters/Membranes: Conflicts with OSH ............................................................................. 68

3.5.1 Conflicting resources – time and cost ................................................................................................. 69

3.5.2 Conflicting cultures ............................................................................................................................ 70

3.5.3 Conflicting or ‘over the top’ rules and procedures ............................................................................. 71

XIV

3.5.4 Conflicting environments ................................................................................................................... 73

3.5.5 Conflicting priorities - The patient ..................................................................................................... 74

3.5.6 Conflicting priorities - The customer ................................................................................................. 75

3.5.7 Interface Conflict ................................................................................................................................ 75

3.6 Influencing Filters/Membranes: Barriers and Enablers ........................................................................ 76

3.6.1 Stability, instability and change .......................................................................................................... 76

3.6.2 Organisational Structure ..................................................................................................................... 78

3.6.3 Temporary or contract workers and job security ................................................................................ 80

3.6.4 Creating a culture of individual ownership of and responsibility for OSH ........................................ 82

3.7 Translation .................................................................................................................................................. 84

3.7.1 Individual, internal translation ............................................................................................................ 84

3.7.2 Translation or adaptation before passing on to others ........................................................................ 85

3.8 Enactment ................................................................................................................................................... 87

3.8.1 Dynamic Risk Assessments ............................................................................................................... 87

3.8.2 Workarounds ....................................................................................................................................... 88

3.8.3 Novel use of OSH knowledge – evolving procedures/evolving practices ......................................... 90

3.9 Ethnographic findings ................................................................................................................................ 92

3.9.1 Where and how OSH-knowledge is learned ....................................................................................... 93

3.9.2 Where and how OSH-knowledge is communicated ........................................................................... 95

3.9.3 How OSH-knowledge is performed insitu where participants were doing actual tasks ..................... 97

3.9.4 Adapting Towards Safety ................................................................................................................. 100

3.9.5 OSH-Futures, Interventions and Change: Implications of the Ethnographic Findings .................... 101

4 DISCUSSION ............................................................................................................................ 103

4.1 Types of OSH knowledge, their interaction and production – How they are channelled, engaged,

navigated, interpreted and enacted ........................................................................................................ 103

4.2 Beyond ‘procedure’ and ‘adaptation’: towards a third-way for safety research .............................. 106

4.2.1 Theoretical context – rule-based or experientially constructed knowledge ..................................... 106

4.2.2 The Third Way – Model 1.5 ............................................................................................................. 110

4.2.3 Fieldwork Evidence for The Third Way ........................................................................................... 111

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4.2.4 Applying the Third Way Continuum ................................................................................................ 112

4.2.5 The Third Way continuum: Conclusions and Implications .............................................................. 114

4.3 Responding to Reality .............................................................................................................................. 115

4.3.1 Partial enactment .............................................................................................................................. 115

4.3.2 Dynamic risk assessments ................................................................................................................ 116

4.3.3 Workarounds ..................................................................................................................................... 118

4.3.4 Behaviour as a resource .................................................................................................................... 119

4.5 Person-Centric OSH Knowledge (P-COK) Flow – Sources, Channels and Filters ........................... 121

4.5.1 The Person-Centric OSH Knowledge (P-COK) Flow Model .......................................................... 122

4.6 OSH message flows across the network ................................................................................................. 128

4.6.1 Impact of a complex network ........................................................................................................... 128

4.6.2 Impact and influence of non-task-related inputs .............................................................................. 133

5 CONCLUSIONS AND RECOMMENDATIONS ........................................................................ 137

5.1 Conclusions ............................................................................................................................................... 137

5.1.1 To flow or not to flow ....................................................................................................................... 137

5.1.2 So, what DOES flow and HOW? ..................................................................................................... 138

5.1.3 How do people receive and process OSH messages? ....................................................................... 139

5.1.4 Rules or experience? The Third Way Continuum ............................................................................ 139

5.1.5 What about enactment? Dynamic risk assessments, workarounds and behaviour .......................... 140

5.1.6 Sectoral and Organisation-size differences ...................................................................................... 142

5.2 Recommendations .................................................................................................................................... 143

5.2.1 Recommendations for OSH practioners and line managers ............................................................. 143

5.2.2 Recommendations for OSH researchers ........................................................................................... 145

5.3 Limitations ................................................................................................................................................ 145

REFERENCES .................................................................................................................................. 147

6 APPENDIX ................................................................................................................................ 154

6.1 Interview inventory .................................................................................................................................. 154

1



1 INTRODUCTIONANDBACKGROUNDThis research report presents our findings from the project entitled:Management of OSH in networked

systems of production or service delivery: comparisons between healthcare, construction and logistics. This

projectwasfundedbytheInstitutionofOccupationalSafetyandHealth(IOSH)andformedpartoftheIOSH

researchprogrammeHealthandSafetyinaChangingWorld.

The report introduces the main concepts of occupational safety and health (OSH) knowledge and

organisationalnetworksalongwiththeinterdisciplinarytheoreticalbasisforourresearch.Weusedresearch

approachesfromhumanfactors,safetyscience,ethnographyandorganisationstudiesas lensestostudythe

topic.Twoofthemodelsdevelopedfromthefindingsareintroducedearlytohelpthereaderunderstandthe

structureandcontextofthereport.Weusedacombinationofmethodsincludinginterviewsandfocusgroups

with individuals involvedinthenetworksofseveralcasestudiestakenfromeachindustrysector,alongwith

participantethnographicobservation. ThefindingsarepresentedassourcesandformsofOSH information;

channels of communication; structure and flow across the network; filters or membranes affecting the

translation of the OSH messages. The sections that follow the findings deal with conflicts, barriers and

enablersforOSHmessages. Wepresentourfindingsoninternaltranslationandthenenactmentbeforethe

ethnographic research is discussed in more detail. The discussion sections present a model to help

understandingofa‘thirdway’forOSHresearch,responsestotherealityofOSHasenacted;OSHfuturesanda

person-centricOSHknowledgeflowmodel.Afurther,practitioner-facingoutputisplannedforthenearfuture.

1.1 Introductionintotheprogrammeandproject

Thework detailed in this reportwas funded by IOSH as part of a larger research programme - Health and

safetyinachangingworld.Thecallinvitedproposalsonoccupationalsafetyandhealth(OSH)knowledgeand

itsmanagement, the balance between public and private sources of regulation and the local impact of the

changinghealthandsafetysystem.

Our research outlined here is the result of a multi-disciplinary project, which brought together engineers,

ergonomists, anthropologists, sociologists and psychologists, entitled ‘Management of OSH in networked

systemsofproductionorservicedelivery:comparisonsbetweenhealthcare,constructionandlogistics’.

2

Ourstudyaimedto identifythetypesofOSHknowledgeandevidencethatcirculateandwork inrelationto

eachotherinorganisationsinvolvedinnetworkeddeliverysystems,howlocalactorsinorganisationsinterpret

informationand,inturn,theinfluencesonOSH.

Ourultimateaimwastoensureallstaffinlargecomplexorganisationshaveaccesstoandanunderstandingof

occupational health and safety. In sharing good practice and insights from and across different sectors,

organisationscanlearnmoreaboutthewaysinwhichsafeworkingisachievedinpractice,aswellaswaysof

improvingtheirhealthandsafetyknowledgeflow,makingitabetterworkingenvironmentforallstaff.

Therewereparticular linkswithanotherproject in the IOSHprogrammeby the InstituteofMedicinewhich

lookedattheOSHknowledgebase.Someofthecontentofthisintroductionhasbeentaken,withpermission,

fromtheirwork.

1.2 Introductiontothemainconcepts

Thefollowingsectionsoutlinethemainareasof interestofourproject. WeexploreOSHinnetworksasthe

overarchingcontextfortheinvestigation.Wethenconsiderthemainconceptofknowledge,includingissues

ofdefinitionandtypology,andhowknowledgemightbesharedortransferred.

1.2.1 NetworksandSupplychains

The Business Dictionary1defines a network organisation as “a group of legally independent companies or

subsidiarybusinessunitsthatusevariousmethodsofcoordinatingandcontrollingtheirinteractioninorderto

appear likea largerentity.” TheDictionary1alsodefines the threemain typesofnetworkorganization ina

businesscontextas:“(1)internalwherealargecompanyhasseparateunitsactingasprofitcentres,(2)stable

where a central company outsources some work to others, and (3) dynamic where a network integrator

outsourcesheavilytoothercompanies.”

Weareusingthephrasenetworkedorganisationstodescribe large,complexorganisationswheresignificant

relationships and connections exist across traditional hierarchical, business or functional boundaries. Such

companieshavebeendescribed as “increasingly collaborative and knowledge-intensive” (Cross et al, 2007).

Networkshaveanumberofsub-networkswhichmaybedepartments,divisions,functions,levelsofhierarchy

orlocationsofpartsofthebusiness.Oftentheyalsoincludedifferentcompanies,actingtogetherinsomesort

ofconsortiumoraspartofan integratedsupplychain. Forexample,DaviesandMackenzie (2013)describe

graphically the sub-networks involved in the construction of the London 2012 Olympic Park as a form of

systemsintegration(Figure1.1).

1www.businessdictionary.com/definition/network-organization

3

Figure1.1 Sub-networksfortheconstructionoftheLondon2012OlympicPark(adaptedfromDavies&Mackenzie,2013)

Crossetal (2007)describethe interactionbetweendifferentpartsof thenetworksand identifykeyplayers.

The “central connectors” are those who are frequently consulted for “information, expertise or decision-

makinghelp.”“Brokers”arethosewhoconnectdifferentsubgroupsinthenetwork.

The Business Dictionary2defines a supply chain as the “entire network of entities, directly or indirectly

interlinked and interdependent in serving the same consumer or customer.” The term ‘chain’ suggests

somethingofalinearrelationshipwhichisoftennotthecaseand‘supplynetwork’maybeamoreappropriate

descriptor.

Safetyacrossnetworked supply chains is key towardsunderstanding systemsafety (Buckleet al. 2006),but

interrelationshipsbetweensupplychainprocessesoftenremaindisconnected,causingdisruptions tooverall

safety efficiency. Benjamin & White (2003), Walker (2005) and Winkler (2006) investigated the effect of

fragmentedsupplychainsonemployeesafetybuthavenotexplicitlycomparedindustrialsectorsinawaythat

mapsontosystematicdifferencesinsupplychainconfiguration.Thisanalysisisimportantbecausepromising

practiceinonesectormaynotfullyapplyinothersectorsgiventhecomplexanddynamicnatureofnetworks.

AreviewbyWaltersandJames(2009)toinvestigatetheroleofsupplychainsininfluencinghealthandsafety

atworkfoundthattheinternaldynamicsofsupplychainsfrequentlyleadtoadverseeffectsforOSH.“These

effectsareintimatelyconnectedtothewayinwhichsuchdynamicsservetoexertdownwardcostpressures

onsuppliers,thereforeleadingthemtoadoptmoreintensifiedandcasualisedemploymentregimes,andmore

generallyact toengenderpoorerqualityandmore fragmentedhealthandsafetyarrangements.” However,

we did find some examples where supply chains were used positively to influence health and safety. For

example, where there were external pressures of wider social, political and regulatory sources that create

reputational risks. Also, the precise effects of supply chains onOSH can vary considerably evenwithin the

samesector.Thiscanbeasaresultofthedifferencesinsuchfactorsastheattitudesandobjectivesofbuyers

andsuppliersaswellasbalanceofpowerthatexistsbetweenactorsintheinthesupplychain.

2www.businessdictionary.com/definition/supply-chain

4

1.2.2 Knowledge

The interdisciplinary context of our projectmade it difficult to define or differentiate between knowledge,

informationanddata.However,inanotherprojectinthisprogramme,theInstituteofMedicine(Crawfordet

al., forthcoming)have investigated thedefinitionof knowledge, knowledge transfer/flowandnetworks in a

largeamountofdetail.Partsofthissub-sectionhavereliedheavilyonfindingsfromtheIOMproject.

A dictionary definition of knowledge is: “understanding of or information about a subject that you get by

experienceorstudy…thestateofknowingaboutorbeingfamiliarwithsomething…”,whereasinformationis

definedas“factsaboutasituation,person,eventetc”3.Thereisasensethatitisinformationthat‘flows’and

itonlybecomes‘knowledge’whenitisunderstoodandappropriatedbyanindividualorgroup.However,this

differentiation isnotabsoluteand iscertainlynotunderstoodbymostpeople. Therefore, in the interviews

andinteractionsforthisproject,wehavetalkedaboutthewaysthatpeople‘knowhow’or‘knowwhy’they

work inacertainway. Thishasavoidedtheneedtodifferentiatebetweenknowledgeflowand information

flow.Theresearchteamalsoacknowledgethecomplexityofhowpeople‘knowhow’and‘knowwhy’andthe

multiplicityofwaysthatknowledgeiscreatedanddiffusedbetweenpeopleandacrossnetworks.Illustrating

thismultiplicitytheethnographicwork(detailedinSection3.9)alsotalksabout‘waysofknowing’tosupport

theargumentthatOSHknowledgedoesnotonly(oralways)‘flow’,butsometimesemergesthroughpractice.

This perspective argues that it is not only static, predefined ‘knowledge’ that is added to action and then

moves around an organisation, but that ‘ways of knowing’ emerge incrementally from and through the

practical, situated actions of workers. Definitions about knowledge are many and varied. Foskett (1982)

proposesadefinitionof knowledgebymakingadistinctionbetweenknowledgeand information.Heclaims

“knowledgeiswhatIknow,informationiswhatweknowandknowledgeisasubsetofthatwhichisbothtrue

andbelieved”(ReferFigure1.2).

Figure1.2 FromFoskett’s(1982)propositionofknowledgeasacombinationoftruthsandbeliefs

ItisclearthatthereisalargeamountofOSHinformationavailablebothinthepublicandindustrialdomain.

Closeexaminationisneededtoensurethequalityandtrustworthinessofthesourcesothatitisusefultothe

averageuser. With this inmindwebegin tounderstand that,whileknowledgeand informationare linked,

theyarealsodifferent.Infacttheknowledgeofafirmcanbecategorisedasbothinformationandknowledge

3http://dictionary.cambridge.org/

Truths Knowledge Beliefs

5

(Zander and Kogut, 1995). However, Reber (1996) extends this definition and states that knowledge is a

collection of information blended with the culture and competence of an individual and their interactions

withinandbetweengroups.Takingthisapproach,itwouldappearthatinformationremainsinformationuntil

itisusefultoorcanbeentwinedintothevaluesandbeliefsofapersonorthecultureofanorganisationwhen

itbecomesknowledge.Inthiscontext,Senapathi(2011)statesthatknowledgemaybedefinedasinformation

whosevalidityhasbeenestablished. Knowledgeisalsothoughttoexist inmanyforms,forexampletacitor

explicit.Tacitknowledgeisthoughttohaveapersonalqualityandisaccumulatedthroughknowledgeandskill

that allows someone to do something more efficiently. It is however, difficult to formalise and to

communicatebecauseitinvolvesbothcognitiveandtechnicalelementsandisnoteasytowritedown(Murray

&Peyrefitte,2007).

Collins (1993) cited five knowledge types, four of which are tacit, ranging from embrained (dependent on

conceptual skills and cognitive abilities) to embedded (part of normal practice and routines). Knowledge is

dynamic;whennewknowledge is created it exists in a tacit form. It is then transformed into codified and

explicitknowledgebysocialcoordinationprocesses (Kangetal.,2010). Thiscanbebeneficialasacommon

lexiconisdevelopedbetweenteamsandknowledgeistransferred.Knowledgeinitspurestformmaynotbe

usefulas it cannotcreatevalueandaddcompetitiveadvantageuntil it is sharedand transferredwithin the

organisation(Kangetal.,2010).However,knowledgeisalsocontextual,itisafluidmixofframedexperience,

contextualinformation,valuesandexpertinsightthatprovidesaframeworkforevaluatingandincorporating

newexperiencesandinformation(Davenport&Prusak,1998) inotherwordsthecontext itself ispartofthe

contentofknowledge(Yakhelf,2007).

Other authors have cited this perception, for example Neisser’s (1978) perceptual cycle originates from

cognitive psychology and foregrounds the role of the environment in the creation and search for new

knowledge. This is also linked to schema theory from early in the last century (Head, 1920; Piaget, 1926).

Schema theory describes how individuals possessmental templates of past experienceswhich aremapped

with information in theworld to produce appropriate behaviour. Barlett (1932) introduced the concept of

schemaasactiveorganisationsofpastreactionsandpastexperienceswhicharecombinedwithinformationin

theworldinordertoproducebehaviour.Inessence,aschemaisratherlikeacognitiveformofbestpractice

template.

Knowledgetransferordiffusion

Thereareseveralmodelsofknowledgetransferanddiffusionofinnovationspresentintheliterature.Rogers

(1983)forexample,arguesthatthediffusionofinnovationsinvolvesfivemainstages:knowledge,persuasion,

decision,implementationandconfirmation.Incontrast,thoseworkingwithinscienceandtechnologystudies

have stressed the malleability of new technologies and processes, showing how these evolve and mutate

throughtheprocessofadoption(Bijker1995).However,diffusionofinnovationsandknowledgetransferare

not necessarily the same thing, simply because innovations and knowledge are in any case contextually

situated.Estabrooksetal.(2006)proposeseveralothermodelswhichmayalsobeappropriateforknowledge

transfer. For example, the ‘bandwagon’ model where organisations are driven to adopt OSH knowledge

6

throughfearnotobtainingbenefitoravoidingputativemeasures. Inthe‘dualcore’model,OSHinnovations

originatefrominternalcoresandserve internalpurposes. Inthemodelof ‘territorialrights’andboundaries

OSH knowledge is perceived as a threat to existing organisational practices. In the ‘desperation reaction’

modelOSH knowledge arises in thedesperation to address adverse situations, such as the aftermathof an

accident.Inthe‘ambidextrousmodel’organisationtypesthatfacilitateinnovativeOSHpracticesmaynotbe

best matched to diffusing or implementing such knowledge, in this case high formalisation and high

centralisationarerequired.

ItisinterestingthatknowledgetransferiscomparabletocommunicationflowaspertheC-HIPmodel(Conzola

andWogalter,2001)whereknowledgeand/orcommunicationtravelsfromasource,throughamedium,toa

user,themessageshouldalsohavesomeformofcontent.

Withinknowledgetransfer,asourceisdefinedastheoriginofdissemination,whetherthatbeanagency,an

organisationoranindividual.Transfermaycomeasapush,withthesourcepushingthecontenttotheuser.

However,insomeinstances,thereisknowledgepullwheretheknowledgeuserthemselvesisthedrivingforce

behindthetransfer. Thecontent istheactualmessagethat isdisseminatedandcantakemanyforms,from

tacittoexplicit.Themediumreferstothewayinwhichknowledgeisdescribedorpackaged.Theuseristhe

intended user of the information or the product to be disseminated. Senapathi (2011) highlights several

factorsthatmayaffectthedisseminationofknowledgewhichrangefromcompetenceandcredibilityof the

source to perceived relevance to the user. Media richness or the ability of information to change

understandingwithinatimeintervalmayalsoaffectknowledgetransfer.Leanmediaismoreappropriatethan

richmediaincertaincircumstances.Forexample,ifamessageisambiguousoropentointerpretationthenit

will need richer media with immediate feedback such as face-to-face contact. The opposite is true for

messagesthatarelessambiguous.

Knowledge is viewed as produced and transferred by social interactions or social networks. As such,

organisational structuremay affect the propagation of knowledge along these networks. In social network

analysisthepointsofinteractionarerepresentedasnodesoragentsthatcanbemadeupofbothhumanand

non-humanagentsoractorsthatformpartoftheinteractingknowledgeproducing/transferringnetwork.The

shape of these networks often determines knowledge flow and uptake. For example, a highly centralised,

hierarchicalorganisationalnetworkisveryeffectiveatknowledgeimplementationasthereareclearpathways

for “knowledge amplification.” However, a hierarchical network may be detrimental for new knowledge

creation,inthisinstanceapeer-to-peernetworkinwhichdecisionmakingisdevolvedisapreferrednetwork

configuration. Taking this into consideration, amoreagile firmordepartmentwithautonomymaybebest

placedforknowledgecreation;however itmaynotbethebestnetworkformationto implementknowledge

onalargerscale.

The use of informal network clusters and/or communities of practice remain a strong theme in the OSH

community.Thesenetworksmayevolvefrompersonalcontactsorsocialmedia.Thesetypesofnetworksare

referredtoassmallscaleorsmallworldnetworksandconsistofsparsecommunicationnetworkswithmore

7

densely connected clusters. These networks can increase in size dramatically, however the number of

communicationpointsinthenetworkincreasesveryslowly.

1.3 Interdisciplinarytheoreticalbasisforourresearch

Changesinworkingconditionsandpractices,governmentpolicyandtheoccupationalsafetyandhealth(OSH)

landscape have created a contemporary context where OSH issues have become increasingly scrutinized.

Health and safety legislationhas enforceda regulatory regimewhereemployers,workers and suppliers are

afforded distinct roles to ensure people in work are protected from harm. Practice-based approaches to

researchingworkplaceshaveprovidednewandrigorouswaysofunderstandingworkplacesascontextswhere

acultureofhealthyandsafeworkingispossibleandpracticed(GherardiandNicolini2002),althoughoftenin

waysthataregeneratedbyworkersthemselves,notsafetyandhealthregulations(Pinketal.,2010,Tuttetal.,

2013). Thecontemporarycontext inwhich institutionalandworker-innovatedOSHplaysout isshapedbya

range of changing factors including: increasing complexity within and between technological and

organisational networks; the shift from public regulation to private advisors; performancemetrics; and the

pivotalresponsibilityandopportunityofOSHprofessionals.Yet,withinthiscontextlittleisknownaboutthe

detailofhowOSHknowledge flows, is learned, shared,engaged inpractice,appropriatedand implicated in

innovation.Consequentlythereareanumberofgapsinourunderstandingastheyrelatetowhodoeswhat

aboutOSHissuesinnetworkedsystems;withwhatevidence;OSHknowledgetranslation;and,thegeneration

ofOSHoutcomes.

We aimed to construct a fresh, interdisciplinary perspective on OSH knowledge within highly networked

workplaces involving a complexmeshof organisations and groupingswithin organisations,where there are

blurred linesofcommunicationandaccountability. Ourapproachwasdesignedtorespondtothe following

questions:WhodealswithOSH issues innetworked systems? What typesofevidencedo theydraw from?

What are the processes through which OSH knowledge flows, transforms and is appropriated through

organisationsandwhatOSHoutcomesaregenerated?

OSHisalreadyamulti-orinterdisciplinaryfieldofresearch,but,neitherthenatureofitsinterdisciplinaritynor

itsimplicationsforthisfieldhavebeenfullyexplored.Thisshouldbeafirststepinconsideringhowdisciplines

mightworkincombinationwitheachother.However,inthecaseofOSHresearchtherearealreadyexisting,

establishedapproaches,whichhavedemonstrableformsofsuccessinaddressingspecificOSHissues.Thisis

anadvantagewhenaskinghowwemightbuildontheir respectivecapacitiesand, invalidating theneed, to

developarelationshipbetweenthem.Yetitalsocreatesachallengeinthattheseexistingapproachesarenot

necessarilytheoreticallyormethodologicallyalignedwitheachother.

We compared the approaches taken by four interrelated disciplines and approaches as they apply to OSH

knowledge: human factors and ergonomics; organisation studies; safety science; and applied ethnographic

practice. We used these different approaches to act as ‘lenses’ through which OSH knowledge can be

8

interpreted, throughexamples of their applicationwithin a rangeof networkedOSHworking environments

includingconstruction,healthcareandlogistics.Thisiscoupledwiththeissueofwhatyoulookforiswhatyou

find (Lundberg et al, 2009) which exacerbates the limitations of examining OSH from the perspective of a

singlediscipline,comparedtoaninterdisciplinaryperspective.

Given our aims to build the research and expertise of different disciplines together, in order to fill gaps in

knowledgeandcreatenewspaces forknowledge,ourstartingpoint forgrowinga formof interdisciplinarity

perhaps comes closest to ‘intra- or supra-disciplinarity’ as “the sustained effort of integrating knowledge

originating from various disciplines” (Krishan, 2009). It correspondswith the ‘agonistic-antagonisticmode’

(Barry et al, 2008) inwhich as they argue that “interdisciplinary collaborations spring froma self-conscious

dialogue with criticism of, or opposition to, the limits of established disciplines, or the status of academic

researchingeneral”.Theysuggestthatsuchantagonisminvolvesacritiqueofthe“givenepistemologicaland

ontologicalassumptionsofhistoricaldisciplines”andisthus“manifestinattemptstoproposeanewontology”

(Barry et al, 2008). In the case of understanding OSH knowledge from an interdisciplinary perspective, as

pointedoutabove,ourresearchhasemergedinrelationtoperceivedgapsinknowledge,thatareduetothe

limits of existing disciplinary approaches. Itwas our intention that, by approaching our research ‘problem’

fromdifferentperspectives,wemightproducenewtypesofknowledge,alongwithnewtypesofproblems.

Thus, we aimed to not simply fill gaps in knowledge but produce new spaces for knowledge. Yet we

acknowledge that this might not necessarily lead to a new ontology, but rather to an appreciation of

ontologicalandepistemologicalpluralism. Insayingthis,ouraim isnot toargue foranewpost-disciplinary

viewoftheworld,butrathertosuggestthattheontologiesofthedifferentdisciplinesweworkwithneedto

be viewed critically, reflectively and relationally. This, we propose, can be best achieved by engaging

interdisciplinarityasaresearchdesigntoolnotanoutcome.

Withinmanagement science,andespeciallymanagementandorganisationstudies, thisposition reflects the

principles of ‘multimethodology’ research design (cf. Mingers and Gill, 1997; Mingers, 2001). As Mingers

(1997)explains,multimethodologycanbe seenas formofmethodologicalpluralism,or combining together

methodologies(eitherinwholeorinpart)totackleproblematicsituations.Withintheorganisationalstudies

fieldtherehasbeenconsiderabledebatearoundthemeritsanddemeritsofmethodologicalpluralismlargely

stemmingfromBurrellandMorgan’s(1979)seminalwork.Althoughtheoreticalpluralismhasbeencriticized

asaresearchstrategy(e.g.Alvessonetal.2008)othersseeitasanaidtocriticalthinking(e.g.Bohman,1999).

InMinger’s terms,combiningmethodologies fromdifferentparadigms(knownas ‘strong’pluralism)enables

the full richnessof therealworld tobeexamined (Mingers,1997). LewisandKeleman(2002)go further in

suggesting thatpluralismcanactasanaid togeneratingmore relevant theory. In thiswaypluralismoffers

understandingsthatalignwiththediversityandcomplexityoforganisationallife,albeitinwayswhichdemand

intensereflexivityonbehalfoftheresearcher.

To begin to develop the foundations of an interdisciplinary research design we turn to what different

disciplinary perspectives might bring to the analysis of these sectors through a discussion of how these

approacheshaveconventionallydevelopedinrelationtoOSHresearchandintervention.Weemphasizethat,

9

whiletheseapproachesofferfundamentallydifferentwaysoforderingtheworldbyassemblingthesewithin

anoverarchingmeta-levelframework,pointswheretheymapontooneanotherareidentifiable.Anemphasis

on understanding the practical activity of people as they work in organisations, and accounting for the

worker’s knowledge, experience, and perspective, is common to each of the approaches. We also draw

attentionto thetypesofappliedknowledgeandpractical interventions that thesehavegenerated;albeit in

diverseways.

1.3.1 Humanfactorsandergonomics(HFE)

Theprimary concernof theHFEdiscipline is thedesignofproductsand systems thatare fit forhumanuse

(Noyes,2001).HFEisconcernedwithunderstandingtheinteractionsamonghumansandotherelementsofa

systemandapplyingtheory,principles,dataandmethodstodesigninordertooptimizehumanwell-beingand

overallsystemperformance(IEA,2000).OneofthemostimportantcomponentsofHFEresearchandpractice

is theapplicationof the systemsapproach to the studyofworkenvironments and contexts (Wilson,2012).

The systemsapproachaims tounderstand the individual, social andorganisational factors that increase the

likelihoodofhumanerroroccurring. Awideofrangeofdomainshavebeeninvestigatedaspartofapplying

the systems approachwithin HFE. Recent examples include the Ladbroke Grove rail accident (Lawton and

Ward,2005)andthe2010DeepwaterHorizonoilspill (Flin,2014). Inrecentyearsanumberofresearchers

haveexaminedthedegreetowhichHFEresearchhasaddressedhumanerroracrossarangeofsystemlevels

(e.g.,individual,team,organisational).Waterson’s(2009)reviewofthecoverageofsystemlevelswithinHFE

researchonpatient safety forexample, found thatmostworkhad so faronlyaddressedanarrow rangeof

system variables, namely individual factors. Waring (2007) also criticised the coverage of HFEworkwithin

patient safety research. In particular, he argues that HFE tends to focus on interventions centred on the

individualworkersuchassafetychecks,warningsystemsandattemptstostandardisetasks.

Other HFE research on UK patient safety has focused on developing tools and instruments to benchmark

aspects of safety performance and safety culture within hospitals and primary care (Vincent, 2006), with

interventionsoftenbasedonthesemeasurements.Researchershavebeguntoquestionthevalidityofsome

instrumentstomeasureOSH(Watersonetal.,2010)andto investigateproblemswiththistypeof ‘measure

andmanage’ approach. Waring (2009) andWaring and Bishop (2010) argue that safety knowledge is not

objective,butsociallyconstructedbyprofessionalsandembeddedinsocialpractice.Thissocialconstruction

takesmanyforms(e.g.‘stories’or‘narratives’relatedtopatientsafetyeventsorincidents).Theliteratureon

organisational learningwithin healthcare also points to a variety ofmechanisms throughwhich knowledge,

includingOSH-relatedknowledge, istransferredandtranslated. CarrollandEdmondson(2002)forexample,

arguethatactionreviews,audits,probleminvestigationsandperformanceappraisalsprovide‘arenas’inwhich

sharedlearningbetweenteammemberscanbefacilitated.OtherworkwithintheNHSlikewisedemonstrates

thatsafetyknowledgeisoftenembeddedwithinworkroutinesandprocedures(e.g.DaviesandNutley,2000).

HFE’sperson-centred,systemsapproachtoOSHhasalsobeenillustratedintheconstructionsectorbyHaslam

et al (2005). Work examining the wide range of causal influences in construction accidents identified

10

knowledgeasashapingfactor,affectingthedynamicinteractionbetweenworkteams,operations,equipment

and materials in the construction work place. Elsewhere in Haslam et al’s hierarchy of causal influences,

design, project management, construction processes, safety culture and risk management are important

knowledgeboundinfluencersoftheconstructiontasksthathavetobeundertakenandtherisksthesepresent.

ItisinterestingnowhowtheinfluencesmodeldevelopedbyHaslametal,rootedinHFEsystemsthinking,has

reached into and been adopted by researchers from a construction engineering andmanagement tradition

(e.g.Cooke&Lingard,2011;BehmandSchneller,2012).Thuswebegintoseehowatameta-levelthereare

alreadylinkagesbetweenthedisciplinesweareworkingwith.

1.3.2 Organisationstudies

The practice-based and situated nature of learning is well established within the organisation and

management studies (OMS) field (e.g. Scarborough et al., 2004; Orlikowski 2002). For example, within

complexprojectbasedenvironments(suchasconstruction),the literatureonlearningrevealsthedifficulties

inherent incapturing,diffusingandsharingknowledgeacross thenetworkofactors thatconstituteprojects

(Bresnen et al., 2004). In particular, it is the shared ‘know how’ that emerges from interaction within

communitiesofpracticethatenables‘knowthat’knowledgetobeshared(BrownandDuguid,2001).Within

thespecificcontextofsafetyandhealthpractice,GherardiandNicolini(2002)haverevealedhowactorswithin

hazardous site environments enter a community of practice (cf. Lave andWenger 1991). They reveal how

safety is not “property ‘added’ to action; rather it is a characteristic of action”. Safe and healthyworking

requiresintegrationofmultiplemodesofappropriateworkingandunderstandingfromworkerswithdifferent

perspectives. Thisacknowledgesthat theecologyand interrelationshipsofgroupswithintheOSHsystemis

also populated and shaped by materials and knowledge from outside. In other words, both formalised

structures and informal ‘webs’ of OSH knowledge co-exist in practice, and both must be accounted for if

knowledge flowsare tobeunderstood. Furthermore, there isaneed toestablishwhatactually flows. Is it

knowledgethat flowsor is itactually information insomeformoranother that flowsbetweenactors? Can

knowledgeexistoutsideofan individualordoeswhat flowsonlybecomeknowledgewhen it isunderstood,

contextualisedandappropriatedbyeachindividual?

Understanding how OSH knowledge (including the strategies that shape knowledge practices) is enacted

within and across highly networked sectors requires a grounded perspective on practice. The ‘strategy-as-

practice’perspectiveasdevelopedinorganisationstudiesarguablyoffersaneffectivestartingpointasaway

of seeing strategy as something that people do rather than something that a firm possesses (Whittington,

2006). Inotherwords,strategizingcanbeunderstoodbyexaminingthespecificsocializedpracticesthrough

which strategy is identified, constructed, translated and transformed. Recent key contributions within the

strategyaspractice literature (JarzabkowskiandSpee,2009; seealso Jarzabkowskietal.2007;Whittington,

2006) have pointed to three objects of analysis as being vitally important: the practitioners (“those doing

strategy”),thepractices(“thesocial,materialandsymbolictoolsofstrategy”)andpraxis(“theflowofactivity

through which strategy is accomplished”). By engaging with all three dimensions, the attendant focus

11

becomesoneofunderstandingthe“situatedsocialpracticesthatareenactedandre-enactedinthe‘doing’of

strategy”(RascheandChia,2009).

1.3.3 AnthropologyandEthnography

As Pink et al. show (2010), the anthropological literature about informal or ‘local’ (indigenous) knowledge

(Brickeretal.,2003)hasshownforothercontextsthatgapsbetweeninstitutionalknowledgeandprocessand

theembodiedeverydaypracticalknowledgeofthepeoplecandiffersignificantly.Apertinentexampleforthe

discussionhereisArceandFisher’sworkwherethey“notehowforemployeesofanoilcompanyinWalesthe

knowledgeoftheirjobprovidedmenwiththeexperiencetodevisepracticalwaystoachievethetaskathand

withoutnecessarilyfollowingthesafetyregulationsdesignedtoavoidthemhurtingthemselves”–inthiscase

by not wearing the required gloves when working in the “paraffin shed” (Arce and Fisher, 2003). Such

scenarios arepartof theeverydayworking lifeofmanypeople andalso,weassume,partof theunspoken

layerofinstitutionalknowledgeabouthowprocessesreallywork.Someofourotherworksupportsthispoint,

as, for example, Pink et al (2010) quote a large construction contractor’s OSHmanager’s discussion of the

ambiguityaroundtheubiquitoususeofmobilephonesonconstructionsites,asheputit:

“Ifyou’reusingyourmobilephoneonsitewetellpeoplenottodoit,butthenwe’renotabovedoing

itourselves,tobehonest.Ifthere’sanincidentonsitethen,youkindof,youwantpeopletodoit,so.

Idon’tthinkwe’re100%straightonwhetherit’srightorwrongyet”(quotedinPinketal2010:651).

Yetmuchofthispractice-basedknowledgeremainsundocumented,informal,unspokenandthusunaccounted

forinourunderstandingsofhowOSHknowledgeislearned,enactedandcommunicatedtoothers.Inmaking

suchknowledgevisible,thesestudiesdonotseektoprivilegethelocalandpracticalovertheinstitutional,but

to explore interrelationships and interdependencies between different ways of knowing. Like the HFE

approachoutlinedearlier,practice-focusedorganisationstudiesapproachassumesthatknowledgeorwaysof

knowingareembeddedinpracticeandroutineandshouldnotbeseparatedfromtheactorsthatreproduce

them.

1.3.4 SafetyScience

The focus of safety science is on the reduction of accidents and incidents, paying special attention to their

precursors. The production and dissemination of knowledge and learning are considered as systematic

attempts to improvebehavioursand reduce incidents andhave traditionally focussedon safety rather than

health. While written procedures and guidelines might attempt to control behaviour, an expanded

perspectiveacknowledgesthepartplayedby individualdifferences,andfocusesonpsychological issuesand

factors that influencebehaviour, akin to approaches that havebeen referred to as the ‘third’ ageof safety

(Hale&Hovden,1998).

Central to the examination of psychological factors inOSH has been the study of climates and cultures for

safety;formingoneofthemoreinfluentialapproachestounderstandingthedevelopmentofsafeandhealthy

12

behaviours. Psychological OSH climate has been investigated to determine the relationships between

individualandsharedemployeeattitudesandperceptions,andbroaderoutcomemeasures,includingaccident

ratesandsafebehaviours,inanattempttoprovideexplicativemodelsofsafebehaviour.Forexample,Zohar’s

(1980)studyfoundsomerelationshipbetweenhissafetyclimatemeasureandsafetyperformance.Mohamed

(2002)likewisefoundsignificantrelationshipsbetweensafetyclimate,anditscomponents,andself-reported

safe behaviour in constructionworkers. Several researchers have also examined the relationship between

climate variables and accident outcomes, for example, Hofman and Stetzer (1996) found their measure of

safetyclimaterelatedtoaccidentrates.

Climate in organisations can be viewed as a collective subjective construct in which there are multiple

subsystemclimatesthatcanbereferencedtocriteriasuchasstructure,effectiveness,andsafety,andcanbe

analysedacrosslevelsovertime(Falcione,Sussman&Herden,1987).Examiningdefinitionsofclimateallows

us to identify anumberof commonattributes; climate refers to sharedperceptions amongmembersof an

organisation regarding its conditions (Reichers & Schneider, 1990) and embodies members’ collective

perceptions about their organisation with respect to a number of dimensions (Moran & Volkwein; 1992).

Effective attempts to improve OSH would, therefore, consider both individual psychosocial and collective

organisational issues, as much as more technical issues. The shared perceptions of the organisational

environment for OSH have implications for how individuals develop and enact OSH-specific knowledge, for

exampletheperceivedknowledgeofcolleaguesinaworkgroupmayhaveadirectimpactonthebehaviourof

workers(Jiangetal.,2010).

Collaborative efforts, from across industry sectors, researchers, regulatory authorities and others, has seen

considerable progress being made in an attempt to understand safety culture and safety climate in 'real'

workingenvironments(Daviesetal.,2001).Useofassessmenttoolshavebeenshowntobeoneeffectiveway

ofencouragingandmaintainingemployee involvement intheirsafety, ifviewsaresoughtandtheyarethen

activelyinvolvedinimplementingimprovementactionsbasedontheinformationobtained.

1.3.5 MappingandApplyingKnowledge

Thesebriefoutlinesof the fourapproaches, the typesof appliedknowledge theyproduceand the typesof

interventions they inform and develop creates a strong argument for seeing each of these ways of

understandingtheOSHworldasviableandproductive.Theapproachescomefromdifferentstartingpoints.

Two of themore obvious ones, practice and behaviour, are different types of category inwhich individual

agencyandmotivationaredifferentlyconceived.Whereaspsychologicalapproachestobehaviourmighttake

the individual,motivationsandrationalchoiceastheir focus,apracticeapproachwouldentertheanalytical

fieldthroughtheprismofpracticalactivity.Suchapproachesthustakethecausal influencesthatdetermine

whatpeopledoandhowtheyknowifitissafeornotasderivingfromdifferentsources.

Yet,incommon,weseethateachofthesedifferentapproaches,albeitindifferentways,focusesontryingto

understand and explain the actual practical activity of people as they work in organisations. Indeed the

growing body of research increasingly calls on researchers to pay close attention to informal and non-

13

standardisedroutesforsafetyknowledgelearning,communication,translation,appropriationandinnovation-

alongside ‘codified’ or formalised mechanisms such as organisational rules, guidelines and training. The

researchwehavereviewedearliershowsthatsuchknowledgeincludesnotonlywhatissaidandseen,butthe

unspoken,theembodiedandperceptual,andsometimestheinvisiblelayersandflowsofknowledgeandways

ofknowingthatweneedtoprobedeeperandengageempatheticallywithworkerstoaccess. Ethnographic

approaches,asyetlittleusedinOSHresearch,offerusanimportantroutethroughwhichtoaccessthesetypes

of researchunderstandings. To fully represent thenovelperspectives thatethnographicmethodologiescan

offer to safety research, and consider how thesediffer fromdominant approaches,we take thepurposeful

stanceofelaboratingontheethnographyelsewhereinthisreport(section3.9).

Relevantresearchinvolvingourteam(Finneranetal.,2012andBoltetal.,2012)hasexaminedoutcomesfrom

OSHactivityandevidenceforinterventionsthatbegintodemonstratethebenefitsofanapproachthattakes

account of worker’s knowledge and experiences. A previous IOSH study investigating the impact of OSH

managementonorganisationsandstaff(Wardetal,2008)foundbenefitsfromaproactiveapproachtoOSH

both on worker’s health and wellbeing and profit margins. Key to this payback is access to and effective

deployment of OSH knowledge. Other work found OSH interventions to improve worker musculoskeletal

healthmust take into account prevailing attitudes, beliefs and readiness to change (Shawet al, 2007). Yet

while this need has been acknowledged in some areas, an international Cochrane review of interventions’

effectiveness forpreventingconstructionworker injuries (vanderMolenetal,2007) foundapoorevidence

baseandanabsenceofrigorouspublishedstudiesstressinganurgentneedtoaddressthisevidencegap.An

HSE review by Clemes et al. (2010) examined the knowledge base for manual handling training guidance,

concluding that exercise training promoted strength and flexibility, butmanual handling training limited to

handling technique alone was ineffective in reducing back pain and injury. Thus again indicating that

‘knowledge’and‘evidence’isfarfrombeingstraightforwardlytransferredintopractice.Suchinterdisciplinary

understandingsshouldbegintoinformthedevelopmentofOSHinterventions.

1.4 Thecasestudysectors:healthcare,logisticsandconstruction

Thecasestudysectorschosenforourstudywereconstruction,healthcareandlogisticsastheyalloperatedin

complexorganisationalcontextsbutyetcoveredaspectrumoftaskandorganisationalenvironments.Inthis

sectionwebriefly introduce somethingof thecomplexityof theseenvironments. Genericorganogramsare

alsoprovidedillustratingthetypesoforganisationsineachsector.

It is worth noting that these organograms represent only simplified versions of organisations and only the

‘formalised’ structure of the organisation, in other words, one that is documented in the company’s

organisational chart and used to demonstrate reporting relationships for workers at all levels of the

organisation.Wealsostressthatthereisaneedtounderstandthat,withinthis‘formalisedstructure’,thereis

also the inevitability of an ‘informal structure’wherebyworkers andmanagers develop their own levels of

14

communicationbetweenonanotherandthiswillultimatelyaffecthowinformationflowsacrossorganisations

as‘official’reportinglinesmaynotbetakeninallinstancesofseekingorsharinginformation.Therefore,we

agree with Cross et al (2007) that “the boxes and lines of formal organizational charts mask myriad

relationships in networks that crisscross the borders of functions, hierarchies, and business units. These

networks define thewaywork actually gets done in today’s increasingly collaborative, knowledge-intensive

companies.

1.4.1. Construction

Theconstructionsector

The construction sector is almost exclusively a project-based sector, whereby temporary organisations are

createdanddisbandedforeachproject. Typically,thesetemporaryprojectorganisationsareformedfroma

combination of client/owner/funder; designers (usually several independent firms); principal contractor;

subcontractors and suppliers along with a plethora of specialists and advisors. In particular, the use of

subcontractorshasincreasedoverthelastfewdecades.

Theoverallprojectorganisationwillonlyusually lastforafewyearswhilsttheprojectisbeingdesignedand

builtandmanyoftheindividualfirmsmayonlyhaveanactiveroleforanumberofweeksormonths. Even

whenconstructionprojectsaredeliveredusingaformofpartneringoralliancing,thepartnershipsdeveloped

still only have a limited life, and conform to single organisational cultures only in asmuch as necessary to

delivertheproject. Oftenthesuccessofsuchenterprises,suchastheLondon2012OlympicPark, isheavily

dependentonthedegreeofintegrationofthedifferentpartsofthenetworks(Boltetal,2012).Furthermore,

even when one organisation is dominant, for instance in the case of a large design-build contractor, the

tendency isstill tooperate indiscretedepartments,almostmimickingthesubcontractmentalityendemic in

construction.Assuch,constructionhashabituallyseenitselfas‘different’andnotabletoimplementpractices

fromother sectorsand thushas failed to learn fromothergoodpractice– thishasmilitatedagainstefforts

towardsamorepluralisticapproach.

Organisationandstructureofconstructionorganisations

Thefollowinggenericorganograms(Figures1.3&1.4)showsimplifiedtypicalorganisationstructuresforthe

civilengineeringandbuildingconstructionsectors.Wedevelopedthesefiguresusingtheorganogramsfrom

the original case studies. Theywere further augmented using interview data and a reviewed to validate a

generic structure. Inboth structures there is a clear linear arrangement for the supply chain. The client is

situatedat the topas is common for the client-centric styleofmanagementusedon constructionprojects.

Subsequently,thelikelihoodofclientOSHmessagesreachingtheworkersisdependentuponthestrengthof

the message and the commitment to it at the managerial and supervisorial levels it has to pass through.

Althoughtheorganogramsshowacleardivisionbetweentheconstructionandsupplychainmembersandthe

‘professional’elements(architect,designersetc.)thereareopportunitiesforsharingofinformationatvarious

15

times through projects during the periodic design and progressmeetings that take place, alongwithmore

regularinformalinteractions.

Figure1.3 SimplifiedgenericorganisationstructureforCivilEngineeringprojects

Figure1.4 SimplifiedgenericorganisationstructureforBuildingprojects

16

Constructioncasestudyorganisations

Construction1

Thisorganisationisanestablishedpropertydeveloperwithin-houseexperiencetoseeaprojectthroughfrom

starttofinish.Operatingfromregionalofficesbutwithanationalpresence,theymanagebothsmallandlarge

developments includingprivatehousing,partnershipdevelopmentandmixed-useprojects. Theorganisation

employsmorethan500staff,manyofwhomarespecialistsfromabroadrangeofprofessions.

ThisorganisationisaPublicLimitedCompany(PLC)withaboardofdirectorsandexecutivecommittee.Oneof

themainboarddirectorshasdirectresponsibilityforOSHandEnvironment.However,daytodayrunningof

OSHmanagement and companywide initiatives is delegated to the Group Health, Safety and Environment

Director. Regionalmanagers are responsible for adesignated regionand report to theBoard. Regionsare

furthersegregatedintobuildareasforwhichtherearebuildareamanagers.Finallyatsitelevelthereisasite

managerwhomanagesthesiteandtheworkersonsite.Somesitesalsohaveanassistantsitemanager,anda

traineesitemanager.

On smaller sites, if the managers are not available, typically the fork lift truck driver, as the only directly

employedmember of staff, takes on the sitemanagement role. External OSH knowledge and information

comesmainly from the House Builders Federation (HBF), a consortium of national house builders and the

HealthandSafetyExecutive(HSE).TheNationalHouseBuildingCouncil(NHBC)providesacompliancerolein

termsoftechnicalsitefunctionandhealthandsafety.

Construction2

This organisation is a leading international engineering and construction group constructing some of the

country’smajorinfrastructureandenvironmentalprojects.IthasoperationsintheUnitedKingdom,Europe,

theMiddleEast,Asia,thePacificRimandAfricaworking innaturalresources(water,waste,nuclearprocess

and oil & gas) and infrastructure (highways, rail, power and airports), with land development activity in

Europe. It provides front-end engineering consultancy, construction and ongoing care and maintenance

services acrossmarket sectors with over 3000 employeesmost of whomwork in the UK. The company’s

servicesincludeadvisoryandconceptdevelopment,specialistdesign,programmanagement,complexproject

delivery,technologyintegration,andassetoptimizationandsupport.Thecivilandbuildingengineeringgroup’s

customersincludebusinessesintheconstruction,marine,transport,retail,hotelandutilitiessectors.

1.4.2 Healthcare

Thehealthcaresector

Oneof thedefining characteristics of thehealthcare sector could be thediverse, and at timesbewildering,

rangeoforganisations,professionalgroups,technologicalsystems,regulatoryandgovernmentalbodiesaimed

at delivering safe, efficient, cost-effective and timely care to patients. As a consequence of this diversity,

healthcareisoftenseenanoneofthemostcomplexsociotechnicalsystemsandpronetofailureintermsof

17

safetyasitappliesnotonlytopatients,butalsotostaffwithinhospitalsandotherhealthcaresettings(Kohnet

al.,1999andCarayon,2012). Forexample,withinthecourseofafewmonths,apatientwithdiabetesmay

‘move’throughseveralpartsofthehealthcaresystem(e.g.primaryandsecondarycare,specialistcentres)and

be treated by a range of people (e.g. general practitioners, social workers, nursing staff, specialists in

diabetes). Moreover, information relating to this patient may be stored in a variety of formats and

technologies(e.g.paper-basedrecords,electronicsystemsandimages).Notsurprisingly,informationmaybe

lostor‘fallthroughthecracks’alongthewayasitcrossesorganisationalboundariesinvolvingbothpeopleand

technology (Vincent, 2010). Evenwithin one setting (e.g. a hospital) the handover of informationmay be

problematic (e.g. fromonehospitalwardtoanother). Incontrast tomanyothersectors (e.g.construction),

theimplicationsofthese‘networks’ofknowledge,informationanddataforOSHareonlyreallystartingtobe

appreciatedforresearchers,policy-makersandhealthcareprofessionals.

Organisationandstructureofhealthcareorganisations

Thefollowinggenericorganograms(Figures1.5&1.6)showsimplifiedtypicalorganisationstructuresforthe

typicalNHSTrusts.Wedevelopedthesefiguresusingtheorganogramsfromtheoriginalcasestudytrusts.

Figure1.5 SimplifiedgenericNHSTrustnetworkstructure

TheywerefurtheraugmentedusinginterviewdataandareviewtovalidateacommonNHSTruststructure.In

both structures there is a clear division between clinical and non-clinical staff. This is because, typically,

servicesstaffweresub-contractedandclinicalstaffweredirectlyemployed.Thismeantthat,inthemajority

ofcases, servicesstaffhadtheirowncompanysafetymanagementsystem. Healthcarestaffweregenerally

distinguished according to their OSH needs with laboratory staff having more regulated needs given their

18

conditionsofwork(e.g.dealingwithbiohazards).Typically,theoccupationalhealthdepartmentwasseparate

tothesafetydepartment.Intervieweesfeltthatthiswasbecauseinmanycasesoccupationalhealthwasrun

as a separatebusinessunit andwas self-funding and that therewere several pertinentoccupational health

risks(e.g.manualhandling).Notwithstandingthisseparation,therewereformalconnectionswiththesafety

departmentwherestaffcouldbereferrediftheywereatrisk.

Figure1.6 SimplifiedgenericNHSTrustnetworkstructure(alternative)

Healthcarecasestudyorganisations

Healthcare1

ThisorganisationisoneofthebiggestandbusiestNHStrustsinthecountry,employingmorethan10,000staff

acrossseverallargehospitalsites,servingapopulousofmorethanonemillionpeople.

ThemanagementofOSHinthisorganisationiscomplex.Afive-persondedicatedOSHmanagementteamsits

within the risk management function, operationalising the Trust’s overall responsibility for all directly-

employedworkers. Giventhenatureofhealthcarework,theOSHteamworkscloselywiththeoccupational

health team. Specific teams and groups are often developed to deal with common health risks such as

musculoskeletal disorders (MSDs), skin disorders, stress, and immunisation. While occupational health is

19

providedasstandardforNHSemployees(directlyemployedbytheorganisation) it isabought-inservicefor

subcontractors.

There are several sub-structures within the overall management structure including healthcare staff

(distinguished based on varying OSH needs as doctors, other in-house healthcare staff, community staff,

contractedhealthstaff),hardandsoftfacilitiesmanagement(FM)staff(domesticandmaintenance),Trustand

managementstaff.FMservices(hardandsoft)arecontracted-outtothirdparties.ThisTrusthasemployeda

separate “client arm” or management structure to oversee and assess work that is completed by

subcontractorsandreportbacktotheTrustmanagement.However,daytodayrunningofsubcontractorOSH

islargelylefttomanagementstructureswithinthesubcontractororganisationswhichtendtohavecompany-

specificOSHstandardstailoredtomeetTruststandardsandrecommendations.

Healthcare2

Thisorganisationistheoneofthelargestinitsregionandconsistsoftwolargehospitalsprovidingarangeof

services including general medical, surgical, maternity, rehabilitation care and accident and emergency

services,withmorethan1000beds.TheTrustwasdevelopedaspartofthePrivateFinanceInitiative(PFI),a

procurementmethodwhichusesprivatesectorcapacityandpublicresourcesinordertodeliverpublicsector

infrastructureand/or servicesaccording toa specificationdefinedby thepublic sector. Thishascreatedan

interestingmanagement structure where the contractors who built the facilities are technically the Trust’s

landlords with the Trust having to fulfil certain criteria of the rental agreement. However, while the

contractorsareprovidingmaintenancework theyareundercontractualobligation to followapprovedTrust

andNHSstandardsofconduct,includingOSH-relatedpolicies.Afurthermanagementstructuresitsbetween

thePFIcontractorsandtheTrust in the formofaprivatelycontracted litigationservicetooverseethe legal

statusofdirectives.

TheTrusthasoverallresponsibilityfortheOSHofeveryonewhoworksattheTrust,includingsubcontractors,

andhasadedicatedOSHteamoftwosafetyprofessionalsandsixoccupationalhealthprofessionals.Interms

ofOSHmanagement, theTrustcanbesplit intotwohalves:clinically-basedandfacilitiesmanagementstaff.

Clinical staffaremanageddirectly through theTrustmanagement structurewhich includes severaldivisions

andsub-divisions.EachdivisionhasaQualityImprovementLead(QIL)toensurethatdirectivesandinitiatives

implemented by the Trust follow a set of strict standards to improve the overall quality of the service,

including any OSH initiatives. Periodical OSH meetings bring together representatives from each of the

divisionstodiscussOSHinitiatives,policiesorissues.

TheflowofOSHtofacilitiesmanagementcontractors(hardandsoft)isoverseenbytheOSHandoccupational

health teams. However, this ismediated by the on-site facilitiesmanagement teamwho are employed to

managetherelationshipbetweentheTrustanditssubcontractors.DirectlyemployedTruststaffhavedirect

accesstooccupationalhealthfacilitiesbutsubcontractorshaveaseparatebought-inservice.Subcontractors

typicallyhavecompany-specificOSHstandardstailoredtomeetTruststandardsandrecommendations.

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1.4.3 Logistics

Thelogisticssector

Aswith the construction and healthcare sectors, the logistics area presents its own complex organisational

issues.Amoretraditionalviewoffirmswithafocusoninternalefficiencyisnolongerappropriateintoday’s

business environment (Lai & Cheng, 2003). Accordingly, distribution management within and between

organisations needs to recognise the integrated and intertwined nature of organisational relationships

(Mentzeretal,2001).Theeffectivemanagementofsuchasupplychainhasbeenincreasinglyrecognisedasa

keyfactorinprovidingacompetitiveadvantageforfirms(Christopher,1998),butdemandscloseintegrationof

anumberof internalfunctionsand, inmanycases,successful linkswithexternalorganisations(Lai&Cheng,

2003).Withinorganisationstheflowofinformationcanbeproblematic,involvingfunctionssuchasresearch,

engineering,sales,andproduction.Thiscomplexitymaybeintensifiedwhenconsideringelementsexternalto

theorganisation.Formanyorganisations,roadtransportformsanintegralpartoftheirlogisticsoperations.In

Australia,NorthAmericaandWesternEuroperoadfreightisthedominantmodeofinternaltransportlogistics

(Mayhew&Quinlan,2006). Theinteractionwiththeexternaltransportenvironment,externalorganisations

andultimately customerspoints to the importanceof clear information flow. IndeedSingh (1996) suggests

that responsiveness to customer demand, and overall customer satisfaction, cannot be achieved without

propermanagementof both the goodsmovement and information flow throughout the supply chain. The

sameistrueofOSHperformanceinsuchanetworkedenvironment.

Organisationandstructureoflogisticsorganisations

The following generic organograms (Figures 1.7-1.10) show simplified typical organisation structures for

different types of logistics organisations. All of the organograms demonstrate a hybrid organisational

structure;howevertheydoleantowardsadominantstructurewhichdifferentiatesthemfromoneanother.

Figure1.7focusesonthedistributionnetworkofagenericretailorganisation.Thisrepresentsamorematrix

type structure which would rely on excellent communication as information would travel across the

organisationfromtoptobottom(andviceversa)acrossdifferentfunctionsandalsoacrossdifferentsites.For

example,direct customerdeliverieswouldbe separate toother retaildeliverieseachwouldhave theirown

functional structure. Each retail site has its own management board and set functional management

structure.Eachwarehousealsohasitsownmanagementstructure.Thesewarehousesiteswouldberunby

theirmanagement,which can impacton theefficiencyof information flowing from themanagementboard

and lead to inconsistencies in the flowof informationdown to theworker level as eachmanagement level

translatesinformation.

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Figure1.7 Simplifiedgenericretaillogisticsnetworkstructure(focussingonwarehouseoperations)

Figure1.8isasimplifiedversionofthenetworkforagenericlogisticsorganisationwithadistributedstructure.

Thisrepresentsamorefunctionalstructurewherebyactivitiesaregroupedtogetherbycommonfunctionse.g.

logistics, human resources, manufacturing, marketing, technical and compliance and so on. Whilst this

structureisusefulforenablingworkerspecialismswithineachfunctionitcancreateanenvironmentwhereby

it isdifficulttocommunicatestrategiesacrossfunctions,Forexample,communicatingchanges inhealthand

safetyinformationfromtechnicalandcompliancetohumanresources.Thistypeofstructurecanalsoinhibit

theflowofOSHinformationbacktoworkersifthereispoorhorizontalcommunicationbetweenfunctionsand

this is likely to impacton theamountof information that flowsdown (andup) thehierarchical levels in the

organisation(e.g.betweenworkersandhigherlevelmanagement).

22

Figure1.8 Simplifiedgenericlogisticsorganisationwithadistributedstructure

Figure1.9 representsadivisional structurebased

on geographical locations both country and then

region. These regions are then divided into

functionalstructures.Divisionalstructuresallowa

global organisation the flexibility to respond to

specific environmental changes (for example

country-specific legislation which would include

OSHlegislation).Byhavingdivisionsitalsoallows

the organisation to adapt to customer needs

whichisimportantiftheorganisationhasspecific

customer contracts. An important problemwith

divisionsisthattheremaybealackofcentralised

specialismsunlikemore functional structures like

figure1.8.

Figure1.9 Simplifiedgenericgloballogistics

organisationfocussingonretail

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Figure1.10representsanorganisationthathasaveryflatclearhierarchicalstructurebasedonfunctions. It

canbedescribedasahybridofthelineandfunctionalstructurewhereauthorityhasaverystructuredchainof

command (hierarchy). In this organisation type, information should freely flow between the levels of

management in each function as the structure is simplified and there is clear authority and responsibility

therefore workers know what their responsibilities are and their accountability relationships. It can also

facilitate fastdecisionmakingas there isalso functional specialismssospecific staffcanadviseonspecialist

areasforexamplehealthandsafety.Someofthedisadvantagesofthistypeofstructurearepotentialconflict

between line management and staff when managing specific problems. To alleviate some of these

disadvantages committees can be developed tomanage specific situations (e.g. particular issues with OSH

incidencesinawarehouse).Committeedecisionsengagemorepeoplebutcandelayresponses.

Figure1.10 Simplifiedgenericlogisticsorganisationfocussingondistribution

Logisticscasestudyorganisations

Logistics1

Thisorganisationhasahierarchicallayeredmanagementstructure.Thelogisticsfunctionconsistsofanumber

ofwarehousesofvarioussizesindifferentlocations.Asmallnumberoflargewarehousesreceivegoodsfrom

suppliersand theseare thendistributed to smaller satellitewarehouses, shopsanda subcontractedcourier

organisation.Thesmallsatellitewarehousesdealwithdeliveriestocustomers’homesandshops.Withineach

24

warehouse,thereisessentiallyastandardsequenceofoperations:avehiclearriveswithgoods;thegoodsare

thenunloaded;stored;‘picked’;andfinallyloadedontoavehiclefordeliveryelsewhere.Thesizeandtypeof

goodsdetermines the typeof storageusedwithin thewarehouse, equipmentusedandnumberofworkers

neededtoperformtasks(e.g.one-personandtwo-personlifts).Non-managementpersonnelcanberoughly

segregated into drivers/delivery and warehouse workers. Warehouse workers have varying levels of skill

depending on the tasks they undertake e.g. forklift truck drivers are skilled and must have appropriate

qualifications. In comparison to delivering goods to customers’ homes, which is a complex and varied

operation,thewarehousesarestandardisedintermsofworkingenvironmentandthereforeoperations.

The OSH department is a small, independent function overseeing the logistics and retail operations. The

responsibilityforOSHisdevolved,withallpersonnelhavingresponsibilityforsafeworkingpractice.

Logistics2

Thisorganisationhasahierarchicalmanagementstructureandoperatesasa logisticsfirmprovidinglogistics

services to a number of different clients, including supply chain solutions. It is a global enterprise which

operates throughout theUK froma largenumberof differentwarehouses. Each site is customer contract-

specific and runs according to the client’s requirements and has its own middle level management. The

companyofferssupplychainsolutions,global logistics,warehousinganddistribution,specific industrysector

solutions,greenlogisticsandfreighttransport.Theyofferanumberofwarehousinganddistributionsolutions

including:ambient,temperature-controlled,bonded,rawmaterials,finishedgoodsandautomated.Interms

ofwarehousinganddistribution,non-managementpersonnelaremadeupofwarehouseworkersanddrivers.

Warehouseworkerswillhavevaryingskillsdependantontheirrolee.g.pickers,forklifttruckdriversandsoon.

Driversalsohavevariedrolesandchallengesbasedonthefactthattheycanbedeliveringtoarangeofretail

outlets,customers’homes,andotherservices.TheOSHdepartmentoperatesfromtheboardlevelandruns

downthroughouttheorganisationthereisanoverarchinghealthandsafetymanagerwhoisresponsibleforall

aspectsofOSHwithinorganisation.EachsitethenhasanOSHmanagerwhoisresponsibleforthatparticular

siteandcommunicateswiththeboardlevelOSHmanager.

Logistics3

This organisation has a hierarchical structure but board level management do not have the same level of

power over the organisation’s various sites as the other two logistics organisations. In this case, people

workingatdifferentsitesareaccountabletothelocalsitemanager.Warehousinganddistributiononlyforms

part of the organisation and is not the organisation’s main function. Each site has a warehousing and

distribution function as an in-house operation and delivers to retailers and wholesalers. In terms of

warehousing anddistribution, non-managementpersonnel aremadeupofwarehouseworkers anddrivers.

Warehouseworkershavevarying skillsdependanton their rolee.g.pickers, forklift truckdriversand soon.

Driversalsohavevariedrolesandchallengesbasedonthefactthattheycanbedeliveringtoarangeofretail

outlets, customers’ homes, and wholesalers. Whilst an OSH manager sits on the board, site level OSH

managersreporttositemanagersandOSHissite-specificratherthanstandardacrosstheorganisation.

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1.5 Modelsandconceptsusedinthisresearch

1.5.1 The‘thirdway’continuum

This is an unusual section for a research report in that we are presenting here, in summary, two of the

conceptualmodelsthatwehaveadoptedthroughtheresearch.Thepurposeistohelpthereaderunderstand

thedataaswehavepresentedit.Thesemodelsarediscussedindetailandjustifiedfromtheresearchfindings

insection4.

The first model seeks to provide a pragmatic view of a third way, between the extremes of a rule-based

approachandanexperientiallyconstructedapproachtoOSH(Figure1.11).Thesetwoextremesaredescribed

byHale&Borys (2013) asmodel 1 andmodel 2. Ourwork provides evidence to expand this thinking and

presents a continuum through which each situation can be better understood. We acknowledge that, in

reality, thewaythatOSHplaysout isnotstraight forwardandwehavedescribed itasa ‘fog’ (Hartleyetal,

2014), dependent on things such as circumstance, hazard context, governance, and culture of practice.

However, we have found this continuum to be a helpful way to increase understanding of the contingent

interplaybetweentheindividual,thetaskandtheenvironment.Furthermore,itwasadesiretoexplorethis

interplaybetweenindividualdecision-making,practiceandenvironmentalfeaturesthat informedandunited

thedistinctdisciplinaryperspectivesframingourresearch.

Figure1.11 TheThirdWayContinuum

Putsimplistically,amoreexperiencedandcompetent individualwouldtendtobeabletooperate inamore

flexiblewaytowardsmodel2andbebetterabletomakeappropriatedynamicassessmentsoftherisksand

requiredbehaviour. A lessexperiencedor less competent individualwould tend towardsmodel1,needing

morecertaintyandclarityofwhatwasallowedandwhatwasnot.Theyarelikelytobelessabletoassessrisks

insituorknowtheappropriatebehaviouralresponse.Anexperiencedpersonwhohasnotbeenwelltrained

mayveertowardsmodel2whichcouldbeproblematicifthemissedtrainingisgermanetothemessageand

task,unlesstheyhadfoundasaferormoreappropriatewayofdoingthetaskintheparticularcircumstances

thantherulessuggest.



Mod

el1

Model2

26





1.5.2 Model3rule-andpractice-basedknowledge

Wealsorecognisethattheremayalsobesituationswhereamodel3approachwouldbeappropriate.People

canaddtheirownpracticetorulestocreatenewwaysofworking.Inthiscasethesearenotworkaroundsor

compromises,butrule-informed,practice-basedwaysofknowing.

Figure1.12 Model3combinationofrule-andpractice-basedknowledge

1.5.3 ThePerson-CentreOSHKnowledgeFlow(P-COK)Model

Inasimilarwayweintroducetheperson-centricOSHknowledge(P-COK)Flowmodel(Figure1.13).Thislooks

at the findings from this research from the perspective of each individual in the network and has built on

Conzola andWogalter’s (2001) C-HIP communicationsmodel. It should be considered in tandemwith the

Third-WayContinuumwhichprovidesmoreofaholisticperspectiveandisdiscussedatlengthinsection4.

Figure1.13 ThePerson-CentricOSHKnowledge(P-COK)FlowModel

This idealisedmodelconsiderseach individualandthespecifictask-relatedmessagethattheyreceive,along

withthemanyotherexplicitandtacit inputsthatarepresentedtothem.Thewaythatthesituation,orthe

3

1 2

27

person’s individual characteristics either help or hinder them interpreting theOSHmessage alongwith the

other‘noise’aredescribedasfilters.Theindividualthentranslatesthemessageinternallytoformknowledge

whichisaffectedconsiderablybytheircognitiveandotherpersonalskillsandcompetencies.Theenactment

thenmay be the passing on of themessage to the next person or group in the network or, in the case of

frontlineworkers,theirbehaviourindoingthetask.

The extent towhich knowledge flows around the network is discussed at length in this report. We argue

especially(butnotonly)throughtheethnographicresearch(seesection3.9)thatmuchknowledgeissituated

and emerges insitu. However,OSHmessages do flow though the network despite being oftenmutated as

eachplayertranslatesthemessagebeforepassingiton.Figure1.14showsanidealisedconstructionproject

networkwiththevariousmessageflowsmarkedasprimary(solidline)andsecondary(dashedline).Asbefore

these aspects are explored at length in section 4, but the model is used to guide the reader through the

empiricalfindingsinsection3.

Figure1.14 NetworkedrepresentationofthePerson-CentricModel(construction)

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2 METHODOLOGY

2.1 StudyDesignandMethodology

2.1.1 ResearchOverviewandpointsforinvestigation

Inthisstudyweaimedtoidentifythetypesofoccupationalsafetyandhealth(OSH)knowledgeandevidence

thatcirculateandworkinrelationtoeachotherinorganisationsinvolvedinnetworkeddeliverysystemsinthe

healthcare,logisticsandconstructionsectors(Forfurtherinformationaboutthecasestudiesseesection1.4).

Our second aim was to establish how local actors in organisations interpret information and, in turn, the

influencesonOSH.Finally,ourlastaimwastodevelopgroundedrecommendationsregardingthebestways

toimproveknowledgeandevidenceflowsandimpetustoacton.

Intheempiricalworkwesoughttoaddressthefollowing:

• ToestablishthewaysinwhichOSHknowledge,evidenceandpracticesareproduced,engagedand

navigatedtoaddressOSHissuesinthecontextofdifferingorganisationalcontextsandpower

relations.Wealsoaimedtoaddressthetensionsbetweenapparentlyconflictingprojectgoalssuchas

enterprisesuccessorprofitabilitywithOSHimprovementsandtheappropriatenessof

professionalisingstrategiesinOSHsystemsandtherelevanceoftraditionalmodelsofprofessions.

• Toobservehowanorganisation’sresponsetohowformalisedOSHpolicyisenactedindiffering

institutionalcontextsandplaysoutinrealtime.Itwashopedthatthiswouldrevealthewaysinwhich

differenttypesofknowledgecombinewithincomplexsocialsettingsaspartoftheecologyoftheOSH

systemandassesstherelevanceoftraditionalmodelsofprofessionsandthebalancebetween

technicalexpertiseandgeneralisedauthority.Weusedcross-sectoralcomparisonstobroadenthe

insightsandensurethattheyarefirmlysituatedwithinparticularnetworkandaccountability

contexts.WeconsideredprofessionalisingstrategiesandthecontributionofOSHpractitionersand

non-professionalactorsindevelopingnewknowledge,facilitatingitsuseandexercisingprofessional

influenceintherestructuredworkenvironment.

• Toconstructethnographiesofverbalised,textualandembodiedknowledge(waysofknowingthatare

unspoken,tacitandembeddedacrossactors,processesandartefacts)withintheconstruction,

healthcareandtransportandlogisticssectors(asexamplesofdecentralisedworkplaceswith

internationalchainsofaccountability).Throughthesenarrativeaccounts(detailedinsection3.9)we

soughttorevealthe‘communitiesofpractice’withinwhichOSHactivitiesresideandhowthe

practicesofthedifferentparticipantsintheOSHsystemcoproduceOSHoutcomes.

• ToidentifytheeffectivechannelsforthemovementofOSHknowledge,motivatorsandpractices.We

studiedhowthesearethentransmitted,translatedandenactedinwayswhichovercomethe

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obstructionstoknowledgeflowswithindistributed,highlynetworkedenvironments.Thisconsidered

facilitatorsandobstructionstoknowledgeflowacrossthenetworks.

Inthissectionweoutlinethejustificationforchoosingparticulardatacollectionmethods,thetechniquesand

methods of data collection, the development of inventories, data analysis, ethical considerations and

limitationsoftheresearch.

2.1.2 Methodologyandstudydesign–Framework

Ouraimspreservedtheepistemicsignificanceof theparticularwithout losingsightof thegeneral. Inother

words, it allowed the different parts of our team to ensure generic understanding of the results without

alienating theoretical and epistemic ideologies. To achieve this, we used a mixed method framework,

engagingbothnon-ethnographicandethnographicmethods(specificmethodsareaddressedinthefollowing

sections).

Theworkwascompletedintwophases(phaseoneandtwo)withthedataemergingfromonephasefeeding

intothenext.Forlogisticsandconstructionthenon-ethnographicworkcommencedbeforetheethnographic

work in each phase so that the non-ethnographicwork informed the ethnographicwork for these sectors.

Finallyresultsfromeachphasewerebroughttogethertoprovidefinalresultsandrecommendations.

Figure2.1providesacomprehensiveoverviewofthedatacollectionmethodsandschedulingofthework.

Figure2.1 ProjectMethodology

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Table2.1highlightsthemethodsandtheknowledgedatatypesthatwerecollected.

Table2.1 Overviewofthemethodsanddatacollected

No Method Knowledgepurpose/type

1 DataFlowDiagram Identifycohortforinterview/focusgroups/CriticalIncidentTechnique.

Visualrepresentationofdata/information/knowledgeflowembellishedwithdataandtheoreticalprospective.

2 Interviews/Focusgroups Captureverbalisedknowledge

3 CriticalIncidentTechnique Capturetacitknowledge

4 Ethnography

Participantobservation,re-enactments,visualmethodologies’,‘interviews’,and‘elicitation/feedbackmethods’

Capturetacit/embodiedknowledge/emplacedknowledge

2.2 Non-Ethnographicdatacollection

Theuseofavarietyofmethodsandsamplestolookatanissueisrecommendedasawayofcheckingfindings

againsteachother(LangdridgeandHagger-Johnson,2009).Therefore,theuseofavarietyoftechniquesfor

collecting data in this data allows for more confidence in the research findings. Our choice of qualitative

methods, in the form of interviews and focus groups, was determined by the complex nature of the

environmentsbeinginvestigated.

Wehad150 face to face interactions (across the threesectors) forming thenon-ethnographic stageofdata

collection. Wehad 80 interactions at stageone, selectedbasedon initial interviewswith “OSH knowledge

hubs” to identify key actors in the knowledge transfer process and piloting of the research instruments.

However,becauseofthedifficultyofgainingaccess inthehealthcaresectorwereachedanagreementwith

thefundersandreducedthesamplesizeforhealthcare(n=20),construction(30)andlogistics(30).Following

preliminaryanalysisofthedatafromstageone;weaugmentedinventoriestoincludedevelopingthemesand

probekeythemes inmoredepth. Instagetwo,weusedtheremaining70 interactionsto investigate issues

raisedthroughtheethnographicfieldworkandisolatethekeyactorsintheOSHknowledgeflowprocess.We

thenaugmentedthedatatoaddresstheresearchaimsandobjectives.

2.2.1 Datacollectiontechniques

DataFlowDiagrams(DFDs)andRelevantMedia

DataFlowDiagrams(DFDs)areavisualrepresentationoftheflowofdatathroughaninformationsystemand

allowtheanalysttounderstandandspecifyasystematthelogicalprocesslevel(AvisonandFitzgerald,1995)

31

andcanbetranslatedintoamorecomplexdesignorembellishedusingtheoreticalperspectivesanddataata

later stage. We produced initial DFDs to illustrate OSH knowledge/information flow graphically based on

results from the literature review and analysis and review by team members. We then developed these

diagrams further as fresh sources of knowledge, new flows andmodes of interaction of different types of

knowledgewereinducedfromthequalitativedata(TheseareshowninSection3.4).Atthisstageweusedthe

DFDsinthefollowingways:

1. DFDsweredevelopedforeachsector(logistics,constructionandhealthcare)basedontheliterature

andreviewbyteammembers.

2. TheDFDswerediscussedwiththe‘OSHknowledgehubs’orthosethatunderstandthepragmaticflow

ofOSHknowledge/informationineachorganisationasameansofinitialverificationandselectionof

participantsforthein-depthsemi-structuredinterviews/focusgroup/criticalincidenttechniquephase

ofdatacollection.Atthisstageknowledgehubswereaskedabouttherelevantmedia.

3. DFDsweredevelopedbasedoninformationgatheredfromOSHknowledgehubs.

4. Cohortsineachsectorwereidentifiedfordatacollectionforinterview/focusgroup/criticalincident

techniquephase1datacollectionbasedonfeedbackfromOSHknowledgehubs.

5. DFDsweredevelopedbasedonfeedbackfrominterviewsandtheoreticalperspectives.

2.2.2 FacetoFaceinteractions

InterviewsandFocusGroups–Phase1

There are several types of interviews and focus groups with varying degrees of structure. The choice of

approach isdeterminedbythephilosophicalandepistemologicalpositionof theresearcher (King,2004). In

thisinstancewetookapositionwhichdrawsontherealistandphenomenologicalapproach(King,2004). In

practice thismeant that the inventoriesdevelopedwere semi-structured, thusprovidinga structure for the

interviews(basedonexistingtheory)whileallowingemergingthemestobeprobedinmoredetail(Pidgeon&

Henwood,1997).

Weheldinterviewsandfocusgroupsatcompanysites,meetingrooms,orparticipants’offices.Allinterviews

andfocusgroupswererecordeddigitallyandtranscribedfollowingethicalconsentbyparticipants.Thelength

of the interviews and focus groups varied, but typically lasted one hour (max 2hr, min 30 minutes). The

interview/focusgroupintroductioncovered,amongstotherthings,theaimsoftheinterview,confidentiality,

andpermissiontorecordandtakenotes. All interactionswereconductedin linewithrecommendationsfor

bestpractice(RobsonandHedges,1993)andinlinewithourethicssubmission.Theformatconsistedof:

• A‘warmup’toputpeopleatease.

• Themaininterviewquestions/developmentofDFDs

• Scenario-basedquestionsusingthecriticalincidenttechniquemethodand

32

• A‘cooldown’whichwillgivepeopletheopportunitytoaskquestionsandraiseanyissuesor

concerns.

• WedesignedtheinterviewquestionsusingrecommendationsmadebyLangdridgeandHagger-

Johnson(2009)forgoodinterviewpracticeandfocusedontheaimsandobjectivesofthestudy.(The

interviewquestionsareprovidedintheappendix)

2.2.3 CriticalIncidentTechnique

Malhotra (2001) estimated that over forty percent of knowledge is tacit or personal and gained from the

workersownpersonalexperience.Personalknowledgeisnotoriouslydifficulttoinvestigateandunlockwhich

is alsowhyweusedmixedmethods for this project, and in particular ethnography,whichwas intended to

exploretacitknowing. Participantsmayact inaparticularwaybecauseofpreviousexperienceunrelatedto

their current job. The exploits of personal knowledge may not be easily identified at the general

interview/focusgroupstage.Inotherwords,itmaybedifficultforparticipantstodescribehowtheysolvedor

appropriated knowledge for a particular OSH issue. The Critical Incident Technique (CIT) (Flanagan, 1954;

Lewis,1992)isajobanalysistechniquethatfocusesparticipantsonaparticularscenario(Cowieetal.,2002).

StudyingphenomenonusingmethodssuchasCIT, it ispossibletogainaccesstopersonalandorganisational

meaningsofthephenomenonaswellascriticalfactorsthatassistorinhibitthephenomenon.Inthiscasewe

developedandinvestigatedtwodiscretescenarios:

1.AnormaldaytodayappropriationofOSHknowledgebytheparticipant.

2.Anemergency-basedscenario.

Ourinitialanalysisofphase1datarevealedthatmanualhandling,personalprotectiveequipment,workingin

thehome,andequipmentwereamongthemostprominent issues. Therefore,weexploredtheseaspects in

moredetailinphase2.

2.2.4 Quality,ReliabilityandValidity–Non-Ethnographicwork

AsperHealyandPerry (2000) the followingquality criteria for validityand reliability inqualitative research

withintherealismspecificparadigmwasthebasisthephaseone,non-ethnographicwork(Table2.2).

33

Table2.2 Qualitycriteriaforvalidityandreliabilityinqualitativeresearchwithintherealismspecific

paradigm(HealyandPerry2000)

Criteria Briefdescriptionofcriteria Howcriteriaismetinthisstudy

Ontologicalappropriateness

Researchproblemdealswithcomplexsocialsciencephenomenainvolvingreflectivepeople.

Astudyoftheflow/transferandtranslationofknowledgeisclearlyofthistype

ContingentValidity Open“fuzzyboundary”systems(Yin,1994)involvinggenerativemechanismsratherthandirectcauseandeffect.

Wefocussedonwhythingshappenandnotjustwhathappened.Wedescribedthecontextofcasessuchasthesizeoffirms,datesofinterviewsandthepositionorroleoftheinterviewee.

Epistemology Neithervalue-freenorvalue-ladenrathervalue-aware.

Ouritinerarywassemi-structured,includingbothinterviewsandfocusgroups.Participantsansweredquestionsastheysawfitandthemesweredevelopedbasedontheirresponses.

Methodologicaltrustworthiness

Theresearchcanbeaudited. Wedevelopedcasestudydatabases.Summarisedfindingsandquotationsfromtheworkareincludedinthisfinalreport.

Analyticgeneralization

Analyticgeneralization(thatis,theorybuilding)ratherthanstatisticalgeneralization(thatis,theory-testing).

Basedontheliteraturereviewandevaluationandreviewbyteammembers,wedevelopedIDEF0diagramsofinformationflowsforeachsectorwhichprovidedaninitialtheorisedinformationflow.Wethendevelopedthesediagramsbasedondatafromtheempiricalwork.

2.2.5 Biasandinternalvalidity–Non-Ethnographicwork

Fourresearchers(twoforlogisticsduetostaffchangesandoneforeachoftheothersectors)conductedthe

interview/focusgroupsandcriticalincidenttechniquefacetofaceinteractions.Therewasapotentialforbias

asarealismapproach(wheretheresearchercanprobeandalterquestioningbasedonthecurrentsituation)

was used. In order to alleviate the potential effects of bias, pilot interviews/focus groups/Critical Incident

Technique) were conducted in each of the sectors. We followed van Teijlingen and Hundley’s (2002)

procedure for the pilot in an effort to improve internal validity of themain study. We used the following

protocolinthepilotinterviews:

1) N=6(2interview/focusgroups/CITpersector).

2) Theinterviewswereledbyoneresearcherwiththepre-definedsemi-structureditinerary.

3) Alloftheresearcherssatinonthesessiontakingnotesfordiscussion.

34

4) Followingcompletionofthepilotstudythe itinerarywasalteredtoreflectresearcherstyleand

generalfindings.

5) Astheresearchdevelopedmeetingswereheldatregularintervalswiththefieldworkersandthe

wholeresearchteamtoupdateandaugmenttheinventorywithnewandemergingthemes.

6) Regularmeetingswereheldwiththenewlogisticsresearchertoallowallresearcherstodiscuss

andensurethevalidityoftheresearchdata.

Scientificadvisorypanel/steeringgroup

We used a scientific advisory panel comprising senior academics and industrialists in each of the specialist

areas and sectors,meeting periodically throughout the project, to identify and validate themes in the data

analysis.

2.2.6 Interimanalysis(Non-Ethnographicdata)

We completed a preliminary analysis following phase 1 data collection. From this we identified emergent

themesthatweretheninvestigatedfurtheratphase2andduringtheethnographicdatacollection.Wealso

developedDFDdiagramsfollowinginitialanalysisbytheresearchersandconsultationwiththewiderproject

team.OnceapreliminarylistofemergingthemesandDFDdiagramshadbeenestablished,theywerechecked

withtheprojectsteeringgroupand“gatekeepers”forcompletenessandaccuracy.Wethenaugmentedand

modifiedinventoriestoadjustforemergingthemesandtofillgapsinthedatafromphase1datacollection.

2.3 Ethnographicresearch

Intheethnographicelementoftheresearch,wesoughttoidentifydifferenttypesofOSH-knowledge(textual,

verbal, embodied, affective, sensory) engaged in networked organisations, and to explore how OSH-

knowledge is acquired, shared, and actually used by workers in their everyday work practices. We used

qualitativeethnographicmethodsatcase-studyorganisationsfromacrossthesectorsofhealthcare,logistics,

andconstruction.Becauseitwasnotpracticabletoundertaketheresearchwiththesameparticipantsasthe

interviewsandfocusgroups,wedidthisresearchatdifferentlocationswith(insomecases)differentkindsof

participants.Specifically,theperspectives,experiences,andday-to-dayactivitiesofmanagers/supervisors,but

especially workers, were examined in-situ to produce in-depth understanding and rich detail on howOSH-

knowledge ‘flows’, as well as how it is accepted, rejected, appropriated, and modified. By taking a

comparative cross-sector approach, we identified shared principles of how OSH-knowledge is learned,

communicated,andenactedindifferentworkplaceenvironments,whilealso investigatingthespecificitiesof

theseprocesses. Theempirical insights challenge the idea that knowledge is always something that ‘flows’

intoandaroundanorganisationbyprovidinganalternativeperspectivebyillustratinghowOSHemergesfrom

practical activity situated in specific institutional, social, material, and temporal contexts. Moreover, the

ethnographic materials reveal how OSH is enacted through intersections with personal and biographically

35

learnedandotherwaysofknowingwhichmightoriginateinothercontexts.Soastomaintaintheintegrityof

thisdistinctargument,wehaveusedtheethnographicinsightsinthisreporttobroadlyinformanalysisofthe

interviewand focusgroup findings (sections3.2-3.8)whilealsoenablinga specific stand-alonediscussionof

theethnographicresearch(section3.9).

Ethnographyisanintensiveresearchmethodandsustainedimmersioninthecontextunderstudyiscentralto

this approach. For the fieldwork, we selected individual case-study organisations located across the UK

including: a NHS healthcare trust, a logisticswarehouse depot, and two construction sites run by different

contractors(aresidentialbuildingprojectandacivilengineeringproject).Weobtainedpermissiontoconduct

research from key organisational ‘gate keepers’ (e.g. OSH-managers), and negotiated further consent with

individualparticipantswhowereselected in termsof theirwillingness toparticipateandrole theyplayed in

relationtoOSH-knowledge.Abroadcommunityofpractitioners(linemanagersandworkers)fromacrossthe

sitesparticipatedintheresearch.Thisincluded16healthcare,7constructionand10logistics‘keyinformants’

who signed written consent forms. The ethnographic researcher spent five weeks at each organisation;

splitting this time in the construction sector between the two different sites. We developed methods in

response to the sites’ contingencies, the opportunities fieldwork presented, andwhatwas perceived to be

emergingthroughtheresearchprocessasimportanttofollow-up.Workingacrossorganisationsandsectors

meant adaptabilitywas key, yetmethodswere applied systematically in response to the guiding questions

using a combination of: formal recorded interviews (with workers explicitly responsible for OSH); informal

discussion(withworkerscarryingouttasks insitu); ‘shadowing’participantsastheymovedthroughdifferent

contexts (including from the organisational base, into a vehicle, and the home of patients or customers);

participant observation of work and non-work spaces (meetings, training, breaks); document analysis (of

organisationally defined OSH); visual methods using photography and video, and structured research

encountersusingre-enactmentandfeedback/elicitationtechniques.

VisualmethodologieswereparticularlyusefulforrevealingtacitOSH-knowledge,orexperiences,perspectives,

andpracticesbeyondwhatwasdirectlysaidorobserved. Forexample,videore-enactmentwithhealthcare

professionalsandphotoelicitationwithconstructionworkersrevealedthewaystheyusedembodied,sensory,

andaffectiveknowledgeintheireverydaytaskstokeepthemselves(andothers)safe.Thesedetails,whichare

more difficult to access through interviews or focus groups, provide a compelling basis for building similar

methodsintofutureresearch.Wedevelopedourmethodologiesthrough‘intense[ethnographic]encounters’

(Pink andMorgan2013). While thesewere short-termengagements compared to traditional ethnographic

methods (whereresearchersconventionallyspend(at least)ayeardoing ‘fieldwork’) theseencountersused

thekindsoftechniquesoutlinedabovetoelicitrichinsightontheactualitiesofOSH-practiceatourcase-study

organisations.Centraltothisapproachwasspendingperiodsoftime(hoursanddays)withspecificgroupsof

workerstogainafirst-handunderstandingoftheiractivitiesandperspectives.

Analysisbeganduringthefieldworkaswereviewedresearchmaterialstogether,discussedemergingand(asis

typical of ethnography)unexpected insights, and sought feedback fromour industry andacademic advisory

36

panels. After fieldworkwe spent amore sustainedperiod in analysis to interrogatematerials for repeated

themes(e.g. localphrases,values,meanings,actions)relevanttothetopicsof learning,communicating,and

enactingOSH.Wehavebroughtthesetogetherinthisreportwithselectedvignettes,quotes,andimagesto

illustratesomeofthepracticalwaysthroughwhichtheseprocessesoccur.

Itwasenvisagedthattheethnographicresearchmaterialswouldbecollectedinasequentialorderinlinewith

thenon-ethnographicdata.However,duetotimetablingissuesandavailabilityofcasestudiesinhealthcare,

thehealthcareethnographicmaterialswere collectedat the same timeas thenon-ethnographichealthcare

data.However,aswiththeothercasestudies,researcherskeptinconstantcontacttovalidateandinvestigate

emergingthemes.

2.4 Presentationoftheresults

In this report we selectively deploy the data and our analyses in various complementary ways in order to

answer theresearchquestionssetoutearlier in thereport. Whereappropriate,wemobiliseaspectsof the

datainconcerttoillustratethecomplexwaysinwhichtacitandexplicitknowledgecombineinbothexpected

andunexpectedways.Additionally,forreasonswehaveflaggedabove,wealsodedicateastandalonesection

(3.9)todiscussethnographicfindingsinmoredetail.Theapproachhereistoavoidprivilegingoneperspective

overtheother,buttoputourdatasets indialoguewitheachother (bothdirectlyand indirectly) inorderto

presentamorecompleteunderstandingofOSHpracticeswithin thesenetworkedorganisationalandsupply

chainsettings.

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3 FINDINGS

3.1 Introduction

In this chapter we present our main findings from the fieldwork. Some are applicable to networked

organisationsacrossthethreeindustrysectorsandsomearepeculiartotheeachsector,andweacknowledge

thatsomemaybeuniquetotheindividualcasestudiesconsidered.

These findingsprovideanoverviewofwhatwehavediscovered in relationtoresearchaims,objectivesand

keyemergentthemesoverlappingacrossthethreeindustries.Thischapterisorganisedintothemainthemes

of the interview inventory (sources, channels, flow, translation and enactment) and overlapping themes

includingconflictswithOSH,andOSHbarriersandenablers.Westudiedseveralpracticalscenariostoprovide

afocusfortheintervieweestodescribehowtheyknewwhattodoandwhy.Thescenariosinclude:manual

handling,personalprotectiveequipmentandworkinginthehome.Insightsgeneratedfromtheethnographic

researchinformedanalysisoftheinterviewandfocusgroupstudyand,whereappropriate,significantrelevant

aspects have been explicitly incorporated, while distinct ethnographic perspectives and details are further

developedbelow(section3.9).

Weusetheperson-centricOSHknowledge(P-COK)flowmodelinthissectionasawayofstructuringthemain

aspects.

3.2 SourcesandformsofOSHinformation

In the translation section of the inventory,we asked participants:What are the best

and least effectivewaysof findingout aboutOSH? Wealso askedwhatOSH source

theytrustedthemostandwhy?AcrossallofthestudyorganisationsOSHinformation

camefromanumberofsourcesandtookseveralforms.However,moregenerally,sourcesmaybedescribed

asexternal(comingfromoutsidetheorganisation)orinternal(comingfrominsidetheorganisation).

Followingourteam’s IOSH-fundedworkoncommunicationontheLondon2012OlympicPark(Cheyneetal,

2011&2012;Finneranetal,2012)weusetheterm‘source’inthisreportastheoriginatorortransmitterof

information.Thesourcecanbeaperson(e.g.amanagerorsupervisor)oranorganisation(e.g.acompanyor

government). Conzola and Wogalter (2001) suggest that given the same information, differences in the

perceived characteristics of the source can influence the receiver’s beliefs about the relevance of the

information.Ineffect,informationfromapositive,familiar,credible,expertsourceisgivengreaterattention.

Inthecaseofcomplexnetworkedorganisationstherewillbeaprimary, initialsource(perhapstheHSE),but

also secondary sources as the knowledge flows around the network. Most actors in the network are both

receivers of knowledge and sources of the translated knowledge to other actors who the influence or for

whomtheyhaveresponsibility.Thisisalsoexploredfromanetworkperspectiveinsection4.6.

38

3.2.1 SourcesExternaltotheOrganisation(bothformalandinformal)

Inlogistics,withafewexceptions,onlyOSHmanagersandseniormanagementusedexternalsourcesofOSH.

Inconstruction,formalexternal informationwasnormallyonlyusedbycompanydirectors,theOSHdirector

andmanagers. However, inhealthcare,managementlevelward-basedstaffalsohadaccesstoexternalOSH

knowledge as part of their everyday work arrangements. Respondents felt that this was due to the

networked,complexityofhealthcareandthedifficultyoffacilitatingtrainingwheretimeofffromclinicaltasks

wasaconcern,particularly forcontractedstaff. ThewardstaffweregivenOSHtrainingandcertificationto

traintheircolleagues.

TheInstituteofMedicine’slinkedworkforISOHmentionedearlier(Crawfordetal,forthcoming)identifiedthe

followingmain OSH knowledge sources: Academic Journal; Employers Organisation; Government (including

HSE); Magazine; Not for profit / charitable; Other OSH info provider; Private company; Professional

Association;TradeAssociation;University/ResearchOrganisations;Voluntary.

Variousexternalsourcesofinformationwerementionedbyintervieweesacrossallsectors.Table3.1provides

asummaryof thesesourcesandanestimateof theprevalenceacross the intervieweetypesandacross the

threemainindustrysectors4.

Thereappearedtobeahierarchyofinformationsources,withemphasisontheHSEastheyweretheregulator

and IOSH, for safetypractitioners at least, as theywere the relevantprofessional body. Inmany cases the

informationwas‘pushed’fromthesource(e.g.amagazineorcircular),buttherewasalsoevidenceofwhere

intervieweeswouldseekoutparticularinformation.

HealthcarestaffatthecasestudyTrustshavejointtrainingsessionswithcolleaguesfromothertrusts,often

focussingonlessonslearntfromimplementationofanewprocedureorprocessandstressingthebenefitsof

thebroaderperspectivethatthisbrings.

Inconstruction,variouspartiessharedlessonslearntfromaccidentson

previousprojects.Certainlylargercompaniestypicallydisseminatedthis

learning across their organisations, typically including their sites and

therefore the site-based personnel from other companies in the

network.Itwasnotclearwhetherthisinformationwasthencirculated

tothenon-site-basedpartsofthesubcontractors’sub-networks.

4Thenumberofintervieweeswhomentionedeachsourcehavebeengroupedasfollows:100%=ALL;51-99%=MOST;11-50%=SOME;1-10%=FEW;0%=NONE.Thesamplesizeisnotlargeenoughforthesegroupstobeconsideredsignificantbuttheyareprovidedheretohelppresenttheoverallpicture.

“Iknowalotofclientsnowareactuallysharingtheiraccidents…theyaregettingfilteredthroughalotmore…weneverusedtoseethem,kindofthing,youknow.So

itmakesyouallaware.”(Constructionsitemanager)

39

Table3.1 Externalinformationsourcescitedbyinterviewees

Externalinformationsources

CitationFrequencybyinterviewees

Healthcare Construction Logistics

Worker Manager OSH Worker Manager OSH Worker Manager OSH

Professionaleducation Most Most All Most Most All Few Few Few

HealthandSafetyExecutive(HSE) Few Most All Some All All Few Most Most

OtherRegulatorybodies5 Most All All Some All All None Few Few

Insurers Few Most Most Some Some Some None Few Few

InstitutionofOccupationalSafety&Health(IOSH) None None All Some Some All Few Most Most

Professionalbodies All All All Most Most All None Some Some

Professionalmagazines Some Some All Some Some Some None Most Most

Equipment/productsuppliers Most Most Some Few Few Some None None None

Themedia(newsaboutworkplaceaccidentsetc) All All All All All All Few Few Few

Personalnetworks Some Some All All All All Most Most Most

The HSE was the primary source used in logistics as both senior and more

junior managers felt it was appropriate to use information from the main

regulatory body. IOSH outputs such as SHP were also frequently cited by

logistics’ OSH managers, along with more specific organisations like the

FreightTransportAssociation.

Therewere differing levels of seeking information from external

sources by workers, ranging from very little or none through to

individualworkersactively seekingoutOSHasmuch information

astheycanfromeverypossiblesource.

5E.g.theNationalHouseBuildingCouncilforconstructionorPatientcarebodiesforhealthcare.

“…obviouslyHSEbecausethey’retheregulatorandIOSHbecausethey’rethemainprofessionalbodyin

thecountry.”(LogisticsOSHManager)

“…I’mtryingtopickupinformationinnewspapers,magazines-anythingI

seeonhealthandsafety…”(Logisticswarehouseassistant)

40

3.2.2 SourcesInternaltotheOrganisation

Wetranslatedanddistilledexternalinformationtomeetinternalaimsandobjectivesacrosseachofthestudy

organisationsinvestigated.Table3.2liststhemaininternalsourcescitedbyinterviewees.

Table3.2 Primaryinternalinformationsourcescitedbyinterviewees

Internalinformationsources



Worker Manager OSH WorkerManager OSH Worker Manager OSH

OSHMangers All All All All All All Some Most Most

Linemanagers All All All All Most All Most Most Most

Colleagues Some Some Some All All All Most Most Most

Acknowledgedchampions(keenies) Few Few All Most Most Most Some Few Few

OSHCommittee Few All All Most Most Most Few Most Most

Most of the networkswe studied had key individualswho acted either as ‘central connectors’ or ‘brokers’

(Cross et al, 2007). The central connectors are people who are frequently consulted for “information,

expertiseordecision-makinghelp.”Brokersarepeoplewhoconnectdifferentsubgroupsinthenetwork.

OSHManagers

Designatedprofessionals, such asOSHmanagers,were generally the central

connectors as themain sources of internal information. Thehistorical term

‘officer’wassometimesusedbyothers,perhapsbetrayingtheperceptionofa

more officious attitude than the softer skills of anOSHmanager. However,

noneoftheOSHpeopleintervieweddescribedthemselvesas‘officers’.

A clinical nursing manager described her dedicated OSH ‘officer’ as coordinating OSH from an overall

perspective and being trained to do things like risk assessments. She explained that, if she had an OSH

problemandneededhelp,shewouldgototheOSH‘officer’whowouldhelpherdothepaperwork,whichshe

described as ‘laborious’. She also acknowledged the input from the OSH professional is challenging her

assumptionsandcheckingthecompletenessofherassessments.

LineManagers

Many construction organisationsmake it clear that the linemanagers have specific OSH responsibility and

cannotpassthisontotheOSHmanager–oftentheseOSHspecialistsarecalledadvisorsratherthanmanagers

toemphasisetheirbackgroundrole.Goodpracticewascitedwherethelinemanagerwouldhabituallybriefa

tasktobedoneinthesafestway.

[TheHealthandSafetyOfficer]helpsusandshe'sverygoodatit…it'shersortofspecialinterest,if

youlike.”(ClinicalNursingManager)

41

In terms of communicating OSH information internallywithin an organisation,managerswould often state

that it is cascaded across the different levels ofmanagement and down to theworker level. Themodeof

communicationandtheemphasisplacedonitthiswoulddependontheurgencyofmakingindividualsaware

oftheinformation.

Whilst specific,detailedOSH informationwouldbe sought from the specialists, theOSHnoticeboardor the

OSHcommittee,itwasassumedthatthelinemanagerswouldknowthekeyprinciples.

Thesocialskillsandmanagementstyleofthe linemanagerswasraised

asan issuethatcouldseriouslyaffect theflowofknowledge. Thiswas

particularly the case for some of the healthcare intervieweeswho felt

thattheperceivedprofessionalhierarchybetweencliniciansandnursing

staffcouldleadtoinstructionsbeinggiveninadictatorialfashionwhich

didnotengenderapositivereaction.

Colleaguesandchampions(‘keenies’)-acknowledgedandunacknowledged

Becauseofthenetworkedcomplexityofeachofthestudyorganisations,certainworkerswerealsogiventhe

opportunitytoactasinternalOSHknowledgehubs.Forexample,eachofthehealthcarewardshadworkers

whotookonanOSHrolesurplus to theirownrole. Theywereprovidedwith trainingto fulfil this rolebut,

giventheadditionalworkload,theyalsoneededastrongpersonalinterestinOSH.

Many logistics interviewees cited the presence of informal

OSHexperts,oftencolleagueswho,foronereasonoranother

hadshownakeeninterestinOSH,orweremoreexperienced,

orhadhappenedtohavemoretraining.TheseunofficialOSH

knowledge hubs were typically called the ‘keenies’.

Sometimes these people were overtly acknowledged and

sometimesnot.Constructionworkersalsocitedexperienced

co-workersasinternalsourcesofOSH.

Aclinicalnursingmanagerexplainedthat, inherTrust,everyteamhadapersonwhohadtheOSH linkrole.

TheywouldtypicallybeanurseorotherhealthcareworkerwhoworkedalongsidetheofficialOSHprofessional

and the line manager, acting as a secondary source for the ward staff directly. This approach had the

advantage that the link person was close to the frontline workers and understood their situation and

environmentsocouldensurethatthemessageswerecommunicatedappropriately.

“…tochangealightbulb,we’lldoascaffoldinsteadofachair,youknowwhatImean?”(ConstructionManager)

“…thedepartmentmusthavetakentheviewthatthat

(adictatorialstyle)wasn’taparticularlygoodwayof

managingstaffforwhichI’mverygrateful.”

(Healthcareofficemanager)

“We’vegotoneparticularguywho'sgotapassionforhealthandsafetyandhetendstopickuponthings.Ithinkhereadsthebookeverynightbeforehegoestobedandlooksattheinternet.He’sverygoodbecausehealertsuslocallytochangesthatmayoccur,buthe’salsothepersonthatdrivesthe

writingofthestandardoperatingproceduresandtheriskassessments”(Logisticssectionmanager)

42

Within one logistics firm information was said to be freely

available toworkerswho frequently citedbeing able to ask co-

workers if they needed OSH information. As the organisation

had a high proportion of long standing employees and low

turnover there was always someone working on the shift who

knewwheretofindinformation.

Thisviewwasechoedacrosstheworkersatonelogisticsfirmasthere

wasanOSHculturethathadbeendevelopedoveranumberofyears.

Workers knew that they were able to approach someone in the

organisationwhowould be a source of knowledge and experience in

healthandsafety. TheseOSHhubworkerswouldalsoprovidearoute

forfeedbackfromtheworkers.

‘SittingwithNellie’ isanexpressionused todescribe theprocessof learningby

watchingamoreexperiencedcolleaguedoing the task. Therewasevidenceof

this being done as an intentional strategy for inexpriencedworkers alongwith

more formal training methods. There was also evidence of it occuring in an

unacknowledgedmannerwhereworkerslookaroundatotherstolearnwhatthe

actualexpectationsareintheparticularworkenvironment,perhapsirresepctive

ofwhatistheofficalpolicy.

OSHcommittee

Many of the locations visited had OSH committees or groups that generated information themselves or

adaptedgenericinformationtosuitthespecificsituation.TheOSHDirectorfromonehealthcaretruststated

thatallthedifferentdivisionsoftheTrustmakingupthenetworkwererepresentedattheOSHcommitteeand

thattheywould“allhappilyandopenlysharewitheachotherwhattheyhavebeendoing–whattheyhave

learnt.”TheDirectoracknowledgedthechallengesinhavingarepresentativegroupgivenhowlargethetrusts

werewithmorethan2500staffbutstillconsideredthatthecommitteestructureworkedwell.

LogisticsintervieweesacknowledgedtheOSHcommitteeasoneoftheinternalsources,althoughcommenting

thattypically,themessageswerethenchannelledthroughthelinemanagerorputonthenoticeboardandso

thecommitteeitselfmaynotbeseenasthesource.Oneintervieweedidcommentthat,asthepicturesofthe

OSHcommitteememberswereallonthenoticeboard,itwaseasytoaskthemembersdirectlyisyouwanted

anyfurtherinformation.

Inhealthcare and logistics, these committees also raised issues from theworkforce andpassed themon to

‘management’foraction.

“Youcanalwaysgetinformation.Ifyoudon’tunderstanditfromonepersonyoucanalwaysgetitfromanotherperson…theymightputyouonto

another[worker]andsay’Heknowshowtodoallthat.Goandseehim.’”

(Retailwarehouseassistant)

“…wehavea(worker)voicewheresomeone’sbeenselectedtolistentoeveryone’sneedsandwantsandthengoesoffandtalkstothehigherranked

people.”(Logisticswarehouseassistant)

Weneversetanybodytoworkwho'sbrand

newwithoutbeingwithsomeoneexperienced,justtoshowthemthe

ropes.”(Constructionsupervisor)

43

However, not all interviewees considered that

the OSH committees were effective, some

arguing that they take too much time talking

anddonotgetthingsdonequicklyenough.

OnehealthcareOSHmanagercitedanexampleofthe ‘plethora’ofcommittees involved inanOSHinitiative

relatingto‘sharps’.Thenewprotocolwasdiscussedbycommitteesoneducationandlearning,risk,medical

advisors, consultants and doctors, and finance before being finalised and presented to the main OSH

committee.Then,onceithadbeenagreedinprincipleandturnedintoadirective,thewaythatitwouldbe

implementedacrossthewholeTrusthadtobeagreedalongwithhowitwouldbedisseminatedtoallrelevant

staff. This infers that some healthcare staff work around this committee structure in the interests of

expediencywhichresonateswithsomeoftheethnographicfindingsandalsosuggeststhat,evenintheNHS,

thereisareluctancetowardsroterulefollowing.

3.2.3 UnknownSources–‘pickingupknowledge’–Sociallyconstructedknowledge

SociallyconstructedOSH-knowledgewillbeillustratedinmoredetailthroughtheethnographicwork(Section

3.9).Yet,itisimportanttobrieflyhighlightthiswhendiscussingtheinterviewsandfocusgroupsbecausewe

alsofoundevidencefromtheinterviewsthatOSHknowledgeisco-createdandinterpretedsociallyineachof

thesectors.Inthemixoftheformalandinformalknowledgeflows,workersoften‘pickup’OSH‘knowledge’

(andOSH practices) from others. This can be intentional or unintentional, formal or informal. It can also

includeagentswhoareexternaltotheorganisation.Forexample,asweconsideredthroughtheethnographic

research,healthcareandlogisticsworkerswerefoundtodrawontheknowledgeofpatientsandcustomersto

enable them to safely approachworking in other peoples’ homeswhen away from the organisational base

(Pinkatal., inpress). Theseagentswererevealedtobecrucialsourcesof informationthatworkersused in

ordertoanticipate,plan,andmanageapproachestosafeworking,andthuswereactivelyinvolvedintheco-

production of OSH-knowledge. The social construction of OSH-knowledge was evidenced by interviewees

from all three sectors often explaining that they did not really knowwhy they did things in a certainway,

arguingthatitwas‘justcommonsense’.Insomecaseswhatworkerspickupseemedtobegood,inothersit

wasthoughttobeginestablishingflawedknowledge.Alogisticsmanagertalkedaboutreceivinganemailfrom

theOSHteamwhichtheyhadnotunderstood.Themessagewasthendiscussedwithothersandcheckedwith

theOSHteamtoensurethatithadbeeninterpretedcorrectly.Thistypeofdiscussionsometimesledtothe

adaptationofpolicies(orrecommendations)tomakethemmoreapplicabletodifferentjobroles.

RecognisingOSHassociallyconstructediscentraltotheunderstandingofhowknowledgeisformed,mediated

andinsomecasescorrupted.Itsuggeststhatknowinghowtoworksafelyisanincrementalandanongoing

process, as approaches were developed in response to specific features of workplace environments. In

particular, the dynamic properties of diverse workplaces (building sites, organisational bases, and

“…ifyouwaitedforthehealthandsafetycommitteeyou’dneverdoanything,becauseeverythingwouldjustbeheldupallthetime.Sometimesyouhavetobitethebulletand

saywe’rejustgoingtodoit”(HealthcareOSHmanager)

44

customer/patienthomes)were foregroundedasworkerswere foundtoberesponding to theuncertainand

ongoinglychanging featuresof thesecontextsbyadapting, improvising,and innovatingOSH-knowledgeand

practice. OSH was found to be contingently situated and enacted in ways that were organisationally,

individually, culturally, and socially appropriate. Together, these insights into OSH practice suggest that

formalised OSH knowledge inevitably becomes intertwined with informal ways of knowing, themselves

continuallyshapedbyunfoldinganddynamichazardcontexts. Thiscontinualre-shapingofwhatconstitutes

OSHknowledgerendersitscodificationcomplexandproblematicinhighlynetworkedsectors.

3.3 ChannelstocommunicateOSH

Again,followingtheLondon2012work(Cheyneetal,2011),thetermchannelconcerns

theway information is transmitted from the source tooneormore receivers. In this

section,wefocusonthecommunicationmediumused(e.g.training,posters, internet,

oralinstruction),totransferinformationorknowledgefromoneusertoanother.Over

40 different channels were cited by respondents. However, Table 3.3 lists themost

frequentlymentioned.

Theimportanceofusingseveraldifferentchannelsforcommunication,appropriatetothecircumstancesand

thereceiverswasstressed.

“…wemakesurethateveryonegetsthemessageinvariousdifferentformats…Wedon’teverusejustonemedium…Wedon’trelyonthefactthatweemailtoalmosteverywardanddepartment…Wedon’trelyonthatalone.Wealsoputitonthehealthandsafetywebpageandwealsoprintthemoffandputthemon

thehealthandsafetynoticeboards,whichareinthemaincorridorsinallthreehospitals.”(HealthcareOSHofficer)

45

Table3.3 OSHinformationchannelsmostcitedbyinterviewees

Informationchannels



Worker Manager OSH WorkerManager OSH Worker Manager OSH

Training All All All All All All All All All

Verbal All All All All All All Most Most Most

Meetings All All All All All All Some Most Most

Intranet(company-specific)

All All All Few Most Most Some Most Most

Posters Most Most Most All All All Some Some Some

NoticeBoards Few Few Few Most Most All Most All All

Emails All All All Few Most Most Few Some Some

Newspapers/magazines Some All All Some Some Some Few Few Few

Leaflets Some Some Some Few Few Few Some Some Some

Internet(www) Few Few Few Few Few Few Few Most Most

Internetforums Few Few Some Some Some Some None Few Few

Real-lifeexamples None None None Most Most Most None None None

TV/Radio Few Few Few Some Some Some None None None

3.3.1 Training

In the interviews, trainingwas themostoftenquotedknowledgechannelpresented invariousguises; from

simple ‘tells’ to more complex training, encouraging workers to process risks actively and determine

appropriatecoursesofaction. All threesectorsemployeda trainingprocess thatbuiltonschool,collegeor

universityeducationand training,alongwithsome formofprofessionalor trade training,particularlyat the

College/School/University

1Professional/tradetraining

2Newsite/locationinduction

3On-goingCPD/Tool-boxtalks

4

46

start of their working career. Therewas then some form of induction for newworkers, eitherwhen they

joined a particular company or a new work location or site. This training was then supplemented by

continuingprofessionaldevelopmentor‘tool-boxtalks’onspecificissues.

Stage1trainingwasobviouslyvariedintermsofOSHdependingonthetype,levelandqualityofeducationof

the individual. The extent of OSH content in Stage 2 training varied significantly across the trades and

professions.Constructionhasadoptedafairlyuniversal(atleastonlargesites)safetypassport(e.g.theCSCS

card)whichincorporatessomeOSHtrainingrelevanttothespecifictrade.Mostlargeprojectsrequireanyone

who wants to come on site to have the relevant safety passport. All three sectors operated Stage 3

‘inductions’ although content, duration and effectiveness varied considerably. All three sectors had some

Stage4trainingwhichwastaskspecificorrespondedtochangingrisksorrecentincidents.

Some form of ‘new start’ induction training (Stage 3) was used across all three sectors. However, in

constructionitwasmorefrequentforworkersastheymovedfromprojecttoproject.Thiscreatedmoreofa

negativeresponseinsomeconstructionworkersastheyfeltthattheywerehearingmuchofthesamethings

timeaftertime.Thiswasdespitetheacknowledgementofthegeneric‘safetypassports’thatwerebecoming

ubiquitous.Intervieweesstillfeltthatbasiccontentwasrepeatedoneachsite.

All three sectors would then offer task-specific (Stage 4) training as the need arose or, in many cases,

periodicallythroughoutaperson’scareer,particularlyformorerecentstarters.

Both formal and informal worker to

worker training was mentioned in all

three sectors, being perceived as more

credibleasitwasdeliveredbythosewho

understoodthejob(alsoseesection3.9).

Onephysiotherapistexplainedthattheyencouragetwomembersofstaff fromeachwardordepartmentto

buddyupwitheachotherthedeliverthetraining.

Therewere aspects in all three sectorswhereworkers had to adapt training to their specific situationover

time. Logisticsworkersdelivering tohomes couldnot guaranteewhat theywould faceentering thehome.

Constructionworkers’taskoutputonedaybecametheirworkplacethefollowingdayastheyoftenstoodon

thefloorthattheyhadjustconstructed.However,ofthethreesectors,healthcarepresentedgreaterdayto

day, minute by minute changes in environment due to the varying needs of the patients and the serious

consequences regarding patient safety. Thus, healthcare staff in particular had to assess risks dynamically,

adaptingtheirgenerictrainingtothespecifictaskusing‘commonsense’.ThiswasacknowledgedintheTrusts

studied by providing ‘scenario-based training’. However, facilitiesmanagement staff (hard and soft) at the

hospital were trained in a more regimented rule-based fashion as they had less direct interaction with

patients.

“Ourkeytrainersonthewardareessentialbecausethey’reontheshopfloor;they’redealingwiththingseveryday.They

wouldmopuppeoplewhodidn’tfallintothemandatorytrainingornewstartersorpeoplecomingbackwithissues.Wecan’tbeeverywhereallthetime.Soatleasthavingalinkpersoninwardsanddepartments,we’vegotthatcommunication.

(Physiotherapist-onOccHealthtraining)

47

In many cases, where possible, the training was

adapted to take the environment and trainer’s

ability into account. Some interviewees

commented that the ability to train comesmainly

from experience and presence (personality and

communication) and the more senior people are

not necessarily the best trainers. The boredom

factorwasacknowledgedbymanyintervieweesand

effortsweremadetoaddressthechallenge.

Most training seemed tobe top-down,basedonpre-determined topicsandexpectationsofknowledgeand

competence. Oneconstructiondirector recounted toolbox talks thatwerealso supposed to involveworker

engagementbutwherethesitemanagertrainerwasreadingoffapreparedscriptandlecturingtheworkers

rather than asking them about their problems and issues and eliciting ideas for improvement from them.

Notwithstanding,therewereindicationsofadesiretorespondtotheworkers’needs,orperceivedneeds.

Typically, younger workers were thought to respond to training opportunities better than older workers

because‘theydon’tknowanydifferent’whereassomeolderworkerswerethoughttobe‘setintheirways’.It

was also acknowledged that most college and university courses now cover more OSH than was the case

previously and so the youngerworkers (and youngermanagers) are thought to bemore accepting of OSH

inputandfocus.

The importance of practical, experiential learning was stressed. For examplemanual handling was a core

training session for all warehouseworkers and included practical ‘shop floor’ practice. The importance of

havingtrainerswhocould‘actuallydothejob’wasstressed,ratherthanjustOSHprofessionalswhoonlyknew

thetheory.

Muchofthetrainingwasrecordedformally. Forexample,onelogisticsorganisationhadaformalprocedure

with formal training cards for each worker that would be signed off by trainers once training had been

completedandcheckedregularlybymanagersandsupervisors.

“Manualhandling,likeallhealthandsafetytraining,isnotthemostrivetingofsubjectsandwegivethemlotsofdifferentwaysofdeliveringthetraining-notjuststandingtheredoingteachingclassroomstyle.”

(Physiotherapist)

“Ifwecouldfind100personablegoodcommunicatorsweprobablywouldneedtorelylessonoursystemsandourprocedures.EverysinglesitemanagerI’veeverinterviewedhastoldmeheorsheisagoodcommunicator.Therealityissomewhat

different.”(ConstructionDirector)

“Whatweneedtogettoispeoplewhorequesttoolboxtalks.Wheretheworkforceperhapsidentifyissuesandtheywanttointeractwithusatalocallevel.Thatisgoingtorequireoursitestafftobetrainedinthoseattributesintermsof,notonlybeingagoodcommunicatorbutalsobeingagoodlistener,somebodywhocanarticulatetherequirementsofthebusiness,butequallycanarticulatebacktothebusinesssomeoftheissues

theworkforcearefacing.That’swhereweshouldbeat.”(ConstructionDirector)

“Idon’tbelievewritteninformationchangesthewayIbehave.TrainingordiscussionwillchangethewayIbehave…Ican’trecallever(just)readingsomethingandI’vethought:‘OhIcoulddosomethingdifferent

now’.Itdoesn’ttendtolandlikethat.” (ConstructionProjectManager)

48

TherewasaviewthatfacetofacetrainingwasessentialforOSHcriticalissues,ratherthanjustcommunicating

viaemailornewsletter.

Notwithstanding, there was also the acknowledgement of some workers’ reluctance to attend training

sessions,particularlyinconstructionwheremanywerepaidfortheworkthattheydinndratherthanonan

hourlyrate.

3.3.2 Verbalcommunication

Verbalcommunicationwascitedacrossthethreesectorsasoneofthemostefficientandeffectivemeansof

conveyingOSHknowledge. Itwasalsobeneficial incaseswhereworkersneededhelpbutwerenotableor

willing to go through themore formal channels, often due to the urgency of themessage or scepticismof

moreformalchannels.Thistypeofcommunicationflowedinvariousdirectionsandbetweenvariouslevelsof

theorganisationsandnetworks. Facetofacewasthemostpreferredmethodofverbalcommunicationand

thisfindingwassupportedbytheethnographicobservations.Thiswasmoreeasilyfacilitatedinthelogistics

and construction case studies where workers worked in close proximity. However, healthcare workers

(especially ward-based staff) tended to work on different shifts or remotely (community based staff) and

therefore,morecommonlyusedelectronicmediaforverbalcommunication.Butthesemessageswereoften

urgentandinformalandsotherewasnoformalmeansoflearningfromtherelatedincidents.

It is acknowledged that verbal communication, on its own, is unlikely to be effective at maintaining the

accuracyofthemessageacrosscomplexnetworks.But,despitethis,itwasstillfeltthattheactualdeliveryof

themessagetothepersonwhoneededitwasbestdeliveredverbally,facetoface.

Amicrobiologistcommentedthattherewasatendencyforpeopletofilloutaformandthenthinkthatthe

problemhasbeensolved.AnOSHmanagerinconstructioncommentedthat,especiallyonbusyprojectsites,

verbalcommunicationisbettereventhoughsendingemailsmaybeeasier.Hearguedthatthereceivercan’t

“…there'ssomuchknowledgethatwepassdownverballythatit'salmostimpossibletowrite

down…”(Theatrenurse)

“…somethingasbusinesscriticalasbehaviouralbasedsafetycannotbesomethingthat’sjustcommunicatedviaemailorothermethods.Itneedstobefacetoface.Itneedstobeapropersession.Youneedto

workshopitout.Youneedtogetopinions.” (Logisticssafetymanager)

“Talkingtothecommittee,talkingtothemanagers,talkingtopeoplethathavebeeninthebranchalongtime.Justmainly

talking.Communicationreally.Justtalkingingeneraltopeople.That’sreallywhereyoufindoutmostoftheinformationhere…”

(LogisticsCateringManager)

“Youwillgetahugenegativereactiononalotofsitestowantingtodoatoolboxtalk.Itmightonlybe15minuteslong,butthat15minutesisworthcashinthehandtothepeopleonthatsite.”

(Externalsafetyconsultant–construction)

49

gaugeyourtonefromanemail,northeurgencyofthemessage.Aconstructionsitemanageremphasisedthat

the‘vastmajority’ofcommunicationwiththeworkerswasverbaland,unlessitwasaseriousmatterwherehe

wouldputitinwritingand‘fireitofftothecompany’,hewouldleaveitasaverbalinteraction.

3.3.3 Meetings

Almostallparticipantsreferredtomeetingsasachannel forOSH informationandknowledge. Construction

andhealthcaremeetingswere generally formalisedandoccurring at regular intervals atmanagement level.

However, as construction and healthcare priorities changed at site orward level thesemeetingswere less

frequent and more informal. Higher-level healthcare meetings had ward-based representatives, however

attendancewasnotcompulsory.

One healthcareOSHmanager commented thatmeetingsworkedwell

but that itwas difficult to get people together as theywere so busy.

Shethenclaimedthat,eventhoughthemeetingswerenotsoregular,

theinformalnetworkwasstilleffectiveinmaintainingOSH.

Inoneofthelogisticscasestudiesmeetingswereformalisedatalllevels.‘Coms’(communications)meetings

occurredweekly and ranged from suggestions for improving customer satisfaction through toOSH training

briefings. SpecificOSHmeetings included representatives fromthe logisticsworkforcebut,unlike thecoms

meetings,theydidnotincludeallworkers.

One of the construction sites held a monthly meeting called ‘work engagement’ and also fortnightly

subcontractors’meetingswhereeachpartyinthesitenetworkcouldfindoutwhattheothersaredoingand

bringupanyissues.Theconstructionsitemanagerdescribedthesemeetingsas‘focusgroups’.Anothersite

managerdescribed subcontractors’meetingswhere the subcontractorsbroughtup things that theprincipal

contractormaynothaveseenanddiscussedinterfacesbetweenthedifferentfirmsinthesitenetwork.These

meetings discussed day to day developments face to face rather than relying on pre-planned schedules on

‘piecesofpaper’.Anothersitemanagerspokeofthelargenumberofmeetingsontheirprojectsuchasdaily

briefings including a largermeeting eachMonday run by the senior supervisor ormanager. They also had

monthlyOSHmeetingsattendedbyrepresentativesfromallthesubcontractorsandoneoftheOSHadvisors

and risk reviewmeetings at the start of each new phase of the project. They hadOSHmeetingswith the

designers following the Construction Design andManagement (CDM) Regulatory protocols and then finally

weeklymeetingsbetweenOSHstaffandthesiteengineerscoveringeachareaofthesite.

Linemanagersandco-workersineachsectorusedbriefinganddebriefingsessionstoshareinformationfrom

thepreviousworkshiftwiththeirco-workers.Constructionsupervisorsbriefedworkersabouttheday’swork

andansweredanyconcernsorquestions. Workerswerealsoupdatedatthestartofanewtaskandwhere

changes required further information. Clinical and community health staff used briefings to share any

informationthatmayaffectthenextworkingshift,includingOSHinformation,forexample,whereapatient’s

“…ifwedidn’thavesuchagoodinformalnetworkgoing,thenwe

wouldhavetohave(more)formalregularmeetings”(HealthcareOSHmanager)

50

conditionhaddeteriorated andmore staff or different equipmentwas required. Hard and soft FM staff in

healthcarewerealsobriefedanddebriefedbytheirco-workersandmanagers;forexample,whichchemicals,

equipment,orPPEwasmostappropriatetouse.

Logistics linemanagers were expected to brief workers at the start of their

shift and sometimes debrief them at the end, typically taking five or ten

minutesbutoccasionallyuptoanhour.Thiscouldincludeinformationabout

performance, targets, general information and, where appropriate, OSH.

Occasionally, when important issues arise, themanagers will get both shifts

togethertodiscussandagreetheinterfaces.

In one logistics organisation, forthnightly meetings with all the staff on the customer delivery team, were

organisedbythelogisticsmanager,toensurethatcommunicationsonpracticeandpolicy,includingOSH,were

consistent.

3.3.4 Electronicinformation&communication(intranet,internetandemails)

Electronic communicationhas revolutionised societyover the last fewdecades,withmostpeople in theUK

owning a smart phone capableof phone calls, emails and internetbrowsing. These technologieshave also

affectedthewaythatbusinessisdoneinthethreesectorsbeingstudiedinthisproject.

Organisation-specific intranetswereusedtosomeextentacrosseachof thecasestudies inall threesectors

with employees having concurrent access to the internet. Many organisations prevent the use of certain

internet applications such as Facebook or Skype during working time or using work equipment. Most

companieshaveacceptableusepoliciespreventinginappropriateuseoftheinternetoremails.

Inhealthcare,onlystaffdirectlyemployedby theNHShad log-ondetails for theNHS intranet,and thiswas

furthercompoundedasnotallstaffhadaccesstocomputers.Ifcomputerswereavailablethenoftentimewas

an issue as staff were told to access this information outside their normal working hours which,

understandably was often not a priority. Those that did access the intranet noted that, while good

informationwasavailable,itwasoftenmuddledanddifficulttosortthrough,whichaddedtotimepressures.

NHSmanagers used the intranetwidely in search of OSH information, accessing a number of resources to

searchforthespecificissueortasktheyareinterestedin.NHSOSHmanagershadaccesstoacommunications

teamthatperiodicallyplacedOSHnoticesontheintranetsystemtoadvertisenewinitiativesandfacilitateOSH

knowledge flow. Newdirectives inhealthcareare typicallypostedon theNHSorTrust intranet, sometimes

combinedwithascreensaverremindertoraiseawareness.

Company-specific intranet was widely used across logistics,

especiallybymanagers seekingOSHknowledge. Severaldifferent

resources were available and managers could search for specific

“…wehaveastartofshiftmeeting.So,whentheteamcomein,westartthemwithusuallyafiveortenminutebriefing…”

(LogisticsSectionManager)

“Everything’sonour(company)Net.Ifwe’reunsureabouthealthandsafety,alltheinformationisthere.Soit’sjustaclickofabuttonreally”

(Logisticsdeliveriesmanager)

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aspects. Workers also had access to their company’s intranet, but the extent to which they used it was

unclear.

Logisticsfirmstendtohaveinformationpostedontheirintranetsothatallemployeescanhaveaccess.Some

employeeshadaccesstothebroaderinternetandwereabletosearchforthings.Firmshadtheirownspecific

OSHwebpagesandoneorganisationhasanOSHhomepagewhereallthemaintaskriskassessmentscanbe

foundandOSHmessagescanbeposted.MostmanagersfoundintranetsveryusefulforfindingrelevantOSH

information.

Inoneconstructioncasestudyoperatinganumberofsmallersites,onlyseniorconstructionstaffhadintranet

access because of limited electronic media on site and the general prohibition of the site use of mobile

phones.Smallersitesinthiscasestudydidnothavecomputersanyway;thereforeanyinformationhadtobe

faxed through from head office on request. Interviewees

felt that there were pros and cons to this approach; for

example, while information was filtered to meet specific

needs it also meant that there was a delay in receiving

informationandthemethodwascumbersome.

In certaincasesconstructionmanagerswoulduse theirownsmartphones toaccessOSH information. This

practicewasofficiallydiscouragedbutunofficiallyencouragedandtypicallypracticedinthesiteofficerather

thanoutonsiteduetotheusual‘blanketban’onsiteuseofmobilephones.Whilstmanagersarguethatthere

is a sound OSH rationale behind such bans, this suggests that OSH

practice is not keeping upwith the socio-technical reality of people’s

lives,andthewidernetworkswithinwhichtheyareenmeshed.There

aremultiplenetworksatplay,someofthemtechnicallyenabled.

Searches across the wider internet were used to some extent across all case studies. However, this was

typicallybyOSHmanagersandgenerallyonlyvia“trustedsites”suchastheHSEorIOSH. Insomeinstances

searchengineswereusedtofind informationfromothersourcessuchasblogsordiscussionforums. Many

people,especiallyyoungerones,arecompetentandsiftingthrough

the plethora of information available on the internet to access the

necessarydetails.

Emails were widely used across all sectors to disseminate OSH

information tomanagers for wider circulation and were seen as a

time-effectivemeansofcommunication,particularlytoalargegroup

“…weuseourown(phonesforemailandinternetaccess)…Ifwe’vegotanissuethatweneedsorting,weuseourown.It’snotideal.(Constructionsitemanager)

“I’dprobablyhavetolookontheinternetandGoogleit.”

(Logisticswarehouseassistant)

“Youputinyoursearchengine,whatyouwanttofind,youcouldgetalotofgarbledgoothatdoesn’tactuallyrelatetowhatyou’relookingfor,butmostofthetimeyoudo(findwhatyouwant).”

(Logisticssectionmanager)

“Wecommunicatebyemail,somesectionmanagersandDM’scarryBlackberry’ssowegetlotsof

communications.Sometimeswegetthesamecommunicationtwice.Ithinkwemayover-communicateif

I’mhonest…”(LogisticsDistributionManager)

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ofpeople.However,thespeedwithwhichinformationwaspassedonwasoftennotasquickasitshouldbeas

themanagermaybeoutoftheofficeorhavealargeback-logofemailstoprocess.

One problem is the common expectation is for an instantaneous reaction,whereas the reality can be very

different,withotherpressuresandprioritiespreventinganimmediateresponse.Furthermore,asmentioned

previously,smallerconstructionsitesdidnothaveaccesstocomputerssomessagesweresentviafaxwhich

wasslowerbutdidallowthemessagestobemorespecificandfiltered.

A number of interviewees mentioned that they had set up their computers or phones to receive regular

emailedupdatesandnewslettersfromorganisationsliketheHSEorIOSH.Somealsostillreceivedmagazines

andnewslettersinhardcopyformat.

Therewashoweversomepushbackagainstthemovetoelectroniccommunicationandtheuseofintranetsin

particular. Anexperiencedmatronbemoanedthe introductionofapaperlesssystemwhereall thepolicies,

guidelinesandapprovedcodesofpracticewerestoredelectronicallyonthe intranet. Sherecalled the time

when she had to print off the policy and then sign a sheet to say that she had entered it in the file. She

explainedthatnowthestaffaremadeawareofnewproceduresandprioritiesthroughthecascadeoftraining

andtheintranetandtheonusisontheindividualto lookfortheinformationandreadit. Sheclaimedthat,

despiteallthetrainingworkshopsandscreensaverreminders,peoplewerestillgettingitwrong.

Most large organisations in all three sectors recorded incidents and accidents digitally to assist with the

analysisandlearningfromadverseevents.Thisaspectwasnotraisedbymanybuttherewasacommentfrom

ahealthcare interviewee. Amemberofahospitalmedicalphysics teamexplained thathealthcare staffare

supposedtotakenoteoftasksthattheycomplete,asawayoflearningandfeedingbacktotheirpeers. He

thenarguedthattheywerelesslikelytodothisforsomethingthathappenedtothemratherthatsomething

thathappenedtothepatient.Heexplainedthat,ifanincidentoccursthereisaninvestigationwhereallofthe

informationisnoteddown.Whilstrecognisingthefailingsoftheprevioushand-writtenaccidentbook,hefelt

that the use of programmes like Datix 6 has meant that data recording has become slow and not as

transparent. Therewasaconcern thatstaffwouldavoidenteringdata feeling that it couldbeusedagainst

themthroughthedatabasesystem.

3.3.5 Initiativesandcampaigns

Therewasevidenceofspecific, time-limitedcampaignsor initiatives, focussingonparticularaspectstoraise

awareness. A healthcare occupational health manager described the New Year’s resolution approach on

healthandwellbeing linked todrinkingmorewater, taking the stairs, stopping smoking,managing stressor

lookingafteryourgeneralcardiovascularhealth.

Inlogisticstherewereexamplesofmanagerstryingtoraiseawarenessthroughintroducingdifferentinitiatives

suchasthesafeuseofmechanicalhandlingequipment.A‘TruckDriveroftheYear’initiativesoughttoappeal6Datixisariskmanagementsoftwaresystemforincidentreportingandadverseeventsinhealthcare.

53

totheprofessionalismofthedrivers, totakepride inwhattheyweredoingandrecognisethattheirvehicle

hasthepotentialtocausegreatharm.

3.3.6 Noticesandnoticeboards

All the case study organisations used notices

andnoticeboardsasOSHchannels.

Even relatively small construction sites had

notice boards stating key information

includingsuchthingsastherequiredpersonal

protection equipment. Many such boards

also include daily hazards and safety

performancedataandaretypicallypositioned

insuchawaytobeveryvisibletothegeneral

public and workers as they enter the site at

thestartofeachshift.

Constructionalsomakesmuchuseofprinted

posters warning of particular hazards. One

member of the research team on their first

visit to a construction site actually thought that the site had put all the posters up for the benefit of the

research team whereas this was just standard practice. There was some suggestion however, of the

‘wallpapereffect’wheretoomanypostersmeanthatpeopledonotactuallynoticeanyofthem.

One of the healthcare Trusts used ‘shared governance noticeboards’ where issues or incidents that have

occurredarepostedalongwithanemailcopyandpapercopiestoallstaff.This‘beltandbraces’approachis

intendedtoensurethateveryoneisawareoftheissue,however,itcanbackfirewithpeoplegettingfrustrated

by receiving the same information several times. Onematron interviewee considered that itwasbetter to

havesomethingthreetimesthannotatall.

Noticeboardswereusedatallsitesateachofthelogisticsfirms,generallyattheentrance,andwereusedfor

displayinguptodateOSHinformationforworkersandvisitors.Managersalsoagreedwithworkersontheir

views about notice boards, suggesting they were useful for displaying OSH information. Contrary to the

Figure3.1 Sitehazardsboardcompletedregularlybyhand“Wehadadailyhazardboard,whatwashappeningontheday…Whenalltheladswalkedintothesitetherewasthisbigboard,itwasupdatedtwiceaday,morningandafternoon.Becauseyoucanhavesomethinghappeningouttherenowandwithinanhourit’sgone,butit’shappeningsomewhereelse…

(But)nooneknowswhat’sonitbecausetheydon’treadit…Thenoticeisthere,youprobablyfirsthavealookatitandyoudon’tpaynomoreattentiontoit,becauseyou’refocusedonyourownwork.”

(Constructionworker)

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previouscommentfromconstruction,logisticsworkersseemedtoappreciatethelargenumberofOSHnotices

andpostersdistributedaroundtheworkplace,commentingthatitisbetterthanhaving‘oneboardstuckout

inthemiddleofnowhere.’OnelogisticsfirmusedtheOSHboardtoreinforcetheworkoftheOSHcommittee,

havingpicturesofcommitteemembersonshow,whichtheysaidmadeiteasierforworkerstobeabletoraise

issueswith theappropriatepeople. This greater significanceofnoticeboards feltby logisticsworkers could

reflect themore regulated, institutionalised environments in a fixed logistics setting over the temporal and

transientspacesdefinedbyconstructionsites.

3.3.7 Feedback

Most of the previous sections have focussed on channels to communicate OSH from the top downwards.

Theoristsandpractitionersagreethatfeedbackisessentialforfullunderstandingand,inparticulartoachieve

continuous improvement. Furthermore, we also observed OSH knowledge being created by workers and

groups of workers rather than flowing down from the top, which is developed further in the ethnography

section(3.9).

FeedbackopportunitiessuchasworkerengagementonOSH

committeeshavebeenmentionedearlier.Otherapproaches

included the construction practice of ‘close call’ or ‘near

miss’ reporting. Many firms operate a paper system but

some are now experimenting with texting and on-line

methodsaswell asemphasising feedbackviaanopendoorpolicy. AprojectbyCranfield, also in the IOSH

researchprogrammeexplainstheuseofworkerdiariesincapturingsafetypracticesinrealtime(Davidsonet

al,2014).

3.4 StructureandFlow

In this section we describe our findings relating to the

movementofOSHinformationandknowledgethoughthe

network.Asmentionedpreviously,wefoundevidenceof

knowledge being generated insitu, in response to the

environmentandopportunitiespresented(seesection3.9).Notwithstanding,itisclearthatsomethingflows

aroundthenetworkandthatthissomethingcanbetranslatedintoknowledgeleadingtoenactmentatagroup

orindividuallevel.

We asked interviewees about the types of OSH knowledge they used to perform their jobs in a safe and

healthy manner. Across each sector, participants stated that they used both formal (in accordance with

convention or standard practice in the organisation) and informal (a more relaxed, unofficial style) OSH

“Wehavethemanualapplicationofthat(nearmissreporting)whereyoufillinaform.We’vegotatextlineandwe’re

workingonanonlineversionofthat.Andthenwehavetheencouragementof

informalcommunication.There’salotofopendoor.”

(ConstructionOSHManager)

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knowledgetodotheir jobsafely. The formaland informalmodesarecoveredseparatelyhere,however, in

practicethetwomodesoftenbecomeentangledandthisdiscussionisdevelopedfurtherinsection4.2.

3.4.1 FormalFlow

WhereOSHknowledgeandinformationwasfoundtoflowthroughorganisations,ittookanumberofroutes

and was determined, to some extent, by the structure and characteristics of the workplace. All the case

studieshadsomesortofhierarchicalflowstructuredespitetheirnetworkednature.

One logistics organisation was particularly hierarchical, with a clear management structure and a stable

workforce,enablingmessagesto‘cascade’downtotheworkforcewithestablishedchannelsforbothbottom-

upandtop-downcommunication.Theflowofinformationwasassistedbytheorganisationculturewhereby

the hierarchical structure was seen positively as workers felt able to communicate with all levels of

management.

Logisticsrespondentsindicatedthatinformationgenerallycamefromabovei.e.theirmanager,OSHmanagers

or occupational health staff – theywould thenpass this information down to the next level. A number of

channelswereusedtopassinformationon,butemailwasfrequentlymentioned.Intermsofformalupward

communication,channelssuchassafetyand‘comms’meetingswereused,with‘reps’canvasingworkersand

actingasconduitsforcommunicationwithmanagement.

Asectionmanagerinlogisticsdescribedtheprocessinvolvedinestablishingandcommunicatinganewmanual

handling assessment process - The managers assembled as a group and then discussed with the risk

management and safety committee - They then brought together workers and managers to discuss

implementation,timinganddisseminationtoensurethatalltheworkforcewereawareofthenewprotocols.

ThelogisticsmanagerfromanotherorganisationwithglobaloperationsexplainedthatOSHpolicywasagreed

anddistributedonaglobalscalefromtheCEO.Hedescribedhowthisthenfiltereddownintocountriesand

regions to be implemented at a local level. This involved compliance auditing, agreeing operational OSH

controlproceduresandtheextentofstandardisationacrosstheglobalnetwork.Havingthenagreedasetof

OSHproceduresthatwouldfitintotheirOSHmanualtheywouldthenmakethemUK-specificand‘rollthem

outacrosseachsub-sectionofthedivision.’

Workerswouldoftenhavetoformallyacknowledgethattheyhadreceived

(andunderstood) specific training. Constructionworkers typically signeda

sheetafter theirnewsite induction. Logisticsworkershad to sign training

cards to say that they had fully understood their training and how they

should perform tasks in a safe and healthy way (in fact it usually just

focussedonsafetyratherthanhealth).

With the extent of churn in multi-layered project-based construction networks, the challenge of achieving

consistency and accuracy in OSHmessages across the network is considerable. Construction interviewees

“Healthandsafety-you'vegottohavesomethingsignedthatyou’vedone

this…andyoufullyunderstandwithasignature

basically.”(Logisticsmanager)

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explainedthatsiteandtaskchangeswerecommunicateddailytoworkersandnewworkerswerenotallowed

tostartworkuntiltheyhadcompletedaformalinduction.Generally,taskupdatesandOSHknowledgewere

diffusedthroughthesubcontractormanagementstructure,whereas jobupdatesweregivenbytheprincipal

contractor. However, subcontractorswereencouraged toworkwith theirmaincontractoremployersatan

earlystage(pre-tender)inordertocoordinateOSHmanagement.Theflowwasmulti-directionalasworkers

weregivenopportunitytofeedbackaswellastakingpartinformalinductionsandtoolboxtalks(specifictask

inductions).

FormalflowinhealthcareOSHmanagementwasmoresimilartoconstructionthanlogistics.OSHknowledge

and training to subcontractors was given via their employers following Trust approval of material and

methods. However, several respondents noted that minimum standards for the subcontracts often

significantlyexceededminimumTrust standards. Clinical staffweregiven standardOSH trainingwhen they

started employment in the NHS which was subsequently supplemented based on feedback from accident

statisticsandchangingregulatoryneeds.

Despite thecomplexityof thehealthcarenetwork,oneOSHmanager claimed that therewereclear linesof

communicationfromtheOSHteamtothedirectorofsafetyandrisk,throughtothemedicaldirectorandthe

chiefexecutive– ‘noneof that isdiluted’. However, therewas considerableevidenceofdifficultiesof flow

betweendifferentpartsofthenetworkandbetweenthedifferentprofessionsandjobgroupsineachlocation,

oftenexacerbatedbythechurninteammakeupduetoshiftworkpatterns.

In thehealthcare case studies therewas concernover theamountof time

initiatives would take to filter through the complex, network. This was

echoed by a construction site manager who claimed that messages

sometimes got lost ‘by the time it gets through the chain’. He considered

thattheywentthroughtoomanyhandsbeforetheygottothepeoplewho

weremostaffected.

Whilst acknowledging the importance of concurrent informal knowledge flows as illustrated by the

ethnographic encounters, themoreoverthierarchyononeof the logisticsorganisationswas thought tobe

extremelybeneficialandfacilitatedefficientOSHknowledgeflow.However,thehealthcareandconstruction

organisationsweremorecomplexandnetworkedandtherewere instanceswhereattempts toapplya rigid

systemwasnotbeneficial. Forexample, someof thehealthcare respondentsnoted that theorganisational

structure would change quite frequently and it was not always clear who the responsible person was. In

construction hierarchical lines were at times blurred through the many layers of subcontracting. This

highlightstheneedforamoreflexiblemanagementstructureinmorecomplexorganisations.

“(Amanager)sendsittothenextoneandhesendsitouttohismanagerbelowhim.Thenhesendsitouttosomebodyelse…Ittakes

days.”(Constructionsitemanager)

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3.4.2 OSHmessageflowdiagrams

DataFlowDiagrams (Section2.2.1)werecreated forOSHmessages for thecasestudies inall threesectors.

OSHmanagementstaffwereaskedtoprovidedetailsoftheroutesthatOSHmessagestakewithin, intoand

outoftheirorganisations.Thediagramsindicatethedirectionofflowofthemessagesaswellasthestrength

ofthemainlinks.Alllinesshowmessageflowwithboldlinesindicatingstrongflowanddashed,weakflow.

Figures3.2and3.3presentthesimplifiedmessageflowforthetwoconstructioncasestudynetworks.

Figure3.2 Construction1simplifiedOSHmessageflow

Intheconstruction1network(Figure3.2),theGroupH&SDirectorwastheseniorhub,gatheringOSHinput

from a number of external sources, particularly the HSE, the House Builders Federation and the IOSH

construction group. There after there were direct lines of OSH communication down through the line

managementof thenetwork to theBuildingDirectorwhohad specificOSH responsibilities. Fromhere the

OSHmessageswerepassedtothedifferentregionalareasandthentothe100orsoconstructionsites.Here

thesitemanagerwasthekeyOSHhub,interactinginparticularwiththesubcontractorswhoemployedmost

oftheworkers.

IntheConstruction2network(Figure3.3),theGroupHealth,SafetyandEnvironment(HS&E)Directorwasthe

seniorhub,commentingthathetookguidancefromalargenumberof internalandexternalsources. There

was very strong line management input from the CEO and main board and the main strong external

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connectionswerewith legal advisors and specialists groups in the supply chain. The GroupHS&EDirector

dealsdirectlywiththeCompanySeniorLeadershipTeamandtherearestronglinemanagementandOSHlinks

intothedifferentpartsofthecompany,eachofwhichhasanotherHealthandSafetyDirector.

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Company

60

Figure3.3 Construction2simplifiedOSHmessageflow

61

These company directors link through to the sections of the company through their Safety, Health and

EnvironmentManagersandtheindividualsitesandprojects.

TheLogisticsdataflowdiagramsconcentratedonthewithin-companynetworklinks,ratherthanincludingthe

externallinksdiscussedintheconstructioncasestudies.TheLogistics1OSHnetworkflowisshowninFigure

3.4,withstronglinksfromthePLCBoard,directlytotheH&SManagerontheManagementBoard.Thereare

direct line management links with various H&S managers on each site. There are Occupational Health

Managers prividing additional input. The upward flow of OSH messages from frontline workers was

emphasisedbythecontributorstothisflowdiagram.

Figure3.4 LOGISTICS1simplifiedOSHmessageflow

TheLogistics2OSHmessageflow(Figure3.5)showedOSHlinksfromtheGlobalLead,whoalsoreceivedsome

feedbackfromworkers(althoughthemechanismforthiswasnotexplained).TheDivisionalH&SManagerwas

the main OSH hub, with strong input from the equivalent individuals from the other divisions of the

organisation.Therewasstrong,directlinkstotheH&SManagersworkingclosetothefrontlineworkers,along

withstronglinemanagementresponsibilitythroughtheshiftmanagers.

TheLogistics3 intervieweeemphasisedthecentralityoftheH&Sfunctionwithstrongdirect linkstothePLC

BoardofDirectorsandthemainlinemanagementfunctions inthecompanyafterwhichthemainOSHroles

weretakenbylinemanagers.TherewasalesswelldefinedflowfromaspecificOccupationalHealthfunction.

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63

We were able to spend more time focussing on OSH message flow within the healthcare networks and

thereforetheyareshownatamoredetailedlevelfollowingdiscussionswithinterviewees.

TheHealthcare1diagram(Figure3.7)wasdevelopedintermsofhowinformationflowsmoregenerallywithin

ahealthcareenvironmentandnotspecificallyOSHknowledgeorinformation.Theinformalnetworkshapeat

thebottomofthediagramrepresentsinformalinteractionsbetweenthoseinthenetworkwithregardtoOSH.

For example,meeting a colleague in thehall andengaging in a quick chat about safetyor health issues, or

calling up the OSH manager to enquire about a safety concern. In some cases, given the viscosity of

information flow in the formal channels this was a preferred method. The strongest link in terms of

informationflowfromthehospitalwastopatientcaremanagement,inthiscasetheOSHmanagerestimated

that up to 90% of hospital knowledge activities were focused on patient care. However, this was to be

expectedgiventhattheprimaryfunctionofahospitalispatientcare.Thisisimportantbecauseithighlights

theimportanceofpatientcareingeneraloverotherhospitalfunctions.However,ratherthanbedeterred,the

OSH manager highlighted that this can be advantageous in the delivery and flow of OSH messages. For

example,relatingamessagetoaspecificenvironmentortaskorpiggybackingasessionthathasalreadybeen

designatedtopatientsafety.However,thismayagaininvolvetakingadvantageofthe“socialnetwork”.

Figure3.7 Healthcare1simplifiedOSHmessageflow

TheformalstructureoftheHealthcare1hospitalappearedtobeorganisedaroundparticularfunctions.Itwas

feltthatthismayhaveinterruptedknowledgeandinformationflowrelatedtosafetywithinthehospital.For

example, on the left had sideof thediagram services like security and fire safety, services that effectwork

environmentandtaskcompletionweresubcontractedouttoexternalcompanies.Thismeantthattherewere

morebureaucraticlevelsforknowledgeandinformationtoflowthroughasitwaseffectivelyflowingfromone

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company to another and back again. Moreover, there was a need for translation between each specific

company’srulesandnormalisationprocedures.

ThelegaldepartmentwithintheHealthcare1hospitalwasalsopartoftheknowledgeandflowarrangements.

Thisdepartmentmainlydealtwithclaimsrelatingtopatientsafety;howeverwhereclaimsrelateddirectlyto

workers, OSH knowledge and information was fed directly back to relevant departments. Interestingly,

occupationalhealthhadadifferentformalflowstructuretohealthandsafety (which,despitethenamewas

exclusivelysafetyfocussed). Therewassomeformal interactionwherethecauseoftheoccupationalhealth

issuewasrelatedtoworkerhealthandsafety.IntermsoftheflowofactualOSHinformation,fourimportant

factors are described in the diagram: Nursing, IT, Finance, and CorporateMedication/Chief Doctor. In this

particularcasestudynursingstaffactedasanimportantmediumtofacilitatetheflowofOSHknowledgeand

informationtootherhealthcarestaff.Itwasfeltthatthenursingstaffunderstoodtheroleoftheircolleagues

better and therefore found it easier to impart information. This particular hospital wasmoving towards a

moreITbasedtrainingsystemwherestaffwouldtakecoursesonlineintheirowntime.Therewerepositive

andnegativeaspectstotraininginthisway.Ononehandstaffneededtobeflexibletoallowthemtocontinue

theirwardduties,ontheotherhandtheirwarddutiesoftenmeanttheyfounditdifficulttotaketheironline

trainingcourses.Inthiscasestudysomestaffpreferredtheideaofbeingabletoblockouttimetoensurethey

couldcompletethecourse.However,ITfacilitatedtheflowofinformationbyplacingsafetyupdatesontoa

homewelcomepageseenbystaffwhohadaccesstocomputers.Ascanbeseentotheleftofthediagram,

internalcommunicationswerefacilitatedbyacommunicationsteamandthebudgetsforthiscontrolledbythe

financedepartment.InthiscasestudytheChiefDoctorwasalsoanimportantfigure,havingtheauthorityand

presencetoreprimandstaffabouttheirbehaviourinrelationtoOSH.

TheHealthcare2 flowdiagram(Figure3.8)showstheOSHmanagerat thecentreof thediagram. TheOSH

manager inthiscasestudystatedthattheybecameinvolvedinthe“socialnetwork”tofacilitatetheflowof

OSHknowledgeandinformation.Aswiththepreviouscasestudytherewasacertainviscosityassociatedwith

followingmoreformalchannelsofknowledgeandinformationflow.FlowtotheOSHmanagercamedirectly

from the board through the Chief Executive to the Executive Director of workforce andmanagement who

providedamissionstatementtotheOSHmanagerdescribingtheTrust’sneedsinrelationtoOSH.TheOSH

manager’sjobwastoputthismissionstatementintoaction.Variouschannelswereusedtofacilitatetheflow

ofthisOSHknowledgeandinformationaroundtheTrustforexample,onestopshops,E-LearningandAd-hoc

eventsalltofacilitateaparticularOSHinitiative.Formally,eachoftheclinicalandnon-clinicaldivisionsatthe

hospitalwere representedat regularOSHcommitteemeetingsattendedbymanagers. In termsof training,

the OSH manager had direct contact with the head of learning and education who validates and certifies

training courses to ensurequality andmeet theoverall Trust needs. TheOSHmanager also collecteddata

fromdivisionswithinthehospital toproducereports for formal feedbackonOSHperformancetomanagers

anddirectors. OSHcommitteeswerepresentateachdivisional level;eachof thesecommitteeshad formal

meetingswiththeOSHmangertodiscussOSHissues.

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Figure3.8 Healthcare2simplifiedOSHmessageflow

InitiativesweregenerallyimplementedviatheQualityImprovementLeads(QILs)whoensuredthatinitiatives

were implementedwithqualityandsafety targets setby theTrust,particularly in relation topatient safety.

Given that the hospital had a collection of specialities, therewere several uniqueOSH needs, for example

radiation risk to radiographers. In the bottom right of the figurewe show several health groups set up to

addresstheseneedsandfacilitatetheflowofOSHknowledgeinformationtoandfromtheOSHmanager.

TherewasalsoaninterestingarrangementfortheFacilitiesManagement(FM)staffonsite. Thiscasestudy

wasbuiltandoperatedviaaPrivateFinanceInitiative(PFI)and,althoughtheTrusthasaFMdepartmenton

site,thisfunctionsinamanagementcapacitywiththeFMworkcompletedbythePFIcontractorandaseries

of subcontractorswith theirownOSHmanagersandprovisions. Technically thehospitalOSHmanagerwas

not responsible for the contractorsOSH,but as theyworkedon site they still needed tobe involved in the

communicationchain.RegularformalmeetingswereusedtoupdatetheOSHmanagerandensuredaytoday

FM activities would not impact on the overall OSH management of the Trust. Finally, the OSH manager

attendedaseriesofexternalgroupsandmeetings.Thiswasnotedasbeingthebestwaytodiscusswithand

learn from peers as, in this particular Trust, the OSH management team was relatively small with only a

managerandanassistant.

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3.4.3 InformalFlow

All of the sectors acknowledged the importance of informalOSH knowledge flow. Healthcare respondents

notedthatarrangementswereveryconsensualandtookalongtimetoflowthroughthesystem.Theflowof

information was largely facilitated by key staff members and groups within the organisation despite an

apparentrobustmanagementsystem.Healthcarerespondentsnotedthat,inthistypeofenvironment,faceto

facecommunicationandsocialinteractionwereamongthemostimportantwaystofacilitatetheflowofOSH.

One theatre nurse described informal training

of more junior nurses as ‘passing on your

inheritance’ and she acknowledged the

‘massive amount of knowledge’ which they

classed as experience and it is ‘nowhere

writtendown’.

Mostof the construction sitemanagerswereproactive, employingdaily face to face interactionson site to

monitorOSH initiatives and speed the transfer ofOSH knowledge on site. Interestingly,workers indicated

that,becauseof the frequentupdatesand ‘all encompassing’ training, theyweremoreawareof, andmore

likelytodiscussOSHthanwaspreviouslythecase.

Someconstructionintervieweesbelievedthattherewasaninformaltransferofknowledgeandgoodpractice

betweensitesandbetweencompanies,particularlyfromlargetosmallorganisations.

OSH message flow in logistics was also facilitated informally; for example, workers could draw on their

informalorganisationalnetwork,includingco-workerswhowereperceivedtobeexpertsinthearea(although

theymaynothaveformalOSHresponsibility).The‘keenies’mentionedearlieroperateinaninformalmanner

whetherornottheirroleisacknowledgedformally.

I'vegotateamoffairlyexperiencedpeople…someofthemhavebeenwithmefor15yearsandwehavejuniorswhocomealong.Andit'salmostlikepassingdownyourinheritance.SothestuffthatIknow,youknow,I'vepasseddowntomyslightlymorejuniorstaffandthey

passitdowntothenextlevel.(Theatrenurse)

“We’llgettheladstogetherminusthesupervisors,onetoone,andbasicallywejusthaveachat…likewe’redoingnow,offtherecord,like.‘Haveyougotanyissues,lads?Isthereanysuggestions?Isthereanything

we’redoingwrong?’Anditalwaysamazesmehowmuchtheypickupon.Butthereisoftenaculturethatthey’refrightened,ifyoulike,somethinkthere’sgoingtoberepercussions...(But)I’dsoonerhaveitsaidtherethangoawayandsay,‘Well[companyname]didthis,[companyname]

didthatanddidnothingaboutit.’Well,tellusguys,andwe’lldosomethingaboutit”.(ConstructionSitemanager)

“’Fredthebricklayer’,iscurrentlyworkingonabig(BigFirmName)siteandisrequiredtox,yandzandhasbeentocollegebecausehewasworkingforabigcontract–abigbricklayingcontractorthatworkedfor(Big

FirmName)…andhasthereforebecomeaccustomedtodoingallsortsofthings.Andthenhegoesoffandeitherstartsworkingforasmallercontractoronmuchsmallercontracts,orgoes

andsetsuphisowncompanyandthatknowledgegetsspread.”(ExternalOSHconsultant–construction)

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In logistics, respondents raised issueswhere themessagewas seenas linguistically complex anddifficult to

interpret and apply. Thiswasmore likely to affectmanagers,who then translatedOSH knowledge into an

understandable form for the workers. When managers or workers received something that they did not

understand they typically relied on co-workers, subordinates, managers and OSH managers to help them

translatethemessageintosomethingcomprehensible. Theywouldoftenhaveconversationswithpeople in

theirnetworktoseeiftheyhadunderstoodmessagescorrectlyandmakeitpertinenttotheirworkarea.In

termsofaidingunderstanding, thefollowingfactorswerehighlighted: thescopetoaskquestions intraining

sessions;competenttrainers;frequentreinforcementofmessages;hands-onpracticaltraining;multi-channel

reinforcement;shocktacticsandrealworldexamples;visualandverbalchannels; informationtotakeaway;

andworker-to-workertraining.

In addition, more subtle informal flow included observing how others

work. This phenomenon is more difficult to track, because the only

evidenceofthistypeofknowledgetransferisindividuals’recollectionof

events.Thisaspectisexploredfurtherintheethnographysection3.9.

Informalcommunicationwasseenasameansofspeedingupanenquiry(evenformoreseriousissues)andas

aformofknowledgeflowfromworkerstomanagers(abottomupprocess).

Somesectorsencourage‘near-miss’or‘close-call’reporting,althoughthisisoftenastruggletogetworkersto

takepart.However,mostincidentswereinvestigatedinsomewayand,ingeneral,paperworkwascompleted

following the informal discussions. However, evidence suggested that this was not always the case if the

potentialoutcomeoftheeventwasnotconsideredtobeserious.

3.4.4 Flowtotemporary/contractworkers

Temporary,agencyorbankworkerswereusedineachofthesectors.Inhealthcareitwasgenerallytheward

manager who trained the staff or provided necessary OSH knowledge and for FM staff it was their line

manager. Construction labour-only subcontractors are often used to facilitate specific tasks and logistics

subcontractors (who are also effectively labour-only organisations) are used to cover busier periods.

Generally, the impactoftheexternalorganisationalcultureandtheambiguousstatusoftemporaryworkers

wereunclear.Thisaspectisdevelopedfurtherinsection3.6.3.

Despitesomeprotestationstothecontrary,inmostorganisationsthere

was considerable variation in training depending on whether the

individualswereemployedbythemainorganisation inthenetworkor

byasubcontractororsupplier.Inparticular,employeesoflabour-only

contractorswerethoughtbymanytobesecond-classcitizensinterms

oftraining.Forexample,permanentNHSstaffattendedformalgeneric

NHSOSH training courses,whereas subcontractors or temporary staff

“…especiallywhenyougotoanewarea,it’seasiertowatchotherpeopletoseewhatthey

do.”(LogisticsDepartment

Manager)

“Anybodywhostarts…that’sbothagencystaffornew

(directemployees)aregiveninduction.Theagencystaffhaveprobablyalittlebitless

induction…butthey’reobviouslyshownallthesitefireexits,fireprocedures,healthandsafetyprocedures.”

(Logisticswarehouseassistant)

68

receivedtrainingeitherfromtheiremployeroradesignatedNHSstaffmember.Inonelogisticsfirm,workers

commented on the high level of training that would be delivered for both permanent and agency staff.

However,permanentstaffwouldalsobeexpectedtoparticipateinfurther,ongoingtraining.Unsurprisingly,

managersstatedthatagencystaffweretrainedtoanadequatelevelsothattheywereabletoconducttheir

jobsafely.

Although these workers were checked for competence and often paired

with a ‘buddy’ to train them (particularly in logistics), it was not always

clear what prior OSH knowledge agency workers had. This presented

challenges for the networked organisation in deciding what additional

trainingwas necessary. Interviewees stated that, once theywerewithin

theorganisation,temporaryworkersreceivedpertinenttraining,often‘on

thejob’.

Inconstruction,thesiteinductioniscommonforallpeoplenewtotheproject,buttheunderpinningtrainingis

likely tobeverydifferent,particularly for temporaryoragencystaff. The introductionof ‘skills certification

cards’incorporatingacertainlevelofOSHtraininghavestartedtoimprovethissituationsomewhatatleastin

termsofabaselevelofcompetence,althoughnotparticularlyrelatingtomorespecific,bespoketraining.

3.5 InfluencingFilters/Membranes:ConflictswithOSH

Inasimple,idealworld,theOSHmessagewouldbetransmittedfromareliablesource

throughaneffectivechanneltoareceptivereceiverwhowouldaccuratelyprocessit

and enact it appropriately. There aremany other aspects that will affect how the

receiverprocessesthemaintask-specificOSHmessagealongwithalltheotherrelated

‘messages’.Wehavedescribedtheseaspectsasfilters,ormembranes,throughwhichthemessagesmustpass

and which will affect how the messages are translated and processed and eventually enacted. In reality

however,thesethingsarenotdiscerniblefilters,butcanbemorelikeafogthroughwhichthemessagespass

andcanbe changedandcorruptedor, in somecases, improved. In themain, the individual receivershave

littlecontroloverthesefilters.Theseaspectsareexploredfurtherinsection4.

Inthissectionwecover“conflicts”,referringtootherprioritieswhichconflictwithOSH.Thesearecausedor

strongly influenced by either the situation or the individual and have implications for OSH enactment and

behaviour. As such, all of themare, to someextent,personalisedand internalisedby the individual, either

consciouslyorsubconsciously.

“They(temporaryworkers)shouldbetrainednormallybytheagencybeforetheyevencomeintothewarehouse.Astowhattheagencytrain

themIdonotknow.Sowewilltrainthemagain

anyway.”(LogisticsSectionManager)

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3.5.1 Conflictingresources–timeandcost

Weaskedintervieweestogivereasonsforunsafebehaviour. Avarietyofresponsesweregivenbutthemain

oneswerepressure,rushingandperformancemeasures.

InconstructionandlogisticsOSHconflictswerelargelyrelatedtoperformanceandtimepressures.Although

workers felt that therewas a genuine concern for their safetyon site they also saw conflict between time,

planning and cost commenting that thismay affectworker behaviour approaching deadlines. Workers felt

that it was difficult to get something done during their shift and would therefore “cut corners” or use

“workarounds”togetthejobdone(SeeSection3.8.2).

Rulescansometimesconflictwiththespeedneededto‘getthejobdone’.Howeveramiddlemanageratone

logisticsfirm,whilstacknowledgingthetemptationtocutcorners,opinedthatmanagersandworkershavethe

understandingtoknowthattheymustfollowrulesevenifittakeslongerorisslightlymoredifficult.

However,therewereexamplesoflogisticsworkersbeingtimedtodo

particular tasks which they believed caused them to make

adjustments in theway theyworked and lessened the priority that

they put on OSH. Limited storage space meant that some had to

workinconfinedandrestrictedspaces,especiallyduringbusyperiods

when more stock needed to be moved in a shorter period. One

logisticssitehadproblemswithspaceowingtotheturnoverofitems,

whichalsowasexacerbatedduringbusyperiodssuchasChristmas.

Warehouse workers working with pallet trucks explained that, at busy times there were more trucks and

hencelessavailablespace,leadingtoconflictsbetweenOSHand‘tryingtogetthepercentagethattheyshould

beon’.

Busy periods were often mentioned as the

time when ‘short cuts’ would be taken and

wherethingsdon'talwaysgetdonesafelybut

havetogetdoneinordertomeettargets.

TheconflictbetweentheOSHneedsofthehealthcarestaffand

the safety of the patient is covered later (Section 3.5.5).

Healthcare interviewees explained that this conflict is

exacerbated when the wards are understaffed due to cost

constraintsbecauseoftherestrictionsonhealthcarebudgetsat

localandnationallevel.Theperceivedenormityofthechallenge

wasobviousinseveralinterviews.

Hospitallaboratory-basedstaffrelyonclinicalstafftoprovidesufficientinformationaboutthesampletheyare

testingsothattheycandotheirjobsafely.However,abiomedicalscientistexplainedhowtimeandpatient

“Thespacedeterioratesandyougetlessworkingspaceturningareas.Yougetmoredamagedstockwhenyourturningareasaredecreased.Whenit’sreallybusypeoplestartrushingaroundtoomuch.Someofthosebasic

thingslikesoundingthehootergooutthewindow.”(LogisticsManager)

“Whenitisbusythere’sabitmoreemphasisongettingthejobdoneoverhowsafeitis…It’smoreaboutspeed…notallthetimebutsometimesitseemstobe…theonlywayyoucanmeetthetargetsthattheywanttosortofsetisby

cuttingcornerssometimes.”(Logisticsworker)

“Ihaveateamthatlookafterhealthandsafety,butwehavenearlyten

thousandstaffwithintheorganisation.Wetakethesafety,careandhealthofthoseveryseriously,butwetreatamillion

patients...”(Directorofclinicalriskandsafety)

70

demandsonthewardmayinfluencethis.Adoctorwasundertimepressureandmadesomeerrorsonaform

requestingsomebloodandurinetests.Theerrorwastoomitthefactthatthepatienthadbeenvisitinga

particularcountrywhichwouldhaveclassifiedthesamplesas‘highrisk’.Asaresultanumberoflaboratory

staffhadtohaveaprecautionarycourseofantibiotics.

Construction projects are typicallyworking to tight time schedules and the subcontracting culture tends to

pass the time pressure down the network through the subcontractor to the frontline workers. Many

constructionworkersarestillpaidonbasisoftheworkthattheydowhichcancreateaconflictwithOSH.

3.5.2 Conflictingcultures

Itwas apparent inhealthcare and construction that therewere several sub-cultureswhichmeant thatOSH

messagescouldbecomedistorted.

Eachof the construction case studieswas implementing anOSH culture

programme but, given the transient nature of the industry, this proved

incrediblydifficult.Subcontractorswhoworkedforshortperiodswere,at

times,unwillingtoaccepttheoverallOSHcultureofthesite.Therewere

someexceptions to this; forexamplewheremorehazardous taskswere

beingdonesuchasgasequipmentinstallationwhichiscloselyregulated–

subcontractworkersseemedtobemoreopentosuchprogrammeswhere

theysawthattherewasanobvioussignificantrisk.

Anumberofhealthcarerespondentssuggestedthattherewere‘severalOSHsubcultures’orseveralgroupsof

peoplewhohavedifferentideasorunderstandingsabouttheimportanceorrelevanceofOSHwhichcancause

multipleissuesintermsofworkersafety.Thiswasconsideredespeciallytruewherestaffwerepatient-facing.

Therewereexamplesofconflictbetweenclinicalandnursingstaff.AnOSHmanagerdescribedasituationon

herfirstdayatwork,whereadoctorhadtoldawardsistertogetthenursestocarryabariatricpatienttothe

X-raydepartment.Whentheyrefusedonthegroundsofmanualhandlingrisks,thedoctorbecameindignant.

ThenursesweresupportedbytheNHSmanualhandlingexpertwhowascalledinforadvicebutitillustrates

someofthetensionbetweenthedifferentprofessionalgroups.

Healthcare is a complexwork environmentwhere staff have differentOSH cultures dependant onwhether

theyarepatient-facing (including the typeofpatient)ornot,aswellas theirownparticularOSHneedsand

priorities. This makes it difficult to portray a consistent and unified OSH message and affects their OSH

informationandknowledgerequirements.Forexample:

“It’ssomethingmorethanknowledge…Peopleknowtherules.Peopleknow

what’sexpected.Buttheydon’tquitebelieveinitanddon’tquitegetitanddon’t

quitewanttodoitsometimes.”

(ConstructionProjectManager)

“…themajorityofpeopleonsite…arepaidbytheamountofwalltheylay…theamountofhole(they)dig…theplumbingthattheyinstall.Soit’salwaysaboutspeed,it’salwaysabouthowquicklycanIgetthecablingintothishouse,howquicklycanIlaythiswall…anythingthatprovidesadelaytothatisviewednegatively.”

(ExternalOSHconsultant:construction)

71

• Lab-basedstaffworkunderstrictOSHregulationbecausetheyoftenworkwithcontagious,biological

samples;arenotpatientfacing;andtosomeextenttheirworkloadcanbemanaged.

• Ward-basedstaffworkindynamicenvironmentswheretheconditionofpatientsmaychangerapidlyand

canaffecttheirworkload.

• Doctorsarepatient-facingbutoperateunderadifferentmanagementstructuretothenursingstaffand

donotseemtohavethesamebackgroundlevelofunderstandingofOSHissues.

• Facilitiesmanagementstaffworkwithinthehospitalenvironment,comeintocontactwithpatientsbut

arenotpartoftheimmediatecaresystemsoarelessaffectedbypatientissues.

• Community-basedstaffworkindynamicenvironments,thatarepatient-facingandoutsidethemore

controllableconfinesofthehospital.

Therewaslessofanissuewithsub-culturesinoneofthelogisticsfirmsdespiteoperatingacrossseveralsites.

Theorganisationwasdescribedashavingasinglecultureamongstallworkerswhethertheywerewarehouse

workers,managers,middle levelorseniormanagerstheywereallableandencouragetocommunicatewith

oneanother.TherewasaconsistentOSHmessageinthisorganisationandallworkerintervieweesknewthe

reasonsforOSHandtheneedtoconsidertheirownandothers’OSHneeds.OSHhadbecomeaugmentedinto

theorganisational cultureandwasactively seenaspartofworkingpractices,workers andmanagerswould

develop standardoperating procedures togetherwhich sought to developworker acceptanceofOSH. This

ethoswasonlychallengedduringverybusyperiodswhenmanyagencyworkersweretypicallytakenonand

permanentworkerswouldnoticeanincreaseinviolationsofstandardoperatingprocedures.

InanotherlogisticsfirmeachsiteoperateditsownOSHsystemsasaresultof

thestructureandsetupoftheorganisationwhichhadbeenhighlightedasa

potential problem by the senior OSHmanager. Thismeant that, unlike the

firmdescribedabove,siteswereallowedtooperatetheirownOSHprocedures

with site OSH managers reporting to site line managers not group OSH

managers. Thiscanpresent issuesoverresponsibilityandhindertheroll-out

ofOSHinitiatives.

3.5.3 Conflictingor‘overthetop’rulesandprocedures

In certain construction cases the client, contractor and subcontractor all had a separate set of rules and

procedurestodealwiththesameissue.Thismaybebecausetheyareallrequiredbylawtomakeprovisions

toprotectworkers regarding that issue; however the legislationdoesnotprescribehow it shouldbedone.

Intervieweesexplainedthatthishadcausedconfusionforthepersondoingtheworkwhenfacedwithseveral

setsofprotocolsthatmayallbesatisfactory indealingwiththe issuebutmaytackle it indifferentways. A

construction sitemanager described the confusion caused for a subcontract crane driverwho had his own

company’sgenericriskassessmentwhichappliedtoanysite,whereastheprincipalcontractorhadtheirown,

more specific, requirements which also incorporated the client’s rules which weremore appropriate for a

“…it’squiteachallengegettinggroupinitiativesintositesbecausetheyobviouslyprioritisesiteactivitiesasopposedto

groupactivities.”(LogisticsOSHmanager)

72

permanent industrial environment rather thana construction site– therewas somedebateoverwhich risk

managementplanshouldbeused.

HealthcareintervieweesexplainedthatrulesweretechnicallythesameforOSHacrosseachTrustnetwork.In

theory there is no conflict between patient safety and healthcare staff OSH, but the enactments are very

different,creatingmanyconflictingpriorities(seesection3.5.5).

There was a spectrum of the degree of rule and procedure standardisation in the logistics organisations

dependingontheirdifferentorganisationalstructuresandcultures.

Unnecessary,bureaucraticpaperwork

Several construction interviewees commented about the increase in (what they considered) unnecessary

paperwork required to show that OSH procedures were being followed. Whilst this is not truly a case of

conflicting rules, it does illustrate the tension between assurance and bureaucracy. One of the reasons

suggestedforthisextrapaperworkwasthatinsurancecompanieswanttheemployerstorecordeverythingso

that,ifworkersorthepublicmakeaclaimagainstthemthereislessofaproblem.Workersfearedthatthey

couldbecomeoverreliantonthepaperworkandnotlookforrisksintheiractivities.Methodstatementswere

ubiquitousandsomeintervieweesfeltthattheywere‘overthetop’andonlyusedtopasstheblameonshould

anythinggowrong,supportedbytheprocedurerequiringworkerstosignthattheyhavereadthedocumentor

understoodthebriefing. Thissuggestsa linkwiththeconflictingculturessection. Theconflictoccurswhen

theruleorprocedureitself,althoughintendedtosupporttheOSHoftheworker,actuallycreatestheopposite

responsewhereworkersrejectthe‘overthetop’approachandsomaymisstheimportanceoftheinitialOSH

message.Anumberofconstructionoperativesfeltthattherewastoomuchrepetitionofthesamerulesand

procedureseventhoughtheworkerswereveryconversantwiththem.

The contrary experience was evidenced at one logistics organisation where all levels of workers and

management were involved in developing the standard operating procedures and they were seen as

somethingusefulandwereregularlyupdated.

Notwithstanding, bureaucratic form filling or report writing was

criticised by a number of interviewees. One healthcare example

dealtwithdecontaminationofequipmentwhere ‘everyonehas to

fillinaformtosaythattheequipmenthasbeendecontaminatedin

acertainway.’But,becauseofareactionagainsttoomanyformsitbecame‘atickboxexercise’andoftenthe

equipmentwouldbesentfromtheclinicalwardtotheworkshopwithouttheformwhichwouldthenbesent

Theyhavetosigntosaythattheyunderstooditbeforetheywentbacktotheworkplace.Wedothoseeveryweek,morethanonce.There'squitealotofpapersigningtodobutIthinkthat'sjustthenormnow.Yeah,Imean,ifthey'resigningtosaythey'veunderstooditthenthey'vegotnoexcuseforgoingoutthere

anddoingsomethingwrongandsayingtheydidn’tknow.”(Constructionsupervisor)

“…Itbecameatickboxexercise,whichisashame.”

(MedicalPhysicsteammember)

73

afterwardsbutfilledoutinaverygenericway,leadingtotheworkshopstaffnottrustingthattheequipment

hadactuallybeencleanedanyway.

AnOSHmanagerinoneoftheTrustscommentedthat

the repeatedwriting of reports and filling in of forms

waspreventingpeoplefromgettingonwiththework.

Conflictinginitiatives

ManyorganisationshaveperiodicOSHinitiativeswheretheyhaveafocussedcampaignonaparticularissue.

Theyalsohaveacorporatehousestyle forposters, flyersandemails. Therewasa suggestion that this can

sometimeshinderthetimelydisseminationofOSHissuesthatdonotfitwiththecurrentinitiative.

In both healthcare case studies the flowofOSH knowledgewas facilitated by an in-house communications

team. However, the provisionof guidance and trainingmaterialwas held back to ensure that itmet Trust

requirements.Forexample,proposedOSHpostersforawardwere(understandably)heldbackastheydidnot

meet the requirements to be ‘wipe-clean’ and ‘splash-proof’ to stop the spread of infection. However,

informationmust also be checked by hospitalmanagement and directors to ensure that it aligns with the

Trustsspecifieddirectives. Thiscanbeanissueas itaffectshowquickly important informationandlearning

canflowaroundtheorganisation.However,thesocialknowledgenetwork,wherepeoplehavecloseworking

relationships,facilitatestheflowofthisinformation,albeitinahighlyunregulatedway.Thisemphasisesthe

needforbothformalandinformalnetworkstoworkinconcert.

3.5.4 Conflictingenvironments

A director of risk in one healthcare Trust explained the different

environmentsinvariousdepartmentsastheyaffecttheOSHculture

andtheriskstohealthcarestaff:

Outpatientclinic:

• Presentsaverylow-riskenvironmentintermsofthepatients

• Thepatientsareself-caringandmobileandarenotresidentwhichposeslessofarisktostaff

• Theclinicisalight,brightenvironmentwithnotalotofcomplexequipment,largelyoperatinginthe

daytime.

IntensiveCareunit

• Patientsareimmobileandneedalotofhelpwithmovingandhandling

• Muchcomplexequipmenttonegotiateandhandle

• Operating24hourswithnight-timeworkingpresentingadditionalrisks

“Intermsofstaffsafety,risksareverydifferentinthedifferent

departments…”(HealthcareDirectorofrisk)

Thereisthisobsessionaboutreportwriting…Whydoyouneedtowriteareportoneverything?

Let’sjustdoit!”(HealthcareOSHmanager)

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ThismakesitdifficulttohaveaconsistentOSH

messageacrossallhospitaldepartmentsand,in

turn, there is a tendency to focus on the

highestriskswithintheorganisation.

HospitallaboratorystaffconsideredthattheyhadastrongerOSHfocusandweremorelikelytocomplywith

protocols because they work in a lab environment which is regularly handling hazardous samples and

chemicals.

3.5.5 Conflictingpriorities-Thepatient

“PatientSafety”isamajorfactorthataffectsOSHknowledgeflow

translationandenactmentinthehealthcaresector.Forexample,

whiletheOSHofhealthcarestaff istakenveryseriously, interms

ofOSHknowledgeflowthereisapragmaticbalancethatisusually

struckbetweenpatientriskandworkersafety.

A ward nurse acknowledged the tension but explained that fairly recent

changes in the approach had started to correct the imbalance and putmore

emphasisonemployeeOSHratherthanpatientsafety.Nevertheless,therewas

also a general feeling among interviewees that certainhealthcare staffwould

choosepatientsafetyovertheirown.Manyhealthcareworkersconsidertheir

role as a practical, hands-on vocation rather than ‘just a job’ and feel

passionatelyabouttheirresponsibilitytocareforthehealthandsafetyoftheir

patients.Often,nurseswouldusethephrase‘mypatient’,illustratingtheirpersonalcommitment.Inaddition,

varioussuggestionswereputforwardtoexplainthepatient-centricfocus.Forexample,fearthatpatientinjury

would result inmore serious repercussions thanworker injury. Lack of understandingofOSH rules among

healthcareworkersandtimepressureswerealsomentioned.

Severalparticipantsalsonotedthatbuildingupacloserelationshiporrapportwithpatientsisvitaltoallow

themtodotheirjob.Itestablishesadegreeoftrustintherelationshipthatfacilitatespatienttreatment.In

thissenseitisalsointerestingthataseparateriskassessmentisconductedforthepatienttoallowthe

healthcareworkertomakejobandtaskadjustmentsthatfacilitatethepatient’ssafetyandtheirown.Building

rapportwithapatientallowstheavoidanceorde-escalationofstressfulsituations.Patientriskassessments

shouldensurethatthecorrecttoolsandequipmentareavailableforthejob.However,eveniftheworkis

planned,buildingarapportallowsthecarertomanagethesituationbetterifthepatient’sneedsorthe

conditionschange.

Acommunitymidwifeexplainedtheprocedureofnotificationofadditionalriskswhenvisitingcertainpatients

inthecommunitybutalsostressedthatshealsohadtobeconsciousoftheunknownrisksthatnoonewas

“…havingoneconsistentmessage(is)quitetrickyinanorganisationlikethis…it’saverydifferentwork,with

verydifferentclients,withverydifferentstaffoperatingatdifferenttimesofthedayandnight.”

(HealthcareDirectorofrisk)

“Peopledogenerallyputthepatientsfirstbecausethey’recaring,whichcanbeaproblembecause,youknow,they

areputtingthemselvesatrisk,sometimesunnecessarily.”(HealthcareOSHmanager)

“…theattitudeofthisparticularmidwifewasthatdeliveringthatbabywasmoreimportantthanherownlife,you

know.Andshe’swrong,butthat’sherculture.”

(HealthcareOSHManager)

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awareof.Thisaspectisexploredfurtherintheethnographysection(3.9).

Employershaveadutyofcaretoprovidemanualhandlingtrainingandnursesaretoldthatifapatientisabout

tofalltheyshouldguidethefallertothefloorandnotattempttoholdupthepatient.However,nurseswere

describedasbeingdedicatedand caringandputtingpatient safetybefore theirown. Inone case, a young

nursewassufferingfrom“frozenshoulder”asshehadtriedtostopanelderlypatientfromfallingand,inher

opinion,‘breakingbones’.

3.5.6 Conflictingpriorities-Thecustomer

Generally,thehealthcareworker’scustomeristhepatientandthatissueiscoveredintheprevioussection.

Some logisticsworkers considered that the focus onperformance for the customermeant that their needs

weresometimesputaboveOSHneeds.Anoperationsmanagerinalogisticsorganisation,havingaparticular

campaignabout increasingcustomerservice,explainedthatdriverswereambassadorsontheroadandthat

deliverystandardshadbeenestablishedincludingthatTVswouldbesetup,washingmachinesconnectedand

bedsbuilt. Adeliverydriveraddedthatthis increasedcustomerservicewasimportantbutthatitdidcreate

somethingofaconflict.Hesaidthatworkerswerenotsupposedtogivetheimpressiontothecustomerthat

theywererushingjusttogetthejobdone.So,insomeways,theincreasedcustomerfocuscreatedanOSH

conflict for delivery workers. Notwithstanding, the impression from the ethnographic studies was that

customerdeliveriesworkersfelttheyhadautonomyandinstitutionalsupporttonotputcustomersatisfaction

abovetheirownneeds– i.e.to ‘fail’adelivery if theirOSHwascompromisedandthis isexploredfurther in

section3.9.

Theconstructioncasestudysitesdidnotgenerallyhaveanydirectinteractionwiththecustomer.Thisaspect

ismorerelevanttoourparallelprojectwhich isconsideringmicroorganisations,whereconstructionwork is

often done in people’s homes. However, the residential building sites in this project do still have some

interactionwiththecustomerwhencertainhousesonanestateareoccupiedwhilstothersarestillbeingbuilt.

However, intermsofOSH,this is likelytohaveapositiveeffectwiththeexpectationthatthesitewouldbe

kepttidierwhenmembersofthepublicwereinthearea.

3.5.7 InterfaceConflict

Healthcarestaffhighlightedthat,at interfaceareassuchasbetweenthelabandtheward,safeworkingwas

moredifficultbecausetherewasalackofunderstandingbetweenthedifferentstaff.Forexample,amember

of the medical physics equipment maintenance team noted that equipment was arriving to their lab

contaminatedwith blood and other biological substances despite a procedure circulated toward staff that

theycleantheequipmentinadvanceofmaintenancework.Themaintenanceteamsaidtheywereforcedto

use a workaround where they wore PPE before they cleaned the hazardous equipment themselves. The

clinicalstaffcitedtimepressureasthemainreasonfornotcleaningtheequipment.

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Inanotherexamplealab-basedmemberofhealthcarestaffstatedthatclinicalstaffwerenotfillinginsample

informationclearly.Formswereeitherincompleteor,astheywerefilledinbyhand,weredifficulttoread.At

this timethis formwastheonlymethodto instruct labworkersabouthowcontaminatedthesample isand

which PPE or equipment they should use. To be ‘better safe than sorry’ they have decided to assume all

samples are the most hazardous and therefore apply the highest level of OSH standards. Curiously, this

workaroundwasonlyinitiatedfollowinganincidentinthelabwhereahighrisksamplewastreatedaslowrisk

(thepaperworkhadnotbeencompletedproperlybytheclinicalstaff).Theriskofinfectionwassohighthat

allsamplesinthelabhadtobedestroyed,thestaffmedicatedandthelabshutdownfortwoweeks.

Thechallengesforconstructionorganisationsattheinterfacesbetweendifferentsubcontractorshasbeenwell

documented previously (e.g. Pavitt & Gibb, 2003 and Al-Hammad, 2000). In our study, construction

respondents in one organisation noted that the main contractor gave subcontractors a template and

guidelines todevelopmethod statements. However, although the subcontractorsused theguidelines, they

developed the documentation themselves to suit their organisation. Conversely, one of the construction

organisationsusedsubcontractors formostoftheirtrades. However,becausethesamesubcontractorsand

the samegangswere generally usedonevery site, theworkersbehavedmuchmore likedirect employees.

Thereforetheinterfaceconflictswerenotasgreat.

3.6 InfluencingFilters/Membranes:BarriersandEnablers

3.6.1 Stability,instabilityandchange

Workforcestabilityandlongevity

Theethnographicdiscussion(3.9)mentionstheOSHbenefitsofworkingrepeatedlywiththesamepeopleand

the challenges ofworkingwith new/unknownpeople. This findingwas

alsoprevalentinthenon-ethnographicinvestigations.

All three logistics organisations were made up of a core of stable

personnel,includingbothmanagersandworkers.Foroneorganisationit

wasnotunusualtospeaktopeoplewhohadworkedattheorganisation

formanyyearsandthisstabilitywasseenasasignificantenablerofgood

OSHknowledgeflow.

The tacitOSHknowledgeandexperienceof long-termemployeeswasan

asset to the organisation. Thiswas often transferred in an informalway

throughobservationandgivinghelpful suggestions tonoviceson the job.

Experienced workers were also a credible source of worker-to-worker

training,beingperceivedaspeoplewhoalsoappreciatedthedifficultiesofdoingthejob.

“50%ofmy[workers]are11yearsplus…ThenifIlookatthemanagementteam,75%of

themhaveworkedbetween15and30years.”

(LogisticsSeniorManager)

“…it’snotsomebodywhositsinanofficeandneverdoesthejobcomingoutand

tellingyouwhattodo,it’sgenerallythepeoplethatdo

thejobthemselves.”(Logisticsworker)

77

The low turnover of personnel enabled relationships and informal

networks to form throughout the organisation. This was particularly

usefulininstanceswherehelpwasneeded(i.e.aproblemhadarisenand

advice was required or information coming from management was

difficult to understand). In these instances, in addition, or instead of

goingtotheirmanagersrespondentsconsultedtheirnetworkforhelp.

By contrast, project-based construction is known for its use of

subcontractors, employingboth itinerantandmigrantworkers.

Thisresultsinalackofstabilityinworkteamswithsometrades

only being on each site for amatter of days or weeks before

movingon,withconsequenteffectsonOSHknowledgeflow.

Thisrelianceonconstructionsubcontractorsemphasisestheneedforsystemsthatensurethatcompetentand

knowledgeable subcontractors are selected. Even in the fluid, and frequently changing environment of

construction,longerterm/morestableworkrelationsarevaluedforOSHbenefits.

Although healthcare had a relatively stable overall workforce, due to shift work and the use of temporary

‘bankstaff, itwascommonforteamstobeveryfluidwithlittlecontinuity

(alsoseesection3.4.4).

Cuts in healthcare funding over recent decades have resulted in many

experienced workers leaving the sector and this appears to have a long

termeffectonknowledgeflow.Awardmanageraddedthat,aswellasthe

lossofexperiencedpersonnel,muchofthepublishedinformationhasalso

beendisposedofduetoalackofspace.

VariableWorkingEnvironment

Theconstructionsiteenvironmentchangesrapidlybecause, inmanycases,today’sworkistomorrow’swork

platform. Alsoeachproject isuniqueandtherearemanydifferenttradesonsite,sometimesonlystayinga

fewdaysorweeks.Thismakesthefirstfewdaysonsitemorehazardousduetounfamiliarity.

The variable working environment also appears to make it difficult to get a consistent transfer of OSH

knowledge across a site network. For example, dependingon the stageof theproject a rangeof different

tradesmaybepresenton-site,eachwithaseparatecultureandgenerallevelorunderstandingofsafety,this

can lead to contrastingwork environments,making safetymessages difficult to implement. In such cases,

adaptedOSHpracticeemergesfromtheworkersorgroupsofworkersandtheOSHknowledgedoesnotflow.

Thisnewenactmentmayormaynotbeas‘safe’astheinitialOSHinstruction,butitwillalmostcertainlybe

different.Thisaspectisexploredfurtherintheethnographysection(3.9).

Ifind(talkingtoexperiencedcolleagues)themostuseful‘causeI’mnotreallyoneforreading…it’snotexactlyaninterestingsubject,isit?I’dratherpickthephoneupand

asksomeone.”(LogisticsSeniorManager)

”Anumberofoursystemsarestillinplacesotheselectionprocessandtherequirementthatthey(subcontractors)

demonstratepasttrackrecord,competencecapabilityisthere.”

(ConstructionOSHDirector)

“There’salotofexperienceandknowledgeandskills

havebeenlostinthechange-withanychangeyouget

that.”(HealthcareWardmanager)

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The warehouse environment in logistics is relatively stable, the only

time thewarehouseenvironment changedwas if the goods received

changed. For example, one warehousemoved from handling white

goods tohandlingmattressesso thereforerequiredadifferentsetof

workingpractices.Thesamesitealsostartedtotakedeliveryoflarge

screen televisions, some up to 60 inches, which also presented

challengesintermsofhandling.

Home deliveries in particular produce a variable work environment and this is

explored in more detail in Section 3.9. Similarly, community-based healthcare

workershave todealwithvaryingenvironments in thehomes that theyvisit. A

communitymidwife explained the challenges of delivering babies in someone’s

ownhome.Despitethemanybenefitsofhomedelivery,shecommentedthatmanylowriskpregnanciescan

turnintoemergenciesveryquickly.

Ward-based healthcareworkers have some stability of environment although

the patients usually provide significant and challenging variability. However,

the changing structure within the Trust made it difficult to write and apply

appropriatepoliciesandprocedures.AhealthcareOSHmanagerexplainedthat

itwasreallydifficulttotryandactuallywriteapolicywhenyou’retryingtoreflectamanagementstructureor

acommitteestructurethatisintheprocessofchanging.

Project-basedculture

Long term organisational learning is important for OSH to maintain continual improvement and avoid ‘re-

inventing thewheel’. However, in construction,onceaproject is finished, any learningor innovations that

maybepassedontofutureprojectsareoftenlost.Reasonsgivenforthisarethateachprojectisuniqueand

something thathappensononesitemaynothappenonanotheror itmayonlyhappenseveralyears later.

However,asconstructionworkersmovearoundsomuchthenthere is thepossibilityofspreadingthisgood

practice.However,workerscanonlysharetheirknowledgeiftheyareactuallypresentonsiteatthattime.In

otherwords,a lotofconstructionOSHknowledge is transferred informally throughtheexperienceof those

thatworkonsite.

3.6.2 OrganisationalStructure

Hierarchicalvsmatrixorganisationalstructure

Asdiscussedearlier,thelogisticsorganisationswhotookpartinthisresearchcouldallbecharacterisedas

traditionalhierarchicalorganisations,withexplicitlinesofcommandfromthetopoftheorganisation,clear

expectationsintermsofOSHmanagers’andlinemanagers’responsibilityforcascadingOSHinformationina

top-downfashionthroughtheorganisations,andformalstructuresforthecommunicationofinformationfrom

“Everything’salwayschanging.Ifnewstockcomesintothe

warehousethatwehaven’tdealtwithbefore,maybethatneedstobelookedatbeforepeoplestartbookingitandpickingitand

puttingitintocagesorwhatever.”(Logisticsworker)

“Youcan’thaveanemergencydeliveryroominsomebody’s

bedroom.”(CommunityMidwife)

“Therearerisksinherentinthesystematthistime

ofchange”(Healthcareoffice

manager)

79

thebottom-up.Allthreeorganisationshadseverallayersofmanagement.

WhenquestionedaboutwhereOSHmessagescamefromandwherethey

werepassedto,respondentsindicatedthatitcamefromtheperson

abovetheminthehierarchy(i.e.theirlinemanagerorOSHdepartment)

andthattheythenconveyedtheinformationtotheirsubordinates.

TheseformalstructuresfacilitatedOSHinformationflow.Inaddition,theformalstructurewasusedasa

meansofpassinginformationbackuptheorganisationalhierarchyandspecificchannelshadbeendeveloped

tofacilitatethis,forexampleformalaccidentreportingorOSHmeetingswithworkerreps.

Notwithstandingthishierarchicalnature,thereweredifferentunderlyingorganisationalstructures,withone

organisationoperatingmoreasacooperativeofdifferentcompanies,withagreaterlevelofdevolved

responsibilityanddecisionmaking.Effectivelythisledtoareductionoftheinfluenceofthehierarchywhich

hasbothpositiveandnegativeimplicationsforOSHmessageflow.

Althoughthelogisticssectordoesusesubcontractorsandexternalsuppliers,therelationshipsbetweenthem

seem to be fairly clear and unambiguous in terms of rules and OSH message flows. Consequently, the

hierarchical structure mentioned above tends to be the overriding influencer for knowledge flow.

Construction also uses hierarchical organisational structures, but the relationships with subcontractors and

sub-subcontractors seemtobemore tenuous inmanycases. Furthermore, themanagementof certainkey

disciplines even within the large contractors can complicate the direct hierarchical management on a

particularsite– for instanceengineers,qualitysurveyors,plannersandprocurementstaff typicallyhave line

managersbasedattheheadofficeorregionalofficeandthereforethesite-basedprojectmanagerneedsto

operateinmoreofamatrixstructure.Thiscanaffecttheclarityofthecommunicationchannels.

Theorganisationalstructureinhealthcareseemstoincludebothasocialandamoreformalhierarchywithin

whichtherearemanycompetingthemes.Thisaddscomplexityandcomplicatesthehierarchicalrelationships.

Forexample,thenurseshavealinemanagementstructure,butinmanycasesthedoctorscancutacrossthis

structure. Insomecasesthiscancomplicatecommunicationandcauseconfusion. Ineffect,healthcarealso

operatesamatrixorganisationalstructure,althoughwithinthattherearesomeclearhierarchies.Therewasa

considerablenumberofnegativecommentsaboutthehierarchicalstructureinhealthcare,particularlyrelating

tosomedoctorsactinginadictatorialmannertonursesandotherhealthcarestaff.

Inthehealthcarecasestudiestherewerealsoconcernsthattherewasa

lackofunderstandingofthecauseofaccidentsinthishierarchalsystem.

Some respondents thought that blamewas often placeddirectly onto

the workers, whereas they considered that the system of work or

conditionswasthemaincause.

“Asahealthandsafetyrep…Itryandgetmanagerstolookat

thesystemtoseewhetherthey’resafe-thereisasafe

systemofwork.”(Matron)

“Theflowofinformation…Updatestolegislationandthingslikethatwouldbe

lookedatcentrallyandthencascadeddown.”

(LogisticsMiddleManager)

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Frequentlychangingstructureoftheorganisation

Severalparticipantsnotedthathealthcareissubjecttotheconditionsofanumberofexternalorganisations,

both external (e.g. HSE, Quality Care Commission, National Patient Safety Agency) and internal (e.g. NHS

procurement,humanresources,QualityAssurancecommittee)andchanges intheserequirementscanbring

significant changes in the Trusts. Moreover, as a publically fundedorganisation, theNHS is accountable to

government and, when the government or even the minister changes, NHS priorities and strategies often

change. This may have some similarities with a construction or logistics company being taken over by a

differentorganisation,butthepublicnatureoftheNHSalsomakesthesethingsmorecrucial. Asaresultof

thesefrequentchangestheflowandtranslationofinformationiscomplexanddifficulttoreconcilewithother

information, andparticipants felt thismade theNHS information flowquite reactive. Forexample,whena

recent critical report7about a major Trust was published, changes were made across the sector. Also,

intervieweesexplainedthatthelastchangeingovernmentalteredthestructureandlayoutoftheNHSwhich

hadaffectedstaffmoraleandcultureandinturnthetranslationofaconsistentmessageforOSH.

This complex structure and reactive nature can have negative effects for OSHmessage flow. Participants

noted that, if the structure of the organisation changed, they may not know where or who to get the

information from. Some participants commented that their training told them to initially contact their

supervisor regarding OSH matters; however, the same participants also highlighted that they were not

completelysurewhothatwas,orwhowasthebestpersontocontactonOSH.

Healthcareparticipantsalsonoted that, ina reactive system,changescanbemadewithoutconsidering the

effectsonotherbusinessareas.ThismayaffecttheimportancethatisplacedonOSH.

To an extent, the project-based structure of the construction sectormeans that the specific organisational

structure changes frequently. However, this seems to be accepted by most in the industry and was not

identifiedasaparticularissuebyinterviewees.

As mentioned previously, logistics tends to have more stability in personnel and therefore also in

organisational structure. Although,major changes in the organisation such as a new CEO or take over by

anotherorganisationislikelytocreatebarrierstotheeffectivediffusionofOSHknowledgethataresimilarto

theothertwosectors.

3.6.3 Temporaryorcontractworkersandjobsecurity

Thisprojecthasfocussedonmorecomplex,networkedorganisationsandthustheuseofsubcontractorsand

suppliers isgermane to this study. In somecases thedifferentorganisations involvedare transparent,with

eachorganisationhavingitsownidentity,typicallyacknowledgedformallyandperhapsbysignageoruniform.

But in other cases the dominance of the primary organisation subsumes the other organisations and they

7http://www.midstaffspublicinquiry.com/report

81

appeartobejustonebody.Notwithstanding,temporaryorcontractworkers,typicallysuppliedbyalabour-

onlyorganisation,areoftenincorporatedintotheprimaryorganisationatleastsuperficially.Knowledgeflow

totemporaryorcontractworkershasbeencoveredinsection3.4.3.

Thepreponderanceof theuseofsubcontractors,particularly inconstructionhasbeendiscussedearlier,but

thissectionconcentratesontheuseoftemporaryorcontractworkers,orlabour-onlycontractors.Thereare

structuralissuesherewithextendedlinesofcommunicationandadegreeofconfusionofwhotheemployer

is. These have been studied extensively elsewhere, particularly the issue of bogus self-employment in

construction. Respondents felt that this issue isgenerallyovercomebyOSHpolicieswherepeopleareonly

hiredfromapprovedsubcontractorsthatenforcedgoodOSHpractices.

TheOSHcultureofaconstructionsiteisdictatedbytheprincipalcontractor,butisalsolikelytobenegatively

affectedwhere therearemore temporaryworkers. There isanecdotalevidenceof identity confusion,with

some contract workers, when asked who their employer was, responding by looking around, noticing the

tower crane and repeating the name that they can see on the crane. Therewas also a somewhat comical

exampleofaworkerlookingatanOSHlogoandclaimingtoworkfor‘ZeroAccidentLtd’.

Therewassomeevidenceofapragmaticacquiescenceofthesubcontractortotheprincipalcontractor’sOSH

processesandsystems. Aconstructionsitemanagerexplainedthatallthesubcontractors ‘signedup’tothe

principal contractor’s paperwork and came under their responsibility while they were on site. He

acknowledgedthat,althoughtheyhadtheirownmethodstatementsandprotocols,theyweremadeto‘sign

on’totheprincipalcontractorssystems,sothattheywere‘fullyversedinwhattheyhadtodo.’

Healthcarereliesheavilyontemporary‘bank’staff,whoareusuallyexperiencedworkerswhohavetrainedin

theNHSbutnowworkflexiblythroughagencies.Suchworkerscanoftenworkmanyhoursinaweekalthough

mostareeffectivelyon‘zerohour’contractsandsomedirectlyemployedNHSstaffwilldoextrashiftsviathe

bank. However,comparedtoconstruction,thesebankworkerswouldalmostcertainlyhavebeentrainedin

the NHS and so there was less of an effect on the overall OSH culture when such temporary staff were

predominant.

Logistics seems to rely less on temporary workers than construction and healthcare, except at very busy

periods such as Christmas. One of the logistics case organisations had a particularly strong OSH culture.

However, atpeak timesofbusiness the significant increase in temporaryworkers could influencehowOSH

wasmanifestedintheworkforcebehaviour,arguably,dilutingthepositivesafetyculture.

Therewas anecdotal evidence about the effect of job security on theway thatworkers responded toOSH

messages.Workersfeelinglesssecurewerethoughttobemorelikelytoperceivemorepressuretomaximise

workoutputandproductivity rather thanOSH– fearing that theymay lose their job if theycommentedon

OSH or were thought to be overly concerned about hazards and risks. An example was given of a nurse

concealing her dermatitis by wearing gloves for longer periods of time (which actually aggravated the

82

condition) so that she could continue working8. Although it was not explored directly in this project, the

recent increased emphasis on empowerment of workers is acknowledged, in particular the right (or even

responsibility)tostopworkiftheyconsideritunsafe.Thisisexploredfurtherinthenextsection.

3.6.4 CreatingacultureofindividualownershipofandresponsibilityforOSH

Ownershipandresponsibility

Notwithstandingtheexternalbarriersandenablers,anumberoftheintervieweesacknowledgedthe

responsibilityofindividualstolisten,appropriate,translateandenactOSHcarefully,effectivelyand

appropriately.Thecultureandenvironmentcreatedinthenetworksandtheindividualworkplaceswas

significantinencouragingordiscouragingthis.

Withinonelogisticsorganisationtherewasaculturewhereeveryone

wasencouragedtotakeresponsibilityforOSHanditwasapparent

thattherewasdevolvedresponsibility,bothforoneselfandfor

colleagues.Thiswasmanifestinattitudes,beliefsandbehaviours.

Therewasaviewfrommanyofthemanagersthattheyconsideredthattheywereapproachableregarding

OSHmatters.Often,butnotinvariably,workerintervieweesfeltabletoapproachcolleaguesiftheyperceived

themtobehavingunsafely.Theresponsibilitytodosomethingaboutunsafeactswhentheyareobservedwas

overtlyemphasisedalthoughactuallyputtingthisintopracticewasseenasbeingmoreproblematic.

Thesupportivecultureofonelogisticsorganisationwaslargelyduetotheexceptionalstatusoftheworkforce,

whoweretreatedaspartnersandhadavestedinterestinthebusiness.Thereappearedtobea‘caring

culture’inthesensethatmanagementgenuinelycaredfortheworkforce,frequentlyidentifyingthemas‘my’

workers.Therewasalowlevelof‘usandthem’,withworkersfeelingabletoraiseissueswithmanagersor

seniormanagers;workerswerelistenedtoandactionsweretakenbymanagersasaresult.Therewas

evidenceofbothmanagersandworkersstrivingtoimprovethe

businessasthishaspositiveimplicationsforprofitsandbonuses.There

wasanappreciationthatpoorOSHwouldhaveanegativeimpacton

thebottomlineofthebusiness.Therefore,inadditiontogenuinely

caringforco-workers’well-being,therewerepragmaticreasonsfor

preventingaccidents.

8Dermatitis isacommonhealthconcern inhealthcareand inextremecasestheskincanbecomebrokenandtender. Inthesecasesnursesarenotallowedtocareforpatients(duetoriskofinfectionasthereisanopenwound)andshouldtakesicknessabsenceorswitchtootherduties.

“We’reallresponsibleforhealthandsafety,everysingleoneofus,regardlessofhierarchy(or)

managementstatus…”(LogisticsMiddleManager)

“There’ssomepeople…youcansaysomethingtoandthey’lljustbiteyourheadoff…They’rethekindofpersonyoukeepawayfrom,youdon’twanttogetinvolvedwith,becausetheygetabitheated…”

(LogisticsWorker)

“…my[workers]welfareisimportanttome,Iwantto

knowthattheycometoworkandthey’vehadasafedayatworkandtheygohomesafe.”(LogisticsFirstlineManager)

83

Effectiveuseofworkerfeedbackwasshownthroughanexamplewhereataskmethodhadbeenchosenon

OSHgrounds,butwasthenthought,bytheworkers,tobecreatingotherOSHproblems–sothemethodwas

changed.

Theoverwhelmingviewof increasedpersonalownershipandresponsibilitywaspositive. However, insome

cases it seems that theunderlying culturewasnot supportiveof this approachand several participants felt

thatifanythingwentwrongitwouldbetheirfaultandtheywouldgetintotrouble.Asaresulttheyfeltthat

theonuswasonthemtofindrightguidanceinformationtokeep‘withintherules’.Theimportanceoftherole

ofthefirstlinesupervisorincreatingthissupportiveculturewasstressed.

Intervieweeswereaskedtogivereasonsforwhytheybehavedsafely.Themajorityofresponsesgivenrelated

toageneralsenseofresponsibilityforsafetywhichseemstopermeatetheworkplace,including:

• caringforothers;

• feelingresponsibleforotherpeople’ssafety;and,

• acculturationintothesafetycultureoftheorganisation.

Recognisingthelevelofrisk

A necessary requirement for and consequence of individual responsibility is the need for individuals to

recognisethelevelofriskthatispresent.Thisabilityisclearlylinkedtotheexperienceandcompetenceofthe

individual. Generally, noviceworkerswouldnotbeexpected tobeable todo thiswhereasexpertworkers

would.However,theexpression‘familiaritybreedscontempt’wasusedandsomeexpertsmayhavelostthe

abilitytoadequatelyassessrisk.Incertainculturesandincertainsituationsinallcultures,itmaybethatthe

individual’srequirementtoassessriskmaybereplacedbysystemsorprotocols.Forexample,fortaskswith

very high consequence risks, a rule-based approachmay be appropriate, however, our work suggests that

involvingtheindividualissensibleasitwillhappenanywayandmaywellbebettertobemanagedproactively

ratherthanignoredinvain.Examplesincludehospitallaboratory

staffconsideringthattheyhadastrongerOSHfocusbecausethey

regularly handle hazardous samples and chemicals and can

appreciatetherisk;orasbestosremovalexpertshavingahealthy

regardfortherisksofingestingasbestosfibres.

“…it’sthenatureoftherolesratherthantheinformationitselfthatmakepeopleinterpretthings

differently.(Healthcareworkforcemanagement

Director)

84

3.7 Translation

3.7.1 Individual,internaltranslation

TheC-HIPmodel(Conzola&Wogalter,2001)focussesontheprocessoftranslationof

messages in a personal sense, in that each person who receives information from a

source throughachannelmust then translate itbefore thenenacting it through their

resultingbehaviour.AccordingtoC-HIPthistranslationisaffectedbythereceiver’sattention,comprehension,

attitudes, beliefs andmotivation. This section considers this individual, internal translation: what goes on

internallytotheindividualreceiver.

Thecognitiveabilitiesofthereceiverandthepsychologicalaspectsoftheinternalprocessingof information

areoutsidethescopeofourproject. Nevertheless,wedid investigatebarriersand facilitators thataffected

the taking in of the OSH messages and their enactment. The C-HIP model excludes other parts of

communicationtheorysuchas ‘noise’thataffectsthecommunicationprocess,whereasourproject included

aspectsotherthanthedirect,taskrelatedOSHinstructiontohelpanswerthequestions:“howdoyouknow

howtodowhatyoudoandhowtodoitsafely?”

Earliersectionshavecoveredtheplethoraof informationsources,both internal totheorganisation,outside

the company but still within the main organisational

networkandalsoexternaltothemainnetwork.

Theenvironmentthatworkersfindthemselvesinwasalso

seen as a reason to interpret the OSH messages

differently. For example, in thehealthcare case studies,

participants noted that while healthcare workers were

awareof appropriateprocedures theywereoftenput in

difficult positionswhere patient care seemed to conflict

withtheirownOSH.Theseaspectsaredevelopedfurther

insection3.6,BarriersandEnablers.

Conversely,factorswhichhindertranslationwerealsohighlighted.Forexample,ambiguousmessages,which

werenotexplainedintermsoftheirconsequencesforaparticularrole,wereproblematic.

The need to ask workers if they understood all of the information they received was raised. This was

particularlythecaseinconstructionwherethereweremanyworkerswhosefirstlanguagewasnotEnglishand

also,generally,lowlevelsofliteracy.Checkingunderstandingwastakenastagefurtherandmoreformallyin

manyinstanceshowever,requiringworkerstosignthattheyhaveheardorreadandunderstoodthemessage.

“Asfarasthenurseisconcerned,that’sherpatient,that’shercareandifsomethinghappens…sheignoresthemanuallifting

procedures…Iknow…I’veliftedpatientsthewrongway.Butyoudo.Youknowit.(I)knowthatIshouldbesquattingdown;Ishouldbe

usingmythighs,keepingmybackstraight.Butwhenthingsaregoingabitwrongyoudon’t

havetimetothinklikethat.”(Emergencyplanner-healthcare)

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3.7.2 Translationoradaptationbeforepassingontoothers

Themain enactment formost of themembers of the network is to pass the OSHmessages on to others.

Invariably, except for literally forwarding an email, this will involve the person receiving the information

themselvesandprocessingitinternallybeforepassingiton,oftenconsciouslybutsometimessubconsciously.

Thiswillmeanthat,evensubconsciously,therewillbeanelementoftranslationorofthemessageasitmoves

through thenetwork. Theremayalsobeamoredefinite adaptationof themessagewhichmay change its

meaning in some way. However, there may also be the conscious decision to change the way that the

messageisconveyedtoimprovethelikelyunderstandingofthepeoplewhowillnextreceivethemessage,or

tomakeitmorepalatable–‘tosoftentheblow’.

Inone logistics firm informationwas interpretedbyexpertsbeforere-written intoamorepractical formfor

workers. The argumentwas that the audiencewere site-basedmanagerswhowould notwant to reading

‘reamsoflegislationandpolicy.’Theywantedtoproduceasimpleguidetowhyandhowtodotheworkand

whatandwherearethetoolstodoitsafely.Theyacknowledgedthatthe‘professionals’neededtoknowthe

legislationinordertocheckcompliancebutoperationalmanagerswereconcernedwithdelivery.Theyargued

that suchmanagersweremuchmore likely to read a onepage summary than a 50 pagedocument,which

shouldbekeptinreservetobereferredtoifnecessary.

Healthcare FM workers were given specific OSH knowledge relevant to their tasks. OSH knowledge was

assessedtoensurethatitmetTruststandards.Thedegreetowhichandstringencywithwhichitwasassessed

appearedtovary;howevertherewasageneralassumptionthatitmetminimumstandards.

Theprimaryaimofhealthcare is toensureahigh levelofpatientcare, so taskspecificOSHknowledgewas

given where workers interacted with patients in order to protect both the patients and the workers. For

example,whereworkon services (water,electricityetc.)was required itwas important toensure that vital

patientserviceswerenotcutoff;howeverarrangementsweremadetorelocatepatientsifurgentworkwas

requiredandservicesneededtobedisconnected.

Patientdignitywasalsoaconcernandwastakenintoconsiderationinplanningsafetasks.Forexampleitwas

considered unethical to publically display information about patient illnesses; but domestic staff needed to

know what type of PPE to wear to prevent cross-infection. A sticker system was used in one Trust with

differentcoloursto indicatetheseverityandnatureofparticular illnesses. Themeaningofeachstickerwas

onlyknowntostaffanditindicatedtheappropriatePPEtoweardependingon

thepatient’scondition.Similarly,inablooddonorsetting,colouredtagswere

hung outside consultation booths to indicate that a particular check was

required,typicallyrequiringadifferentmemberofstaff,withoutdisclosingto

thewaitingmembersofthepublicwhatthehealthconcernwas.

Inasimilarwaytologistics,onematronexplainedthatshecouldunderstandthecodeofpracticedocuments

because she ‘lives and breathes’ OSH, but the main audience are looking for practical ways to apply the

“…verysimple,inyourface,anditwasattachedtoeverybody’spayslip.”

(Matron)

86

principles–whatdoesitmeantome?WhatdoIhavetodo?Shealsocitedaninitiativewheretheyattached

messages to thepayslips inorder toget themessageout. This is similar to theTrojanHorse initiative (SCI,

2005) inconstructionwhereOSHmessageswerefixedtomaterialsandproductssothatworkerswouldsee

themwithoutlookingforthem.

ClinicalstaffweregivenbroaderOSHtrainingwhichrespondentsfeltwasunderstandablefromatheoretical

perspective. However,becausethetrainingwassobroad, itwasdifficulttounderstandhowtoactuallyuse

thetraininginpracticeandhowOSHneedscouldbeconsideredinconjunctionwithpatientsafetyneeds.OSH

managers in both case study trusts highlighted that they were

availabletohelpstaffworkthroughtheseissues. However,this

washamperedbylimitedstaffresources;ineachTrusttherewas

amaximumoffourOSHmanagers.Furthermore,itisinteresting

that lab-based staff,who arenot patient-facing, found theOSH

knowledgebeneficial anduseful in theirwork. Itwas suggested that, becausepatient risk training ismore

dynamicthanOSHtraining,ittendsto‘stick’betterinthemind.

Inconstruction,anumberofchannelsandchannelcharacteristicswerediscussedasaidstounderstanding;for

example practical training given by co-workers was perceived to be a good means of message transfer.

Conversely, factors which hinder translation were also highlighted; for example there were problems with

ambiguousmessages,whichwerenotexplainedintermsoftheirconsequencesforaparticularrole.

There were also examples of adding visual and physical aids to get the message across. One example

highlightedbyaconstructionmanagerwashowinformationaboutwalkwaysthatweresubjecttodailychange

was communicated. Initially workers were asked to contact their supervisors and sign-off once they had

receivedspecificinformation;butthereweretimingissueswiththistypeofdelivery.Subsequentlyemployees

weregivendiagramswithcolourcodingtorepresentchangesinthelocationofwalkways.However,thesite

managershighlightedthat,eventually,theyhadtoimplementasystemoftallerbarrierssothatworkerswould

notbeabletoenterunsafeareas.

Some difficulties with translation by managers and supervisors before passing the message on were also

raised.AHealthcareofficemanagertooktheviewthatwhatshehadbeeninstructedtoorganisewouldnot

work‘furtherdowntheline’whichaffectedherenactmentoftheinstruction.

A number of interviewees also commented that the effectiveness of translation for the

benefitofotherswasoften strongly influencedby the translator’sdevotion toOSHand

thereforethedesiretopassthemessageoneffectively.

“…attheendoftheday,mostofthoseyou'retryingtogettoareatthecoalface,andyouthenneedtobevery

cognitiveofhowitiscommunicated.”(ConstructionProjectManager)

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3.8 Enactment

Wehavementionedpreviouslythatthemainenactmentformostofthemembersofthenetwork istopass

the OSHmessages on to others. However, in this section we deal with the enactment at the end of the

network,bythepeoplewhoaredoingthetasksandaremostlikelytobehurtifsomethinggoeswrong.TheC-

HIP model (Conzola & Wogalter, 2001) uses the word ‘behaviour’ which is appropriate for this workface

enactment.

The reality is that many players in the network do not enact in precisely the way that the initial source

intended.Thismaybemiddlemanagerswhodonotpassonthemessageaccuratelyortheworkerwhodoes

notfollowtheprocedurescompletely.Thereasonsforthisarecomplexbutarelikelytobeacombinationof

howwell theyunderstand themessage,what they thinkabout thepersonororganisation that isgiving the

message,whatothermessagesareimpactingonthematthetimeandwhethertheythinkthatthemessageis

applicabletothespecificsituationthattheyface.

AfullconsiderationofOSHbehaviourisoutsidethescopeofourwork,buttherewasaconsiderablenumber

of comments in the interviews on workarounds and dynamic risk

assessments,butalsonoveluseofOSHmessagesandproceduresevolving

throughpractice.Theseaspectsarealsodevelopedfurtherinsection4.3.

3.8.1DynamicRiskAssessments

There was a clear difference between the environments faced in static,

relatively unchanging work environments and those where the situation was constantly changing or more

unpredictable.Often,itwastheselesspredictablesituationsthatpeoplecitedasthereasonforassessingthe

risk‘inthefield’.

Forinstance,ward-basedhealthcarestaffhadamoreconsistentenvironmentthanthosewhoworkedinthe

community.Allhealthcarestaffhadtodealwiththechangingsituationsandbehaviourofpatients,but,inthe

ward, at least the overall environment was fairly constant. Community-based staff were faced with the

variation in patient condition and behaviour but also the significant variation in the home environment.

Communitystaffhadbothunofficialandofficialroutestoexchangeinformationaboutcertainpatientsorthe

environmentsincertainhomes.

Trainingofhealthcarestaffincludestheuseofscenarios,whichareintendedtoprovidetheskillstocopewith

changingcircumstancesandtheneedfordynamicriskassessments.

Another areawhere insitu consideration of risk is needed iswhere aworker encounters a task or product

where there does not seem to have been a risk assessment, or at least the worker is not aware of it. A

healthcareOSHmanagerrecountedasituationwhereanursewasconcernedabouttheuseofanewtypeof

‘plaster of paris’ for which there was no safety data sheet or task risk assessment. The initial phone

“Trainingdoesn’tcoverallscenariosandthere’s

alwaysthehumanfactor.There’salwaysthepatientwhodoesn’tdowhatyou

askthemtodo(Wardnurse)

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conversationestablishedthesituation,theextentoftheexposuretoriskandwhatriskcontrolmeasureswere

alreadyinplace.Themanagerthenmetupwiththenurseandobtainedthenameoftheproduct,checkedthe

safetydatasheetontheintranetandconfirmedthattheventilationmeasuresthatwerealreadyinplacewere

adequate. Themanager also confirmed that health surveillancewas not required. The nursewanted the

adviceinwritingwhichwasprovided.

Homedeliveryworkersinlogisticsfacedthevariableenvironmentsofthehousesthattheyweredeliveringto.

ThereweresomegoodexamplesofOSHknowledgebeingpassedbetweendeliveryworkersregardingspecial

circumstancesatadeliverypoint,withthefirstdriverhavingtoassessthesituationinsituandadjustthedetail

ofthemethodbutthenpasstheinformationontofuturedriverssothattheyweremoreprepared.

As mentioned previously, the construction work environment is forever changing, but this is normal and

therefore is often taken into account in the way that risk assessments are drawn up. Furthermore, in

constructionthereisusuallyamanagerorsupervisorpresent,atleastonlargerprojects,andthereforelessis

left up to the discretion of the individual worker compared to a logistics delivery driver or community

healthcare worker. Therefore, in construction, it is mainly where unforeseen situations occur that true

dynamicriskassessmentsarerequired.

In all sectors there has been amove to spendmore time considering unforeseen situations and to ask the

question: what is the worst that could happen? A number or organisations also organise mock ups of

emergencies to test the resilienceof their systemsandprotocols andalso, by inference, theabilityof their

stafftoassesstherisksinsituandrespondappropriately,basedonthehealthandsafetyframeworkthathas

beenestablished.

3.8.2 Workarounds

The term ‘workaround’ seems to be somewhat emotive in all three sectors, and, particularly amongstOSH

professionals.Thereisanassumptionbysomethatworkaroundsarealwayswrongandalwayslesssafethan

the prescribed method. The term ‘shortcut’ was also used frequently, although often in a slightly more

negativewaythanworkaround,suggestingthattheshortcutwasperhaps lesssafethantheofficialmethod.

Occasionallyanintervieweetalkedabout‘breakingtherules’buttheywouldoftenindicatethatthiswasstill

done safely. The reasonswhy people usedworkarounds or shortcutswere discussed, for example, lack of

necessaryequipment, situationbeingdifferent to theoneassumed in the instruction/method statementor

perceivedtimepressure.Sometimesitwasseenastheonlywayinordertodothejobandwasdeemedthe

safestwayto‘bendtherules’,thusmitigatingtherisk.

The interviews uncovered both ‘as intended’

enactmentand‘notasintended’enactmentacross

thenetwork. Intervieweescommentedthatthere

was both ‘good’ and ‘poor’ practice across all

“…ifit’sashortcutthatthemanagersaysmakesthejobmoreefficient,moreeffective,thenthey’lllookatitandifit’sdeemedtobeagoodthingtodo,then

they’llputitintheprocedures.”(LogisticsWorker)

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sectorswheretheyconsideredthatpeopleeitheractedmoresafelyor lesssafely. However,theyalsocited

alternatives to the official way to do a task, based on an insitu assessment of the risks that were still

consideredsafe,atleastbytheworkersthemselves.Workaroundsweremorelikelywheretheworker,rightly

orwrongly, considered that the risk resulting from the newmethodwas not great, probably because they

consideredthattheriskfromtheoriginaltaskwasnotgreateither.Thus,workaroundswereconsideredless

likelyforhighrisktasks.

Some logistics respondents stated that theydidnot behaveunsafely. Withinoneorganisation therewas a

devolvedsenseofresponsibilitywiththeworkforcewherebytheyknewtherulesandwhatwasexpectedof

themandtheyunderstoodtheneedforsafeworkingpractices.Butitwasnotunusualforthemtodothings

whichwerecountertoorganisationally-specifiedruleswhichtheycalled‘shortcuts’.However,wheretheydid

‘break the rules’ theywould typically indicate that thiswasdonesafely, implyingadegreeofacceptanceof

distributedleadershipbytheorganisation,whereworkerswouldappeartobeabletomakesuchdecisionsin

theirownright.

Sometimeswithintheorganisationtherewouldbedifficultiesindevelopingsuitablesafesystemsofworkand

ensuringthatthesepracticeswereundertakenbyworkers.Oftenmanagershadtodecideonthe‘best’wayto

dealwithawkwardgoodsreceived.ThiscreationofOSHpracticeinsituisexploredfurtherinsection3.9.

Ahospitalwardmanagerexplainedhowstaffusedworkaroundstomanageflawsthatexisted inthesystem

and that they are almost forced to do so. However, his view was that you ‘should not need to find a

workaround’becausetheprocessesshouldbebetterandmorealignedtoreality.

OSH behaviour in healthcare is an interesting conundrum. First, the many different facets of healthcare

workerculturesneedtobetaken intoconsideration. Ingeneral, itwas felt thatdomesticandmaintenance

staffwerefarlesslikelytobehaveunsafelyor“breaktherules.”Severalassertionswerepostulatedastowhy

thismaybethecase;forexamplealthoughtheyworkinahospitalenvironmenttheymaynotbeinvolvedin

patientcare.Moreover,therewerestandardisedrulesandregulationsfortheirjobswhichweremoreroutine

thanforhealthcarestaff. However,healthcarestaffweredeemedtobeverydifferentculturally,whichwas

thoughttohaveasignificantimpactontheirOSHbehaviour.Forexample,somerespondentsconsideredthat

doctorsoftenconsideredthemselvestobeoutsideofthemanagementstructureandtherefore,didnotneed

tofollowOSHrules.Therewasalsoafeelingthatthehistoricfocusonpatientsafetyhaddeeplyaffectedthe

development of an effective OSH culture in healthcare. There were further differences between hospital-

based and community workers, whose behaviour may have been affected because they work outside the

confinesof thehospital. However, lab-based staffwhowerenotpatient-facingandworked in a controlled

environmentwithchemicalsandbiohazardswerethoughttodemonstrategoodOSHbehaviour.

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Despite the overwhelming opinion that workarounds were ‘safe’, one construction worker described his

methodofwalkingandstandingontheopenjoistsofanupperfloorofabuildingwhichbroketherulesand

whichheadmittedwashazardous.Hesaidthathediditbecausehecould,becausehehaddoneitmanytimes

beforeandbecause itwasaquick job. Hebelievedthathe ‘probablywouldn’t falldownthroughthe joists’

andhurthimselfandthathewouldhavefinishedthetaskbeforeanybodynoticed.

Thissalutaryexampleemphasisedthat,despiteallthewell-intentioned,wellthoughtoutworkarounds,there

werestillworkerswhowerewillingtotakesignificantrisks,breakingtherules‘becausetheycould’.Thisisnot

actuallyaproblemwithknowledgeflowastheworkerdidwhathedidinthefullknowledgeoftheriskhewas

taking. Hence, effectiveOSHmessage flow does not necessarily lead to safe behaviours, just as emergent

practicedoesnotnecessarilyleadtounsafebehaviours.

3.8.3 NoveluseofOSHknowledge–evolvingprocedures/evolvingpractices

EvidencethatOSHknowledgeisinterpretedandco-createdwas

foundacrosseachofthesectors.Therewereexamplesoffacilitating

proceduresinnovelenvironmentsandevolvingproceduresthrough

practice.Thisiscloselyentwinedwithbothworkaroundsand

dynamicriskassessmentsandisdevelopedfurtherinsection3.9.

Several healthcare OSH managers argued that they were not

managers,butfacilitators;healthcareworkcanvaryandthereforeitisdifficulttohavea“onesizefitsall”OSH

solution. Instead, itwasconsidered important thatOSHmanagersunderstandcurrentOSH legislation,NHS

standards, and the systems and interconnected levels of work within the system so that they may use

participatorymethodstodevelopthemosteffectiveOSHknowledgeforaparticularsituation.Forexample,if

a new product or way of working was needed, staff would probably need help to make sure it was

implementedsafely.

As part of a strategy for continual

improvement within one logistics firm

there is opportunity for workers to

suggestchangesandbepartofdevelopingOSHknowledgeaslongasitdid

not conflictwith safeworking practices. Amiddlemanager commented

thattheygetalotofworkerstakingadvantageofthisbyidentifyingthings

that theyconsidered ‘need lookingat’, challenging theexistingoperating

proceduresoridentifyingnewequipmentortechniques.Theircommittee

structure,mentionedearlier, facilitatesthiscreativedevelopmentofOSHproceduresbyhalfof itsmembers

beingfrontlineworkers.Onceaccepted,thenewmethodwouldbeincorporatedintothecompany’sstandard

procedures. Thisprocessgaveworkersownershipof theseproceduresandcreatedacultureof ‘buy in’ for

safeworking.

They’retheonesworkingoutontheshopflooranddoingthejob,sotheyknowbest.Andthenwecanhavealookatitandthensee

whatwecando.”(LogisticsManager)

“Ifthetrialrundoesn’tworkthenI’msorry;theprocesswe’veusediswrong.”

(Constructionsitemanager)

“…becauseIcandoit,that’sthewayI’vedoneitalotofthetime…Iprobablywon’tfalldownthroughthejoistsandhurtmyselfandit’squickand,quitefrankly,bythetimeyounoticemedoingit,I’llhaveprobablyfinisheddoingthe

job.”(Constructionworker)

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Aconstructionsitemanagerdescribedtheuseoftrial-runstotestoutmethodstatementsfornewtasks.He

explainedthat,eveniftheythinkthattheyhave‘coveredallthebases’byplanningeverydetailandassessing

theriskstheywouldstillhaveatrialruntocheckthingsbefore‘doingitforreal’.

Thereappeartobetwodifferentthingshappeninghere.Inhealthcareitismoreaboutfacilitatingprocedures

innovelenvironmentswhereasinlogisticsandconstructionproceduresareevolvingthroughpractice.Inone

case we are talking about new things in a constrained environment, in the other about new procedures

developedthroughnewexperiences.

Another construction supervisor described their ‘simple’ solution to prevent the need for the driver of a

telehandlerfromneedingtoassesseachbundleoftrussestodecideiftheyweretooheavytolift–theymade

surethatthesupplierprovidedbundlesthatwerenomorethan600kgandthereforewellwithinthe lifting

capacityofthemachine.

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3.9 Ethnographicfindings

Ourreportsofarhasmainlydiscussedthenon-ethnographicdata.However,akeyobjectiveoftheresearch

wastouseethnographicresearchmethodstocomplementthenon-ethnographicfindings.Liketheinterviews

andfocusgroups,withtheethnographywesetouttounderstandhowOSHknowledge‘flows’–orislearned,

communicated, and actually used by workers – in complex networked organisations from across the

healthcare, logistics, and construction sectors. Themesdiscussed in theprevious sectionswere found tobe

reiteratedthroughtheethnographicresearch(aswillbefurtherillustratedbelow),andethnographicinsights

havethusimplicitlyinformedtheprecedingdiscussion.

Yet, while complementary in its aims, the ethnographic approach also differed from the non-ethnographic

studyinseveralkeyways.Newareasoffocus,includinganinterestin‘quietsafety’(PinkandMorgan2013)

andworkers’adaptationstowardssafetyincontextsofuncertainty(Pinketal.,inpress)emerged.Thesedid

not always easily translate across research contexts, and to attempt tomerge thesewith discussion of the

interview and focus group findings would run the risk of obscuring ethnographic specificity. Partly this is

commontoethnographicmethodswhichtypicallyforegroundthe‘unexpected’,butitalsoreflectsthat(dueto

it not being practicable to undertake the research with the same participants as the non-ethnographic

research) the ethnographywas conducted at different locations and, in some cases,with different kinds of

participant (i.e. frontline workers rather than OSHmanagers). Moreover, as we have noted earlier in this

report, the ethnographic research started from a slightly different interpretive position. Differing from

conventionalapproachestoOSH,theethnographysoughttounderstandhowOSHisarticulatedasa‘wayof

knowing’ratherthansimplyas‘knowledge’.

Tounderstandthesedifferencesthedistinctionbetweeninstitutional-OSHandtacit-OSHisuseful.Previously

wehavemadevisibleandexploredthesedifferencesthroughafocuson‘localknowledge’intheconstruction

sector (Pink et al., 2010). Attempting to understand ‘what people know’ and ‘how they know it’ requires

‘attentiontothedetailof theireverydaypracticalactivities,commonbeliefs,valuesanddiscourses inwhich

thisknowledgeismanifested’(Pinketal.,2010:651).People‘knowhow’todotaskssafelynotonlyfromwhat

theyreadoraretold,butthroughembodied,sensory,andaffectiveknowledgesengagedinpracticalactivities

undertakeninspecificworkplacecontexts.Here,aswehavealsodiscussedelsewhere(Pinketal.,2014a),our

approachconnectsinsomeways(yetdiffersinothers)toabroaderfieldof‘practicestudies’safetyresearch

(e.g.GherardiandNicolini2002)whichunderstandsOSHas‘knowinginpractice’,orknowledgethatis‘learnt,

adapted,modified,andengagedinpracticebygroup(s)ofpractitionerswhoareinfrequentcontactwitheach

other’ (Pinketal.,2010:653). Preciselybecauseof its tacit (orunspoken, taken-for-granted,andotherwise

noteasilyarticulated)nature,toinvestigatesuch‘localknowledge’requiresethnographicapproacheswhich,

through sustained immersion in the context under study, reveal the kinds of easily overlooked details of

practicesandunderstandings(usually)moredifficulttoaccessthroughinterviewsorfocusgroups.Moreover,

whileexistingliteraturehasshownhow‘localknowledge’sometimesdiffersfrominstitutionalisedorregulated

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OSH,theethnographicresearchthatweaccountforinthissectionpointstowardsratherdifferentconclusions.

It revealsanentanglementbetweenthesedifferentknowledgebasesaswefoundworkers toskilfullyblend

thelocal/institutional,tacit/explicitandinformal/codifiedtoensuresafeworking.

TheethnographicfindingsdemonstratedthatOSHhappensinandaspartofanongoinglychangingworld,in

whichpersonalandtacitwaysofknowingarevital.Byrevealingtherolethattacit(orusuallyunspoken)ways

of knowing – including the embodied, sensory, affective, and experiential – play in worker safety, the

ethnographyposeddifferentunderstandingstotheideathatOSH-knowledgealways‘flows’anddoessoonly

through formalisedmechanisms from one person to another. Learningwas found to also happen through

informalmechanisms, and knowinghow towork in safe andhealthywayswas generated throughpractical

activityundertakeninspecificworkplaceenvironments.

Thus,theethnographicfindingssuggestthat:OSHknowledgeisnotstatic,butinstitutionally,individually,and

socially constituted while inextricable from the sensory and material environments in which it is learned,

communicated,andenacted.Knowledge isnotonly something that ‘flows’ intoandaroundanorganisation,

butemerges frompracticalactivityengagedwithmaterial, social, sensory,and representationalelementsof

the environment.OSH is enactedat the intersectionbetween the formal / informal; institutional / personal;

individual/social;regulated/improvisatory;andexplicit/tacit.

Tofurther illustrate thisdistinctargument, thissectionreportsonthe findingsof theethnographic research

which were part of the broader study, and outline shared principles to have emerged from a cross-sector

analysis of how OSH is learned, communicated, and used by workers. It also flags implications of, and

recommendationsgeneratedfrom,theethnographicperspectiveforOSH-practicewhichwillsubsequentlybe

takenforwardintheproject-widediscussion(section4)andconclusions(section5).

3.9.1 WhereandhowOSH-knowledgeislearned

OSHknowledgeinourethnographicstudy(aswassimilarlyflaggedthroughinterviewsandfocusgroups)was

receivedfromexternalsources(e.g.throughprofessionalbodies,equipmentsuppliers,networks)andwasalso

internally generated by organisations as they analysed and reacted to incidents or, in the case of the

constructionsector, identifiedand regulated forproject-specific risksandhazards. The formal ‘flow’of this

OSHknowledgethroughorganisationstookanumberofroutesandwasdetermined,tosomeextent,bythe

structure and characteristics of the workplace. Yet, common to the sectors, there was an institutional

approachtoknowledgeacquisitionthatunderstoodthatworkerslearnedOSHwithintheformalisedspacesof

training (e.g. induction) and through themechanisms of instruction (e.g. policy, guidelines). Learning was

mainly understood to be a one-way and mono-directional ‘flow’ of knowledge between people (e.g. from

trainertotrainee,orsupervisortoworker),althoughthereweresomeinnovativeapproachestoreconfiguring

learningOSH throughworkerengagement initiatives. Forexample,within the logistics case study,workers’

preference forbeing instructedby their (suitablyqualified)peerswasbuilt into training,asweremixedand

hands-onmethods,andholdingtrainingon-aswellasoff-site.Acrossthesectors,specificcharactertraitsof

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trainers– includingpracticalexperienceofthe industry,usingparticipatorycommunicationstyles,andbeing

“trusted” by workers – were associated with participants as prompting uptake of OSH-messages by giving

“credibility”tocommunicatorandOSH-content. Intheconstructionsector“toolboxtalks”wereintendedto

facilitategreaterworkerinvolvementandsitesusedcardsystemstoinviteworkerfeedback,withoneoffering

rewards for thebestOSH“innovations”. At this site, aswell asdisplayingadopted ideasonanoticeboard,

(Figure3.10),management response toworker concerns and ideaswere communicatedbydisplaying cards

thatwere“inprogress”andcardsthatwere“completed”withtheresulting“actiontaken”recordedfor the

workforcetosee.

Figure3.10 anexampleofaconstructionworkerOSH“innovation”throughafeedbackcardsystemDespitethesenovelapproachestolearning,OSHknowledgewaslargelyconsideredsomethingthatwasadded

to the workplace (through verbal, textual, and visual channels) beforeworkers undertook practical tasks

within, and encountered the specific social, material, temporal, and institutional features of, workplace

environments.WhileworkersevidentlypositionedtheirpracticeinrelationtotheOSHknowledgetransmitted

throughsuchorganisationaltrainingandinstruction(e.g.communityhealthcareworkersspokeabout‘conflict

and resolution’ training and the ‘lone worker policy’ as enabling them to work safely away from an

organisational base) the ethnographic research revealed how workers also learned to work safely in less

formal,more indirectandsubtleways. Individualsusedtheir informalorganisationalnetworks includingco-

workerswhowereperceived tobe ‘expert’ in the area (although theymaynot have formal or officialOSH

responsibility) and talked about their experiences during fleeting moments (e.g. in-between shifts, during

vehicle journeys, on breaks). In such spaces and moments of learning they developed skills and abilities

neededtoanticipate,plan,andmanageapproachestoworkingsafely.Furthermore,learningOSHwasshown

to be an incremental and ongoing process. This finding supports our claim that workers enacted and

developed ‘ways of knowing’ rather than simply receiving, sharing, and transferring already formed OSH

‘knowledge’.

Therewas a general sentiment shared betweenworkers that ‘learning by doing’ – orwhat one participant

referred to as being “experiential learning” – was key to ‘knowing how’ to undertake tasks safely. A

construction site groundworker expressed this viewpoint during an interview when he recounted his

experiencesoftranslatingvocationaltrainingintositework.

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This comment resonated more broadly with notions of “experiential learning” that characterised worker’s

understandings of how they have come to ‘know how’ towork in healthy and safeways; or the idea that

undertaking work tasks safely required blending institutional training and the continuous experience of

undertakingpractical taskstodevelopabilities,skillsandembodiedtechniquesto identifyandappropriately

respondtocontingentfeaturesofspecificscenariosandworkplaceenvironments.

3.9.2 WhereandhowOSH-knowledgeiscommunicated

Managers, supervisorsandotherswithexplicitOSH responsibilityplayedakey role formally communicating

OSH-knowledge to workers, and did so by using textual (handbooks, guidelines), electronic (emails, online

resources), visual (noticeboards, signs, walkways), verbal (training), and audio-visual (DVDs, PowerPoint

presentations) methods. They understood themselves to play an important communicatory role as they

selectedwhatinformationtosharewithworkers,madeitrelevanttotasksundertaken,andenlistedothersto

helpdistribute this information. Responsibility for safetywas simultaneouslydiffused throughout the case-

studyorganisationsasworkerswerealsoencouragedtotakecareofthemselvesandothers.

Yet, the ethnographic research revealed and provided detail on how communication of OSH knowledge

occurred, again, in less formal,more subtle and tacit ways. To better understandwhere, when, and how

workerscommunicatedaboutOSH, itwas importanttopayattentionnotonlytohowworkerstalkedabout

safetyinexplicit‘OSH’terms(i.e.safetyguidelines,regulations,andprocedures)buthowtheydidsoinother

ways and not only through talk. This included identifying routine and taken-for-granted ways of ensuring

workersafety;characterisedasbeing“quietsafety”(PinkandMorgan,2013).Indeed,thesefindingssuggest

that focusingonlyon formalisedOSHknowledgeacquisitionand transfermayoverlook theotherways that

workerslearnaboutandcommunicatesafetyintheworkplace,andmaynotrecognisethesafepracticesthat

workers have already developed in response to the contingencies of particular workplace scenarios and

contexts. Suchpracticeswerefoundtohavebeendevelopedbyworkersfromworkingwith,talkingto,and

watching others, as well as the embodied, sensory experience of undertaking practical tasks. Thus, OSH

knowledgewassharednotonlyinverbalortextualways,butthroughembodiedandsensorycommunication

channels.

Thiswas illustratedthroughthepractical techniques (orwhatwascommonlyreferred toasbeing“the little

things”) developed and shared between co-workers andwithin teams tomake tasks ‘easier’, ’quicker’, and

ultimately ’safer’. Logistics deliveriesworkers, for example, used a shared verbal and physical language of

“[…]whenyou’redoingyourticket[…]allthefootpathsareperfectandthere’salittleplacetherewereyou’regoingtobediggingout,butthat’snotlikethatonasite.Onasite,there’sgoingtobeunevengroundthatyou’regoingtobewalkingon.Sothat’sallstuffthatyou’regoingtohavetodealwith[…]layingflagsinthatsituationisgoingtobealoteasierthanactuallywhenyou’reoutonsite[…]youjust

havetogetonwithitattheendoftheday.Theycan’tsay,‘goonacoursetolearnhowtowalkonunevenground’.”(Constructiongroundworker)

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agreeduponmanualliftingtechniques,orknowingwheretopositiononeshandsonagood,howtoidentifya

securegrippingpoint,andwhatpartofthebody(arms,legs,shoulders)wouldtakethestrain(Figure3.11).

Figure3.11 acustomerdeliveriesworkerdemonstrateddifferentliftingtechniques

Although commonly used, workers struggled to describe physical and bodily techniques for these lifts

(suggesting that these taken-for-granted techniqueswere rarelyexplicitly spokenaboutwithothers), yetby

usingvisualethnographicmethodologieswhileaskingworkerstonotonlydescribebuttoshowushowthey

liftedandcarriedgoods,thesesubtleandotherwiseeasilyoverlookeddetailswererevealed.Workersdidnot

regard these shared approaches – and the verbal and bodily language to accompany these – to have been

explicitlytaughtorotherwiseformallycommunicated,yettheydidstresstheseincorporatedtechniquesfrom

manual-handling training (e.g. bent knees, straight back, holding objects close to the body). Thus, these

techniques(andprocessesforacquiringthem) illustratedhowregulatedOSHcametogether inpracticewith

less formal approaches including experiential learning and embodied interactionwithmaterials, goods, and

equipment. Thesesharedapproacheswereregardedtohaveemergedthroughthecontinuedexperienceof

doingthejob;encounteringadiverserangeofgoodsandpackaging(e.g.knowingcertainbrandsofgoodsto

be heavier than others); and responding to their specificmaterial qualities (e.g. looking for secure gripping

points)bydevelopingtechniquesthoughttomakeliftingandcarrying“easier”,“quicker”and“safer”.Slippery

orsmoothsurfaces,unevenlyweightedobjectsandbulkyshapesweresomeofthechallenges(andpotential

riskstoworkersafety)navigatedthroughsuchphysicaltechniques.

Insomeorganisations,non-verbalmethodsofcommunicatingsafetymessageswereembracedbymanagers

andsupervisors. For instance, in theconstructionsectorwhistleswereusedbybanksmen/slingers tosignal

lifting cranes, and coloured hard-hat schemes used to visually flag the role, status, and responsibility of

differentworkers.Inallsectors,mobileanddigitalmedia(e.g.cellphones,radios,email,electronicdatabases)

were used to communicate OSH content as workers developed OSH practices in relation to their use.

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Community healthcare workers could usemobile phones to send a text message to co-workers with their

whereaboutsiflateforanappointment,whileononesiteaconstructionsupervisorcitedtheimportanceofa

mobilephoneforenablinghimtocommunicatewithhisworkersin“realtime”(seePinketal.2014b).Beyond

beingapracticalwayto ‘flow’OSHalongcomplexnetworks,workers(especiallythoseundertaking loneand

mobilework)valuedthesemediaforenablingthemtofeel“connected”,“backedup”,and“supported”when

workinginisolation.Ascitedelsewhere(Pinketal.,2014b:343),onecommunityhealthcareworkerdescribed

how:whiletheroleofnewtechnologiesinenablingsafeworkingshouldnotbeunder-estimatedthese(ashas

beennotedbyothers–e.g.Cook,2008:28)mustbeco-joinedwitheffectiveorganisationalsupportsystemsso

thattheydonotcreateafalsesenseofsecurity.

Significantly,whenconsideringOSHcommunication,ourethnographicresearchfoundthatpeopleexternalto

the organisation such as the patient (in healthcare) or customer (in logistics) were also crucial sources of

information thatworkers used to anticipate, plan andmanage approaches to safeworking, and thuswere

involved in the co-productionofOSH-knowing. For communityhealthcareand logistics customerdeliveries

workerspre-arrivalphonecallswereimportantwaysforworkerstogatherinformationtohelpthemplantheir

visits to other peoples’ homes (see Pink et al., in press). In healthcare, responding to referrals required

balancing a need for speed with information gathering from the referrer, electronic databases, external

agencies (e.g.GPs, hospital, carers) and the patient themselves and/or their family. A phone call from the

organisational base was used to find out about access to their property, equipment in the home, services

already involvedandthepatient’sopinionontheircondition. Suchinformationwasusedtomakedecisions

aboutthecombinationofspecialistworkersandequipmentneededandissuestheworkerwouldneedtotake

careof(e.g.accessissues,animalsontheproperty).

3.9.3 HowOSH-knowledgeisperformedinsituwhereparticipantsweredoingactualtasks

OurethnographicresearchexaminedhowOSHknowledgewasusedandproduced insituby focusingonthe

everydaywork-based activities of healthcare, logistics, and constructionworkers. Guided by the emerging

empiricalfindings,itwasnecessarytoasknotonlyhowsafetycouldhappeninthesecontextsbuthowitwas

already happening, or to understand OSH as something that is both regulated and practiced (as being

‘performed’). At all sites covered by the ethnography, safe working was found to occur through the

nondramaticandroutinewaysthateverydaytaskswereperformed.Ourresearchrevealed‘quiet’(orusually

taken-for-granted, commonplace, and unseen) activities that workers did to ensure their own and others

safety.Byexploringtheseactivities,ourresearchprovidedinsightonhowworkers‘knowhow’toworksafely

inways thatwentbeyondwhatwasonly talkedaboutorcouldbedirectlyobserved to include (yetarenot

limitedby)bodily,sensory,affective,intuitiveandexperientialwaysofknowing.

For example, the use of embodied, sensory ways of knowing how to work safely was evident in the

construction sector. Thiswas common to the diverse trades thatwere involved: bricklayers described the

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importanceof‘mortarcontrol’orusingmovementofthetroweltofeelfortherightconsistencyofmortar(not

toowetordry)tominimisesplashingofthiscorrosivesubstance(Figure3.12),whilescaffoldersdemonstrated

howtheyknewawedgetobesecureastheylooked,listenedandfeltforaparticular“bounce”ofthehammer

whenknockingtheseintoposition.Theseskillsofworkingwithparticularkit(andknowinghowtointuitively

judge when an activity had been done safely by recognising and responding to physical sensations and

materialqualitiesoftools,objectsandequipment)wereconsideredtobelearntovertime,throughrepeated

experience,andencounteringdifferentscenariosinwhichtechniquesneededtobeadaptedthroughaprocess

oftrial-and-error.Forinstance,heavierblocksrequireadifferentconsistencyofmortarfromlighterblocks,as

doeslayingtheseindryordamp,hotorcoldconditions.

Figure3.12 abricklayerdescribedfeelingthroughthetrowelforthe“right”consistencyofmortar,anddevelopingphysicalproficiencyworkingwiththismaterial

Byhighlightingtheseaspectsofsafeworkingwearenotsuggestingtheseweretheonly(orevendominant)

ways of knowing how to do tasks safely, and indeed constructionworkers cited following instruction from

supervisors(whointurndescribedtheirpracticeandsupervisionoftasksasinformedby‘methodstatements’

and ‘risk assessments’), looking at site plans, using specialist equipment, talking to co-workers, and their

vocationaltraining.Itis,however,toindicatehowdiversewaysofknowing-includingknowingsafetythrough

bodilyand sensorial response -wereentangled inpractice, andhow thesewaysof knowingcomplemented

moreformalOSHknowledgecommunicatedthroughtraining,instructionandguidelines.

Moreover, our ethnographic research indicated how these kinds of knowledge were especially important

when scenarios couldnot always bemapped in advance. For instance, community healthcare and logistics

customerdeliveriesworkersusedbiographicalandlocalknowledgegainedfromgrowingupin,orworkingin

an areaover time, to safely approachworking inotherpeoples’ homes (seePinket al., inpress). Logistics

workers supplemented information generated through organisational guidance (printed delivery sheets),

digitalmedia(theSatnav)andtheirtrainedcapacity(toriskassess)with‘localknowledge’toanticipateaccess,

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parking and the types of homes they may be likely to encounter in particular neighbourhoods, and the

subsequent delivery implications. Similarly, community healthcareworkers recognised and valuedways of

knowingthatcouldnoteasilybewrittenintoinstitutionaltrainingyetwereevidentlyconsideredimportantfor

navigatingtheunknownqualitiesofhomevisits. Whenfacedwithunpredictablequalitiesofthehomevisit,

tacitwaysofknowing(inadditiontothosecarriedwithworkersthroughtheirtrainedcapacities,equipment,

uniforms)weredrawnon to guideactions anddecisions tonavigate towards safety. This includedwaysof

‘sensingsafety’orwhatworkersdescribedasbeingan‘instinct’or‘gutfeeling’enroutetothehome.Thiswas

expressedbyonehealthcareworker(alsocitedelsewhere-Pinketal.,2014inpress):

Thespatial,material,andsensoryqualities(lowceilings,dimlighting,unpleasantodours)oftheroutebecame

partofhowsafetywas‘sensed’and‘felt’bythisworker.Thisfeelinghademotionalresonance(e.g.evoking

anxiousness, fear, or uncertainty) while flagging actual risks (e.g. isolation, unclean or non-sterile

environments, difficult exit routes). It also indicated, though the reference to being ‘aware’ of risk from

working repeatedly in thearea,of theperceived importanceofexperientialknowing inenablingworkers to

navigatetheemergent,uncertainaspectsofhome-basedwork.

Thus,throughsuchempiricalexamples,ourethnographicresearchofferedanovelperspectivebyrevealinga

complexecologyofOSH-knowledge.Inadditiontoformalisedandregulated-OSH,thesetacitwaysofknowing

maybecategorisedas:

• experientialor‘knowinghow’fromaccumulatedexperienceoverthebiographyofanindividual’s

workinglife

• embodied/sensoryor‘knowinghow’throughbodilyandsensoryencountersincludingtouchand

sound

• intuitiveor‘knowinghow’fromafamiliarityandempathywithaplace,person,orthing

• affectiveor‘knowing’howfromthingsfeelingsafe,right,andeffective

Thesewaysofknowingwerenotantagonistic tobutwerebrought togetherwith (andused to supplement)

institutional-OSHthroughthecognitive(problem-solving)approachesandembodied,sensoryperformancesof

workerswhichmadeOSH‘feelright’or‘workinpractice’.

“[…]Iwasinnotaverygreatpartoftown,andIwasgoingintoamulti-storeyblockofflatsandIwasgoinguptothe11thflooranditwasquiteeeriefeeling;it’sverylowandit’snotverynice,therewasn’tagreat

smell,therewasn’tagreatfeeloftheplaceandIwasonmyownthen.Iknewmycolleaguewasalreadyinthebuilding;they’dmetmethereandthey’dalreadygonein,butitwasthatsenseof,‘whereismyphone?’Justincasethisdooropensonthisliftandthere’ssomebodywaitingtherewhoisn’tasfriendlyandit’sjust–IknewthatmyphonewasthereincaseIneededit,buteverythingturnedoutfineintheend.Butit’sjust

awareness,Ithink,thatI’vehad[…]Iamawareofareasthataren’tsonice”(Healthcareworker)

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3.9.4 AdaptingTowardsSafety

The adaptive and improvisatory aspects of safe working were foregrounded through the ethnographic

research, as workers were shown to respond to the ongoing and changing features of the workplace

environment.Thiswasespeciallyheightenedinthehealthcareandlogisticssectorswherecommunityworkers

anddeliveriesteamsworkawayfromtheorganisationalbaseinotherpeoples’homes(widelyconsideredto

be ‘unknown’ and ‘unpredictable’ contexts). Yet, the dynamic nature of the work environment was also

navigated by construction workers as they responded and adjusted their practice to the ongoingmaterial,

physical, spatial, social, and temporal changesofbuilding sites. Thisdoesnot suggest abinary relationship

between‘dynamic’non-organisationalcontextsanda‘regulated’organisationalbase; indeedobservationsin

the logistics sector support more complex understandings as variable features (time pressures, available

equipmentorhelp,kindsofgoodsenteringthesystem,layoutandspace)ofthewarehousewereexperienced

by warehouse workers as making for an continually changing environment. Likewise, institutional OSH

accessedthroughtraining,handbooks,PPE,standardizedequipment,riskassessment,methodstatementsand

soonwereusedbyworkerstostaysafebeyondtheorganisationalbase,butwerebroughttogetherwiththe

ways of knowing outlined above. However, if workers are understood to perform safety in changing

environments,thenitfollowsthatsafeworkingdemandsfromworkerstheabilitytomakedecisions‘onthe

spot’abouthowbesttosafelyimprovise.

As workers were followed moving through different work contexts and scenarios, the ethnographic

observationsrevealedhowinstitutionalOSH-knowledgeisappropriated,modified,andadaptedbyworkersto

produce new ways of knowing intended tomake tasks (as noted above) ‘easier’, ‘quicker’, and ultimately

‘safer’. Inhealthcare,aswehavealsodiscussedelsewhere(Pinketal.,2014a),nursesoccasionallyremoved

gloves,oradaptedthese(bycuttingoffafingertip)sothattheycouldusetheirhighlyresponsive,skilledand

trained sensationof touch to find a “good” vein fromwhich to take a blood sample. Sometimes they also

removed their shoes (part of theworkuniform)before entering a patients’ home to show “respect” for its

aesthetics and furnishings; and the patients’ expectations of how they should act appropriately as a

professionalandasa“visitor”or“guest”inthiscontext.Oneworkerexplained(Alsocitedelsewhere-Pinket

al,2014asubmitted):

Byremovinghershoesthenurseindicatedfeelingsofsafety, illustratinghowOSH-performancesaredonein

ways that are organisationally, individually, culturally, and socially appropriate. Additionally, safe working

across these sectors requiredworkers to navigate institutional commitments - for example, in construction

“ItendtotakemyshoesoffwhenIgoinahouse.Notallthetime[…]butwedohavesomecultureswhich[…]theydon’tagreewithshoes,when[Ivisit]Itakemyshoesoffintheirhouses.Icould[also]walkinandseecreamcarpets.There’snowayI’dwalkontocreamcarpetswithmyshoes.SoIrespect,straightawayI

respectpeoples’homesassoonasIwalkthroughthedoorandthewaytheykeeptheirhomes.Ifit’sraining,ifit’ssnowing,ItakemyshoesoffeverywherebecauseI’mnotgoingtowalksnowandwetshoes

intopeoples’homes”(Healthcareworker)

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those of workforce productivity and speed, in logistics that of customer satisfaction, and in healthcare an

emphasis on patient safety. Participants (as is supported by findings in the interviews and focus groups)

recognisedthepotentialfortheseprioritiestoconflictwithworkersafety,andacknowledgedtheimportance

ofinstitutionalsupportandworkerautonomyinupholdingworkersafetywhennegotiatingdifferentpriorities

inpractice(e.g.theabilitytosaynototasksfelttocompromiseworkersafetywithoutexperiencinganadverse

outcome).

These kinds of insights revealed how workers in our ethnographic study were confronted with complex

situationsthat–wewouldargue–alwayshavesomeelementofuncertainty,preciselybecausethefutureis

unknown.Indeed,aswehaveaccountedforelsewhere(MorganandPink,submitted),thiswasanelementof

our ethnographic practice that we likewise had to navigate to uphold our own researcher safety when

operatinginthesepotentiallyhazardouscontexts.Intheseworkplaceenvironmentstherearesetsofvariables

that are ‘known’ that workers can be reasonably certain of given their training and past experiences.

However,there isalwaysanunknownanduncertaintyaboutexactlywhatthe immediatefuturewillbe like,

andthustheneedtoimprovisearisesasthosemomentsemerge.Thisisanimportantpointbecauseitadds

further nuance to understandings of ‘workarounds’ previously introduced in this report (section 3.8.2) by

suggesting thatoftenworkersadapt towards safety rather thanaway from it. This understanding assumes

thatworkers frequently ‘need’ to improvise in relation both to the context inwhich they areworking (the

environmentalmaterialandsocialelements,forinstance)andtheOSHguidancethatframestheiractivities.In

emphasisingthispointwewouldmakeitclearthatwearenotsuggestingthatOSHguidanceisnotnecessary.

Rather,thatitneedstobe‘open’enoughtoencourageimprovisationstowardssafetyoutcomes,whileprecise

enoughtoensurethatimprovisationisdirectedintherightways.

3.9.5 OSH-Futures,InterventionsandChange:ImplicationsoftheEthnographicFindings

The ethnography demonstrated thatOSHhappens in and as part of a continually changingworld, inwhich

personal, embodied, and tacit ways of knowing are vital. This paves the way for developing applied

interventions around how OSH knowledge is learned, communicated, and used by organisations. While

regulatory intervention isoneway toachievesafeworking,werecognise thatalternate interventionswhich

recognisethedifficultiesofattemptingtoaccountforallofthecontingenciesfacedbyworkersarealsovital.

By acknowledging the inevitability of uncertainties, rather than seeking to account for them through

regulatoryprocesses,thechallengeforOSHpractitionersistodesignwaystobettersupportworkerresponse.

Toachievethisgoal,organisationsmaybenefitfromseekingtounderstandhowinformalwaysofknowingand

practicing safetyareused in relation to, andcomplement, formalised-OSH. Theethnographic findingspush

forwards thisunderstandingby revealing the specificpracticalways throughwhichOSH-knowledge learning

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andtransferhappens;includingtheplacesandactivitiesthroughwhichitoccurs,andthesocialrelationships

andinstitutionalprocessesthisinvolves.

OurfindingssuggestalternateunderstandingstotheideathatOSH-knowledgealways‘flows’anddoessoonly

through formalised mechanisms from one person to another. Learning also happens through informal

mechanisms; and safety knowledge is generated throughpractical activity undertaken in specificworkplace

environments. OSH-knowledge isnotonlytransferredbetweenpeople (e.g. trainertotrainee),butworkers

generateapproachestosafeworkingfromtheirrepeatedinteractionswithotherpeople(inandoutsideofthe

organisation),objects,materials,andspaces.Learningisanongoingandincrementalprocess,whichhappens

not only from what people are told or from what they see, but also the embodied, physical and sensory

experienceofdoing.

OSH training would benefit from incorporating these perspectives on how workers learn and share OSH-

knowledge. Training should be designed to equip workers with the skills and confidence to adapt their

practice as appropriate to specific contexts, yet this must necessarily be precise enough to ensure that

decisions taken by workers are directed towards safe working. Additionally, training methods that

acknowledge the situated, practical and socially co-constructed nature of learning and transfer of OSH-

knowledgeshouldbeencouraged. Forexample: ‘handson’mixed-methods;visualmedia includingvideoto

encouragereflectiononhowOSHislearntandused;‘buddyingup’ofmorewithlessexperiencedworkers;and

on and in-site training (e.g. walking site induction) may be harnessed for effective learning strategies.

Standardizedandgenerictrainingshouldbecomplementedwithlocallyspecificmethodsandinformation.

Byacknowledgingthepositiverolethatworkersplayinmaintainingtheirownandothershealthandsafety–

inoftenunnoticedways–organisationscouldbetterseektoidentifyandbuildintosystemslocallygenerated

innovations that have emerged from the experiential learning of workers. Existing worker engagement

initiatives(e.g.feedbackcards,rewards-scheme,workerrepresentatives)shouldbeencouragedasavenuesto

involveworkersinthedesignofsafetystrategies.Butthereremainsaneedtocapturesafetyinnovationsas

theyarecontinuallyexperiencedandoccurinnormalworkactivities;particularlythekindsofsubtlepractice

revealed through the ethnographic research. Institutions should develop strategies to enable workers to

openly discuss, reflect on, evaluate, and share decision-making processes,while recognising and seeking to

alleviatethepowerandstatusdifferentials,orfearofreprimand,thatmayresult inreluctancetotalkabout

OSHissuesandinnovations.

Inthissectionwehaveoutlinedkeyinsights,perspectives,andimplicationsemergingfromtheethnographic

research. These will now be taken forward with findings from the non-ethnographic research into the

discussion sectionof this report. Ouraim indoing so is to considerhow, in tandem, thesemixedmethods

haveinformedthedevelopmentofanintegratedmodeltounderstandaproductiveandnovel‘thirdway’for

OSHresearch.

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4 DISCUSSIONInthissection,weseektopositionthefindingsfromthisstudyagainstcontemporarydebatesandemerging

theoretical thinking concerning approaches to OSH. As part of this, we interpret the findings from of the

fieldwork, drawing on our different disciplinary perspectives, using this to formulate a pragmatic, person-

centricapproachaccountofknowledgeand informationflow,applicableto individuals inanetworkandthe

networks themselves. Where appropriate in our commentary, we highlight what we believe to be key

implicationsfortheOSHprofessionarisingfromtheresearch,basedonourinterpretationofthedata.

4.1 TypesofOSHknowledge,theirinteractionandproduction–Howtheyarechannelled,

engaged,navigated,interpretedandenacted

OneoftheaimsofourstudywastoidentifywhattypesofOSHknowledgeandevidencecirculateandworkin

relationtoeachotherinorganisationsinvolvedinnetworkeddeliverysystems.Themaintypesofknowledge

foundinthestudyaremodel1(formal,top-down)andmodel2(social,bottom-up).Inthissectionwediscuss

how these two interact and the necessity of social knowledge as the network becomes more and more

complex.InSection4.2weproposeathirdwaycontinuumwithmodel1andmodel2attheextremesanda

model3alternativeinclusiveperspective.

The formal knowledge base associated with OSH management in complex, networked

workplacesettings

The formal knowledgebasehasbeenmappedby the InstituteofOccupationalMedicineaspartof another

project inthisresearchprogramme. TheIOMidentifiedthattherearea largenumberofgroups involvedin

disseminatingOSHincludingthoseinprofessionalpracticeandnon-professionalswhoaretaskedinindustry.

TherearemultiplesourcesofOSHavailable,howevernotallare freelyavailable in thepublicdomainanda

subscription must be paid to access them. The IOM work brings the cohesiveness of the current OSH

landscapeintoquestionwherethereisalotof“knowwhat”ratherthan“knowhow”topreventionofinjury

andillhealthatwork.Thereisalsoaneedtoidentifythequalityandtrustworthinessofthesource.

Theinformal,sociallyconstructedOSHknowledgebase

Both our interview and ethnographic data suggested that OSH knowledge is co-created and interpreted

socially, both in an informal and formal manner, often leading to workers ‘picking up’ knowledge either

explicitlyortacitly.Ourethnographicstudiesalsorevealedhowknowledgeisnotstaticbutis,inpart,socially

constructedinandthroughpractice.Workersplacedvalueof‘learningbydoing’andmoreinformalclustersof

knowledge. These findings support Waring’s (2009) and Waring and Bishop’s (2010) argument that OSH

knowledgeissociallyconstructedandembeddedinpractice.

Theimportanceofsocialnetworksasasourceofinformationwasalsohighlightedbyinterviewrespondents–

many relied on social networks and colleagues as sources of information. This is unsurprising given the

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prevalenceof strong social hierarchies inmanywork organisations (for example as noted in thehealthcare

case described here) and the natural development of ‘arenas’ for shared learning (Carroll and Edmondson,

2002).

In this report,wehave foregrounded the role that tacit, informal, and ‘alternative’ (i.e. non-organisational)

‘waysofknowing’playinmaintainingworkersafety.Ourethnographicstudy,inparticular,offeredempirical

materialssupportingthesestatementsbyprovidingthekindsofdetails thatarenotsoeasilyaccessedfrom

theinterviews(preciselybecausetacitknowingisnotalwayseasilytalkedaboutorobserved).Italsoenabled

ustodevelopdifferentperspectivesfromthosedominantinsafetyresearchbyexploringhowworkerOSH,the

environment,perception,andpracticeinteracttoproducesafeworking.

Interactionbetweenformalandinformalknowledge

The extent to which individuals rely on formal and informal knowledge can be a function of experience,

familiaritywiththeworkenvironmentandinstructionfromtheirorganisation.Indeedthenatureofadynamic

workenvironment(suchasthosefacedinmanyoftheorganisationsstudiedhere)suggestsalevelofflexibility

intheinterpretationofformalinformationaswellastheuseofmoreindividuallyand/orsociallyconstructed

practices.Thesetwotypesofknowledgeareoftenusedtogethertodevelopanapproachappropriatefor‘in

the field’ operations. We discuss the exact nature of this flexible approach in some detail as part of the

proposed‘ThirdWay’continuuminsection4.2.3.

Productionofknowledge

As outlined above, knowledge can be produced both top-down and constructed by individuals and social

networksfromthebottomup.FormalexternalsourcestendtobeusedbymanagersandOSHprofessionals.

Many internal sources played an active part in knowledge production, including managers, professionals,

colleaguesandchampions.Aswellasthemorestructured,top-downinformationusedinproduction,informal

knowledgetendedtobesociallyconstructedviacolleagues,championsandexternalagents(includingpatients

orcustomers)whowerealsocrucialsourcesofinformationusedtoanticipate,plan,andmanageapproaches

tosafeworking.

Effectivechannels

The most commonly used effective channels for the movement and transmission of OSH knowledge,

motivators and practices that we found were face-to face (meetings, training and verbal communication),

electronic (internet, intranet and emails) and written media (notices, leaflets and posters). On the whole

verbalcommunicationwascitedasoneofthemosteffectiveandefficientchannels,inlinewithviewsonthe

importanceofmediarichnessinconveyingmessages.However,itwasfelttobeimportanttoemployseveral

different channels appropriate to theneedsand circumstancesof the receivers, especially thoseworking in

dynamicenvironments.

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KnowledgeFlow

OurworkhasquestionedtheextenttowhichOSHknowledgeflowsinalinearsense.Rather,whatunitesthe

variousstrandsofourstudyisthatOSHknowledgeisshapedandreshapedthroughtheprocessofenactment;

attimesitisappropriated,whileatothersitisaugmentedthroughitssituatedapplicationandre-application

elsewhereinthenetwork.Itis,therefore,alwaysmutatingasittravelsthroughtimeandspace.

ThewaysinwhichformalandinformalOSHknowledgeinteractandmutuallyshapeeachotherisaproductof

both the complexity of the networkswithin and acrosswhich itmust travel, and the nature of the hazard

context and regulatory environment forwhich it has been designed. In some cases formal knowledgewill

gather tacit practices as it travels, growing in terms of its scale and complexity. In other situations it will

remain largely intact, shaping anddetermining the processes andbehaviours it is designed to govern. The

challengefortheOSHpractitionercommunityistounderstandtheroleoftheinstitutionalcontextinshaping

this pathway, knowing when to accept localised contingent practice as being equally valid to formalised

knowledge,andhowtoharness thepowerofemergentpracticesalongside thoseofcodifiedapproaches to

achievingpositiveOSHoutcomes.

Furthermore, in considering the aspects ofOSHmessages that do flow, large networks can be challenging,

creatinglongcomplexcommunicationpaths.ThereforetheOSH‘successes’oflargenetworkedorganisations

areallthemoreremarkablewhichmaysuggestaverykeenandactiveOSHsupportfromandstimulationfrom

seniormanagement.

Enablersandobstructions

Notwithstandingtheabove,thereisstillevidenceofOSHmessagesmovingacrossthenetworksandthereare

manyenablersandobstructionstothisflow;filtersormembranesthroughwhichinformationandknowledge

mustpassbeforeenactment.Thetransmissionofknowledgeanditsfinalenactmentcanbeinhibitedbylack

ofstability,timepressures,priorities,socialgroups,orsub-cultureswithinorganisations,conflictingmessages

fromdifferent sources and the interface between organisational departments. While thesewere themain

obstructionscited,therewerealsoanumberofenablingconditionsthatfacilitatedthetransmissionandflow

ofknowledge.Thestabilityandstructurewithinorganisations,aswellasdiffuseresponsibilitywithinaculture

ofOSHownershipwerelikelytoeasethetransmissionof,andpromote,appropriateinformation.

NetworksmayposeadifficultenvironmentforOSHbutthereisanimportantfacilitatorrolefortheOSHhub

(who may be an OSH manager or consultant or may be a keen worker), namely the ‘political reflective

navigator’. This iswhere theOSHhub,whetheracknowledged formallyornot, is an ‘actor’whopursuesa

work environment agenda in a complex network in which other actors pursue other agendas such as

productivity, economics and quality. The OSH hub person is political in the sense of pursuing a work

environment agenda; and is reflective in the sense of being able to switch between different roles and

mobilizedifferenttypesofknowledgedependingonthecontext; theOSHhub isanavigator inthesenseof

knowing how to navigate in the complex organisation surrounding the technological change process. The

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competenciesofapoliticalreflectivenavigatorareoutlinedwiththeaimofrevisingthetrainingnecessaryfor

OSHprofessionals(BrobergandHermund,2007).

Engagement,navigation,interpretationandenactment

Engagement,navigation, interpretationandenactmentwasstudied inthecontextofdifferingorganisational

contexts andpower relations andalsoaddressed the tensionsbetweenapparently conflicting goals suchas

patient safety and occupational safety in healthcare or productivity and worker occupational safety in

constructionorlogistics.WecovertheenactmentofOSHmessagesinsection4.3.

4.2 Beyond‘procedure’and‘adaptation’:towardsathird-wayforsafetyresearch

4.2.1 Theoreticalcontext–rule-basedorexperientiallyconstructedknowledge

OverthelastdecadeormoreanongoingdebateinsafetyresearchhasfocusedontheextenttowhichOSHisa

productofrule-basedcompliance,orinsteadapracticedormorecontingentcognitiveactivity.Theunderlying

emphasisof thisdebatehasbeenon theextent towhich thosewhoare subject toOSHpolicyuse rules to

definetheirrole,orpreferencemoreindependentorcontextualwaysofworking.Theongoingnatureofthis

debate is unsurprising given the focus of OSH professional practice on risk management and regulatory

compliance, and thepsychological foundationsofmuch research in theOSH field. Howevera resultof risk

management being so enshrined in safety practice, and the behavioural emphasis of so much safety

scholarship, is that the safety research community is left having to simultaneously confirm and deny the

importance of worker independent thought (Dekker et al 2012). Moreover, efforts to understand safety

knowledgetendtofocusoneithertop-downrationalisticperspectives,orbottom-upconstructivistmodelsof

safety knowledge. Suchdebateshave therefore largelyproceededalongparallel trajectorieswith relatively

littleworkexaminingformalandtacitOSHknowledgeinpractice.

TheconceptofdistributedcognitionemanatedfromworkbyHutchins(1991)suggestingthatmostmodelsof

cognitionarebiasedtowards‘knowledgeinthehead’ascomparedto‘knowledgeintheworld’.Hutchinsand

Normanrefertotheinteractionbetweenthetwoasthe‘divisionofcognitivelabour’.Usingthisterminology,

someoftheexamplesthathavebeendiscussedearlier,suchasthebricklayingexample,wouldbeclassedas

‘knowledge in the world’ which are also referred to as cognitive artefacts. The idea is that cognition is a

process of continual interaction between these internal (‘in the head’) and external (in theworld) types of

knowledge.Inthissense,theenvironmentisaresourceforsafety.

In line with the notion of factional approaches to OSH, Dekker (2003) outlined two perspectives on rule

development in the workplace, model 1 (procedure application through rule following) and model 2

(procedureapplicationas substantive cognitiveaffectivity). HaleandBorys (2013)developed thesenotions

furtheroutliningtheadvantagesanddisadvantagesofeach.

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Model1:Top-downclassicalrationalapproachtoformallypassonOSHinformation.

Fromthisperspectivethereis‘onebestway’,whichcanbedictatedbyformalproceduresorrules.Theseare

devisedinadvanceby‘experts’andimposedandimplementedbymanagement.Thisisalogicalandrational

approach; both the rules and the consequences of breaking them are explicit. From an organisational

perspective,thisisclassicTaylorismbutithasalsobeendiscussedmorerecentlyinthecontextofpublicsector

organisations(Diefenbach,2009). Rulesofthistypearesaidtobegoodfornovicesandusefulwhen‘golden

rules’ (key rules or checklists which aid fast working or must not be broken because of the extreme

consequences)arenecessary.However,thisapproachcannotdealwithanomalieswell,canresultinablame

cultureanddisempowersworkers.

Model2:Bottomupconstructionistapproachtosociallyconstructedpractice.

This approach indicates that a range of behaviours are acceptable within permissible boundaries. In this

context workers are experts and apply their experience and knowledge to develop rules. Rulemaking is

ongoinganddynamic,evolvinginaneverchangingworkingenvironment.Thisapproachissaidtodealbetter

withtheambiguousrealitiesofwork. However, thereare limitationstothisapproach, it lackstransparency

andcanthereforebedifficulttoauditandproblematicfornovices.Theroleoftheorganisationisdiminished

andtheactivemanagementofrulesisundervalued.

Dekker(2003)indicatesthatwherethereisafocusonModel1,itresultsina‘doublebind’.A‘doublebind’

occurswhenthereisagapbetweenproceduresandpracticei.e.workerscanfailtoadapttoaproblemwhen

adaptationwasnecessaryorworkersattemptanadaptationwhichresultsinaproblem.Ratherthanseeking

toincreasecompliance,throughtheapplicationofpressure,organisationsshouldtryandunderstandthegap

betweenproceduresandpractice,andaddresscompetencieswhichwillhelpworkersadapttonewsituations.

Moreover, Hale and Borys (2013) suggest that a combination of the classical rational and constructivist

approacheswillenableorganisationstomanagesafetymoreeffectively.Theyproposea“Frameworkofrule

management”,andcallformoreresearchexploringhowrulesareusedinpracticeandethnographicresearch

inthisfield.

Thedescriptor‘absorptivecapacity’referstotheprocessbywhichvaluableexternalknowledgeisassimilated

atmultiplelevelswithinanorganisation, involvingseveralprocessesthatshapethewaythatnewlyacquired

knowledge is combinedwith existing knowledge (Lane et al., 2006). This construct contributes to the links

betweenmodel1andmodel2.Forexample,training,CPD,learningfromguidelinesandrules(model1)and

experiential knowledge, on-the job knowledge and socially constructed knowledge (model 2). Some

organisationsaregoodatabsorbingknowledgeandhence learningfromit,othersarepoor. Anexampleof

this iswhereorganisations takeworker’ssuggestionsandturnthem intoprocedures. The logisticsexample

citedinsection3.8showedthattheorganisationlearnedfromtheexperiencesoftheworkersandadaptedthe

methodsandprotocolstosuit.Waterson(2014)exploressomeoftheseissuesinhisbookonpatientsafety.

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Harveyetal(2014)suggestalinkbetweenabsorptivecapacityandperformance.Theyshowedthatstrategic

priorities,processesformanaging information,communicationandorientationto learninganddevelopment

impacted on the organisation’s ability to engage successfully with external stakeholders and make use of

availableknowledge.

AnotherauthorwhohasrecentlydiscussedOSHintermsoftwodifferentmodelsisHollnagel,whotalksabout

Safety-I and Safety-II and contrasts them as the past and the future (discussed further later). However, in

reality,thesetwo‘types’ofsafetyco-existandourconsiderationisthatbothapproachesarenecessarytofully

graspthefullpicture.

Thisalsolinkswiththecreationandfosteringofcommunitiesofpractice(Wengeretal,2002;Cambridgeetal,

2005).Communitiesofpracticearerelevantherebecausethey:

• Connectpeoplewhomightnototherwisehavetheopportunitytointeract,eitherasfrequentlyorat

all.

• Provideasharedcontextforpeopletocommunicateandshareinformation,stories,andpersonal

experiencesinawaythatbuildsunderstandingandinsight.

• Enabledialoguebetweenpeoplewhocometogethertoexplorenewpossibilities,solvechallenging

problems,andcreatenew,mutuallybeneficialopportunities.

• Stimulatelearningbyservingasavehicleforauthenticcommunication,mentoring,coaching,andself-

reflection.

• Captureanddiffuseexistingknowledgetohelppeopleimprovetheirpracticebyprovidingaforumto

identifysolutionstocommonproblemsandaprocesstocollectandevaluatebestpractices.

• Introducecollaborativeprocessestogroupsandorganisationsaswellasbetweenorganisationsto

encouragethefreeflowofideasandexchangeofinformation.

• Helppeopleorganizearoundpurposefulactionsthatdelivertangibleresults.

• Generatenewknowledgetohelppeopletransformtheirpracticetoaccommodatechangesinneeds

andtechnologies.

Our research has aimed to investigate the interaction between these two extremes of formal and informal

knowledge. We take this concept further by providing evidence to explore this ‘thirdway’ combination of

model1andmodel2.

Rule-basedbehaviour(Model1),experientiallyconstructedbehaviour(Model2)andsomemixtureofthetwo

(Model1.5)existasaresultofacombinationoftheexperienceandcompetenceofthepersonorgroup,the

type of task and the context or environment. In some cases rule-based behaviour (e.g. in a safety critical

context) will be appropriate, in others it leads people to create workarounds to artificially constrain OSH.

However,thesetwomodelsshouldnotbeseensimplyasoppositesbutratherthattheyshiftaroundaccording

totheprevalentconstraintsandopportunities.

Therearevariousgraphicalpresentationsofmodels1and2,forexampleFigure4.1.

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Figure4.1 Graphicalrepresentationsofmodels1,2andmodel1.5

ImageAinFigure4.1isaninappropriatewayofrepresentingtheknowledgemodels.Inreality,models1and

2arenotseparatedomainsandthecombinationofthetwodoesnotcreateanewmodel3asacompletely

separate domain. Image B is more interesting in that it acknowledges that there is some middle ground

(Model1.5)andthiswouldthensuggestthatanimprovedsituationisImageCwherethereisagreateroverlap

andmore engagements are occurring inmodel 1.5. However, these representations do not allow for the

almost continual movement between the extremes of the two models depending on the person, the

environmentorthetask.

Model3rule-andpractice-basedknowledge

Figure4.2suggeststhatbothmodels1and2occurtogether,sidebysideandareactuallysubsetsofalarger

andmoreappropriate realitywhich ismodel3. We recognise that theremayalsobe situationswhere this

typeofmodel3approachwouldbeappropriate. Peoplecanadd theirownpractice to rules tocreatenew

waysofworking.Inthiscasethesearenotworkaroundsorcompromises,butrule-informed.

Figure4.2 Model3combinationofrule-andpractice-basedknowledge

Thetwoextremes(models1&2)interacttomutuallyshapeeachotherthroughpractice.Thus,farfromOSH

representinganinternalisationofrulesortheadditionofknowledgetoaction,itrepresentsawayofknowing

thatemergesincrementallythroughinteractionsbetweensocial,spatial,temporal,material,sensoryfeatures

ofworkplacecontexts.So,formalisedOSHknowledgebothshapes,andisshapedbyknowinginpracticeina

rangeofunfoldingandcomplexways.WearguethatthisblendedperspectiveonOSHrepresentsa‘model3’

perspective for OSH research in that it simultaneously accounts for formal, codified and explicit OSH

knowledge(itselfenshrinedinOSHprofessionalpractice),aswellasinformal,emergentandtacitknowledge.

Movingbeyondaperspectivewheretheformalandinformalareseenasbeinginopposition,toexaminethe

1 21.51 2

3

1 21.5

A B

C

3

1 2

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ways in which they dynamically and continuously shape and reshape each other, is significant for OSH

professional practice. For example, an acknowledgement of the changing nature and context of OSH

environments presents a radically different vision of the role of the OSH professional in shaping OSH

outcomes, especially in the ways in which risk is considered and accounted for in dynamic work-based

assessments.

4.2.2 TheThirdWay–Model1.5

However,alloftheserepresentationsaretoostaticanddonotreflectthedynamicrealityofOSHknowledge

or enactment in large, networked organisations. They also do not lend themselves to helping identify the

factorsthatinfluencetheextentofrule-basedorimprovisedenactment.Theymaydescribetheproblembut

do not lead the way to a solution. Figure 4.3 is an alternative representation of the combination and

interactionbetweenmodel1andmodel2.Itrecognisesthatthereareneversituationswhereeithermodelis

fully employed, but that there are variations in the proportion of each model due to differences in the

individualorgroup,thetaskortheenvironment.

Figure4.3 TheThirdWayContinuum

A more experienced and competent individual would tend to be able to operate in a more flexible way

towards model 2 and be better able to make appropriate dynamic assessments of the risks and required

behaviour.Alessexperiencedindividualwouldtendtowardsmodel1,needingmorecertaintyandclarityof

what was allowed and what was not. They are likely to be less able to assess risks insitu or know the

appropriatebehaviouralresponse. Anexperiencedpersonwhohasnotbeenwelltrainedmayveertowards

model2whichcouldbeproblematicifthemissedtrainingisgermanetothemessageandtask. However, it

couldbe argued that a lower level of experience fostersmoreon the job learning as theydonot have the

formalisedrulesembeddedintheirpractice.





1.11.21.31.41.51.61.71.81.9

Mod

el1

Model2

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4.2.3 FieldworkEvidenceforTheThirdWay

Our research has studied the types of OSH knowledge and evidence that are in circulation and how they

interactwitheachotherinnetworkedorganisations.Morespecifically,weinvestigatedhowworkersinterpret

the multifaceted information they are exposed to and how this interpretation, in dynamic work contexts,

influences their behaviour. The data obtained illuminates how top-down rules (explicit information) and

socially constructedknowledgemanifestandcombine indifferent typesoforganisations,groupsofworkers

andindividuals.

In line with these theories, we found that both types of rule formation occurred concurrently, with the

productionofbothtop-downrulesandfacilitatingconstructivistapproaches. Theworkingenvironmentwas

themaininfluenceonthetypeofapproachtaken.Incontrolledenvironmentstop-downapproachesaremore

likely;however,indynamicenvironmentsexpertworkersaregiventhemeanstodeveloptheirownpractices.

Notwithstanding, thereality ismuchmorenuancedthanthisandthetwoapproachesoftenappearasa fog

through which workers must negotiate the OSH landscape (Hartley et al, 2014). Workers operate in a

hinterlandwhere,consciouslyorsubconsciously,theyuseacombinationofformalrulesandinformallearning

and experience to determine their behaviour. When questioned and observed it becomes apparent that

workersareoftenusingacombinationoftop-down,sociallyconstructedandexperientialexpertknowledgeto

informtheirperformanceofagiventask. Forexample,deliverydriversuseacombinationofformalmanual

handlingtraining,experience,and‘on-the-job’learningfromcolleaguestomanoeuvregoodsintocustomers’

homes. Behaviours varied depending on the circumstances,withworkers evaluating their course of action

havingtakenaccountofmultiplevariables.Forexample,workersmayormaynotaskforhelpliftingaheavy

object depending on the proximity and workload of their colleagues – if their colleague is busy or some

distanceawaytheywillnotaskforhelp,iftheyareclosetheywillaskforhelp.Rulesareadapted,thisisdoes

notnecessarilycompromisesafety,asworkersareabletoapplytheirknowledgetoadjusttosituations,infact

we found that often workers adapt towards safety rather than away from it. However, when rules were

broken,withresultantnegativeconsequences,evidenceof‘thegap’wassometimesfound.

Inthisresearchwearecontributingtoattemptstoreconcilethisbiaseddebatebyshiftingthedebateaway

fromtheruleandcompliancebasednatureofthecurrentOSHknowledgedebatesandfocusonwhatactually

happens in OSH practice. However, a simplistic distinction between formal OSH rules and situated OSH

practicelimitstheunderstandingofafarmorecomplexandsubtlepicturewherethetwointeracttomutually

shapeeachotherthroughpractice.

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4.2.4 ApplyingtheThirdWayContinuum

The followingsnapshot scenariosareused to illustrate thesortsof tasks, individualsandenvironments that

willrequire,orarelikelytopromotebehavioursatdifferentpointsofthespectrumbetweentheextremesof

thetwomodels. Thescenariosarenot intendednecessarilytoshow‘ideal’ortrainedbehaviour,butrather

likelybehaviourgiventhesituationsfaced.

This snapshot shows two different

individuals with different tasks in the

samehospitallaboratory.Eventhough

the lab is highly standardised and

controlled, the biotechnologist would

need to be able to respond flexibly if

somethingwentwrong,albeitbasedon

aclearframeworkofriskminimisation.

Thetechnologistwouldalsoneedtobe

abletodifferentiatebetweenmoreand

less highly contaminated samples and

choosetheappropriateprotocols. Thecleanerwouldbeabletouseroutinecleaningproceduresbutwould

need to be fully aware that theywere nowworking in amore hazardous environment than normal. They

wouldbeunlikelytobeabletodifferentiatebetweendifferenthazardsinthelabandsowouldneedtofollow

theappropriateprocedureswhenintheenvironment(e.g.wearingthecorrectPPE).

On the day ward the nurse would be

carrying out routine tasks; however,

each patient is different and has

different needs. Moreover, the nurse

willneedtobeawareoftheriskinthe

jobandmakeappropriatedecisionsfor

personalOSH.Thetaskscompletedby

the health care assistant (HCA) are

generally very routine and low risk.

However, this is still potentially a

relatively high risk environmentwhich

mustbeunderstoodalongwiththeappropriateactionif incidentsoccur. Acommonincidentforhealthcare

workers iscausedbythepatientstumblingorfallingandtheworkerbeing injuredtryingtopreventthefall.

Theprotocol is toallow the fallbut ‘guide’ thepatient to the floor tominimise thepotential injury toboth

parties.Patients’conditionsandbehaviourswillstillvarybuttheyarelikelytobelessinfirmonthisdayward

thanonanotherhospitalward.

Qualifiedbiotechnologist,testingandhandlinghighlycontaminatedsampleinahighlyregulatedenvironmentintermsof

procedures,protocolsandPPE1.4

Novicecleaner,cleaningaregulatedlabarea,needingtowearPPEbutnotdealingwithhazardoussamples1.2

HospitalLaboratory

1 2

Dermatologyout-patientclinicnurselancingboilsonapatient’sbackinaclosedwardenvironmentwheretasksareperformed

routinely.Sharpsandbiologicalcontaminantriskspresent1.6

HeathCareAssistantassistingwithpatientcare(e.g.makingteaorguidingthepatienttotheclinicalarea)inaclosedwardenvironmentwheretasksareperformedroutinely.Sharpsandbiologicalcontaminantriskspresent1.3

HospitalDayWard

1 2

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Healthcare work in the community

requires a more flexible, contingent

approach than similar work in a

hospital ward. Complex home

environmentsarenotuncommonand

in some contexts, such as mental

health, the risk of violence can be

high. The routine check-up could be

rescheduled and so the nurse could

(andmaybeshould)makethedecision

to follow normal lone working

protocol andwalk away. However, given the samehazardous homeenvironment, themidwifemay take a

differentapproachandneedtoassesstheriskanddeterminetheirbehaviourmuchmoredynamicallydueto

therealrisktothepatientandunbornbaby.

In logistics, the warehouse

environment is relatively stable and

enablesareasonable levelofcontrol.

Operations which are particularly

hazardous such as using forklifts and

handling large goods often have

specific protocols. However, a

delivery driver must adjust to the

environment of the house to which

theyaredelivering.

Principalscancertainlybeset,buttheoperationalisingoftheprincipalswillbedowntothedriver.

Construction sites are hazardous by

nature, even at ground level, but falls

from height are a particular problem

andscaffolds,astemporarystructures,

are even more hazardous. A general

operative cleaning the scaffold may

also not be familiar with working on

the scaffold. Therefore, even though

themethodofthetaskitselfwouldnot

needtoberulebased,thelocationmeansthatthisworkerwouldneedtofollowagreedprotocolsonworking

atheight. Inadditionofcourse, incleaning thescaffold therewouldbea riskof thedebris fallingover the

Communitymidwifeattendingtoapatientwhohasgoneintolabour.Astressful

homeenvironmentwheretheremaybesomeviolence1.9

Nursedoingaroutinecheckonapatientinthecommunity.Astressfulhomeenvironmentwheretheremaybesomeviolence1.3

CommunityMidwife

1 2

Deliverydriverunloadinglargeitemsanddeliveringtoanupstairsroomina

residentialdwelling1.7

Warehouseworkerusingmechanicalequipmentwithhighstacksoflargegoods1.2

Logistics

1 2

Operativesweepingconstructionsiteatgroundlevel1.6

Operativesweepingscaffoldingonthe4thfloorofanofficeblock1.2

Construction

1 2

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edgeofthescaffoldandinjuringthosebelow,whichthisworkermightnotbeawareof.Thisisanotherreason

whyamorerulebasedapproachwouldbeappropriate.Theworkersweepingatgroundlevelwillstillneedto

be aware of the site hazards and adjacent work, also probably mechanical equipment. Nevertheless, the

sweeping task would be open to a degree of flexibility and some opportunity for the worker to develop

suitabletechniquesbasedonmoreframeworkprotocols.

4.2.5 TheThirdWaycontinuum:ConclusionsandImplications

In practice, classical rational and constructionist rule development are conjoined and symbiotic; in dynamic

workingenvironmentstheirmanifestationiscomplexwiththeinfluenceofeitherapproachwaxingandwaning

dependingoncircumstances.Ourdatarevealgoodpracticewithinorganisationswhomanagethetransferof

OSHknowledgewellinthattheyrecognisethevalueofbothapproachesandadapttheirstrategiesdepending

onthejobroleandsituation.

Individualsandgroupstendencytowardseithertherulebasedortheexperientiallyconstructedunderstanding

ofOSHknowledgewilldependonanumberofentwinedandinteractingfactorsincludingtheexperienceand

competence of the individual or group, the nature and complexity of the task and the influence of the

environment.

The Third Way Continuum has been proposed as a way of both better understanding the reality of OSH

knowledgeanditsenactmentbutalsoprovidingpointerstowardsmoreeffectivemanagementofresponsesto

thechallenges.Thereisalwaysacombinationofthetwomodelsandorganisationsshouldrecognisethefact

andharnesstheopportunitiesratherthanbemoanthereality.

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4.3 RespondingtoReality

Wehaveproposedanalternativetothetwoextremesofrule-basedandanexperientiallyevolvedapproachto

OSHpractice(Section4.2)withtheintentionofhelpingpeopletorespondtotherealityofthe‘fog’thatisOSH

communication and enactment. The situationswhere ‘it is obvious’ are very rare and bothmanagers and

workersneedtobeable to respondto thereal-lifechallenges thatare faced. This sectionconsiderspartial

enactment,workaroundsanddynamicriskassessments.

4.3.1 Partialenactment

Asexplainedinsection3.8andillustratedinsection3.9,theenactmentofOSHmessagesisrarelycompletely

inlinewiththeintentionoftheoriginalsource.Acknowledgingthedangerofoversimplification,therearea

number of different types of enactment, using the word ‘exact’ to represent enactment in line with the

intention of the source. The boundaries between these categories are both flexible and porous as each

categoryisnotexhaustive.

Exactenactment Partialenactment

1 2 3 4 5

Exactenactmentofinitialmessagefollowingaccurateinterpretationandassimilationofthetransmittedmessage,bothbytheindividualandpreviouslyacrossthenetworkandgivenanenvironmentsuitablefortheintendedenactment.

Exactenactmentofthedirectmessageasgivenbytheimmediatesource,butonlypartialenactmentoftheinitialmessagewhichhasbecomecorruptedacrossthenetwork

Partialenactmentofthemessagebecausetheindividualdoesnotunderstandit.

Partialenactmentofthemessagebecausetheindividualconsiders,rightlyorinadvisably,thattheconditionsandenvironmentthattheyfacemakesthemessageinappropriate.

Partialenactmentornon-enactmentofthemessagebecausetheindividualdecides,consciouslyorsubconsciously,nottofollowtheguidanceorinstructionofthemessage.

Perfectbutunrealistic

Likelyinlargecomplexnetworks

Likely,especiallyforinexperiencedworkers

Likelyinchangingcircumstances–workarounds&dynamicriskassessments

Requiresactiontoaddressriskandpreventreoccurrence

6Enactmentwhollyorlargelydetermined,basedoncontingentknowledge,createdbytheindividualorgroupconcerned.

Category1isidealisticandprobablyunrealisticinmostcases.Corruptionofthemessagethroughthenetwork

(2)canalsoapplytocategories3-5andwouldleadtoanenactmentevenfurtherawayfromtheinitialintent.

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Category6islikelytoapplyfullyinsomecases,butisalsolikelytobeaninfluenceontheothercategories.In

otherwords,somelevelofco-creationofknowledgebytheindividualorgroupoccursinallcases.

Category2:corruptionacrossthenetworkhasbeenconsideredpreviously(particularlysection3.4).Category

3: failure of understanding has been considered briefly in section 3.7. Category 6: co-created, contingent

knowledge is discussed at length in section 3.9. This section deals with category 4 and, some aspects of

Category5,inparticular,thetopicsof‘workarounds’and‘dynamicriskassessments’.

It is also acknowledged that, even if the message is clear and suitable for the person, the task and the

environment,someworkersjustdonotdowhattheyknowtheyshoulddoforthemandtheirco-workersto

staysafe.Afullconsiderationofthisissueisoutsidethescopeofthisresearchproject,however,weconsider

that, if the good practices thatwe have identified are applied then the number of people choosing not to

follow theOSHmessagewill be significantly reduced. The recommendations in section 5 provide practical

adviceonhowtobestmanagethissituationandamorepractitioner-focusedoutputisplannedasafollowup

tothisreport.

4.3.2 Dynamicriskassessments

Dynamic risk assessments fall into enactment category 4: Partial enactment of the message because the

individual considers, rightly or inadvisably, that the conditions and environment that they face makes the

messageinappropriate.

Therewasadifferencebetween theenvironments faced in static, relativelyunchangingworkenvironments

and those where the situation was constantly changing or more unpredictable. For patient-facing staff in

healthcareitwasoftentheunpredictablenatureofthepatientthatprovidedthisunpredictabilitywhereasfor

community healthcare workers or residential delivery drivers in logistics it was the unknown of the home

situation.

Construction workers faced a constantly changing environment, but one that was expected and, to some

extent,predictable–predictably changeable. Furthermore, constructionworkersonmost siteswere facing

these changes in the workplace along with their colleagues and supervisors. The project-based, itinerant

natureofconstructionseemstohavebuiltupaculturethat,atleastwhenitispractisedwell,cancopewith

thevagariesintheworkplace.Thecatchphraseresponseofthechildren’sTVcharacterBobtheBuildercomes

tomind:“Ohdear,Bob,it’sgonewrongagain,canyoufixit?”–“Yeswecan!”However,someconstruction

workersandmanagers,atleastinthesmallercompaniesandsitesseemtousethisequalityandanexcuseto

notplanatall.ThisaspectisbeingaddressedonaparallelprojectonSMEandmicroorganisations9.

9SMEs andmicro organisations engagement with occupational safety and health – A Loughborough University project

fundedbyIOSH(2013-15)

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Wheretheworksituationwassuchthatitwouldregularlychangebeyondtheboundariesenvisagedwhenthe

taskwasplanned,alternativewaysofestablishingagreedmethodsandappropriatetrainingarerequired.The

scenario-orsimulation-basedtraininginhealthcare,albeitusuallyfocussingonpatientsafetyratherthanOSH,

seems to provide an example of this approach (e.g. Rosen et al, 2008). The term “simulation” has been

definedas“instructionthatmakesuseofsimulationsofrealworldcontextswherelearnersinteracttoacquire

knowledge,skills,andaffectiveelementsthatwillultimatelytransfertotherealworldcontext” (Salasetal.,

2013). Simulation-based training has been used for many years to train those who work in hazardous

environments.Effectiveandsafeperformanceinthesesettingsrequiresbothhighlyskilledindividualsanda

high degree of team coordination. In addition to individual competence, communication between team

members and decision making become particularly important during the management of crisis scenarios

(Moorthyetal.,2005).Theconceptof‘safeimprovisation’couldbeexplored,whichwouldrequiretheteam

tohaveasoundunderstandingof theunderlyingprinciplesofassessingriskanddesigningtasksrather than

justunderstandingtherulesthathavebeenset. Throughworkerfeedback,these improvisationscouldthen

beincorporatedinrevisedsafeworkmethods.

Insituassessmentofriskshouldnotbeusedasanexcusenottoplanorassesstheriskinadvance.But,ifthe

risksareassessedinsituproperlythenthiscouldleadtoaneffectiveworkaroundwhichwouldnotneedtobe

lesssafethantheoriginalmethod.

Itisacknowledgedthattherearesometasksthathavelegallyprescribedrestrictionsbutmanagersareadvised

not to try to control things that don’t need tobe controlled and to avoid ‘making sackableoffencesoutof

trivia based on dubious statistical studies’. The evidence that we have gathered would suggest the best

solutionwouldbe tominimise the situationswheremanagers try to control the risk by settingprescriptive

rulesandtomaximisetrainingbasedoncontingent,scenario-basedapproacheswherepossible.

The links between minor, insignificant events and more serious incidents have been used to drive down

accident rates inanumberofhigh risk sectors including construction,especiallywith the reportingof ‘near

misses’or‘closecalls’.However,itmaybethatoneundesiredeffectofthisemphasishasbeenthetrivialising

ofOSHandtheoveremphasisonrule-basedapproaches,evenfortaskswherethenegativeconsequencesare

minor. Of course, this needs tobe taken in the context of acknowledging that someapparentlyminorbut

repeated incidents can lead to significantproblems in the long term,especiallywith regard tooccupational

healthincidents.Thisisclearlynotasimpleproblemandrequiresfurtherpragmaticengagementawayfrom

therhetorictoworkoutsensiblewaysforward.

Thefindingssuggestthatmanagersneedtobemoresophisticatedinmanagingtheseinsituassessmentsand

there is not ‘one size fits all’ approach for all sectors, all network types, all individuals and all situations.

Nevertheless,theyhappen,peoplewillassesstheriskforthemselvesandmakedecisionsonthatbasisbutstill

need to beheld accountable for their decisions and actions. The reality needs to bemanaged rather than

ignored,hopingitwillgoaway.Weneedtostimulatepeopletounderstandtheconsequencesoftheiractions,

both for themselves and others. If we take a narrow, directive, procedural approach we should not be

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surprisedwhenitdoesnotwork–peoplewilladaptandstretchtheboundaries–weneedtounderstandthis

andmanageitaccordingly.ThereisadifferencebetweenOSHasimaginedandOSHasactuallydone.

4.3.3 Workarounds

Workarounds, shortcuts, cutting corners and bending the rules are expressions thatwere prominent in the

interviews andworkshops for this project. Sometimes the words were used interchangeably tomean the

samethingalthoughtherewerealsonuanceddifferences in thewaysome individualsdiscussedthesubject

(seesection3.8.2).

Shortcutsor cutting corners sometimes suggested that theworkerwasnotdoing the jobproperly andwas

somewhat‘slap-dash’ intheirapproach. Itwasthoughtthatthismayhavea,usuallynegative,effectonthe

qualityoftheworkoronOSH.Bendingtherulessometimessuggestedtheideaofpushingthelimitsasfaras

possiblewithoutactuallybreakingtherulesor interpretingtherules inawaythatwasprobablydifferentto

their initial intention. Workaroundshoweverweremoreoftentalkedofaspragmaticwaysofdoingthe job

whichcouldnotbedoneexactlyinthewaythatwasinitiallyplanned.Thisdiscussionthereforeusestheterm

workarounds in this way, although we acknowledge that this is not always how it is used. In this way

workaroundswould the resultofa consciousor subconsciousdynamic riskassessment. Inotherwords the

OSHimplicationsofthenewwayofdoingthetaskwouldhavebeenconsideredbeforemakingthechange.

Relatingtosection4.3.1,mostworkaroundsfallintocategory4:Partialenactmentofthemessagebecausethe

individual considers, rightly or inadvisably, that the conditions and environment that they face makes the

messageinappropriate.

Itwasnottheintentionoftheresearcherstomakevaluejudgementsregardingthepreciserisksofthetasks

discussed. Nevertheless, this research has identified enactment that is at variance with the agreed or

prescribedmethodsororganisationalpolicywhichareacceptedbytherespondentsasbeingequallysafeor

evenmoresafe.Furthermore,thishasnotbeenthecaseofworkerssayingtheyweresafeandmanagersor

OSH advisors saying that theywere not, but rather an acceptance that alternativemethods are sometimes

appropriate. The ethnographic work (section 3.9) suggests that workers will always make changes to the

‘formal’proceduresand that this isanormalpartofhumanbehaviourandshouldnotbe seenasnegative.

Theinterviewsandfocusgroupsdatawouldsuggestasmall,butsignificantchangetothisclaim,namelythat

thesechangesshouldnot‘automatically’beseenasnegative.

ItmaybethattheOSHprofessionalnormallyonlyhearsthe‘badnews’:the(few?)workaroundsthatdonot

workratherthanthe(verymany?)onesthatdo.Theydon’tmeasuresuccessesofworkaroundsbecausethey

neverseethem.

Workarounds were seen as ways to achieve the intended end goal when faced with situations that were

differentthanthoseplannedortomanage‘flawsinthesystem’thatwereoutsideoftheircontrol.Thereisa

close link herewith dynamic risk assessments – inmanyways they canbe considered as dynamic problem

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solving.Therewerealsodifferencesbetweenanindividualworkerdecidingtouseaworkaroundandateam

discussing the issueandcoming to thesameconclusion,whetherornotanofficial ‘supervisor’waspresent

and whether or not the workaround was subsequently acknowledged and adopted as standard (and by

implication‘safe’)practice.

Notwithstanding,despiteallthewell-intentioned,well-thought-outworkarounds,therewerestillworkerswho

were willing to take significant risks, breaking the rules ‘because they can’, because ‘it won’t take long’,

because‘ononeiswatching’.Thisisasalutarylessonwhendiscussingtherealityofworkarounds.

A number of the organisations studied hadways of encouragingworker feedback and responding to it. In

theseorganisationsitwouldseemthatanideal‘solution’toworkaroundswouldbethat,exceptinextremely

urgentsituations,theworkerwoulddecidethataworkaroundwouldbebeneficialbutpassthatmessageback

upthenetworktoeffectachangeinprocedure,ratherthanjustusetheworkaround.Certainly,thecontinued

use of the same workaround suggests a breakdown in the feedback mechanisms. From this perspective,

workaroundswouldonlybeshort-termfixesonlyandbecomeregularisedassoonaspossible.

Asmentioned intheprevioussectionondynamicriskassessments, theuseofscenario-orsimulation-based

training is likely to be a good opportunity for staff who would be regularly facing these changeable work

environments.

4.3.4 Behaviourasaresource

Behaviourasaresourcehasbeendescribedasanextensiontoresourceadvantagetheory(e.g.Doherty,2001)

whichispartofthegeneraltheoryofcompetition.Weconsiderthatitcanandshouldbeappliedinrespectof

OSH.

Ina recentpaperpresentedat the IOSH-supportedWorkingonSafetyconference,Kirsten Jørgensen (2014)

citedaprevious colleagueCarinSundström-Frisk from1982andargued that “peopledon’t causeaccidents,

they prevent them”. Sundström-Frisk’s words were: “People can work day in and day out in a hazardous

environment.Throughtheirthoughtfulness,ingenuity,attentionandphysicalabilitiestheycancompensatefor

poorlydesignedequipment,facilitiesandroutines,andthuspreventtherisksbeingtriggered.Thenonedayin

a fewsecondssomeone loseshisorherattentionandtheaccidenthappens.” Sheargues that this iswhen

peoplearegiventheblameforsomethinggoingwrong.

Behavioural safetyorbehaviouralmanagement isan important focus formany industries today,particularly

construction. MostcompanieswanttohaveaBBSsystem(BehaviouralBasedSafetySystem). Muchofthis

focusconcentratesoneliminatingnegativebehaviourandstimulatingpositivebehaviour.Thisinitselfisnota

problembutmanywhoareinvolvedinoperationalisingtheBBSsystemsassumethatthedefaultbehaviouris

badandthattheyneedtoworkhardtomakeitgood.Thebasisofthisnegativitymaywellbeaconcernthat

people tend to make changes to formal procedures and apply workarounds. We tend to agree with

Sundström-Frisk that people are thoughtful, ingenious and attentive,most of the timeusing their cognitive

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andphysicalabilitiestogetthejobdoneandgetthejobdonesafely.Ifwecouldharnessthisbehaviourasitis

andapplyittothechallengeofcreatingahealthierandsaferworkplacethenwewouldachievemuch.

ThisapproachissimilartotheSafety-IandSafety-IIapproachbyEricHollnagel(2014).Hollnagelarguesthat

theexistingapproach(Safety-I)workstoreinforcecomplianceandavoidthingsgoingwrongandistherefore

linked to and focussing on failure rather than success. It attempts to prevent failure, for example by

constraining performance. He argues that the challenge here is that, as OSH performance improves and

incidentsdecrease,thenthereisalowfrequencyoffailuresandhencelessopportunitytolearnfromthem.He

challenges the assumption that there is a correlation between a successful outcome and a low probability

failure.Hearguesthatsystemsanddecomposableandfunctionalityisbinary.HollnagelproposesSafety-IIby

movingthemanifestationofOSHtofocusonwhatgoesright,movingfrom‘everything’goingrightto‘enough’

goingright, from‘avoiding failure’ to ‘ensuringsuccess’.This ismorethanpurelysemantics;hearguesthat

thisapproachcancopewithemergentpropertiesandthattheoutcomesareduetotransientphenomena.

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4.5 Person-CentricOSHKnowledge(P-COK)Flow–Sources,ChannelsandFilters

The person-centric OSH knowledge (P-COK) flow model looks at the findings from this research from the

perspectiveof each individual in thenetwork. It shouldbe consideredalongside theThird-WayContinuum

which provides more of a holistic perspective. Members of the research team have previously looked at

communicationflowontheOlympicParkconstructionforLondon2012(Cheyneetal,2011&2012;Finneran

etal,2012)whichbuiltonConzolaandWogalter(2001)C-HIPmodel(Figure4.1).

Figure4.1 TheC-HIPcommunicationmodel(adaptedfromConzola&Wogalter,2001)

Other literature,particularly fromthehumanfactorsdomain, leans favourably towardsthiswayof thinking.

Participatory ergonomics, for example, uses participative techniques and tools in projectswith peoplewho

have sufficient knowledge and control to achieve desirable outcomes (Wilson, 1995). In task design,

participatoryergonomicsisanumbrellatermforanumberofuser-centredfactorsthatimprovethesuccessor

integrationofanewwayofworking(Hainesetal.,2002;Vinketal.,2005).Endsley(2011)definessituational

awareness as the operator being aware of the ‘here and now’ or their current environment, and

understandingwhatinformationmeanstothemnowandinthefuture.Thisinformationisusuallydefinedas

what is important in terms of a particular job or goal. Situational awareness is broken into three stages:

perception of the elements in the environment, comprehension of the current situation, and projection of

futurestatus. Onceanoperatorhasreachedthefinalstagealternatingbetweenbottom-updatadrivenand

top-down goal directed processing of the message is one of the vital mechanisms supporting situational

awareness.Inotherwords,shouldthepersonsticktothegoalsofthetaskoraltertheirworkbasedoncues?

However,goodsituationalawarenessdoesnotalwaysmeanthatthebestdecisionwillbemade.Forexample,

individuals may have good situational awareness, but have inadequate strategies or tactics guiding their

decision processes. There may be limited decision choices available due to organisational or technical

constraints.Thepersonmayhavelimitedorinsufficienttrainingorexperiencetomakethemostappropriate

decisions.Individualfactorssuchasimpulsivenessorindecisivenessmaymakesomeindividualsmorelikelyto

makepoordecisions.Whateverthereason,theimportantpointhereisthattheseapproachesareputtingthe

individualatcentreand investigating the factors thataffectknowledge flowandaction. Theperson-centric

OSHknowledge(P-COK)flowmodeltakesthesameapproach.

Attention Comprehension Attitudes/Beliefs Motivation BehaviourChannelSource

Receiver

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4.5.1 ThePerson-CentricOSHKnowledge(P-COK)FlowModel

The P-COK flow model takes a pragmatic, person-centric approach

towardsknowledgeand informationflowandcanbeappliedtoeach

individual in the network. The research team acknowledge the

theoretical and intellectual limitations of this approach and the

potentialdifficulty inusingformalgeometricalshapes– inreality it is

muchmoreofa‘fog’ofcomplexinteractionswhichcannotbebroken

downintosimplecomponentsasshownhere.

We acknowledge Dekker (2011) who

criticises theapproachofbreakingdown

everythingintocomponentswhichmakes

themseemartificialortrivialratherthan

recognising the complexity of thewhole

system.

Figure4.2IdealisedPerson-CentricOSHKnowledge(P-COK)FlowModel

Idealisedknowledgeflowprocess

Theidealisedknowledgeflowprocessassumes:

• Areliable,trustworthyandknowledgeablesource• Aneffectivecommunicationchannel• Noothersignificantinfluences• Theperson’sadequatecognitiveabilitytoachieveaccurate

translationofOSHmessage• Theperson’sobedientenactmentofthemessage

This is perhaps best understood as the employer’s direct input

relating to the task at hand. Typically this is transmitted to each

person in the network by their linemanager, either verbally or in

somewrittenform.Theformofenactmentvariesdependingonthe

person’spositioninthenetwork.Formany,theprimaryenactment

is topassontheknowledgeor informationtothenext levelofthe

network. Atthefinalworkfacetheenactmentisthetaskitselfand

these ‘workers’ are the ones who are most affected by the

informationandknowledgeastheyaretheoneswhoaremostlikely

tobehurtbydoingthetask.

EmployerSource

Channel

Enactment

TranslationtoCreateKnowledge

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Source(Employer)andimmediatecommunicationchannel

TheP-COKflowmodeldistinguishesthemainformalOSHmessagesource

andchannelfromothersourcesandchannels.Forafrontlineworker,this

messagewouldtypicallybecommunicatedbytheimmediatesupervisoror

manager.Itisacknowledgedthat,inpractice,thesourceandchannelare

not separate and are significantly affected by other knowledge flow.

Factorsaffectingthissourceandchannelinclude:

• Accuracyofcommunicationofmessagetothispointinthenetwork• Qualityofinformation/guidance/instruction• Appropriatenessofthechannel• Influenceofemployernetwork• Cultureoftheorganisationand/orteam• Employmentstatusoftheworker(temporary/jobrole)

Innetworkedorganisationsitisimportanttoacknowledgethesignificance

ofmultiplelevelsoforganisationsorsectionswithinorganisations.Figure

4.3istakenfromastudyofcommunicationontheprojecttoconstructthe

London 2012 Olympic Park (Bust & Gibb, 2011) and this aspect is

developedfurtherinsection4.6.

Figure4.3 CommunicationloopsontheLondon2012OlympicParkconstructionproject

EmployerSource

Channel

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Translation

IntheP-COKflowmodel,translationreferstowhatgoeson‘insidethehead’

of the receiver of the message. This includes C-HIP’s comprehension and

aspects of attention but not attitudes/beliefs & motivation, as these are

covered in the P-CKF model as part of the filter or membrane. This also

excludes the influence of external information sources, both explicit and

implicit.

Inthecontextofthismodel,itisinformationthatflowsandknowledgeisonly

createdbyeachindividualbytranslatingtheinformationforthemselves.

Effectivetranslationdependslargelyonthecognitiveabilitiesofthereceiver

beingmatchedtothechannelchosenforthecommunication.

Thisaspectofthemodelisincludedforcompletenessbutwasnotstudiedin

detailasitwasoutsidethescopeofthisproject.

Explicitnon-task-specificinput

Themodeldistinguishes themain task-relatedOSH input, typically from

the employer, with other inputs. This part of the model covers the

explicitnon-taskspecificinputandtypicallyincludes:

• Previouseducation• Previoustraining• Employertraining(nottask-specific)• Trade/profession-basedskillstrainingandpublications• Onthejobtraining• Writtenguidance(nottask-specific)• Genericmethodstatements• GenericOSHrules• TradesUnionguidelines• Magazines/newsletters• Blogs/discussionforums• GeneralmediacoverageofOSHortheindustryorsite• Insurancecompanyorclaimsadvisoradverts• Advicefromfriendsandcolleagues

TranslationtoCreateKnowledge

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TacitSubliminalInputandInfluence

Thisincludesalltheinputsthatarenotobvioustothereceiver.Often,

when asked how they knew what to do or how to do it safely,

intervieweessaidthatthey‘justknew’orthatitwas‘commonsense’.

However,manyunseen,unacknowledgedfactorswillcontributetoa

person’sknowledgeandunderstanding.Theseinclude:

• Industry/tradeculture• Employer/projectculture• Perceptionofownroleand‘worth’inthenetwork• Co-workerexample• Peerpressure• HistoricalexperienceoftaskandOSH• Witnessingaccidents• Familysituationandbackground• Lifephilosophyorreligiousbeliefs

Many of these inputs will impact on the C-HIP model’s

attitudes/beliefsandmotivationcategories.

Membranes/Filters

Themembranesorfiltersareawayofdescribingtheconscious

or subconscious action of the individual to either welcome or

resist the explicit and implicit inputs and the conscious or

unconsciousactiontodoornotdowhattheyKNOWisright.

These include some of the C-HIP model’s attitude/beliefs

motivationandalsoaspectsofattention

However,itisimportanttodifferentiatebetweenwhathappens

atthemembrane(i.e.whentheinformationistakenin)andthe

person’sabilitytotranslateorprocesstheinformationtoturnit

intoknowledgeandenactment.

For the sake of clarity, we have shown two specific filters or

membranes: individual and situational. These attempt to

describe the fact that different individuals will interpret the

same set of information prompts differently and also to

acknowledge the situated nature of knowledge. Obviously, in reality, these membranes do not exist as

separate entities but are used here merely to represent the influence of the individual, the task and the

situationorenvironment.

Membrane/Filter

Situationalfilter Individualfilter

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EmployerMembrane

The ‘employer’ membrane or filter represents the conscious or

unconscious action of the individual to either welcome or resist

the instruction from theemployer. Thiswill be affectedby such

thingsasthereceiver’srelationshipwiththeemployeringeneral,

or their agent (i.e. probably their immediate line manager or

supervisor),theirperceptionofthecredibilityofthelinemanager

(forexampleanolder,moreexperiencedworkerwithayounger,

lessexperiencedsupervisor).

This can also be influenced by how the individual identifieswith

theemployerortheiragent;orratherhowimportant itmightbe

toidentifywiththecommunicator

ExplicitNon-Task-SpecificInformationMembrane

Thismembranerepresentstheconsciousorunconsciousactionofthereceivertobeinfluencedbynon-task-

specificinputs.

Thisisaffectedbysuchthingsasthetrustworthinessofthesource,

the appropriateness and impactfulness of the channel of the

information and the individual’s personal engagement or past

experiencewiththesource.Forinstance,apersonwhoisstrongly

supportive of the trades union is likely to paymore attention to

informationfromtheunion.Ayoungerperson,morefamiliarwith

theinternetmaybemoreinclinedtobeinfluencedbyweb-based

information.

Furthermore, theremaybesomesocialpressure toaccept these

influencesonthecreationofknowledgeandenactment,workers

could becomemore certain of issues that they have to rehearse

explicitlyandpossiblyjustifypublically(CowanandHodge,1996).

127

Tacit/SubliminalMembrane

Thismembrane represents the conscious or unconscious action

oftheindividualtoeitherwelcomeorresistthesubliminalinputs

andinfluences.

Itcouldbearguedthat,asthesearesubliminalinputs,theperson

cannot choose to filter them. However, strongly held belief

systems,suchas religion,cancreateaneffective filter to inputs

which do not accord with the belief system, or, alternatively

welcomeinputsthatdo.

There is some evidence to suggest that peripherally processed

messages (where the recipient is not paying full attention) rely

on certain cues (like attractiveness of the communicator and

reactionsofotherrecipients)(WoodandKallgren,1988).

EnactmentMembrane:Whydopeoplenotdowhattheyknowtheyshoulddo?

This is one of the questions that most troubles practitioners:

“Whydopeoplenotdowhattheyknowtheyshoulddo?”

Thismembranerepresents theconsciousorunconsciousaction

of the individual to either do or not do what they know they

should do. It is affected by such things as cost, time, lack of

resources,bossbullyingandego. Theseaspectsarecovered in

moredetailintheThirdWayContinuum(Section4.2)

This project did not specifically measure behaviour and

therefore field data to describe this membrane is limited to

commentsmadeandattitudesdisplayedbytheinterviewees.

Asmostofuschooseto ignorecertain lawswhereweconsider

that they are inappropriate or overly restrictive – perhaps one

example for many of us would be the 70 mph speed limit on

motorwaysingoodweather–so,weshouldnotbesurprisedwhensomeworkerschoosetonotobey‘tothe

letter’alloftherulesthatweset,especiallywheretheyconsidertheminappropriate.

TheP-COKFlowModel

Figure 4.5 shows the completedmodel. In this version, the size of the arrows denoting inputs have been

variedtoindicatethattheinfluenceofdifferentinputswillvaryaccordingtotheperson,situationandtaskand

128

alsovaryover time. Furthermore the significanceof themain ‘employer’ task-related input is also likely to

varyconsiderablyandmayactuallybeindistinguishablefromtheotherinputs.

4.6 OSHmessageflowsacrossthenetwork

4.6.1 Impactofacomplexnetwork

Throughoutthisreport,wehaveshownthatmuchOSHknowledge isexperientiallyconstructedandactually

doesnot flow. However,wehavealsoarguedthatsomemessagesdoflowandtherefore it is importantto

considertheextenttowhichthenetworkhelpsorhindersthisflow.

Section 3.4 has shown the complexity of themovement ofOSHmessages across largemulti-organisational

networks. Figure4.6providesa generic representationof thePerson-CentricOSHKnowledge (P-COK) Flow

model as part of a networked construction organisation. This also demonstrates the complexity of direct

‘employer’inputstomanyofthereceiversinthenetwork.Thisgenericnetworkisalsomuchsimplifiedas,in

virtuallyallconstructionorganisationstherewillbemanyseparateprojectsitesandmanysubcontractorsand

suppliers working on each site. Furthermore, the OSH relationship with other actors, such as the client,

designersandotherexternalbodies,hasbeenomitted.

129

Figure4.5 ThePerson-CentricOSHKnowledge(P-COK)FlowModel

IdealisedInputs

Reducedinfluenceofemployertask-specificinput

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130

Figure4.6 NetworkedrepresentationofthePerson-CentricOshFlowModel(construction)

Asdiscussedpreviouslymostactors in thenetwork receivemessagesandpass themon toothers,with the

frontline workers being the ones who are generally most at risk and most affected by the accuracy of

communicationacrossthenetwork.

TheredlinesinFigure4.6showtheprimarycommunicationroutes,mostofwhichareshownasoneway,top

down. This does not deny that there is some two-way discussion and feedback of OSH knowledge up the

network,but thepredominant flow isdownwards. The linksshownas two-wayaregenerallybetweenOSH

professionalsandthepersonorgroupthat theyreport to. This reflects thatpractice that theywill typically

both advise their superiors regarding OSH issues and take instructions from them to pass on through the

network. The dashed lines indicate secondary communication links for example between the main board

directorsoftheprincipalcontractorandthesubcontractors. Theselinescanbetakentorepresentthemain

employertask-relatedinputasshownintheP-COKflowmodel(section4.5).Eachactorwillalsobereceiving

additionalexplicitandtacitinputswhichwillaffecttheirtranslationandenactment,whetherthatbepassing

onthemessageordoingtheultimatetask.

Thenetwork shown in Figure4.7 is actually a seriesof sub-networkswhichadd layersof complexity to the

alreadychallengingroutefortopdownOSHmessagesandOSHfeedbackupthroughthenetwork.

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Figure4.7 PrincipalContractorHeadOffice/RegionalOfficeandProject-basedNetworks

Figure 4.8 shows the principal contractor (PC) networks both at head office or regional office and also at

projectlevel. Typicallyinconstruction,disciplineheadswillbecentrallylocatedandsite-basedprofessionals

willrelatebothtoasitemanagementstructureandtoafunctionalstructurelinkedtoheadoffice.Onlarger

projectsmoredisciplineswillbebasedonsite,whereasonsmalleronestheywillvisitseveralsites.

Figure4.8 SubcontractorandSupplierSub-networks

Most largeconstructioncontractorsemploysubcontractorstodothework. On largeprojectstheremaybe

several layers of subcontractors. In addition, some will also use labour-only providers for certain tasks.

TypicallythefirstlinesupervisorwillbeemployedbythesubcontractorbutwillbedirectlylinkedintothePC’s

site management team as well. Similarly, suppliers will communicate directly with the subcontractor

supervisorbutalsothepurchasingstaffofthePCwhomaybebasedonsiteoratheadoffice.

Figure4.9showsthesite-basednetworkinvolvingthePCandsubcontractors(ofwhichtherewillbeseveral)

andalsotheinteractionswiththesupplierandsubcontractornetworksbothonsiteandoffsite.

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Figure4.9 Multi-companysite-basednetworkandinteractionswithsubcontractorandsuppliers

Finally,Figure4.10bringsthevarioussub-networkstogether, indicatingthecomplexityatthe interfacesand

themultipleroutesforOSHmessagestoflowtothefrontlineworkers.Inrecentyearsthekeyroleplayedby

the construction supervisor has been recognised (Cheyne et al, 2012). These diagrams show how many

differentsub-networksthesupervisorrelatestoandhowmanydifferent,potentiallyconflictingOSHmessages

thatthesupervisormustprocess.

Figure4.10 Simplifiedsub-networksforatypicalconstructionproject

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4.6.2 Impactandinfluenceofnon-task-relatedinputs

TheP-COK flowmodeldistinguishesdirect, task related inputs fromotherexplicitexternaland implicit tacit

inputs.Thissectionintroducessomeoftheseinputsandshowshowtheywillalmostcertainlyvaryacrossthe

network. Figure4.11shows typical inputs toamainboarddirectorofaconstructioncontractor. Themain

‘task’inputrelatingtoaparticularprojectwouldbefromtheclient/funderoftheprojectandthedesignteam.

Actually,thedetailofthisinputmaybegivendirectlytomorejuniormanagerswhothenwouldneedtobrief

thedirector.Clearlytherearealargenumberofadditionalexplicitinputs,manyrelatingtohowthecompany

isperforming,orwouldbeaffectedbyOSHshouldanincidentoccur.Tacitinputswill includeorganisational

andpersonalfactorsandalmostcertainly‘whatthecompetitorsaredoing’.Therehavebeensomeinteresting

legacy impacts fromtheOSHsuccessof theLondon2012constructionwork:many largeprojectsaresaying

‘wewanttodobetterthantheOlympics!’

Figure4.11 Typicalknowledgeinputs:ConstructionMainBoardDirector

Thefrontlineworkerislikelytobegiventhemaintask-relatedOSHmessagefromthelinesupervisor.

However,Figure4.12indicatestheplethoraofadditionalexplicitandtacitinputs.

Furtherworkisrequiredtodeveloptheserepresentationsandtoestablishtherelativeinfluenceofthe

differentsourcesandchannels.However,itisclearthatthisisacomplextopicdeservingcareful

consideration.

134

Figure4.12 Typicalknowledgeinputs:ConstructionSubcontractorFrontlineWorker

Table4.1providesagenericconstructionexampleofhowsomeofthemainexplicitsourcesdifferacrossthe

networkand,inparticularatthedifferentsenioritylevelsinthenetworkforbothprincipalcontractor(PC)and

subcontractor (SC) personnel. As discussed in Section 3.2, some of these sources are internal to the

organisationand someexternal. Therewill obviouslybe specific variationsdependingon thenatureof the

organisation or project. More work is needed to explore these issues further as they are key to the

effectivenessoftheflowofOSHmessagesandOSHknowledge.

Lookingfirstatsourceswhichhavethemostcoverageacrossthenetwork.Intheoryatleast,everyplayerwill

havesomedirectinstructionregardingtheirrolewhichincludesOSH,inparticularinconstructionduetothe

significant increase in the profile of OSH over recent years. Also, everyone is affected by their previous

educationalortrainingandtosomeextentbythesocialorindustrycirclesinwhichtheymove.Withrecent

high profile incidents, it depends on how recent, howhigh profile andhow relevant to the person’s job or

interests. ‘Everybody’ knows about Deepwater Horizon, but howmany knowmore detail about the links

betweenprocesssafetyandnearmissreportingthatwereunearthedinthathighprofileincident.

ThePCOSHadvisorislikelytohavetheir‘fingersinallthepies’,butmaynothaveanydirectinvolvementwith

someofthesitedetailssuchasmaterialspecificationsheets.TheSCOSHadvisormaybesimilarormayhave

slightlylesslinkstothepolicyandproceduralaspectsthatareoftenmorerelevanttolargerorganisations.The

preciseroleoftheOSHadvisorisrelevanthere.Insomecasestheyjust‘advise’inaverygenericsense,setting

policyandauditingperformancebutleavingthedetailoperationalizationtothelinemanagers.Inothercases

135

theywillbe involved inthedetailaswell. Morework isneededtoexplorethisaspecttoprovideadviceon

goodpracticeandtheprosandconsofeachapproach.

Table4.1 ExplicitSourcesdifferacrossthenetwork(constructionexample)

ExplicitInputSources(Construction)

PCM

ainBo

ard

PCOSH

adviso

r

PCProcuremen

t

PCPurchasing

PCRegiona

lman

ager

PCProjectm

anager

PCSectio

nman

ager

SCM

ainBo

ard

SCOSH

adviso

rSCRegiona

lman

ager

SCSup

ervisor

Supp

lierM

ainBo

ard

Supp

lierO

SHadviso

rSupp

lier

SCFrontlineworker

Internal

DirectOSHinstruction X X X X X X X X X X X X X X X

Specificriskassessments

X

X X

X

X

Materialspecificationsheets

??

X??

X

X

X

Sitecampaigns

X

X X

X

X

X

External

Legaladvice X X X

X

X X

X X

HSExecPolicy X X

X ??

X X

HSExecPractice

X

??

X??

X

GovernmentPolicyreports X X

X ??

X X

UKContractorsGroupetc X X

X

X X

FederationofMasterBuildersetc ?? X X X

ConstructionProductsAssocetc ?? ?? X X ??

Recenthighprofileincidents X X ?? ?? ?? ?? ?? X X ?? ?? X X ?? ??

Industrycampaigns

X

X X X

X

X

Social/industrynetworks X X X X X X X X X X X X X X X

Previouseducationalinputs X X X X X X X X X X X X X X X

KEY PC:PrincipalContractor SC:Subcontractor

Some individuals, such as procurement or purchasing staff, are often considered to be peripheral to site-

relatedOSH.However,emphasisoverrecentyearson‘preventionthroughdesign’andrelatedlegislationsuch

astheConstructionDesignandManagementregulations,shouldreallynotonlyconcentrateonarchitectsand

designengineers,butonanyonewhoinfluencestheworkorworkplace,includingthosewhodecidewhatthe

contracts say or which materials or products will be bought. In a similar way, suppliers of materials or

equipmentalsohavearole(e.g.seeGibbetal,2005and2006). Theextenttowhichthesemoreperipheral

individualsororganisationsacknowledgethisrolehasnotbeenestablishedinthisstudy.

The influence of campaigns will again very much depend on how well they are devised and executed.

However, in general, site campaigns seem to have an effect only on site-based people and industry-wide

campaignsseemtomissoutthosewhoaremoreinvolvedinpractical,workfaceissuesratherthanpolicy.

136

Unsurprisingly, industry bodies tend to ‘look after their own’ in that they have a reasonable influenceover

their ownmembers but often less so over others. The key here therefore is that these bodies need to be

communicatingwitheachotheratahighleveltoensurethattheirindividualmessagesarecomplementary.

137

5 CONCLUSIONSANDRECOMMENDATIONS

5.1 Conclusions

5.1.1 Toflowornottoflow

CollectivelyourworkhasquestionedtheextenttowhichOSHknowledgeflowsinalinearsense,orevenifit

flowsatall(asraisedespeciallybytheethnographicresearchinSection3.9).Whatunitesthevariousstrands

ofourstudyisthatOSHknowledgeisshapedandreshapedthroughtheprocessofenactment;attimesit is

appropriated,whileatothersitisaugmentedthroughitssituatedapplicationandre-applicationelsewherein

the network. It is, therefore,mutating as it travels through time and space, both ‘picking up’ and ‘leaving

behind’aspectsofthemessage.

ThewaysinwhichformalandinformalOSHknowledgeinteractandmutuallyshapeeachotherisaproductof

both the complexity of the networkswithin and acrosswhich itmust travel, and the nature of the hazard

context and regulatory environment forwhich it has been designed. In some cases formal knowledgewill

gather tacit practices as it travels, growing in terms of its scale and complexity. In other situations it will

remain largely intact, shaping anddetermining the processes andbehaviours it is designed to govern. The

challengefortheOSHpractitionercommunityistounderstandtheroleoftheinstitutionalcontextinshaping

this pathway, deciding when to accept localised contingent practice as being equally valid to formalised

knowledge, and knowing how to harness the power of emergent practices alongside those of codified

approachestoachievingpositiveOSHoutcomes.

This is not OSH as an internalisation of rules or the addition of knowledge to action, but rather a way of

knowingthatemergesincrementallythroughinteractionsbetweensocial,spatial,temporal,material,sensory

features of workplace contexts. We argue that this blended perspective on OSH represents a ‘model 3’

perspective for OSH research in that it simultaneously accounts for formal, codified and explicit OSH

knowledge(itselfenshrinedinOSHprofessionalpractice),aswellasinformal,emergentandtacitknowledge.

The changing nature and context of OSH environments

presents a radically different vision of the OSH

professional’s role in shapingOSHoutcomes,particularly

in how risk is considered in dynamic work-based

assessments. Specifically, a ‘model 3’ perspective

encourages OSH professionals to go beyond conventional approaches to safetymanagement and practice.

Responding to Hale and Borys’ (2013) plea for the pressing need to find a middle ground for safety-rule

management,thisperspectivepavesthewayfordevelopingunderstandingsthatblend‘model1’and‘model

2’ aspects including (as they characterise): the need for safety rules to cope with diversity and dynamism

3

1 2

138

(model 2 ‘flexibility’) but also for these to be grounded in principles of transparency, consensus, and the

explicitidentificationandcommunicationofnon-negotiable‘goldenrules’(model2‘standardisation’).

A‘model3’perspectivemovesawayfrominstrumentalapproachestoOSH-knowledgeorafocusonexamining

how OSH rules, regulations, and procedures are (or could be better)managed and/or improved. In some

contexts,theextenttowhichworkersareawareofOSHregulationsandtheways inwhichtheyapplythem

canbeeasilymeasured.However,inothersthereareaspectsofOSHthatneedtobeaddressedinnewways–

especially incontexts(asourfindingshaverevealed)whenroutestosafeworking,andtheconfigurationsof

knowledges,objects,persons,andcircumstancesthatshapesafety,requirethatOSHregulationsareadapted

oraddedtowhencontextualisedthroughworkers’ownexperience-basedandculturallyspecificknowledgeof

contextsorprocesses. ThisrequiresarethinkingoftheexpectationsandapproachesthataretakentoOSH.

Byattending to themoredifficultquestionofhowOSH isenactedandknown inpracticeaspartof specific

workplace environments and contexts, a ‘model 3’ blended perspective offers a productive avenue for

understandinghowOSHisactuallydoneandhowitmightbeeffectivelydesignedinthefuture.

5.1.2 So,whatDOESflowandHOW?

Notwithstanding our argument above that assuming linear knowledge flow is simplistic and inappropriate;

there is still evidenceof theboth formal and informal flowofmessageswith some remaining largely intact

across and through the networks. But, even here the network and sub networks, each with their own

subculture,addcomplexitytotheflowsandpathwaystoeventualenactment.Therearemanyenablersand

obstructions to this flow; filtersormembranes throughwhich informationandknowledgemustpassbefore

enactment. Effective social networks and OSH knowledge hubs, whether acknowledged or not, acting as

‘politicalreflectivenavigators’haveaverysignificantpositiveeffectonknowledgeflow,bothassourcesand

channels,oftenproviding‘arenas’forsharedlearning.Increasedstabilityandstructurewithinorganisations,

aswellasdiffuseresponsibilitywithinacultureofOSHownershipwerelikelytoeasethetransmissionof,and

promote,appropriateinformation.However,someOSHknowledgestructuresaresofragilethattheinfluence

of the OSH knowledge hub can be negated. ‘Absorptive capacity’ is the process where valuable external

knowledgeisassimilatedatmultiplelevelswithinannetwork,involvingseveralprocessesthatshapetheway

thatnewlyacquiredknowledgeiscombinedwithexistingknowledge.

The transmissionof knowledge and its final enactment canbe inhibitedby lackof stability, timepressures,

priorities, social groups, or sub-cultures within organisations, conflicting messages from different sources,

over-bureaucraticcommitteestructuresandtheinterfacebetweenorganisationaldepartments.

Mostactorsinthenetworkreceivemessagesandpassthemontoothers,whoseethemasthesourceand

mayormaynotacknowledgetheoriginalsource.Thefrontlineworkersaregenerallymostatriskandmost

affectedbytheaccuracyofcommunicationacrossthenetwork.Theinteractionbetweenthevarioussub-

networksisalsokeyinsuccessfulmovementofOSHmessages–effectivemanagementoftheseinterfacesis

crucialforOSHmessagetransfer.

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5.1.3 HowdopeoplereceiveandprocessOSHmessages?

Our work has identifiedmultiple sources for OSHmessages across the network, with people closer to the

workfaceoftenhavingseveraldifferentformalsourcesaswellasthemanyinformalsourcesandtheunknown

orunrecognisedsourcesoftacitknowledge.ThemoreformalsourcestendtobeusedbyOSHprofessionals

andmanagerswhereastheworkers

tend to rely more on additional

informal sources for OSH

knowledge. However, there is

much more “know what” than

“knowhow”.

The best combinations of channels

forOSH knowledgewill depend on

the nature of the message, the

peopleandthenatureofthehazard

context or situation. The most

commonandeffectivechannels for

OSH knowledge were face-to face

(meetings, training and verbal

communication),electronic (internet, intranetandemails) andwrittenmedia (notices, leafletsandposters).

Someorganisationswerefailingtoadjusttotheopportunitiesandchallengesoftechnologicaladvancessuch

assmartphoneinternetaccess.

Managers should understand the individual nature of workers and how knowledge can be translated and

transformedbasedon factors thataffect themspecificallyalongwith the taskandhazardenvironment that

they work in. There are also tensions between apparently conflicting goals such as patient safety and

occupationalsafetyinhealthcareorproductivityandworkeroccupationalsafetyinconstructionorlogistics.

WehavedevelopedthePerson-CentricOSHKnowledge(P-COK)flowmodel,buildingonpreviouswork,tohelp

explaintheexplicitandtacitsourcesandchannelsforOSHmessages.Themodelalsoimaginesfiltersor

membranesdependingonthesituation,thehazardcontextandindividualthatconsciouslyorsubconsciously

prioritise,encourageordiscouragethetakinginofthedifferentmessages.

5.1.4 Rulesorexperience?TheThirdWayContinuum

Previous authors have introduced two types of knowledge or knowing: model 1 (formal, top-down, rules-

based)andmodel2 (social,bottomup,contingent,experientiallyconstructed). Arguably, thepursuitof the

rule-based,model 1 approach in theOSHdomainhas ledus toundervalueormaskout the complex social

orderandthesophisticationoftheOSHpracticesusedbyworkerswhentheyworksafely.Thereisaneedto

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1.11.21.31.41.51.61.71.81.9

Mod

el1

Model2

balanceoutmodel1andmodel2,wheremodel2isnotnecessarilyunsafeandactuallymaybe‘moresafe’.

Thisissometimeswhatwouldbecalledthe‘enactmentofsafety.

Wehave introducedanddefendedthe

Third Way continuum as a

representation of the combination of

these two models, arguing that there

are never situations where either

modelisfullyemployed,butthatthere

arevariations intheproportionofeachmodel. Theextenttowhich individualsrelyonformaland informal

knowledgecanbeafunctionofexperience,familiaritywiththeworkenvironmentandinstructionfromtheir

organisationandourresearchhasempiricallyrevealedinfluencingfeaturesonsuchdecisions.Dynamicwork

environments and changing hazard contexts suggest a level of flexibility in the interpretation of formal

informationaswellastheuseofmoreindividuallyand/orsociallyconstructedpractices.

Individual’s and group’s tendency towards either rule based or experientially constructed understanding of

OSHknowledgewilldependonentwinedandinteractingfactorsincludingtheexperienceandcompetenceof

theindividualorgroup,thenatureandcomplexityofthetaskandtheinfluenceoftheenvironment.Thereis

always a combination of the two models and organisations should recognise the fact and harness the

opportunitiesratherthanbemoanthereality.

5.1.5 Whataboutenactment?Dynamicriskassessments,workaroundsandbehaviour

Weacknowledgethatthereisaclearneedtoproperlyconsideralltasksandtoestablishappropriate,safeand

healthy methods to complete them. It is also important to ensure, as far as possible, that all tasks are

completedinasafeandhealthymanner.Forhighrisktasks,greatcareshouldbetakentoavoidinappropriate

alterationof theagreedmethod,although, indynamichigh-risksituations, it isessential that those involved

areabletoassesstherisk‘inthefield’andtotakeappropriateaction.ManycontemporaryOSHmanagement

systemsstress theneed forworkers tobeempoweredtostopany taskorprocess that theyconsider isnot

safe.Wealsoacknowledgethat,forasmallnumberofsituationsortasks,‘stopping’thetaskisnotanoption

andtherecouldbeaneedforactiontobetakenimmediatelytopreventacatastrophe.Wheresuchtasksare

envisaged,individualsshouldbeproperlytrainedtobeabletomakegooddecisionsunderextremepressure,

forexampleusingscenario-basedtrainingmentionedearlier.

Notwithstanding,inthemajorityofcases,particularlyforlower-risktasks,althoughsafeworkingmethodsmay

have been agreed, theremay be several alternativemethods to do the task safely. Furthermore, the task

environmentmaychangesuchthat thepreviouslyplannedmethod is inappropriate. It is insuchcases that

acknowledging that the enactment of OSHmessages is rarely completely in line with the intention of the

originalsourcecanactuallyimproveOSHmanagementandincreasethelikelihoodofunwantedconsequences.

141

Dynamicriskassessmentsarepartialenactmentsofthemessagebecausethe individualconsiders,rightlyor

inadvisably,thattheconditionsandenvironmentthattheyfacemakesthemessageinappropriate,atleastin

part. Such insituassessments–as theethnographic researchparticularlyenabledus tounderstand–were

morelikelywherethesituationwasconstantlychangingormoreunpredictableratherthaninstatic,relatively

unchangingworkenvironments. Shortcutsorcuttingcornerssometimessuggestedthattheworkerwasnot

doingthejobproperlyandmayhavea,usuallynegative,effectonthequalityoftheworkoronOSH.Bending

therulesoftensuggestedtheideaofpushingthelimitsasfaraspossiblewithoutactuallybreakingtherules,

orinterpretingtherulesinawaythatwasprobablydifferenttotheirinitialintention.Workaroundshowever

weremoreoftentalkedofaspragmaticwaysofdoingthejobwhichcouldnotbedoneexactlyinthewaythat

was initially planned. Workarounds would be the result of a conscious or subconscious dynamic risk

assessmentand inmostcasestheOSH implicationsofthenewmethodwouldhavebeenconsideredbefore

makingthechange.Workaroundswerealsomorelikelywheretheworker,rightlyorwrongly,consideredthat

theriskresultingfromthenewmethodwasnotgreat,probablybecausetheyconsideredthattheriskfromthe

originaltaskwasnotgreateither.Thus,workaroundswereconsideredlesslikelyforhighrisktasks.

Thereweredifferencesbetweenanindividualworkerdecidingtouseaworkaround(whichwasnotadvisable)

andateamdiscussingtheissueandcomingtothesameconclusion,whetherornotanofficial‘supervisor’was

presentandwhetherornottheworkaroundwassubsequentlyacknowledgedandadoptedasstandard(and

byimplication‘safe’)practice.

Workarounds will happen – they must be managed. Typically managers cannot measure the success of

workaroundsastheyonlytendtohearabouttheonesthatfail.Thissuggestsapressingneedforpractitioners

tobetter recognise therangeofeveryday (andoftenunnoticed)adaptationsofpracticeandOSHguidelines

thataredirectedtowardssafeworking.Workerswillalwaysmakechangesto‘formal’proceduresasanormal

part of human behaviour and should not automatically be seen as negative. While adaptation and

improvisation is inevitable,wewould go beyond this assertion to suggest that itmay also be considered a

crucialcomponentofeffectiveOSHpracticeifitisapproachedasprovidingreflexiveopportunityforindividual

andorganisationallearningandgrowth.Thus,ratherthantryingtoincreasinglyregulateagainstuncertainty,

efforts may be more productively directed towards better supporting and enabling workers to improvise

towardsandthroughsafety.Yet,notwithstandingthisclaim,someworkersstilltakesignificantrisks‘because

they can’, ‘because it’s quick’ and ‘because no one is watching’. However, many people are thoughtful,

ingeniousandattentive,mostofthetimeusingtheircognitiveandphysicalabilitiestogetthejobdoneand

getthejobdonesafely.Weshouldharnessthisbehaviourasaresourceratherthanseeingbehaviourjustasa

liability.Oneimplicationofthisperspectiveisthatmanagersandorganisationsneedtoactivelyseekdeeper

understandingofhowandwhysuchimprovisationstakeplace,andonthebasisofthisunderstandingshould

thereforebeabletodeterminethebestwaystoharnessthistendencytoimproviseinwaysthatwillproduce

saferworkingpractices.InmakingthisclaimwereiteratethatOSHguidanceis,ofcourse,necessaryandvital.

Yet, given the impossibility of regulating for every scenario and future uncertainty, it must be ‘open’ and

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‘flexible’enoughtopermitworkerimprovisationwhileremainingpreciseenoughtoensurethataredirected

towardscreatingsaferworkingenvironmentsandpractices. Thisremainsthekeychallengeforthosetasked

withdesigningeffectiveOSHfutures.

5.1.6 SectoralandOrganisation-sizedifferences

Oursamplesizeandresearchapproachdoesnotmakeitpossibletoprovideaformalcomparisonbetweenthe

three sectors studied. Furthermore, as all of our case studies were, by definition, large, networked

organisations,wehavenot sought to identify the transitionbetween ‘simple’ andnetworkedorganisations.

ThisaspectisexploredfurtherinourcompanionreportforIOSH(Gibbetal,Awaited)onoccupationalsafety

andhealthinmicro,smallandmedium-sizedenterprises.

Notwithstanding, there are someobvious differences between the sectorswhich have some impact on the

waythatOSHmessagesandknowledgeemergesandmoves:

• Healthcarehasthemajorchallengeofthepotentialtensionorevencompetitionbetweenoccupationalhealthandsafetyofthestaffandpatientsafety.Thereareshadowsofthisin‘customercare’inlogisticsdeliveriesbutnottothesameextent.

• Healthcareinvolvesgreaterinteractionbetweendifferentlevelsofstaffwithdifferentbackgrounds(e.g.doctors,nurses,supportstaff,facilitiesmanagementstaff).

• Therearealsodifferenttypicalentrylevelsacrossthethreesectors,withconstructiongenerallyhavingtheloweracademicrequirementsattheworkerlevel.

• Thetrainingapproachesandexpectationsaredifferentacrossthethreesectors.• Communityhealthcareandlogisticshomedeliveriesbothhaveastronginteractionwiththepublicin

theirhomes.Thelargerconstructionorganisationsstudieddonot,whereasmicroconstructionorganisationsdo(SeeGibbetal,Awaited).

• Organisationsinallthreesectorswerenetworked,butthereweremoreexternalorganisations(i.e.subcontractors)involvedinconstruction.

• Thereisasignificantdifferenceinenvironmentbetweenwarehouseanddeliveriesinlogisticsthanbetweenthedifferentcontextsintheothersectors.

• Theworkplaceenvironmentinconstructionchangesmorerapidlythantheothersectorsandinfluencessuchastheweatheraremoreprevalent.

These factors do affect how OSHmessages and knowledge are handled. However, this report has drawn

lessons from each sector and shown where they cross over or are particularly relevant for specific work

environments. There aremore similarities andopportunities for cross sectoral learning than is often given

credit.Weencouragethoseinvolvedwitheachofthesectorsandothersectorsbeyondthesethree,toread

thewholereportand,ratherthandismissfindingsthinkingthattheyarenotrelevanttothem,toreviewtheir

ownenvironmentandsituationtolookforwaysinwhichthelessonscanbeadaptedandappliedtoimprove

theoccupationalhealthandsafetyofallinvolved,particularlythosewhoaremorelikelytogethurt.

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5.2 Recommendations

5.2.1 RecommendationsforOSHpractionersandlinemanagers

ThereisadifferencebetweenOSHasimaginedandOSHasactuallydone.Therefore,asanOSHpractitioner

orlinemanager,werecommendthatyou:

• readthisreportandcarefullyconsidersitsfindings–theyarenotstraightforwardandcouldeasilybemisinterpreted

• promoteamorethoughtfulunderstandingofOSHknowledgeflowacrossyournetwork,inparticularof:

o howOSHknowledgeisco-createdandinterpretedsocially,bothininformallyandformally,leadingtoworkers‘pickingup’knowledgeeitherexplicitlyortacitly

o howembodied,sensory,affective,intuitiveandexperientialwaysofknowingarecrucialtohowworkersmakeOSH‘feelright’or‘workinpractice’

o howOSHknowledgemovesacrossnetworkedorganisationsoftenininformal,subtle,andlessdirectways

§ donotimaginethatanOSHmessagewillreachitsdestinationinastraightforwardmannerandintact

§ effectivetransferofknowledgewillneedtouseseveralchannels,requiring‘retuning’and‘recalibration’activityastheknowledgemovesaroundnetworks

o howformalandinformal,internalandexternalexplicitknowledgesourcesandtacitknowledgewillinfluenceyourstaff

o howthe‘fog’createdbyOSH-philicandOSH-phobicfilterswillhelporhinderOSHmessagesgettingthroughtotheindividuals

§ donotassumethatwhatappearstobeastraightforwardOSHinstructionwillbeenactedinthewayintended,onceithaspassedthroughthevariouschannelsandfilters

• usethe3rdWayContinuumtoconsidertaskplanning,takingtheindividualandenvironmentintoaccounttochoosetheappropriatepositiononthecontinuumbetweentop-down,rulebasedapproachandabottomup,contingentapproach

• usethePerson-CentredOSHKnowledge(P-COK)flowmodeltoimproveyourandyourstaff’sunderstandingofhowindividualstakeinexplicitandtacitOSHmessagesthataffecttheirtranslationandenactment

• workwithyourpeople:o identify,supportandcultivateyourOSHhubs,especiallythoseneartothefrontlineworkers

(often‘keenies’)o concentrateontrainingandsupportinginparticularthosewhoinstructfrontlineworkers

(e.g.supervisors)o considerbehaviourasaresource

§ usepeople’sbehaviourasapositiveinfluencetoavoidaccidentsintherealworldo identifyandsupportroutine,taken-for-granted,or‘quietsafety’practicesthathavebeen

devisedbyyourworkerstoensuretheirownandother’ssafetyo developeffectiveprocessestoholdpeopleaccountablefortheirdecisionsandactions

§ someworkersstilltakesignificantrisks‘becausetheycan’,‘becauseit’squick’and‘becausenooneiswatching’–intentionalunsafebehaviourshouldberespondedto

• whenplanningtraining:

144

o avoida‘onesizefitsall’approachforallsectors,allnetworktypes,allindividualsandallsituations

o worktominimiserepetitionandbureaucracyinsiteorworkplaceinductions,especiallywhereindividualsarelikelytoattendmultiplesimilarevents

o complementstandardisedandgenerictrainingwithlocallyspecificmethodsandinformationo developtrainingschemesandapproachesthatacknowledgeandexploitlearningasan

ongoingandincrementalprocesswhichissituated,practical,andsociallyco-constructedandwhichhappensnotonlyfromwhatpeoplearetoldorfromwhattheysee,butalsotheembodied,physical,andsensoryexperienceofdoing

o designtrainingtoequipworkerswiththeskillsandconfidencetounderstandtheprinciplesandnotjusttounderstandtherules,sotheycanadapttheirpracticeasappropriatetospecificcontexts,yetmakeitpreciseenoughtoensurethatdecisionstakenbyworkersaredirectedtowardssafeworking

o improvetrainingtohelpallworkersunderstandwhatriskisandhowtoassessitratherthanjusttellingthemtoobeytheapprovedmethodstatement

§ e.g.usescenariotrainingmethodstohelpworkersgainanimprovedunderstandingofriskinthefieldsothattheyarebetterabletomakegooddecisionsifrequiredinchangingsituations

§ focusonindividualswhomayneedtomakeimmediatedecisionsunderextremepressuretoalteranagreedsafeworkingmethodtoavertacatastrophe

• encourageworkerinvolvementinthedesignofsafetystrategies:o developstrategiestoenableworkerstoopenlydiscuss,reflecton,evaluate,andshare

decision-makingprocesses,whilerecognisingandseekingtoalleviatethepowerandstatusdifferentials,orfearofreprimand,thatmayresultinreluctancetotalkaboutOSHissuesandinnovations

o identifyandbuildintosystemslocallygeneratedinnovationsthathaveemergedfromtheexperientiallearningofworkers

o useworkerengagementinitiatives(e.g.feedbackcards,rewards-scheme,workerrepresentatives)

o developtechniquestocapturesafetyinnovationsastheyareongoinglyexperiencedandoccurinnormalworkactivities

• whendevelopingsafeworkmethodstatementsandriskassessments:o involvefrontlineworkersinproposingmethodswheneverpossible,ideallydirectly,or,ifnot

throughworkerfeedbackmeans,OSHcommitteesetco berealisticanddon’tover-statethelevelofrisk-trytoavoid‘makingafuss’overminor,

low-riskorverylowlikelihoodhazards(e.g.trytoavoidthe‘Bonkers,Conkers’trap)o ifitisalower-risktask,seektoprovideasmanyalternativemethodsaspossibleo chooseappropriatemitigatingactionshouldtheworkerdecidethatthemethodcannotbe

followedwhen‘inthefield’§ wherepossible,avoidjustsaying‘stop’ifyoucan’tfollowthemethodprecisely,

becauseyouknowthattheworkerprobablywillnotfollowthatinstructionunlesstheyconsidertheyareatahighrisk

• takeworkaroundsanddynamicriskassessmentsseriously:

145

o acknowledgethatdynamicriskassessments,leadingtoworkaroundswilloccurandshouldbespecificallymanaged

o carefullyconsiderlikelyworkaroundsandplantomakethemsafe10o don’tcondemnworkaroundswithoutconsideration

§ Wecan’tmeasurethesuccessofworkarounds–weonlyhearabouttheonesthatfail

o understandtheroleoftheinstitutionalcontextinshapingOSHknowledge,decidingwhentoacceptlocalisedcontingentpracticeasbeingequallyvalidtoformalisedknowledge,andknowinghowtoharnessthepowerofemergentpracticesalongsidethoseofcodifiedapproachestoachievingpositiveOSHoutcomes

5.2.2 RecommendationsforOSHresearchers

WerecommendthattheOSHresearchcommunity:

• developsandteststhetheoreticalconceptspresentedinthisreportaroundthebottom-up,contingentnatureofOSHknowledge

• continuestheevidence-basedinvestigationofdynamicriskassessmentsandworkarounds• extendsthisworktocompareandcontrastlow-riskandhigh-risktasksandsectors• seeksevidence-basedevaluationofHollnagel’sSafetyIandSafetyIIapproach,movingfrom

‘everything’goingrightto‘enough’goingright,from‘avoidingfailure’to‘ensuringsuccess’

5.3 Limitations

Byitsverynature,allresearchhaslimitations.Inthiscasewehavestudiedanumberoforganisationsacross

threeindustrysectors. Weconsiderthatthishasprovidedsomesignificant insights intohowOSHmessages

andOSHHknowledgeworks innetworkedorganisations. Wehavenotedsomeimportantdifferencesacross

the sectors (see section 5.1), but our sample size and approach does not enable us to make sector-wide

conclusions.Furthermore,ourcasestudieswerealllarge,networkedorganisationsandthereforewearenot

abletodrawspecificcomparisonswithnon-networkedorganisations.Thisaspect,tosomeextentatleasthas

beenexploredinourcompanionIOSH-fundedreport(Gibbetal,Awaited)onoccupationalsafetyandhealth

inmicro,smallandmedium-sizedenterprises.

10Anexamplewasgivenwhereconstructionworkerswerefixingthereinforcingsteel foran insituconcretewall. There

wasascaffoldateachside,buttomovefromonesidetotheother,theinitialsafeworkingmethodstatementassumed

thattheworkerwouldclimbdowntheladdertogroundlevel,goaroundtheendofthewalltotheotherscaffoldandthen

climb up the ladder. The obviousworkaroundwas that theworkerswould climb up the reinforcement cage and step

through to the other scaffold. The sensible action from the supervisorwas to create a safe access directly across the

reinforcementcage.

146

The initial intendedmethodwas thatourethnographicworkwould follow the firstphaseof interviewsand

focusgroups ineachsector. ThiswasthecasefortheLogisticssectorand,tosomeextenttheconstruction

sector. However, for the healthcare sector, both approaches were applied concurrently. However, have

carefully reviewed the work, we consider that this did not significantly alter the findings from either the

ethnographicorinterviewphasesinanyofthesectors.

Weadoptedaninterdisciplinaryapproachwhichwasaprincipalfeatureoftheproject.Fivedifferent

disciplineswereinvolved:humanfactorsandergonomics,organisationstudies,safetyscienceand

ethnographywereusedas‘lenses’tointerpretthedatagathered.Weconsiderthatthisisasignificant

strengthofthework,buthasalsohadimplicationssuchasourdifficultyindemonstratingsimplelinear

connectionsbetweenthedatacollectedandtheconclusions.Theconclusionswerereachedfollowingclose

considerationofthevariousdatasetsandconsiderabledebateamongstthemulti-disciplinaryteamtostriveto

achieveareasonablebalancebetweentheviewsthroughthedifferentmethodologicallenses.Specific

perspectivesfromthedifferentdisciplineshavebeenandwillbepublishedinotherjournalsandconferences

asappropriate.

147

REFERENCES

Al-Hammad, A (2000) Common interface problems among various construction parties, ASCE Journal ofPerformanceofConstructedFacilities,14:271-74.

Alvesson, M. Hardy, C. and Harley, B. (2008) Reflecting on Reflexivity: Reflexive Textual Practices inOrganizationalandManagementTheory,JournalofManagementStudies,45(3):480-501.

Arce,A.andFisher,E.(2003)KnowledgeInterfacesandPracticesofNegotiation:CasesfromaWomen'sGroupin Bolivia and anOil Refinery inWales.In:Pottier, J.,Bicker, A.andSillitoe, P.(eds.)Negotiating localknowledge:powerandidentityindevelopment.PlutoPress,London,pp.74-97.ISBN9780745320076

Avison, D.E., Fitzgearld (1995) Information Systems Development: Methodologies, Techniques and Tools,Secondedition,London,MCgrawHill

Barry,A.,Born,G.,&Weszkalnys,G.(2008)Logicsofinterdisciplinarity.EconomyandSociety,37(1),20-49.

Bartlett,F.C.,1932,Remembering,CambridgeUniversityPress.

Behm,M.andSchneller,A.(2012)ApplicationoftheLoughboroughConstructionAccidentCausationmodel:aframeworkfororganizationallearning,ConstructionManagement&Economics,availableonline2012,www.tandfonline.com/doi/abs/10.1080/01446193.2012.690884

Benjamin,K.,White,J.,(2003)OccupationalHealthintheSupplyChain:ALiteratureReview.HSL

Bijker, W. (1995) Of Bicycles, Bakelites and Bulbs: Towards a theory of Sociotechnical Change, MIT Press,Cambridge

Bohman,J.(1999)Theories,Practices,andPluralism,PhilosophyoftheSocialSciences,29(4):459-480.

Bolt, H., Haslam, R.A., Gibb, A.G.F. & Waterson, P. (2012) Preconditioning for success: characteristics andfactorsensuringasafebuildfortheOlympicPark,ReportfortheHSE,143pp.

Bresnen,M.,Goussevskaia,AandSwan,J.(2004)EmbeddingNewManagementKnowledgeinProject-BasedOrganizations,OrganizationStudies,25(9):1535–1555.

Broberg, O., & Hermund, I. (2007) The OSH consultant as a facilitator of learning in workplace designprocesses: Four explorative case studies of current practice.International Journal of IndustrialErgonomics,37(9),810-816.

Bicker, A., Pottier, J., & Sillitoe, P. (Eds.). (2003)Participating in development: approaches to indigenousknowledge.Routledge.

Brown, J.S.,andDuguid,P. (2001) ‘Knowledgeandorganization:Asocial-practiceperspective’.OrganizationScience12/2:198–213.

Buckle, P., Clarkson, P. J., Coleman, R.,Ward, J., & Anderson, J. (2006) Patient safety, systems design andergonomics.Appliedergonomics,37(4),491-500.

Burrell,G.andMorgan,G. (1979)SociologicalParadigmsandOrganisationalAnalysis,Aldershot,Hampshire:Ashgate.

Bust,P.D.&Gibb,A.G.F.,2011,DeliveringHealthandSafetyonthedevelopmentoftheLondon2012OlympicParkandVillage:AreviewreportfortheOlympicDeliveryAuthority,19pp(ADDWEBACCESSADDRESS)

Cambridge, D., Kaper, S. and Suter, V. (2005) Community of practice design guide. Availableat:http://net.educause.edu/ir/library/pdf/nli0531.pdfhttp://net.educause.edu/ir/library/pdf/nli0531.pdf(lastaccessed29thOctober2014)

Carayon,P. (2012)HumanFactorsandErgonomics inHealthCareandPatient Safety (2ndEdition). London:TaylorandFrancis.

Carroll, J.S. andEdmondson,A.C. (2002) Leadingorganisational learning inhealthcare.QualityandSafety inHealthcare,11,51-56.

148

Cheyne,A.,Hartley,R.,Finneran,A.M.&Gibb,A.G.F.(2012)TalktheTalk–walkthewalk:AnevaluationofOlympic Park safety initiatives and communication, IOSH, Institute of Occupational Safety & Health,http://www.hse.gov.uk/aboutus/london-2012-games/research-reports.htm

Cheyne,A., Finneran,A.M.,Hartley, R.&Gibb,A.G.F. (2011) Communication and action for a safer London2012OlympicandParalympicGames,OlympicDeliveryAuthority,,RefODA2012/269,Dec2011,11pphttp://learninglegacy.independent.gov.uk/documents/pdfs/health-and-safety/260-communication-action-aw.pdf.

Christopher,M.(1998)LogisticsandSupplyChainManagement:StrategiesforReducingCostsandImprovingServices(2nded).London,FinancialTimesPitmanPublishing.

Clemes, S., Haslam, R.A. & Haslam, C. (2010) What constitutes effective manual handling training?OccupationalMedicine,60,101-107.

Collins,H.M.(1993)"Thestructureofknowledge."SocialresearchVol.60(No.1):pp.95-116.

Conzola,V.C.&Wogalter,M.S.(2001)ACommunication–HumanInformationProcessing(C–HIP)approachtowarningeffectivenessintheworkplace,JournalofRiskResearch–4(4),309-322

Cook,N.(2008)OutofSite.TheRoSPAOccupationalSafety&HealthJournal,September,pp23-29.

Cooke,TandLingard,H.(2011)Aretrospectiveanalysisofwork-relateddeathsintheAustralianconstructionindustry, Proceedings of the ARCOM 27th Annual Conference, Association of Researchers inConstructionManagement,ISBN9780955239052,279-288.

Cowan, G., & Hodge, C. (1996) Judgments of hate speech: he effects of target group, publicness, andbehavioralresponsesofthetarget.JournalofAppliedSocialPsychology,26,355-374.

Cowie,H.,Naylor, P., Rivers,I., Smith, P.K., Pereira, B. (2002)MeasuringworkplaceBullying, Aggression andviolentbehaviour,7,33-51.

Crawford,J.,Doust,E.,Davis,A.,Cowie,H.,Ritchie,P.,Rashid,S.,Dixon,K.,(inpress)OSHLandscapeProject,InstituteofOccupationalMedicine

Cross,R.,Parise,S.&Weiss,L. (2007)Theroleofnetworks inorganizationalchange,McKinsey&Company,WashingtonDC.

Davenport,T.H.,Prusak,L.(1998)Workingknowledge:Howorganizationsmanagewhattheyknow,HarvardBusinessSchoolPress,Boston.

Davies,A andMackenzie, I. (2013)Project complexity& systems integration: constructing the London2012OlympicsandParalympicsGames,InternationalJournalofProjectManagement,32:5773-790.

Davies,H.andNutley,S.(2000)DevelopinglearningorganisationsinthenewNHS.BMJ,320(7240),998-1001.

Davies,F.,Spencer,R.andDooley,K.(2001)Summaryguidetosafetyclimatetools,HSEOffshoreTechnologyReport,London,HMSO.

Davison, R., Pilbeam, C., Doherty, N. & Denyer, D. (2014) Capturing safety awareness through diaries, inLearning from the past to shape the future, WOS-NET 2014 - Working on Safety 7th internationalconference,Scotland,pp.26-29.

Dekker,S.(2012)Justculture:Balancingsafetyandaccountability.AshgatePublishing,Ltd.

Dekker,S.(2011)Patientsafety:ahumanfactorsapproach,CRCPress.

Dekker, S. (2003) Failure to adapt or adaptations that fail: contrasting models on procedures andsafety.Appliedergonomics,34(3),233-238.

Diefenbach, T. (2009) New Public Management in Public Sector Organizations: The Dark Sides ofManagerialistic Enlightenment, Public Administration 87 (4): 892–909. doi:10.1111/j.1467-9299.2009.01766.x.

Doherty,B.(2001)Resourceadvantagetheoryandfairtradesocialenterprises,Journalofstrategicmarketing,19:4357-380.

149

Endsley,M.R.(2011)Designingforsituationawareness:Anapproachtouser-centereddesign.CRCPress.

Estabrooks C.A., Thompson, D.S., Lovely, J.J., Hofmeyer A, (2006) A guide to knowledge translation theory.JournalofContinuingEducationintheHealthProfessions,26,25-36

Falcione, R.L., Sussman, L. andHerden, R.P. (1987) Communication climate in organisations, In F. Jablin, L.Putnam,K.RobertsandL.Porter(eds.)HandbookofOrganisationalCommunication.London:Sage.

FinneranA,HartleyR,GibbA.G.F.,CheyneA,BustP.(2012)Learningtoadapthealthandsafetyinitiativesfrommegaprojects:anOlympiccasestudy,PolicyandPracticeinHealthandSafety10(2):81-102

Flanagan,J.C.(1954)Thecriticalincidenttechnique,PsychologyBulletin,51,327-358

Flin, R. (2014) Non-technical skills: enhancing safety in operating theatres (and drilling rigs).Journal ofperioperativepractice,24(3),59-60.

Foskett,A.C.(1982)Thesubjectapproachtoinformation,LinnetBooks,TheShoeStringPress,Inc.,Hamden,Connecticut,

Gherardi,S.andNicolini,D.(2002)LearningtheTrade:ACultureofSafetyinPractice,Organisation,9-2,191-223.

Gibb,A.G.F.;Pinder, J.;Bust,P.D.;Cheyne,A.;dainty,A.R.J.;Fray,M.;Finneran,A.M.;Glover, J.;Hartley,R.;Haslam, R.A.; Jones,W.;Morgan, J.; Pink, S.;Waterson, P.&Gosling, E.Y. (awaited) Engagement ofmicro,smallandmedium-sizedenterprisesinoccupationalsafetyandhealth,InstituteofOccupationalSafetyandHealth,pp109.

Gibb, A.G.F., Haslam, R.A., Hide, S., Gyi, D.E. & Duff, A.R. (2006)What causes accidents, Civil Engineering,ProceedingsoftheInstitutionofCivilEngineers,Vol.159,SpecialIssue6,pp.46-50,ISSN0965089X-http://hdl.handle.net/2134/5729

Gibb,A.G.F.,Hide,S.,Haslam,R.A.,Gyi,D.E.,Atkinson,S.&Duff,R.(2005)Constructiontoolsandequipment–theirinfluenceonaccidentcausality,JournalofEngineeringDesign&Technology(JEDT),Volume3Issue1pp.12-23,ISSN1726-0531-http://hdl.handle.net/2134/5940

Haines, H., Wilson, J. R., Vink, P., & Koningsveld, A. E. (2002) Validating a framework for participatoryergonomics(thePEF).Ergonomics,45(4),309-327.

Hartley,R.,Dainty,A.,Cheyne,A.,Waterson,P.,Gibb,A.,Haslam,R.,Morgan,J.,Finneran,A.,Bust,P.&Pink,S.(2014)Thefogofwork:thenecessityforblackandwhite,andgreyrulestoensuresafeworkplacebehaviour, in Learning from the past to shape a safer future,Workingonsafety.net 7th internationalconference,IOSH,p71-72.

Hale, A.& Borys, D. (2013)Working to rule, orworking safely? Part 1:state of the art review - Part 2: Themanagementofsafetyrulesandprocedures,SafetyScience,v55,pp.207-231.

HaleA. andHovden, J. (1998)Managementand culture: the thirdageof safety.A reviewof approaches toorganisational aspects of safety, health and environment. In: Feyer A.M. & Williamson, A. (Eds.)OccupationalInjury:Risk,Prevention,andIntervention.London:Taylor&Francis.

Harris,M. (2007) Introduction:WaysofKnowing. InM.Harrised:WaysofKnowing,NewApproaches intheAnthropologyofExperienceandLearning.Oxford:Berghahn.

HaslamR.A.,HideS.A.,GibbA.G.F.,GyiD.E.,PavittT.,AtkinsonS.andDuffA.R.(2005)Contributingfactorsinconstructionaccidents.AppliedErgonomics,36,401-415.

Harvey, G., Jas, P., Walshe, K., & Skelcher, C. (2014) Analysing organisational context: case studies on thecontribution of absorptive capacity theory to understanding inter-organisational variation inperformanceimprovement.BMJquality&safety,bmjqs-2014.

Head,H.,(1920).StudiesinNeurology.NewYork:OxfordUniversityPress,

Healy,M.andPerry, C.(2000) Comprehensive criteria to judge validity and reliability of qualitative researchwithin the realism paradigm,Qualitative Market Research: An International Journal, Vol. 3 No. 3,pp.118-26

150

Hofmann,D.A.,andStetzer,A.(1996)Across-level investigationoffactors influencingunsafebehaviorsandaccidents.PersonnelPsychology,49,307–339.

Hollnagel,E.(2014)Safety-IandSafety-IIThepastandfutureofsafetymanagement,Ashgate,Surrey,England,ISBN9781472423054

Hutchins(1991)Organisingworkbyadaptation,OrganizationScience,2:1,14-39.

Jørgensen , K (2014) Preventionof themany simple accidentswhichhavemajor consequences, in Learningfromthepasttoshapeasaferfuture,Workingonsafety.net7thinternationalconference,IOSH,p15.

King,N(2004)Usingtemplatesinthethematicanalysisoftext,inC.CassellandG.Symon(Eds.)EssentialGuidetoQualitativeMethodsinOrganizationalResearch.London:Sage.

Kohn, LT.; Corrigan, JM.; Donaldson,MS., editors (1999) To Err is Human: Building a Safer Health System.NationalAcademyPress;Washington,D.C:

Krishnan, A. (2009) Five Strategies for Practising Interdisciplinarity, ESRC National Centre for ResearchMethods, NCRM Working Paper Series, National Centre for Research Methodshttp://eprints.ncrm.ac.uk/782/1/strategies_for_practising_interdisciplinarity.pdf

LaneP.J.,Koka,B.R.,Pathak,S.(2006),Thereificationofabsorptivecapacity:acriticalreviewandrejuvenationoftheconstruct.AcademyManagementReview,31,833–63.

IEA(2000)ThedisciplineofErgonomics(InternationalErgonomicsAssociation).

Jarzabkowski,P.,Balogun,J.andSeidl,D.(2007)Strategizing:thechallengeofapracticeperspective,HumanRelations,60(1),5–27.

Jarzabkowski, P. and Spee, A.P. (2009) Strategy-as-practice: A review and future directions for the field.InternationalJournalofManagementReviews,11(1),69-95.

Jiang, L., Yu, G., Li, Y. and Li, F. (2010) Perceived colleagues’ safety knowledge/behavior and safetyperformance:Safetyclimateasamoderatorinamultilevelstudy,AccidentAnalysisandPrevention,42(5),1468-1476.

Kang,J.,Rhee,M.,&Kang,K.H.(2010)Revisitingknowledgetransfer:Effectsofknowledgecharacteristicsonorganizationaleffortforknowledgetransfer.ExpertSystemswithApplications,37(12),8155-8160.

Lai,K.H.,&Cheng,T.C.E.(2003).Supplychainperformanceintransport logistics:anassessmentbyserviceproviders.InternationalJournalofLogistics:ResearchandApplications,6(3),151-164.

Langdridge,D.,&Hagger-Johnson,G.(2009)Introductiontoresearchmethodsanddataanalysisinpsychology.PearsonEducation.

Lave&Wenger(1991)SituatedLearning.LegitimatePeripheralParticipation.CambridgeUniversityPress.

Lawton,R.J.,Ward,N.J. (2005)A systemsanalysisof the LadbrokeGroveTrainCrash.AccidentAnalysis andPrevention,37,235-244.

Lewis,C.(1992).Employeeselection.Cheltenham:StanleyThornes

Lewis, M, W. and Keleman, M, L. (2002) Multiparadigm inquiry: Exploring organisational pluralism andparadox,HumanRelations,55(2):251-275.

Lundberg, J., Rollenhagen, C. and Hollnagel, E. (2009) What-You-Look-For-Is-What-You-Find – Theconsequences of underlying accidentmodels in eight accident investigationmanuals, Safety Science,Vol47,Iss10.

Malhotra,Y.(2001)Knowledgemanagementandbusinessmodelinnovation.IdeaGroupPublishing,Hershey,PA..

Mayhew,C.,&Quinlan,M.(2006)Economicpressure,multi-tieredsubcontractingandoccupationalhealthandsafetyinAustralianlong-haultrucking.Employeerelations,28(3),212-229.

Mentzer, J. T.,DeWitt,W., Keebler, J. S.,Min, S.,Nix,N.W., Smith, C.D.,& Zacharia, Z.G. (2001)Definingsupplychainmanagement.JournalofBusinesslogistics,22(2),1-25.

151

Mingers, J. (2001)Multimethodology–mixingandmatchingmethods, in J. Rosenheadand J.Mingers (eds)RationalAnalysisforaProblematicWorldRevisited,2ndedn.,Wiley,Chichester,289-309.

Mingers,J.andGill,A.(1997)Multimethodology:TheTheoryandPracticeofCombiningManagementScienceMethodologies,Wiley,Chichester.

Mingers, J. (1997) Multi-paradigm Multimethodology. In Multimethodology: The Theory and Practice ofCombiningManagementScienceMethodologies(J.MingersandJ.Gilleds.),Wiley,Chichester,1-20.

Mohamed,S.(2002)SafetyClimateinConstructionSiteEnvironments,JournalofConstructionEngineeringandManagement,128,375-384.

Moran,E.T.andVolkwein,J.F.(1992)Theculturalapproachtotheformationoforganisationalclimate.HumanRelations,45,19-47.

Morgan, J and Pink, S (submitted) Researcher safety?: A critical autoethnography of regulation andimprovisation.

Mu,J.,Tang,F.,&MacLachlan,D.L.(2010)Absorptiveanddisseminativecapacity:Knowledgetransferinintra-organizationnetworks.ExpertSystemswithApplications,37(1),31-38.

Murray, S.R., & Peyrefitte, J. (2007) Knowledge type and communication media choice in the knowledgetransferprocess.JournalofManagerialIssues,19(1),111-133.

Neisser,U.(1978)Memory:Whataretheimportantquestions?InM.M.Gruneberg,P.E.Morris,&R.N.Sykes(Eds.),Practicalaspectsofmemory(pp.3-24).London:AcademicPress

Noyes,J.(2001).Humanerror.PeopleinControl:HumanFactorsinControlRoomDesign,60,1.

Orlikowski, W. (2002) ‘Knowing in practice: Enacting a collective capability in distributed organizing’.OrganizationScience,13/3:249–273.

Pavitt, T. & Gibb, A.G.F. (2003) Interface management within construction, ASCE Journal of ConstructionEngineeringandManagement,129:18-15.

Piaget,J.(1926)TheLanguageandThoughtoftheChild.NewYork:Harcourt,Brace.

Pidgeon, N., Henwood, K. (1997) Using grounded theory in psychological research, In N, Hayes (Ed.),Doingqualitativeanalysisinpsychology,Hove:PsychologyPress.

Pink,S.,Morgan, J.,andDainty,A. (inpress)Otherpeople’shomesassitesofuncertainty:waysofknowingandbeingsafe,EnvironmentandPlanningA

Pink, S.,Morgan, J., andDainty, A. (2014a) The safe hand: gels,water, gloves and themateriality of tactileknowing.JournalofMaterialCulture.E-pub20Oct2014.DOI:10.1177/1359183514555053

Pink,S.,Morgan,J.,andDainty,A.,(2014b)Safetyinmovement:mobileworkers,mobilemedia.MobileMediaandCommunication2(3):335-351

Pink,SandMorgan,J.(2013)Short-termethnography:intenseroutestoknowing,SymbolicInteraction36(3):353-363

Pink, S., Tutt, D.E., Dainty, A.R.J. and Gibb, A.G.F. (2010) ‘Ethnographic Methodologies for ConstructionResearch:Knowing,PracticeandInterventions’BuildingResearchandInformation,38(6):647-659

Reber,A.S.(1996).Implicitlearningandtacitknowledge.OxfordUniversityPress.

Rasche, A. and Chia, R. (2009) Researching Strategy Practices: A Genealogical Social Theory Perspective.OrganisationStudies,Vol.30,No.7,713-734.

Reichers,A.E.andSchneider,B.(1990)ClimateandCulture:Anevolutionofconstructs.InB.Schneider,(ed.),OrganisationalClimateandCulture,SanFrancisco:Jossey-Bass.

Robson, S. and Hedges, A. (1993) Analysis and interpretation of qualitative findings,Journal of theMarketResearchSociety.35(1),23-35.

Rogers,E.M.(1983)DiffusionofInnovations,3rdEd,MacMillanLondon.

152

Rosen,M., Salas, E.,Wilson, K., King, H., Salisbury,M., Augenstein, J., Robinson, D. & Birnbach, D. (2008)Measuring Team Performance in Simulation-Based Training: Adopting Best Practices for Healthcare,JournaloftheSocietyforSimulationinHealthcare,3:133-41doi:10.1097/SIH.0b013e318162627

Scarborough,H.,Swan,J.,Laurent,S.,Bresnen,M.,Edelman,L.andNewell,S.(2004)Project-BasedLearningandtheRoleofLearningBoundaries,OrganizationStudies25(9):1579–1600.

SCI-SteelConstructionInstitute(2005)TrojanHorseconstructionsitesafetymessages,HSEResearchReport,RR336,HealthandSafetyExecutive,55pp.

Senapathi,R.(2011)Disseminationandutilisation:Knowledge.SCMSJournalofIndianManagement,8(2)85-105.

Shaw,Haslam,C.&Haslam,R.A. (2007)AstagedapproachtoreducingMSDs in theworkplace:A longtermfollow-up(HSE:London),RR545

Singh, J. (1996) The importance of information flow within the supply chain.Logistics InformationManagement,9(4),28-30.

Tutt,D.E.,Pink,S.,Dainty,A.R.J.andGibb,A.G.F.(2013)‘OurOwnLanguage’inPink,S.,A,DaintyandD.Tutt(eds)EthnographicResearchintheConstructionIndustry,London:TaylorandFrancis,pp40-57

vanderMolenHF,LehtolaMM,LappalainenJ,HoonakkerPLT,HsiaoH,HaslamR,HaleAR,Frings-DresenMHW,VerbeekJ,2012,Interventionstopreventinjuriesinconstructionworkers.CochraneDatabaseofSystematicReviews

VanTeijlingen,E.,Hundley,V.(2002)Theimportanceofpilotstudies,NursingStandard,16(40),33-36

Vincent,C.(2010),PatientSafety(2ndEdition).Oxford:Wiley-Blackwell.

Vink,P.,Jong,A.D.,&Koningsveld,E.(2005)Makingmoneywithparticipatoryergonomics.HumanfactorsinOrganizationalDesignandManagement–VIII,IEAPress,SantaMonica,443-448.

Walker,M.(2005).Unpackingthenatureofdemandandsupplyrelationshipsintheminingcapitalgoodsandservices cluster: the case of PGMs. InTrade and Industrial Policy Strategies 2005 Annual Forum–Johannesburg.

Walters, D.,& James, P. (2009)Understanding the role of supply chains in influencing health and safety atwork.Leicester,IOSH-InstitutionofOccupationalSafetyandHealth,Leicester.

Ward,Haslam,HASLAM(2008)Theimpactofhealthandsafetymanagementonorganisationsandtheirstaff(IOSH:Leicester),ResearchReport08.1.

Waring, J.; Bishop, S.(2010) Watercooler learning: knowledge sharing at the clinical backstage and itscontribution to patient safety,Journal ofHealth,Organisation andManagement, Vol.24 (4), pp. 325-342.

Waring,J.(2007)Gettingtothe‘roots’ofpatientsafety.InternationalJournalforQualityinHealthCare,19,5,257-258.

Waring, J.J. (2009) Constructing and re-constructing narratives of patient safety.Social science &medicine,69(12),1722-1731.

Waters T.R., Putz Anderson V., Garg A. and Fine L.J. (1993) Revised NIOSH equation for the design andevaluationofmanualliftingtasks,Ergonomics,36,749-776.

Waterson, P.E., Griffiths, P., Stride, C., Murphy, J. and Hignett, S. (2010) Psychometric properties of theHospitalSurveyonPatientSafety:FindingsfromtheUK.BMJ:QualityandSafetyinHealthCare,19,1-5.

Waterson,P.E.(2014),PatientSafetyCulture:Theory,MethodsandApplication.Farnham,UK:Ashgate.

Waterson, P.E. (2009) A critical review of the systems approach within patient safetyresearch.Ergonomics,52(10),1185-1195.

Wenger, E.,McDermott,R.&Snyder,W. (2002) CultivatingCommunitiesofPractice:AGuide toManagingKnowledge(Boston,MA:HarvardBusinessSchoolPress)

153

Whittington, R. (2006) Completing the Practice Turn in Strategy Research,Organisation Studies, 27(5), 613-634.

Wilson, J. R. (1995) Solution ownership in participative work redesign: The case of a crane controlroom.InternationalJournalofIndustrialErgonomics,15(5),329-344.

Wilson, J. R. (2012) Fundamentals of systems ergonomics.Work: A Journal of Prevention, Assessment andRehabilitation,41,3861-3868.

Winkler(2006).Client/contractorrelationshipsinmanaginghealthandsafetyonprojects.HSERR462.

Wood,W.,&Kallgren,C.A.(1988)Communicatorattributesandpersuasion:Afunctionofaccesstoattitude-relevantinformation.PersonalityandSocialPsychologyBulletin,14,172-182.

Yakhlef, A. (2007) Knowledge transfer as the transformation of context. The Journal of High TechnologyManagementResearch,18(1),43-57.

Zander, U., & Kogut, B. (1995) Knowledge and the Speed of the Transfer and Imitation of OrganizationalCapabilities:AnEmpiricalTest.OrganizationScience,6(1),76-92.

Zohar, D. (1980) Safety climate in industrial organisations: Theoretical and applied implications. Journal ofAppliedPsychology,65,96–101.

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6 APPENDIX

6.1Interviewinventory

Introduction and overview for participants –We are interested in themanagement of Health and Safetywithinyourorganisationoranyoneelseyourorganisationdealswith. Morespecificallyweare interested inhowhealthandsafetyflows,andisunderstood.

Introduction(notrecorded)

• Thankyouforagreeingtobeinterviewed

• Researcher(s)introduceselves/roles/group

• Briefreminderaboutthefocusofthestudy–identifythemaingoals/objectivesofthemeeting

• Timeavailable

Permissiontotape-Interviewquestions:(recordedwithparticipantsconsent)

• Permissiontoquote/Confidentiality/Anonymity

• Sayingthingsofftherecord

• Accesstothereport

• Weareinterestedinyourperspectivesonhealthandsafetytherearenorightorwronganswers!

• FocusGroups–trynottotalkovereachother.

Thankyouforagreeingtoparticipateinthisresearch!!

Interviewquestions:(recordedwithparticipantsconsent)

Warmup:

FocusGroups–Goroundthetablegettingrespondentsfirstnameandbackgroundinformation.

• Briefly-I’dliketostartbygettingsomebackgroundinformation:whoyouworkfor,whatyoudo,whereyouwork,howlongyouhaveworkedhereandifyouhavepreviousexperiencewithinthisindustryorotherindustries.Canyoutellmeaboutthehealthandsafetyhere?Isitdifferenttopreviousjobsyouhaveworkedon?How?

1. Networkedorganisations(yourorganisationandothers)

Canyoutellmewhatyouthinkanetworkis?

WhatdoyouthinkanetworkisinrelationtoOSH?

Canyoudrawthisforme?

DoyouthinkthestructureofyourorganisationaffectsOSHflow?

155

2. Flow

CanyoutellmeaboutOSHflowatthecompanyasyouunderstandit?HowdoyoufindoutaboutOSH?Isthereanythingthathindersorhelpsthis?

3. Translation

DoyouthinktheOSHinformation iseasytounderstand? Isthereanythingthat inhibitsorenablesyourunderstandingofOSH?Doyouthinkthatthereareanyparticularmethodsthathelpyouunderstand?

WhichtypesofinformationarethebestforimprovingyourunderstandingofH&S?

WhatisthebestwayoffindingoutaboutH&S?

WhatistheleasteffectivewayoffindingoutaboutH&S?

WhatH&Sinformationsourcesdoyoutrustthemost?Why?

4. Enactment

HowdoyourespondtotheOSHinformationyoureceive?

Canyoutranslatetheinformationyoureceivetodoyourjobsafely?

Whichtypesofinformationarethebestforimprovingyourmotivationtobehavesafely?

WhichtypesofH&Sinformationhavehadthemostinfluenceonyourbehaviour?Why?

Doyouever takeshort-cuts/useworkarounds? Underwhatcircumstances/Why?Could/wouldtheseworkaroundsaffectyourabilitytodoyourjobsafely?

ProfessionalisingQuestions:

WhenthereisaworkpracticewhichconflictswithH&Swhatdoyoudo?

Have therebeennewH&S rulesorpracticeswhichmake itdifficult foryou todoyour job? Whatwasdoneaboutthis?

HaveyouworkedwiththeH&SmanagerstosolveaH&Sproblem?

5. ScenarioandCriticalIncidentTechnique:-Casestudies

6. CouldyoutellmeaboutatimewhentheOSHknowledgeorinformationflowanduseaffected(positivelyornegatively)yourabilitytodoyourjobsafely?

Inparticularcouldyouthinkofexamplesthatrelateto:

a. ManualHandlingb. PPEc. Workinginthehomed. Equipment

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PointersforCriticalIncidentTechnique(Pleaseusetheseasaguide)

1. Creatingadetailedtimelinea. Asktheintervieweetogiveaquickrun-throughoftheincident.b. Listenforareastoprobefurther.c. Identifydecisionpoints,gapsinthestory,conceptualleaps,errors,orshiftsinsituation

assessment.d. Whenanintervieweementions,“Ijustknewxwouldhappen,”or“itwasjustagutfeelingto

choosethatCOA(CourseOfAction),”Flagthosepointsforfurtherprobing.2. DeepeningonDecisionPoints

a. Askkeyprobesthatinvestigateflagsyouhavenotedincreatingthetimeline.b. Probesforinvestigatingdecisionpointsandshiftsinthesituationassessmentmayinclude:

i. Whatwasitaboutthesituationthatletyouknowwhatwasgoingtohappen?ii. Whatwereyouroverridingconcernsatthatpoint?iii. Howwouldyousummarizethesituationatthatpoint?

c. Probesforinvestigatingcuesandexpertstrategies,andgoalsmayinclude:i. Whatwereyounoticingatthatpoint?ii. Whatinformationdidyouuseinmakingthisdecision?iii. Whatknowledgedidyouhavethatwasabsolutelynecessary?iv. Whatareyouhoping/intendingtoaccomplishatthispoint?

3. Probingwith“What-If”queriesa. Askaboutotheralternativesthattheintervieweemayhaveconsidered.b. Askifsomeoneelse,perhapswithlesserexperience,mighthavetakenthesameposition.

Determinewhatinfluencetheinterviewee’sexperiencehadonthechosencourseofaction.

Cooldown:

• Doyouhaveanyquestionsforusoranythingyouwouldliketoaddtothisdiscussion?

• Arethereanyquestionsthatyoufounddifficulttounderstandordidn’tmakesensetoyou?

THANKYOUFORTAKINGPARTINOURRESEARCH!!!

All rights reserved. Permission to reproduce any part of this work will not be withheld unreasonably, on condition that full attribution is given to the publication and to IOSH.

While this paper reports on research that was funded by IOSH, the contents of the document reflect the views of the authors, who are solely responsible for the facts and accuracy of the data presented. IOSH has not edited the text in any way, except for essential formatting requirements. The contents do not necessarily reflect the views or policies of IOSH.

All web addresses are current at the time of going to press. The publisher takes no responsibility for subsequent changes.

© IOSH 2016Published by IOSHThe GrangeHighfield DriveWigstonLeicestershireLE18 1NNUKt +44 (0)116 257 3100f +44 (0)116 257 3101www.iosh.co.uk

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We set standards, and support, develop and connect our members with resources, guidance, events and training. We’re the voice of the profession, and campaign on issues that affect millions of working people.

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