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Organisational Stress –a management model
Dil Sen, Clinical Senior Lecturer in Occupational MedicineCentre for Occupational & Environmental Health, University of Manchester, UKEASOM Aug.2015
Lake Bled, Slovenia
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““Hard work never killed Hard work never killed anybody…anybody…
but why take a chance?”but why take a chance?”Charlie McCarthy
(Edgar Bergen,1903-1978)
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Agenda
DefinitionsSome myths & confusionsFacts & figuresCore featuresA management model
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Hazard & risk mechanisms (ILO)
"Psychosocial hazards are those which relateto the interaction between job content, management systems, environmental controlon the one hand, and workers' competenciesand needs on the other."
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“a natural reaction to excessive pressure” (HSE)not a disease…till it’s excessive/goes on for long time,can lead to physical & mental ill harm (evidence base)PRESSURE is the stimulus in the STRESS equation -
STRESS is a negative imbalance in the system (transactional model of Cox & Mackay or Selye’s model of psychological strain)
when perceived DEMAND(s) exceed ability to COPE (job demands – control model)
pose an important problem via the negative impact on work capacity & productivity
What is stress ?
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"managers only get stressed" - not so"it's my own fault" - predisposition ?"it's good for you" - arousal "yes"...stress "no"same as job dissatisfaction, BUT people with high level of job satisfaction can also be greatly stressed
can be used to define cause…or effect (confusing?)
Some myths...
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Facts & figurestotal number of cases of stress in UK in 2011/12 was 428 000 (40%) out of a
total of 1 073 000 for all work-related illnesses (LFS) [Slight decrease!]on average each case lead to 24 working days lost (10.4 million days lost in
total, 2011/12) [UK] industries reporting highest rates of total cases of work-related stress (three-
year average) were human health and social work, education and public administration and defence [UK]
occupations reporting highest rates of total cases of w-r stress (3-year average): health professionals (in particular nurses), teaching and educational professionals, and caring personal services (eg. in welfare and housing )
European Agency for S&H at Work - ~28% affected in EUE20billion/yearsecond biggest OH problem in EU after back pain….
11% of all disease claims (Nat.Council of Compensation Insurance)
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stress is a process that happens over time and to people
individual perception & cognition very important (perception of control ?)
Imbalance 1 - demand v coping capacity (Karasek & Theorell)
Imbalance 2 - effort-reward paradigm (Siegrist)other influences: “flexible workforce” & “short term contract” culture
consequencesconsequences are physiological;behavioural;cognitive;emotional
Core features
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PHYSIOLOGICAL
PHYSICAL HEALTH
PSYCHOLOGICAL HEALTH BEHAVIOURAL
TYPE A PERSONALITY
PSYCHOLOGICAL
Individualcharacteristics
Symptoms Disease
Sources of stress
Physical & Mental ill health
Career developme
nt
Intrinsic to job
Role in org
Relationships at work
Org structure/climate
Personal
PHYSICAL(CONTROL)
(SUPPORT)
(CHANGE management)
(DEMAND v CONTROL)
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Some organisational "symptoms"
Physiological- not applicable
Behavioural-high absenteeism/sick leave-high staff turnover-poor industrial relations-increased acc/illness rates-poor quality/productivity-increased claims
Cognitive- not applicable
Emotional-low morale-loss employee contributions to planning/process improvements
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Some 'Stressors'Workload
long workhours ( >45hrs) [Kecklund G. Scand J Work Env Health 2005;31(5):325-327
Milner A et al. Occup and Env Medicine 2015;72(8):573-586] OR not enough work monotonous work
Physical environment- hot/cold; noisy; bright/dark…..
Relationships- with boss, colleagues, subordinates- problems with delegation
"Work-life balance"- personal crises (money, health...)- work v family demands
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Managing 'stress' at work
Step 1-"Do we have a problem?"(Recognition & Acceptance). Initiate risk assessment....
Step 2-”How bad ?” Analysis of work situation & identification of likely organisational risk factors
Step 3-”What do we need to do?” ACT on it..
Step 4-”Has it worked?” Monitor/audit what has been done and evaluate long term impact
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Prevention
Organisational approaches
Preventive strategies -job redesign/worker management training/betterorg.communications
Timely reaction-earlyrecognition/management,group problem solving/reward orientated mgt style
Support strategy - treatment, rehabilitation & counselling
Hard
to
do
Easy t
o
do
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Managing 'stress' - 5 steps
policy and proceduresorganisation of staffplanning and setting standardsmeasuring performanceaudit and review
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R e v iew in g pe rfo rm a n ce
M e asu ring p e fo rm a n ce
P la nn ing a nd im p lem en ting
O rg an is ing
P o lic y
Auditing
The HSG 65 Modelhttp://www.hse.gov.uk/pubns/books/hsg65.htm
Information link
Control link
Policy
Development
Organisational development
Feedback loop to improve performance
Developing techniques of planning, measuring & reviewing
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Is there a clear 'stress' policy & is it written down ?Does it specify who is responsible and the arrangements for identifying org.stressors, assessing risks and controlling them ?
Do employees (& managers) know....are they involved ?Is it up to date ?
Is there a policy ?
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•Acknowledges that work-related stress is primarily an organisational, not individual, issue•Allocates roles and responsibilities (and explains the responsibilities of managers and staff)•Recognises that stress is a health and safety issue which can be integrated into existing arrangements
•Has an emphasis on prevention; lighter emphasis on provision of training/support services•Has in-built review mechanisms• Is applicable to all staff•Has been created in partnership with employees and is not ‘owned’ by the organisation
Characteristics of a good stress policy
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Organisation of staff ? -competence, control, cooperation, communication
specific people for specific H&S tasks ( especially managers)
consultation with staff & representativesinform staff about risks & preventive measuresexpertise and training as appropriatespecialist support ( OHS, counselling)
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setting of objectives to manage stressthe hazards/organisational stressors?what are the risks?are there standards (measurable, achievable, realistic ) for people and processes?
Planning ?
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Active monitoring ( before things go wrong)- are standards being implemented ?- are they effective (check ill health data) ?
Reactive monitoring ( after things go wrong)- investigating incidents, complaints- why was 'performance' sub-standard?
Measuring performance
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focus on the concerns of the majority of employeesdeveloped through work with partnersapplied & considered across “high-risk” sectors
health, education, finance, social care….covers the main stressors:
DemandControlSupportRelationshipsRolesChange
Management Standards [MS]
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•remains popular across all employment sectors
•website receives over 25,000 visits per month
•many organisations have adapted MS tools for use with individuals for RA and as part of r.t.w procedures
•the most effective interventions have been those designed & implemented jointly (management, workers, TU)
www.hse.gov.uk/stress
Management Standards
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Management Standards Process
The Management Standards
Who can be harmed & how?
Step 1: Identify the hazards
Step 2: Decide who might be harmed and how
Step 3: Evaluate the
risk and take action
Step 4: Record your findings
Step 5: Monitor and review
Gathering information
Linking to problems
Communicating the results
Action planning
Evaluation / Continuous Improvement
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HSE Stress management Standards:Making the Management Standards work - pdfHSG218 – managing the causes of WRSManagement standards tools & downloadsCase studies
COEH teaching modules: Mental ill health & Stress at Work [Module 2F online]Common Mental Health problems and the Workplace [Module 3J]
Resources ?
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by own staff, different department or outsidersto check effectiveness of 'Stress' policy
- degree of compliance with standards- areas where standards need review- stress case data, possible causes, trends....
Is there a review process ?
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So who’s stressed then?
Any questions?
http://www.coeh.man.ac.uk/