The development and testing of a hierarchical measure of project OHS performance

Purpose - This paper seeks to examine a hierarchical measurement model for occupational health and safety (OHS) performance developed for use in the Australian construction industry and tested over the life of one case study construction project. The model was intended to provide a more sensitive and informative measure of project OHS performance than traditional injury frequency rates. Design/methodology/approach - Two measurement tools were tested. The tools, a monthly weighted safety index and a quarterly safety climate survey, were used to measure OHS performance and performance data are presented. Findings - The data suggest convergent validity, indicated by consistent results between the two measures. Results also indicated that a combination of measurement techniques provides more comprehensive data pertaining to project OHS performance and enables the diagnosis of OHS issues that would be undetected with reliance exclusively on traditional measures, such as lost time injury frequency rates. Research limitations/implications - The implications for future research lie in the demonstrated need to carefully evaluate the validity of the safety index and safety climate survey in future construction projects, and in the broader construction context. The results were limited to an evaluation of the measurement model in a single case study construction project and future testing is needed to determine the generalisability of the model. Practical implications - The implications for practice are that multiple measures of OHS performance, including leading indicators and surveys of workers' attitudes and perceptions of project OHS, provide a more useful basis for the development of targeted OHS improvement strategies

Prevention through design: Trade-offs in reducing occupational health and safety risk for the construction and operation of a facility

Purpose - The research aims to explore the interaction between design decisions that reduce occupational health and safety (OHS) risk in the operation stage of a facility's life cycle and the OHS experiences of workers in the construction stage. Design/methodology/approach - Data was collected from three construction projects in Australia. Design decisions were examined to understand the reasons they were made and the impact that they had on OHS in the construction and operation stages. Findings - The case examples reveal that design decisions made to reduce OHS risk during the operation of a facility can introduce new hazards in the construction stage. These decisions are often influenced by stakeholders external to the project itself. Research limitations/implications - The results provide preliminary evidence of challenges inherent in designing for OHS across the lifecycle of a facility. Further research is needed to identify and evaluate methods by which risk reduction across all stages of a facility's life cycle can be optimised. Practical implications - The research highlights the need to manage tensions between designing for safe construction and operation of a facility. Originality/value - Previous research assumes design decisions that reduce OHS risk in one stage of a facility's life cycle automatically translate to a net risk reduction across the life cycle. The research highlights the need to consider the implications of PtD decision-making focused on one stage of the facility's life cycle for OHS outcomes in other stages

Looking and learning: using participatory video to improve health and safety in the construction industry

Construction health and safety (H&S)is usually managed using a top-down approach of regulating workers' behaviour through the implementation and enforcement of prescriptive rules and procedures. This management approach privileges technical knowledge over knowledge based on workers' tacit and informal ways of knowing about H&S. The aim is to investigate the potential for participatory video to: (1) identify areas in which formal policies and procedures do not reflect as practised by workers; (2) encourage creative thinking and elicit workers' ideas for H&S improvements; and (3) provide an effective mechanism for capturing and sharing tacit H&S knowledge in construction organizations. Interviews were conducted in two case study organizations (CSOs) in the Australian construction industry. The results suggest reflexive participatory video enabled workers and managers to view their work practices from a different perspective. Workers identified new hazards, reflected about the practical difficulties in performing work in accordance with documented procedures and reframed their work practices and developed safer ways of working. Workers described how the participatory video capturing the way they work enabled them to have more meaningful input into H&S decision-making than they had previously experienced. Workers also expressed a strong preference for receiving H&S information in a visual format and commented that video was better suited to communicating H&S 'know how' than written documents. The research is significant in providing initial evidence that participatory video has the potential to improve H&S in construction

Application of Q-methodology in studying construction stakeholders' perceptions of OSH risks - An introduction to the preliminary stage

There is increasing recognition that many construction occupational health and safety (OSH) hazards arise as a result of activities in the planning and design stage. Improvement of construction OSH performance can be influenced by various stakeholder groups, not just the appointed construction contractor. It is important for stakeholder groups to take each other's perspective when considering OSH risks. However, different stakeholder groups may have different perceptions of OSH risk, leading to difficulty in establishing a common strategy to eliminate hazards and/or and reduce risk. This study aims to map the similarity/difference between stakeholder groups' OSH risk perceptions. An innovative Q-methodology is adopted for data collection. Q-methodology involves a number of procedures by which respondents sort a set of sample objects (known as a Q-set) into certain order, according to their subjective judgements. Photographs will be used as stimuli for the Q-sort in this study. This paper introduces the rationale of Q-methodology, and describes the process of developing and validating the Q-sort instrument for this construction application

Exploring the link between early constructor involvement in project decision-making and the efficacy of health and safety risk control

The position of the constructor in communication networks, including those before the commencement of construction, is likely related to the quality of work health and safety (WHS) outcomes realized. In order to examine the extent of this relationship, 23 cases were drawn from 10 participating construction projects in Australia and New Zealand. Social network analysis was used to mathematically and graphically model information exchanges in 13 of these cases. For each case, the quality of WHS risk control outcomes was measured. This measurement was based on an established 'hierarchy of control' in which risk controls are classified in descending order of effectiveness from the elimination of a hazard (the most effective) to the reliance on personal protective equipment (the least effective). Social network metrics were calculated reflecting: (1) the ratio of actual links among parties in the project network relative to the maximum number of links possible (network density); and (2) the extent to which the constructor communicated with other parties in pre-project planning and design stages (the constructors' degree centrality). Network metrics were compared for cases in which the risk control scores were higher and lower than average. The results showed a significant difference in constructors' pre-construction degree centrality for cases with high and low risk control scores. The results provide preliminary evidence as to the potential WHS benefits of ensuring that constructors' knowledge about construction methods, materials, WHS risks and means of risk control, are integrated into pre-construction decision-makin

Are we on the same page? Exploring construction professionals' mental models of occupational health and safety

Photographic Q-methodology was used to explore construction professionals' mental models of occupational health and safety (OHS). Sixty Australian construction professionals participated in the research, including 15 architects, 15 engineers, 15 constructors and 15 OHS professionals. Participants were asked to sort photographs depicting different building systems into a grid based upon their judgement of the likelihood of accidental injury resulting from the construction of each of the building systems depicted. Responses ranged from Rare (-2) to Almost certain (+2). Sorting patterns relating to eight photographs of different façade systems were analysed using Q factor analysis. Three distinct sorting pattern types were identified in the data, representing clusters of participants whose sorting patterns were similar. These sorting pattern types cut across occupational/professional groups. Interpretation of the factors revealed substantial differences between the OHS judgements made by participants in the three clusters. Qualitative explanatory information revealed participants in the three clusters used different attributes when considering the likelihood of accidental injury. These attributes shaped their sorting patterns. The results suggest shared mental models (SMMs) are unlikely to exist in construction project teams, as each individual uses their own frame of reference to understand OHS. Opportunities exist to understand these different frames of reference and create more consistent team mental models of OHS. However, incorporating a diversity of viewpoints into project decision-making is recommended in order to produce effective decision-making in the choice or specification of building systems

The relationship between pre-construction decision-making and the quality of risk control: Testing the time-safety influence curve

Purpose - The purpose of this paper is to explore the relationship between the timing with which decisions are made about how to control work health and safety (WHS) risks in construction project (i.e. either pre- or post-construction) and the quality of risk control outcomes. Design/methodology/approach - Data were collected from 23 construction projects in Australia and the USA. Totally, 43 features of work were identified for analysis and decision making in relation to these features of work was mapped across the life of the projects. The quality of risk control outcomes was assessed using a classification system based on the "hierarchy of control". Within this hierarchy, technological forms of control are preferable to behavioural forms of controls. Findings - The results indicate that risk control outcomes were significantly better in the Australian compared with the US cases. The results also reveal a significant relationship between the quality of risk controls and the timing of risk control selection decisions. The greater the proportion of risk controls selected during the pre-construction stages of a project, the better the risk control outcomes. Research limitations/implications - The results provide preliminary evidence that technological risk controls are more likely to be implemented if WHS risks are considered and controls are selected in the planning and design stages of construction projects. Practical implications - The research highlights the need for WHS risk to be integrated into decision making early in the life of construction projects. Originality/value - Previous research has linked accidents to design. However, the retrospective nature of these studies has not permitted an analysis of the effectiveness of integrating WHS into pre-construction decision making. Prospective studies have been lacking. This research provides empirical evidence in support of the relationship between early consideration of WHS and risk control effectiveness

Interdisciplinary communication in the intensive care unit

Background. Patient safety research has shown poor communication among intensive care unit (ICU) nurses and doctors to be a common causal factor underlying critical incidents in intensive care. This study examines whether ICU doctors and nurses have a shared perception of interdisciplinary communication in the UK ICU. Methods. Cross-sectional survey of ICU nurses and doctors in four UK hospitals using a previously established measure of ICU interdisciplinary collaboration. Results. A sample of 48 doctors and 136 nurses (47% response rate) from four ICUs responded to the survey. Nurses and doctors were found to have differing perceptions of interdisciplinary communication, with nurses reporting lower levels of communication openness between nurses and doctors. Compared with senior doctors, trainee doctors also reported lower levels of communication openness between doctors. A regression path analysis revealed that communication openness among ICU team members predicted the degree to which individuals reported understanding their patient care goals (adjR2 = 0.17). It also showed that perceptions of the quality of unit leadership predicted open communication. Conclusions. Members of ICU teams have divergent perceptions of their communication with one another. Communication openness among team members is also associated with the degree to which they understand patient care goals. It is necessary to create an atmosphere where team members feel they can communicate openly without fear of reprisal or embarrassment

Interprofessional communication with hospitalist and consultant physicians in general internal medicine : a qualitative study

This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist and consultant physicians, as well as the experiences of providers working with them. The implications of this research are globally important for understanding how to create opportunities for physicians and their colleagues to meaningfully and consistently participate in interprofessional communication which has been shown to improve patient, provider, and organizational outcomes