DOCTORS TO A SICK INDUSTRY

The Gulf region is a vibrant, exciting and rapidly growing area of the world, it reminds me of Hong Kong in the 1980’s, and while there are thousands of wonderful things that the Gulf can justifiably be proud, its management of occupational Safety and health is not one of them.

During my frequent visits to the region, I have the opportunity to see both living and working conditions of the workforce, many of whom are having their basic human rights violated.

To many, especially in construction, death, injury disease and waste are constant companions for the million or so third world, labor force who come to the region simply to feed and provide for their families in India, Pakistan and the Philippines.

Trying to find out the size of the problem is difficult, even to establish how many people are killed or injured at work is a guessing game.

The powers that be, need to understand the cause and effect of these “accidents”, and start to hold Managers, Directors and owners accountable for poor safety standards, jail time and multi million $ fines will soon see an improvement, I have never seen or heard of a government inspector ever visiting a site before an accident, (pro-active) only after (reactive).

There are strong similarities between the treatment of accidents and disease and error free performance with thoughtful attention by managers of occupational safety and health functions.

Some 2,500 years ago the science of medicine as we know it today began with principles laid down by ancient teachers of the Hippocratic Corpus. This logic separated superstition from realism using scientific study of the human body and its diseases supported by a set of basic truths. For example, The Hippocratic Oath of Medicine (CIRA 400 BC) is a solid principle for all doctors to accept even today.

Today’s struggle in the Gulf. To control occupational losses, whether resulting in injury, damage or production losses have many of the characteristics of those faced by the medical profession, The nature and causes of both disease and operational errors appear to be much the same.

Medical parallelism over centuries of tediously slow development suggest that a process of subjective reasoning be added to objective inspection to block out harmful pathological agents of functions of an individual enterprise.

If one can visualize individual components of a corporate body, as did the 17th century physician with the human body, the need for better management of its functional parts for the excellence of the whole becomes evident. Space permits emphasis of only a few empirical qualities of this process of diagnosis directed toward performance improvement.

INSULTS TO A BODY

Let us first consider that diseases and trauma are to a human body as human errors and condition defects are to a corporate body.    Then, each performance error can be accepted as the inevitable outcome of some industrial “virus” to be identified and traced back to its origin.

In this context, both disease and mishaps are pervasive insults to the respective body systems (biological and social). Philosophically, both may be viewed as breeding grounds for social, political, and economic problems for both patients and managers. Each “insult” is an undesired event the same definition as accident.

Viewed as error-provocative situations, the process of their prevention suggests a need for somewhat more academic rigor than routine safety inspection. It suggests knowing more about the structure, practices, and principles of management. It means also, the acceptance of a truth: flawed management practice, latent in most industrial mishaps, cannot be subject to elimination by technical correction. The corporate body will not respond as well to compliance with law as with logic of correcting its own flawed functions.

EPIDEMIOLOGY OF MISHAPS

Epidemiology must be given thoughtful consideration by those who would choose to manage a system’s safety activity. Decisional oversights, as symptoms of managerial incompetence, conform to the same biological laws in a corporate body, as do diseases in a human body. Treatment is similar.

The process of discovery and diagnostic removal of causal factors for imperfect performance of corporate functions does not appear intrinsically different from that of the treatment of disease in the human body. Therefore, science, which investigates the causes and elimination of epidemic anomalies, applied equally well to industry as to people. One must not restrict this concept just for its “broad application to mass disease,” writes Dr. J.E. Gordon in his article, “The Epidemiology of Accidents,” which was published in American Journal of Public Health. “It is not so generally appreciated that injuries (and damage), as distinguished from disease, are equally susceptible to this approach…”

IMPRESSION V. REALITY

Medical science has had lengthy experience with negative public attitudes and general reluctance to accept its practice. A parallel situation exists today for many safety practitioners facing a lack of high-level understanding and support of their services. For years, the skeptical patient perceived the doctor as a “pill pusher and syrup dispenser.” Modern medicine has replaced this image of necessary evil” with a broad “wellness movement”, showing concern for conditions of the complete body and not just the part that hurts.

The target did not change. Medical science just took advantage of a holistic desire by society to improve quality of life. With a sample modification of its sense of purpose, the field of medicine underwent a fantastic change in public acceptance and support. In short, it took advantage of behavioral science and customer satisfaction.

NEEDED: AN EDUCATED CUSTOMER

“Who is your customer — labour or management?” might be asked of a systems safety practitioner. The answer, of course, must be both. If management supports the field of occupational safety & loss prevention, another question arises, “What does this customer want?”

Occupational safety may have to adopt a page from the medical book of experience. The universal image of a compliance inspector dispensing “gloom, doom, and Band-Aids,” as perceived by management, deserved a change. It might start by recognizing the corporate goal of industrial excellence. Then the question must be asked: “What is the safety function doing to support that goal?”

The answer may be found in the medical recipe for success that follows the advice of Peter Drucker, the father of modern management philosophy: “What the customer thinks he is buying, what he considers value’, is decisive. It determines what the (safety) business is, what it produces, and whether it will prosper.”

Time (probably years) and academic study will be needed to make this concept work at the professional level as well as within management itself. It should be a business administration requirement for schools that are presently turning out graduates ignorant of the science of managing for error-free performance. This will not develop by itself.

Comprehensive academic preparation is just as critical to causal diagnosis, program correction, and flaw evaluation in a corporate system as in a human system. This new direction demands acceptance of a common principle. Control demands multifactual evidence backed by qualified evidence. For the systems safety manager, every operational mishap, regardless of result, becomes a symptom of management incompetence. Management must be educated to accept this truism.

TRIADIC ANALYSIS OF FLAWED SYSTEMS

A system view of an industrial mishap will need study to accept flaws in three of its components – biological, physical, and social. Some will see this better if identified as unsafe practices and condition defects, and management oversights.

The diagnostic process to be learned is called “triadic analysis of flawed systems” (TAFS). It is based on a law: all systems are in a constant mode of failure and in a continuous state of deterioration.

Hence, the process of systems safety management demands the same intensive study of the corporate anatomy as demanded of a doctor for the human body system. A corporate safety manager must have knowledge of planning and organizing to eliminate flaws of functional systems; communication technology to identify flawed decisions to the process, principles, and practices of functional direction; and administrative strategy to establish an etiological method of control and elimination of error-provocative situations before they occur.

EVIDENTIARY ISSUES

It took centuries to move medical science away from cure by physical examination made outside the body. A prospect of ‘seeing” what is going on inside the body system was hard to accept.

This was overcome by Andreas Vesahus (1514-64), who produced, by use of surgery, an entirely new paradigm of direct confrontation with the origin of disease. This was the start of a search for disease by cutting into the body of cadavers

Advances in medicine and technology today have discovered many ways to diagnose internal flaws of a body system on a living patient. Dr. J.S. Reiser, in Medicine and the Reign of Technology, traced the development and use of devices that have greatly advanced the frontier of diagnosis, i.e., the microscope, stethoscope, thermometer, ophthalmoscope, laryngoscope, x-ray, electrocardiograph, sphygmograph, cytoanalyzer, CT scanner, and others. Such advances, he says, not only modified the premise of diagnosis but also altered the relationship between doctor and patient.

Success of medical innovations can also suggest a possibility of methods other than visual plant inspections to identify causal factors of loss in a corporate body. Unsafe acts and conditions rely on objective judgments that depend on the law of the situation. Removing managerial oversights is not a matter of objective compliance with rules and regulations. Subjective evidence related to management practice is required to apply logic to the situation.

Notably, some experimental work has been made in this area with reasonable success. It is based on flaws in the elements of management, i.e., planning, organizing staffing, directing, coordinating, reporting and budgeting. Each is supported by application of management principles that are to the practice of managing what safeguards are to the protection of people and things. Flawed application of principles can also be clues to the origin of many industrial mishaps if the safety professional can learn to recognize them.

PRINCIPLES AND FLAWED MANAGEMENT

Formal courses of management teach that elements are supported by their principles (of which there are many to be learned and used). Their applications, like recipes to a chef, are basic but not absolute. Wrong or inadequate use can become the origin of bad industrial results now being charged to wrongful acts and conditions. Managers, too, must share some of the responsibility between their potential and labor’s actual contribution to operational problems resulting in harm and damage.

A principle is formulated to predict results; therefore, it should be used to control management behavior. G.R. Terry and S.G. Franklin, in Principles of Management, compare the need for a set of management principles to support the quality of its practice with the need for a table of materials’ strengths and weaknesses by a civil engineer in order to guide the accuracy of his calculations. “By using them,” goes the explanation, “managers can more easily achieve the objectives and avoid making fundamental mistakes in their activities.” Ergo, wrong or inadequate use of principles can cause industrial mishaps.

The time has arrived to calculate a rate of managerial error as a more valuable measurement of performance control than the popular rate of disabling labor injury. Pointing an industrial finger at quality of management, rather than just blaming the worker, would certainly open a new area of executive interest for error-free performance.

What medicine has achieved to improve quality of life translates easily into quality of industrial excellence. Approach to either practice relies on a common principle. In spite of the ever-increasing emphasis on industrial excellence, in contrast with that of Centers for Disease Control, study of flawed management practices generating mishaps in manufacturing has yet to be established. Consider how much more money is currently spent on medical research than on accident prevention. Time for industrial funding to improve the quality of its decision-makers has arrived.

IS SYSTEMS THEORY THE ANSWER?

A system is simply a way of viewing things as parts or components of a whole – all cooperating to provide support. When the body is seen as composed of skeletal, muscular, organ, glandular, nervous, and fluid-circulatory systems, the whole function of the body comes into clearer focus in respect of how each support or fails to support the quality of life. An industrial enterprise is a man-made social system with a complex of subsystems and proliferation of operations that must, as systems of the human body, work in unison to support the corporate goal.

The medical profession founds its answer by apply the general theory of systems to the functions of a human body. In 1628, Dr. William Harvey published his magnum opus, “De Motu Cordis,” introducing the discovery that blood travels through the body in a never-ending circular system. He had discovered a new paradigm of medicine that would not accept until a century later.

Today, medical science recognizes that concept of systems as a quantum leap forward in its history. In his classic biography of medicine titled, “Doctors: The Biography of Medicine, Dr. E.B. Nuland wrote: “With that single step, Harvey solved the most elusive puzzle that had delayed the progress of medicine., making it a principle medium of biological research.”

FINAL THOUGHT

Only a few of many similarities between safety and medical practice have been examined. However, if the reader is kind enough to reach this point without stopping, the image of becoming a “doctor to a sick industry” may come to fore. It is a far-out thought with some potential.

A career transition from the technically oriented safety practitioners to a corporate systems safety manager is for those willing to invest hard study and concentrated work. The outcome means knowledge and insight to work as a manager with other managers. What management is, how it works, and where to apply it is a new field for the loss prevention specialist, focusing on the corporate goal of industrial excellence with the principle: “First, let no harm or damage occur.”

Bio:

Dr. Bill Pomfret; MSc, FIOSH; RSP. FRSH; CHCM; RSP;
Managing Consultant; Safety Projects International Inc.
Can be contacted at
26, Drysdale Street, Kanata, Ontario, K0A 3M0.
Tel: 613-2549233.
e-mail: pomfretb@spi5star.com
www.spi5star.com