Pilot project – risk assessment and control of workplace stress.

The Institute of Occupational Medicine (IOM) developed an Organisational Stress Health Audit (OSHA) to identify and control sources of stress in the workplace. The Health Education Board of Scotland (HEBS) commissioned the IOM to assess the feasibility in terms of cost and acceptability of applying the OSHA in Scottish workplaces. A further aim was to provide the basis for a research proposal to undertake a larger, controlled trial of the approach. Additional financial support for the study was provided by Lothian Health Board and the East and Mid Lothian NHS Trust.The OSHA is a cross-functional, top down, primary intervention acting at the organisational rather than the individual level. Therefore, the approach sought to ensure that staff at all levels within the organisation were represented, and included as many different disciplines as possible. It is also consistent with the risk management control cycle framework adopted for most other health and safety hazards.The OSHA is a three-stage approach to stress management at source, covering hazard identification, risk assessment, review of existing control measures, recommendations for improved control, and evaluation of control. Stage I provides an organisational overview by identifying the presence or absence of work-related stressors and opportunities for risk reduction. Stage II focuses on investigating in more detail areas of concern identified in Stage I. Stage ffl involves assessing the extent to which actions identified in Stages I and n have been implemented and their effectiveness in reducing organisational stress. The development and traceability of the IOM OSHA are outlined in this report. In this study, Stages I and II were applied in three organisations.Background information provided by the company was used to develop semi-structured interview questionnaires for Stage I. These questionnaires were designed to identify potential environmental, physical and psychosocial stressors. Interviewees were selected so that each level and department was represented, from Senior Management down. The interviews were conducted by experienced professional IOM personnel. A confidential written report was provided to each company.In Stage II, the investigation conducted in each organisation was one where it was considered that intervention could help in the short term. In two of the companies, the focus was on a specific group of employees highlighted from Stage I as being under particularly high pressure due to issues of workload, staffing levels or job design. In the third company, Stage I had identified poor communication of change as an important stressor; so the Stage II investigation focused on examining the potential for improvements. Appropriate combinations of standard and purpose-designed questionnaires were applied to address these issues. As with Stage I, confidential written reports were provided to each company.The main outcomes are presented in relation to the feasibility of six specific issues:* recruitment of companies* cross-functional, top-down approach* risk assessment / management approach to organisational stress* evaluation and documentation of the process* pilot methods for evaluating its impact and outcomes* development and implementation of the approach.Companies with existing concerns about stress in the workplace were recruited, and this may prove to be the most effective means of recruitment. However, a larger study in the future would provide an opportunity to evaluate alternative recruitment methods. The approach chosen also ensured adequate representation of all grades of staff across various disciplines within the companies.This study has clearly demonstrated the feasibility of Stages I and n of the OSHA in identifying a range of work related stressors across different organisations. Responses from companies clearly indicated that the approach has benefits in terms of effectiveness; minimal down-time and disruption; and limited costs of the process. Companies showed a willingness to implement recommendations made for risk reduction. A further study would allow a more detailed evaluation of the effectiveness of the risk reduction strategies.A number of aspects have been identified regarding the development of a large scale controlled trial of the approach, one of which relates to developing tools / techniques which could be applied by organisations themselves (including small companies), particularly those with limited knowledge of occupational stress. “”