To reduce physical strain, Tanya Lughermo, an occupational therapist and manager of health and productivity services, designed an approach for employees at high risk that promotes a “rapid response” to discomfort. This approach includes an ergonomic assessment and intervention, such as an adjustment of workstations and equipment, and a work processes assessment, such as workload or job rotation.
Supervisors and employees also receive education in prevention. A clinical assessment identifies workers who may need additional medical evaluation and treatment. Other recommendations made on an individual basis may include stretching, job specific conditioning, and changes in work behaviors and postures.
Senior management (with the support of Chevron’s Chairman and CEO Dave O’Reilly) asked all business units to address the rising incidence of RSIs.
Behavioral Factors. Although the ergonomic solutions and physical conditioning of the Repetitive Stress Injury Prevention Program program have been effective for many and RSI cases have significantly decreased, Lughermo discovered that several groups of employees present a particular challenge to program staff. The common denominator in this population seems to be more psychosocial and behavioral than biomedical. Many pain experts now embrace a biopsychosocial model of pain, acknowledging the complex interaction between biological, cognitive, emotional, behavioral and social factors in the perception of and response to pain.
Workers who ignore or deny early warning signs of discomfort are one example of a group that presents a challenge to staff. These employees, “super workers,” push through to meet project deadlines or to complete work-related travel and place undue emotional and physical strains on themselves. They try not to draw attention to themselves, to complain, or to use company resources unnecessarily.
However, by not making their health a priority, super workers do use resources eventually when the discomfort moves to considerable pain and they are unable to complete work tasks effectively. The goal with these workers is to keep educational information in front of them and to alert managers to the issue, making them aware of the business impact of such practices.
Employees with major stressors at work and home are another challenge. Their problems can include relationship difficulties, most frequently with supervisors, children, or spouses. They may be out of condition physically, over weight, or single parents, sometimes with self-esteem difficulties and ineffective coping strategies.
Lughermo recognizes the many psychosocial and behavior change issues this group faces. She is working with Lee Sparling, manager of employee assistance and work/life services, in this area so that the Repetitive Stress Injury Prevention Program team can make earlier referrals to appropriate EAP staff or elsewhere. By identifying appropriate support measures and encouraging follow-through, the team may be able to preserve the employee’s work performance.
A mentoring relationship with EAP staff will be included for the Rapid Response team along with training in the process of behavior change. This will help staff identify where participants are in the behavior-change cycle, what support they need, and which motivation strategies might help them follow through with recommendations.
Another challenging group is the approximately 1,300 U.S. employees working outside the U.S. These employees face significant challenges in the long stretches of travel they must endure and unpredictable changes in their lifestyle.
Lughermo and Sparling, along with their colleagues in occupational medicine and in the HR cultural training group, have a proactive approach for them and their spouses as well, providing information about coping with living abroad and helping them prepare emotionally and physically for their adjustment.
Early Detection. As one of its strategies to identify psychosocial risk factors early, Chevron added mental health and coping strategy questions to its health risk appraisals (HRAs). Employees are encouraged to complete the HRAs at least yearly to assess lifestyle habits and identify health conditions early prevention and proactive treatment.
Behavioral health questions are also a part of Chevron’s disease management programs for individuals with chronic conditions like coronary artery disease and diabetes. Early identification of co-occurring depression and rapid referral to the EAP has been built into these programs for a seamless approach.
A new cardiovascular health program, to be launched globally in 2008, will also reflect the strong integration of behavioral and physical health. Lughermo and Sparling recognize the strong contribution of depression and stress to cardiovascular disease and are building in systems for identification and concurrent treatment.
Next Steps. Future plans for the Repetitive Stress Injury Prevention Program team include:
- Developing a checklist of potential psychosocial problems for ergonomic specialists to use as they evaluate physical aspects of employee workstations.
- Developing mentoring relationships between workstation evaluators and EAP staff to encourage referral to EAP when psychosocial problems are identified.
- T raining all team members in the behavior-change cycle so that intervention strategies can be matched to an employee’s readiness to change.
