Robert Pater, MA & John K. Glenn, PA-C

Does your company, like so many others, have a few people who seem to have much more than their share of accidents? Do these "frequent flyers" (as one organization calls them) create frustration or embarrassment--as well as having a negative effect on your overall safety efforts?

You are not alone. A recent study in British Columbia revealed that there were 15,000 workers out of a sampled group of 1.8 million who each had at least 20 workers comp claims and that their rate of injury was ten times higher than the average.

The "typical" approaches to accident repetition haven't worked. Shame and blame-based attempts to control accident repetition seem to have as much affect as do lecture and discipline tactics against out-of-control teens. Trying to avoid the problem, either by willing it away, or by seeking to screen out those who are "accident-prone" doesn't work and can even backfire, potentially violating bargaining unit contracts or legislation such as ADA.

Experience with many organizations shows a major stumbling block to these approaches comes from: a. their missing important information that might help solve problems, b. treating all accident repeaters as if they were of only one type and, c. not knowing how to turn people around, even those sincerely hoping for tangible help.

So what can you do? Take a 5 step approach:

1. Start by setting your objectives:
   • to prevent initial incidents from turning into repeat problems
   • to break the chain of long-standing accident patterns
   • to facilitate early return to work
   • to strengthen organizational safety culture overall
2. Then, assess the real problem. It seems that many managers and key safety people assume that there's something wrong with accident repeaters, that they are just disgruntled or problematic people.
   But experience shows there are many types of accident repeaters, including those who were working in jobs where physical risk of injury was high, those too "tough" to report minor injuries until they sustained one that became an ongoing difficult-to-shake problem, some who "over-reported" any mishap as they were instructed, others who sustained re-injury of a weak spot partly due to poor medical management (i.e. lower back pain), those with referred injuries--if you hurt your foot, you'll likely walk differently, which can lead to knee problems--and many more.
   Some have medical conditions they may not even be aware of--such as diabetes, hypertension and many others--that can play a role in repeat accidents. A 1999 study published in Clinician Reviews revealed that even mild sleep deprivation can reduce daytime alertness by 33% and has been implicated in up to 30% of traffic accidents. Of course, there are always some people who may be misrepresenting injuries, but studies show this percentage is quite small. And if you believe you have a serious problem with people faking and looking for an easy way out, consider examining what in your organizational culture encourages this.
   Identify specific contributing factors in accident repetition in your company. There are always three kinds: Environmental (tasks, tools, working conditions), Human (individual factors such as work habits, vision, preexisting medical and physical conditions, medications taken, ability to control reactions to stress) and Organizational (medical management, quality of training provided, kind of accident investigations, supervisors' training and safety monitoring abilities and more).
3. Next, plan your intervention. The most useful interventions de-stigmatize "repeaters" (so they don't live down to expectations of clumsiness), are helpful rather than punitive, positive, and focused on skills so people can take greater personal control and responsibility for their own safety and well-being.
   We've found that true "turnarounds" result from training people in the right combination of practical methods for attitude and attention control, quickly improving balance and coordination, heightening judgment, stress control, and understanding even hidden contributing factors in accidents. In addition, it is essential to develop a workable individual "contract" with each person for personal improvement and elevated control of their own safety.
4. Pilot the program. Select a fair cross section of those who've had repeat accidents--enlisting volunteers would be ideal to start. Be sure to alert supervisors, managers and union leadership what is involved and invite their input as early as possible.
5. Monitor, evaluate, adjust and reinforce. Lasting change in accident repetition will most likely blossom from commitment to a planned and well-reinforced effort. It's important to plan in consistent, frequent reinforcement of program goals and values. Monitoring and evaluation should focus on a wide range of intermediate objectives (positive reactions, small changes in behavior), not just injury-reduction.

While accident repetition can be frustrating and costly to everyone, you can realize real and lasting change. And, as well as breaking the chain of repeat injuries--which will immediately improve safety statistics--a well-crafted approach can also boost safety culture and performance overall.