Posted By Peter MacDonald Here's the background to this request. My company have been involved in a demolition project for a major client that so far has lasted 8 months. Until very recently we had only one first aid but in the last 3 weeks have 'suffered' two MTI's or to be more precise Medical Treatment Injuries as defined by OSHA. The first was an individual who had removed his hard hat and placed it on the pavement outside the hut. It was a non PPE area but when bending down to pick up said hat he cracked his head off the open window of the smoke hut. Result, one inch cut to forehead which had medical glue applied (it would have been paper stitches but it was in the hair line). Funny thing is, if he'd had paperstitches it would only have been classed as a first aid, but that's another story involving arguments over what constitutes 'wound closure' and 'wound covering' The second was while marking pipe lines for removal with spraypaint an operative received an amount of spray in the eye (was wearing safety specs but not goggles). Again the eye was bathed at the site hut, then at the client first aid who sent him to the hospital. The hospital saw it was OK (did not irrigate) but gave him a tube of ointment to apply if there was any irritation. This act of passing him a tube of ointment again reclassified the injury from first aid to medical treatment. I feel we've worked really hard and have developed a good safety culture on our site, we have regular training of supervisors and mangers, roll out a safety 'habit' every month, pass on learning from other sites, carry out pre-task checklists (obviously came up short on that one with the missing goggles) but in large the boys on site have really bought into the safety management philosophy. Anyway, here's the thing. I've been called up to a meeting with the client to explain our deterioration in safety performance and to be honest I'm at a loss at what I can tell them we can do next. It's down to behaviours this one and I'm asking for any advice to get the guys to 'get to the next level' We have more than enought bits of paper and policies, permits, meetings and committees. I need to connect with the staff. Any ideas??

Posted By Peter MacDonald Neil MD, Safety Officer and Senior Contracts Manager and two supervisors, all trained a nd competent. Safety Audits every day.....management and supervision is ok. I know the stats are relatively meaningless but the client is stat driven and two MTI's on the graph spells disaster. I have to work within these parameters. To tell them we've done our best and that's that would be commercially very bad. Any ideas on improving safety behaviours? Peter

Posted By fats van den raad Peter What abut telling them that the way to get rid of MTI's is to attack the FAC's head on.Tel them that you are not going to get involved in the argument about whether these were MTI's or FAC's, becuase as far as you are concerned, the fact that they happened at all tels you that there is opportunity for improvement. It does look like you need some behavioural intervention though.

Posted By Raymond Rapp If that is all you have to worry about two minor accidents then you or your client are very fortunate. Even the HSE acknowledge that there is no such thing as zero accidents, no matter how save the environment. I suggest you get hold of some stats, perhaps relative to your industry, then put them to your client with - welcome to the real world. God forbid anything serious should happen ! Regards Ray

Posted By Kieran J Duignan Peter You write: 'It's down to behaviours this one and I'm asking for any advice to get the guys to 'get to the next level' We have more than enought bits of paper and policies, permits, meetings and committees. I need to connect with the staff.' Yet is it really down to behaviours? From your observations and the replies, there appears to be a consensus that you are connecting with your readers here who question the validity of the measures being used. Research confirms that stress is a significant source of errors (mistakes, slips and lapses),such as the MTI's you outlined. I don't know what system of measurement you are using but I wonder how well it measures stress and its sources.

Posted By Kieran J Duignan Peter Respectful of the evident and impressive care you are taking to explore every option to make effective improvements in the safety system for which you are accountable to your client, I've been trying to figure out how you can work to better effect within the tight control system apparently imposed on you. While I'm very appreciative of the value of behavioural safety, its methodological limitation is that it operates within the same largely 'left brain' paradigm of your client. On the basis of the limited information available, it seems to me that what you need to do is to to redress the balance of styles of thinking and feeling to engender more tolerable levels of stress. In this light, a suitable course of action for you is to find a coach who can facilitate the development of the 'right brain' style of mindfulness. Shorn of its Buddhist associations, this highlights the human mind's power to concentrate intensely provided its owners, i.e. employees at all levels, learn techniques of meditation to calm the mind and emotions. As far as I know, the best source of the scientific approach to this in the UK is a cognitive psychologist, Guy Claxton, who is Professor of Educational Psychology at the University of Bristol. Judging by his writings in recent years, he's a very down to earth communicator. Operating at a more intuitive level, good teachers of Martial Arts (as distinct from sports) such as Tai Chi, also enable people to forst mindfulness. Wacky? Perhaps. But such approaches are also very inspirational and effective for many who try it out.

Posted By Heather Aston Peter On a totally different tack - are you sure that the second incident is really classified as "medical treatment"? It only counts if the ointment given was "prescription medicine". If it was something the employee could have bought himself over the counter without a prescription, it does not fall into the OSHA definition of medical treatment. Heather