It is often said that two heads are better than one. The University of Kentucky and Kentucky Employers' Mutual Insurance have found this to be true. They have teamed up to improve workplace safety through several unique occupational health initiatives. One project that has drawn a great deal of attention is a safety initiative targeted at small, residential construction companies.
The faculty and staff of the University of Kentucky (UK) were experienced at designing and implementing unique research programs to identify and understand occupational hazards and then developing training materials to address these hazards. Several faculty members had been involved in developing latent-image narrative training exercises for mining and agriculture and had received recognition from the National Institute for Occupational Safety and Health (NIOSH) and the Mine Safety and Health Administration for their efforts.
Kentucky Employers' Mutual Insurance (KEMI) is the largest provider of workers' compensation insurance in Kentucky and serves approximately 14,000 policyholders. KEMI is dedicated to promoting workplace safety through direct consultation with its policyholders and the development of training materials.
In 1996, these two agencies worked together to tackle a question that has perplexed many safety professionals: How can you effectively train workers of small, residential construction companies? These companies have been labeled a "hard-to-reach" population by many safety professionals because the majority of these companies has fewer than 10 employees, does not belong to a trade union or organization, and job sites change regularly. These factors make safety training difficult to conduct.
The UK faculty and staff wanted to develop materials for small, residential construction companies, but did not know how to access the workers of these companies and get them to participate in the training program. KEMI agreed to provide companies who participated in the safety program with a discount on their workers' compensation premiums. This was right in line with KEMI's principles: companies that make efforts to train their workers on safe work practices should be rewarded for their effort in the form of reduced premiums. This premium discount turned out to be just the carrot that employers needed to motivate them to take the time and effort to train their workers on safety matters.
The team wrote a grant to NIOSH that was funded in October 1996. The project has completed its third and final year of funding. The first year of the project entailed traveling throughout the state to conduct focus groups with construction workers to gather information useful in developing the materials. Workers were asked an array of questions about their job sites, work habits, preventive measures, most-common hazards and methods of training new and inexperienced workers. This step was necessary to ensure that the materials developed were accurate, realistic and addressed the perceived concerns of the workers.
Training Exercises
The UK faculty and staff used the information from the focus groups to develop reality-based exercises that describe a common work situation and ask the participant to make decisions related to safety and health. For example, one of the exercises describes a cluttered job site that poses serious slip and trip hazards for cabinet installers. The participant is asked if the cabinet installer should 1) call the boss to tell him about the clutter and ask what he should do, 2) clean it up himself, 3) don't do anything about the mess, just get started, or 4) just clear his immediate work area.
When participants choose the answer or answers from the problem booklet, they go to the answer booklet and select the corresponding number(s). It has no text beside it at first. However, a latent image marker is used to highlight the area on the answer sheet and information appears. The information tells participants whether their selection was correct or incorrect and gives an explanation of the answer.
In the example mentioned earlier, if the participant chooses answer No. 2, the information would say: "Correct. Even though it is not his mess, working around all that clutter will slow Joe down and increase his chance of injury." On the other hand, if the participant had chosen No. 3, the information would say: "Joe shouldn't start the job until the job site is picked up. Remember, he will be adding to the mess by removing old cabinets."
The "invisible ink" was an excellent way to provide immediate feedback and stimulate thought. It really engaged the participants, and facilitators in the group sessions had to keep them from working ahead of the group.
Once these materials were developed, groups of workers were asked to review the exercises and provide feedback. From this feedback, the exercises were modified and put into final format.
The next question to address was how to conduct the training. Both group meeting and home-based trials were conducted. The team had predicted that the participants in the group format would benefit more from the exercises because of their involvement in the group discussion. However, after eight group meetings, we compared the evaluations of the two groups and found there were no statistically significant differences. Given the resources needed to conduct the group training and the inconvenience to the workers who had to travel to the training site, it was decided to go strictly with the home format.
The Results
The exercises have been a huge success. More than 300 individuals have completed the exercises and returned them to UK. There are a six exercises that depict roofers, carpenters, block masons and other construction tradesmen in realistic work scenarios making decisions that affect their safety or the safety of those around them. The exercises address back injuries and slips and falls, two of the most common causes of work-related injuries. Each exercise has a lengthy evaluation that enabled the team to improve the exercises and determine their effectiveness. The exercises have received the equivalent of an "A-" or "B+" from the participants on being realistic, accurate and effective. Also, the exercises can be completed at home, which increases participation by eliminating the need to interrupt work schedules or to travel to a meeting place.
KEMI has assumed full responsibility for the materials since the end of the funding and is in the process of making them available to all of their policyholders involved in construction trades. KEMI will continue to offer premium discounts to policyholders that take the time and effort to train their workers. The training will be available in paper and Web formats. The Web format has an audio component to provide the immediate feedback given by the "invisible ink."
This relationship with UK created a winning situation for everyone involved. The UK researchers got access to a hard-to-reach population so they could test their training materials. KEMI had a chance to promote a cutting-edge training program and make training materials available to their policyholders. Finally, policyholders received valuable safety training and an opportunity to earn a discount on their premiums.
Continuing Efforts
More recently, UK and KEMI have teamed up on another project. UK's Kentucky Injury Prevention and Research Center has received funding to develop a multisource surveillance system for occupational burns to develop prevention strategies.
KEMI assists UK by identifying injured workers who have been burned in the course of their work. The staff at UK collect information from the individual regarding the primary and secondary causes of the accident, costs associated with their treatment, and a wealth of other information that will assist them in developing prevention strategies. These strategies will be communicated back to KEMI and to other insurance companies, public health officials, employers and trade organizations with the goal of preventing occupational burns.
This team approach has worked so well for both agencies that we continue to look for new and innovative programs to prevent occupational injuries. With both parties working together, we are able to draw on each others' strengths and accomplish a common goal: to promote the safety and health of Kentucky's workers.
Jonathan Mays, MS, is policyholder services manager at Kentucky Employers' Mutual Insurance, the largest provider of workers' compensation in Kentucky. He manages their loss education efforts and is based in Lexington, Ky.