Revival

by Judy Jackson

Tuesday, April 4, 2000 was a proud day for the Technical Division. That was the day they received a plaque from the Fermilab director recognizing them as the laboratory division with the "most improved safety record for 1999." On that day, employees of the Technical Division had worked for 628 straight days without an injury serious enough for anyone to require time off from work.

Pride goeth before a smashed finger.

On Thursday, April 6, just two days after receiving the safety award, a Technical Division employee hurt his finger while using a machine. The injury was serious enough to require stitches, and the employee went home.

After more than a million working hours without a serious injury, the Technical Division's "Days Without a Lost-Time Injury" board went to zero. Moreover, since April, the division has been plagued by a series of accidents and near misses that have kept the number of injury-free days frustratingly low.

What happened? And, more important, what is the Technical Division doing to get back on track?

"Just as in religion," said Bill Griffing, head of Fermilab's Environment, Safety and Health Section, "backsliding is very common in safety. When an injury destroys a long safety record in an organization, it's very normal for more injuries to follow. People might let up a little in their extreme attention to safety, because they are not so worried about being the one to end the great safety record. Sometimes people with chronic injuries who have suffered in silence may come forward after the safety record is gone."

When that happens, Griffing said, "it means you've got to re-immerse yourself. When you start to slide into those old bad habits, you need the equivalent of a religious revival. It's time to get fired up again and think hard about safety. What has happened in the Technical Division is very common in organizations, and we can all learn from their response."

Their response has meant taking a hard new look at policies and procedures throughout the division.

"In the Technical Division, we are disappointed but not discouraged in our determination to be completely injury free," said Division Head Peter Limon. "We might be tempted to think that our recent string of accidents was just a streak of bad luck, or that our previous excellent safety record was just good luck. But if we look at each of the accidents, and also at some recent close calls, we see that every one of them could have and should have been prevented. In each case, there were specific, identifiable causes that shouldn't have happened."

As a result, Limon said, the division has made changes in policy and in training.

For example, a near miss occurred when a portable lifting device proved inadequate for the weight to be lifted. This prompted a review of the policy for using such devices.

"It was generally a good policy for most lifting situations," said Associate Division Head Romesh Sood, "but after the close call, we found that it didn't cover portable lifting devices. Now, it does."

Although no one wants accidents, Sood said, each one brings a new perspective.

"Each accident does represent an opportunity to re-examine our policies, our training and our workplace and to make them safer," he said.

The division's senior safety officer, Rich Ruthe, has had many opportunities in recent months for the safety equivalent of soul searching.

"The series of accidents that we've had since April have forced us to re-think what we're doing," Ruthe said. "Maybe we got a little smug. That's an invitation for accidents to happen. The good news is that all of these accidents were preventable. That's encouraging, because it means we can do something. It is definitely possible to achieve our goal of zero injuries. The same integrated safety principles that let us achieve 629 days without a serious injury still apply. We just have to redouble our efforts to practice them every day."

Meanwhile, Sood said, a series of safety "revival meetings" with the division head has brought together more than 90 percent of the division's employees for a message of rededication to safety in the workplace. At each meeting, Limon reminded employees that each of them has not only the power but also the responsibility to stop the work at any time if they think it is unsafe.

"Instead of dwelling on our disappointment that our string of work days without serious accidents is ended," Limon wrote in a recent letter to Technical Division employees, "we should take this opportunity to remind ourselves that we need to think about safety in everything we do. Before any operation, no matter how trivial it seems, take a moment and look around, think about what you are about to do, make a mental risk-assessment. Stop and think. If anything seems amiss or unusual, think again. Don't hesitate to ask for help. Now is the time to redouble our dedication to safety at the workplace and to begin a new record-breaking string of safe work days. Our intention is never to have another accident."

Amen.