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From Aviation to Healthcare: How System Factors Drive Safety Decisions with Norman MacLeod

From Aviation to Healthcare How System Factors Drive Safety Decisions



Don’t miss our latest episode on The Safety Guru! Join us as Norman MacLeod, a seasoned expert in organizational human factors, shares decades of experience and a wealth of knowledge with us. Drawing from his extensive background in both aviation and healthcare, Norman shares the critical system factors influencing safety decisions within organizations through riveting research findings and real-life examples. Gain invaluable insights and practical solutions to navigate system impacts in your organization. Tune in now!


Real leaders leave a legacy. They capture the hearts and minds of their teams. Their origin story puts the safety and well-being of their people first. Great companies ubiquitously have safe yet productive operations. For those companies, safety is an investment, not a cost, for the C-suite. It’s a real topic of daily focus. This is the Safety Guru with your host, Eric Michrowski, a globally recognized ops and safety guru, public speaker, and author. Are you ready to leave a safety legacy? Your legacy success story begins now.

Hi, and welcome to the Safety Guru. Today, I’m very excited to have with me Norman McLeod, who has deep expertise in Aviation Safety and a really good understanding of the impact of system and system factors on safety. Norman, welcome to the show.

Thank you very much, Eric.

Norman, let’s get started a little bit about your background because you’ve got a lot of years and a lot of experience in aviation safety.

Okay. Where to start? When you’re my age, there’s a lot to talk about. So, my degree is in Botany and zoology. So, I’ve always had an interest in systems from a biological perspective. When I was in the Air Force, I was involved with training young officers and leadership training. And then I moved into being a training specialist on the Charlie 130 transport aircraft. That led me to observe a lot of crews flying, and I was amazed at the differences between how crews function. That got me interested in this idea of, well, crew resource management, although we didn’t call it that back then. Sure. But it’s this whole thing about how people work together, but more broadly, how the system functions. How does the behavior of the crew, in this case, how does the bigger picture influence it? What are we trying to achieve by sticking people in an airplane and sending them to war? How do bigger decisions about, say, tactics and strategy elsewhere shape how the crew functions? Now, I know that probably sounds a little bit crazy, but it was this fascination, how you couldn’t really look at things in isolation.

You had to see the bigger picture to understand why things happened. So that’s what really got me going. And then when I left the Air Force, I moved into civil aviation. And again, I found it was how an airline works was probably more interesting than necessarily how individuals work. And it seemed that relationship between what are the business goals. What’s the airline trying to achieve? And how does that filter through to the operation and shape how individual pilots do their job? Pilots is where I’ve spent a lot of my work, but I’ve seen cabin crew as well. And then in the last few years, I’ve tried to get a foothold in health care. And there, unless you take the bigger picture, you really can understand the way a health care system works. So that’s a rough trajectory that gets me to where I am today.

It’s Phenomenal. So, your themes on systems are very complex. Many organizations are challenged to understand the linkage between different events, like what you talked about, and how the context in which I’m operating impacts my decision-making. One thing that really struck me when we first connected is that when you talked about the purpose of the business, you talked about this financial purpose. Tell me a little bit more about that theme.

Okay. Well, at the end of the day, an entity exists in a commercial sense to generate a return on investment. Sure. Even if you look at something like emergency helicopters or police helicopters, you’ve got similar constraints there in that although you’re not generating a return on the investment, you’ve got to generate capability within budget. So therefore, everything is driven by money at the end of the day, either in a constraint sense or in an output sense. And how a business configures itself to make money and then shapes things like, in an airline’s case, what routes do you fly? What aircraft do you operate? What’s the age of your aircraft? What technical support do you give to your crews? Where do you recruit your crew from? How many crews per aircraft? What’s the turnover rate? So, there are so many factors that are driven by those financial decisions, and half the time, managers are not necessarily aware of the relationship between their decisions. They think they’re just doing the best job for their shareholders. I don’t think they see the relationship between those decisions and what happens out on the line and how that affects safety because that’s the bit that I’m interested in.

How is it likely to either put people in a position they’re not prepared for or put people in a position that they are possibly not fully motivated to deal with? Okay, I’m going to be careful what I say here. Nonetheless, that relationship between business decisions percolates through into things like morale, motivation, and skills level. I’m doing work in health care at the moment. You have a high turnover rate. So, the problem you’ve got is staffing. Now, you’ve got to recruit them. You’ve got to train them. You’ve got to retain them. But if you have a high churn rate and also your gapping posts, you’re actually putting the load on the remaining healthcare workers. I was talking to someone recently. They’ve had a big recruitment drive. They’ve got a lot of new stuff. That sounds like a good idea. No, it just adds to the oversight because you’re constantly doing your own work and making sure the new people are doing their job properly as well. So that’s what I mean by the relationship between management decisions and safety out on the line.

And your point linking it to financial purposes is very good. And I think the other element is it translates indirectly What you talked about just there is the financial link to, say, the HR practices around the recruiting, which are also driven by the financials. We’re not saying we shouldn’t be financially driven. We’re not saying we shouldn’t be trying to provide a profit. But how do we also educate the rest of the organization about those decisions that I’m making that can ultimately impact safety? Is that a fair comment?

Yeah. It’s naive to ignore the need for financial viability. The airline wouldn’t exist if it weren’t making money. It’s as simple as that. But an example I gave when we first spoke is a carrier I worked with in Southern Europe. It is a very seasonal operation. So, they recruit seasonal cabin crew that just do the summer period. And I was able to track through their numbers, the baseline permanent crew, the arrival of the new hires, the time it took to train the new hires and get them out on the line, which lagged behind the increase in summer traffic. So, at the front end of the season, you have that tension between the speed of getting the new hires out into productive flying and the demand because you’re selling seats to holidaymakers. And the way that was manifested was two things. The first is at the front end of the season, you got this spate of slides being set off accidentally because you’ve got new hire staff who are not fully capable with the vessel in the world. You’ve got high operational demand. This was reflected at the start of every summer season, with all of these slides being deployed accidentally.

Now, it settled down as they gained their experience. But then the next thing you saw at the back end of the season, as the traffic started to decline and the summer hires started to go back to other jobs, your long-term sickness went up, and it was strange how it was lagging everything else. What it suggests is your permanent crew was working so hard that you had this bout of long-term sickness absence, usually stress-related, which you then carry through the winter. And that’s what led me to believe that it must be the permanent staff that is affected by the stress of getting through the summer because your summer casuals have left the company. Your high sickness rate is due to the permanent staff recovering during the winter period. So that’s what I mean by the relationship between the business model, which is seasonal, based on holidaymakers who want to go to the south of Europe, and then how that’s reflected in your recruitment policies, your training policies, and how you see the effect in adverse events and true sickness.

And for those who don’t come to aviation, a slide deployment is not a good thing. It could kill somebody very easily because of the impact and the force of the deployment of a shoot or slide and the pace at which it does it. Plus, it causes operational issues and costs. It’s a huge slowdown on aviation.

Exactly. The aircraft is taken offline. The slides have to be replaced. I have spoken to someone who was in the forward galley when a slide went off inside the airplane. Inside? Yeah. If you don’t go out of the way, it can hurt.

Oh, boy. Phenomenal example. You also had an example from an Asian carrier related to fatigue and scheduling. I’d love it if you could touch on that one as well.

Okay. Now, fatigue is a big burning issue in lots of safety-sensitive areas. It’s something that I’m looking at in health care at the moment. But I look specifically at a career as a pilot in an Asian carrier. I’m grateful to the pilots for tolerating me and answering all my questions. However, there are two types of fatigue. You can see, you can call it acute fatigue, which is in simple terms, and a real psychologist will shoot me for this. Just call it tiredness. You can usually recover from acute fatigue by having a couple of good night’s sleep. And that’s the fatigue that is measured in fatigue risk management systems that are commonplace in aviation. They’re trying to introduce them into health care in the UK. And that’s fine. But it only looks at one aspect of fatigue. The other aspect of fatigue is just basically the psychological effect of the daily grind. You can call that chronic fatigue, and that’s like having a rucksack on your back. And a good night’s sleep is not going to have anything to do with that. It’s your morale and motivation. It’s your work-life balance. And I was able to, on the one hand, look at the acute fatigue.

I tracked how fatigue built during the working day as such. I was able to look at relationships between that and error rates. So, this operator, they were 24/7. I looked at night cargo. And what I found was that if you were a local pilot operating night cargo, you were flying off your body clock. So, you were flying at the time of day when you should have been asleep. If you then compared those with the crew that operated long haul, so they were now flying during the night in the local area, but their body clock was still on home base. So, it was daytime for them. If you look at the relationship, the people who were flying daytime body clock, but local night, their error rates were less than half those that were forcing themselves to stay awake and fly through what we call that window of circadian load, that period between, say, I don’t know, 2:00 and 4:00 in the morning. When your body is just screaming out to go to sleep. So, that was one aspect of it. But when you then look at the chronic fatigue side, the psychological side of things,

Now, you’ve got to think of, first of all, what’s the baseline? And there haven’t been, and that’s the problem when you look at fatigue in particular. We don’t really know what normal looks like. So, the few studies that have looked at this idea of chronic fatigue in the normal population suggest that 30 to 40 % of the average person in the street, if they were tested, would be showing signs of chronic fatigue. You look at health care, you’re looking at 65 to 70 %. You look at aviation, and I know of four studies that have used the same benchmark. So, you can do the comparison. And for pilots, you’re looking at about 80 %. So, 80 % of the workforce is showing signs of chronic fatigue. Okay, the question is, so what? You’ve then got to look at what are the other effects that flow from that? And here’s where you see things like excessive daytime sleepiness. That’s a standard measure that’s used. It’s the propensity to fall asleep. So, you sit down in an armchair, and before you know it, you’ve dozed off. If you have excessive daytime sleepiness, it correlates with mental health.

About 20% of airline pilots are above the threshold of daytime sleepiness, which suggests they’re at risk of mental health effects. But then I also looked at work-life balance. And again, if you scored high on chronic fatigue, your work-life balance was adversely affected. And I looked at a global measure of mental and physical health now that this thing has been used all around the world, and it’s well established. And again, high chronic fatigue correlates with poor mental health. So, That aspect of fatigue is not addressed in any way by the regulatory framework. It just deals with the sleep side of it. So you’ve got two problems here in aviation and in health care. We try to measure one bit to control it. We ignore the other bit because it’s too difficult. And now, we come back to where we started this conversation. So there’s a big trend at the moment for well-being, peer support, and things like that. And a lot of airlines do give their support to peer support groups within their airlines. I’m going to be a bit radical that’s actually the airline avoiding its responsibility. It’s tokenism.

The people involved are genuinely doing the best job they can. But this is a piece of band-aid. So we’re trying to fix the problem by letting people have access to a support network. What we’re not doing is fixing the problem at source. So, it’s an easy way out. Now, how do you fix the problem at source? Well, that’s the challenge because there is no one size fits all. There’s the age effect, there’s the type of flying, and there are so many variables. It’s difficult. Each individual airline has to recognize the problem and work out a solution that works for them. But never underestimate human nature. So, in the UK, With the introduction of the European Working Time Directive, working hours in health care were capped. A common model is doctors and nurses working three 12-hour shifts a week. And that means they reach their total. A 12-hour shift is frankly crazy, from a safety perspective, in a domain like health care. But if you do customer satisfaction surveys, what you’ll find is a lot of nurses, and I just happened to have looked at a study of nurse attitudes—a lot of nurses like doing three 12-hour shifts. 

Because it gives them four days a week, they can do overtime.

But that keeps you away from your rest.

Something that is trying to limit your effort for beneficial reasons creates a situation where people can do something that they want to do because they want more money. It’s working against itself. And then this is always the problem in all of this: you’ve always got to remember that there is human nature at work. So, there is the perfect world, and there’s the real messy world of human beings. And even when you’re trying to do things in the best interest of human beings, meetings will have other motivations.

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Regarding your aviation example, there was another one you shared with me, which was another Asian carrier as well around fatigue and linked to scheduling. And this had to do with flying over China, airspace being restricted, and how fuel loads would also be impacted.

Yeah, this is where it does start to get messy. There are two aspects there. We’ve also got to remember we’re talking geopolitics to a degree. Chinese airspace, for example, Because the military controls it, and they have a huge tendency to suddenly shut down blocks of airspace because they’re having an exercise of some sort. You might not even know about it until you’re able. Now, that’s going to have an effect on your routing, which means that for all long-haul carriers operating through that airspace, fuel management is an issue and does require crews to properly understand how to manage the fuel on their aircraft. You will find crews arriving at the destination after 12 hours of flying, seriously having to manage the fuel remaining. Then, of course, you’ve got weather effects that could mess up your best plan when you arrive at the destination. That’s one side of it. But then you’ve got another aspect.

On the one hand, you’ve got the effects of fatigue on performance. You’re asking people to manage complex situations that are unpredictable whilst tired. You will see decision-making that is probably not because people think the simplest thing to do is to get the aircraft on the ground.

And in so doing, they sometimes take risks that you wouldn’t expect from a properly rested crew. But the other thing you’ve got is We get back to the business side of it. Aircraft are dispatched with enough fuel to get to the destination with a contingency. And there are computer programs that manage this and build in seasonal variability and the routes flying, et cetera. But you’ll always have pilots who want to take a bit more. I worked for a European airline once, and it was affectionately known as Auntie Betty’s Tun. So, at dispatch, you’d get your planned fuel, and then you’d add a ton for Auntie Betty. All the pilots call it that. Which, of course, you burn fuel to carry fuel, so that’s inefficient. But what I was finding was that as pilots get older, they like a quiet life. So, if I looked at the pilots who carried more than planned fuel, it was typically the older pilots because they wanted a quiet life. They didn’t want to be in a position where they were suddenly presented with a challenge. I would speak to first officers about this, and they’d say, look, I fly with these guys.

Some of them are naked. They don’t want to do anything that will add to that burden. This is where you see that relationship between what’s in the best interest of the airline, what the attitude to the job, and the effects of fatigue all come together in a lack of efficiency. So that’s something that came out of some of the work that I did.

And these are all phenomenal examples because very few organizations are able to track the relationship between these decisions that are part of the system. How do you go about in an organization surfacing these themes, and how do you drive solutions around some of these system impacts?

Right. If I had the answer to that. The first issue, of course, is knowing the scale of the problem. And I return to that cadre of pilots who kindly answered my questionnaire. The number of times people would say to me, well done for trying, but no one will listen. And I said, Yeah, but Management can’t know what it now knows. So, if they don’t understand the scale of the problem, then they’re in a position just to ignore it. So, the first thing you’ve got to do is to reveal the problem. But the real challenge in something like aviation is that it is fundamentally safe without a shadow of a doubt. And pilots, the practitioners, the people who work in those systems, work to keep themselves safe. So, to a degree, the risk that’s inherent in what we’re talking about here is masked because people are pragmatic They work hard. They sort things out in real time. What they don’t necessarily do is share the risks they’re exposed to. So, for example, my study of fatigue. I had more than one pilot would come up to me in class and give me an example of when they fell asleep at the controls of the airplane.

Sure. And I said, did you report that? And they laughed at me and said, you’ve got to be killing. There is no way I would own up to that. And this is where reporting systems don’t really capture the whole problem. I hate to say it, but it’s an area where we need to start thinking about other technological solutions. I mean, trains, for example, have the technology to detect when a train driver might be dosing off.

Sure. Some cars nowadays even have that ability built in.

Yeah. So, although it will be fiercely resisted on airplanes, maybe the time has come to start looking at wearable technology. There are all sorts of things we could start to use now because, at the end of the day, we want to protect the crew as well as the passengers. So, nobody’s more important on that airplane. Everyone’s got to come home safely at the end of the day. But the thing is, first of all, you’ve got to establish the scale of the problem. You’ve got to explore the implications of it. For example, we were talking about how to reduce fatigue. Well, work less. And the answer you get every time is that that would involve spending more money. Well, actually, it doesn’t. So, I was looking at some studies of nurses in another country. They were reducing the working week from five days to four days. What they found was that productivity went up, and sickness absence was reduced. So, the net cost was the same at the end of the day. You ended up with a happier workforce who were there more often than they used to be. So, part of the problem is just resistance to doing something differently.

But we’ve got to look at things like that. On the personal side of it, I talked about nurses who like three-day weeks so they can do overtime. One UK operator I was aware of did offer reduced contracts to some of the older pilots. A colleague told me of a friend who opted for this, and what he found was that because of the UK taxation system, by flying less, he got paid less. But when you took out the reduced tax bill, the net loss was negligible compared to the improved home life, and everything went with it. So, it was a price worth paying. Now, of course, not Everybody can make a salary sacrifice. If you’re younger, you’ve got a family, these things are challenging, which is why one size does not fit all. But it’s a case of exploring. And what I’ve just said there is the answer. I have adaptable contracts according to pilot needs based on where they are in their life cycle. It just requires progressive HR departments. That’s all. It’s not rocket science at the end of the day. The evidence is all out there if people go looking for it.

And part of where you started at the front end is that businesses are financially driven, which is perfectly fine. But we also tend to talk about safety at the operational level. So, in aviation, we’ll talk about safety for the flight crews. But we don’t necessarily talk as much about safety to the finance department or the HR department to understand how they impact a perfect day for a pilot. And there’s an element of awareness in the decision-making that also can have a key impact.

Exactly. And this is why you have to start looking at that bigger systems view. So, we’ve just introduced the equivalent of an air accident investigation branch into health care. And it’s just been reorganized and given a new name. The first report that it published just a couple of months ago was on whether healthcare needs a safety management system. The new interim chief executive announced the report and made a comment that finance directors need to get more involved. Now, that created a furor, and the Health System Finance Directors have their own little Trade Union, and they went public criticizing this comment. So, I wrote a little article, which went out on a blog, and I said that finance Directors do have an effect on safety.


And here’s how. And I developed this systems model. If you think about an organization, it’s a hierarchy of decision-making. I’m at the bottom, and I make decisions about how I’m going to do my job when I turn up for work. I make decisions about things like, am I even going to come to work today because I don’t feel very well? Once I’m at work, I’m part of a team. I’m surrendering some of my autonomy to be a team member. The team, whether it’s the crew on the aircraft or it’s the department I work in, makes decisions about the allocation of responsibilities. What are our goals? How do we apportion tasks and jobs?

There’s a level of decision-making there about the organization of work. And then I’ve already said, the next level up is the organization itself, the airline. And it makes a set of decisions. It’s all decisions that drive outcomes. And then above the airline, of course, you’ve got the regulator. So, the regulator decides how aviation will run within its jurisdiction. So, I was just trying to elaborate on this model and show how decisions made by, in this case, finance directors, as we’ve already alluded to, do have an effect on the front line and will shape safety.

But the problem is, and here, when you start thinking about systems, you’ve got to consider cross-scale effects. An act in one area will have an outcome in another area, but in ways that you possibly couldn’t predict, you couldn’t anticipate, and therefore, you couldn’t manage for. You just have to live with it but recognize that it’s a possibility that your decisions will work in ways you never really intended.

It’s a lot more frequent and common than we think. The complexity as well from a system standpoint, and this in some of the examples that I’ve seen is the impact of a decision doesn’t necessarily manifest itself that day, that week, that month. In the examples you shared, there was proximity. But I’ve seen the impact of decision-making, particularly when you’re talking about hiring, where you have hiring peaks because we talked about seasonality, but sometimes there are good years, and there are bad years financially. And so, there’s big hiring, some years, and then you don’t hire for a couple of years. That can have an impact three or seven years down the road in terms of the level of proficiency skills that people had because they weren’t necessarily properly trained or didn’t have the experiences they needed. And so that becomes easier to abdicate the role of my decision to the impact. But the other element is safety, not the absence of injuries or events. And so, if I take one pound or a dollar for a particular transaction if I take a penny out, probably there’s no impact. If I take two pennies out, there will probably be no impact.

If I take three, maybe not. And so, there’s a complexity there. You don’t know where there’s a trigger. If I cut something, when’s the impact? Could it have an impact 3-7 years down the road?

Yeah, exactly. I worked with an airline once that had a very stable workforce, and they’d all grown old together.

Wow, that’s rare.

Some of them were now getting to the point where it was time to retire and move on to other things. So they had a little recruitment drive, and it was absolute chaos because the workforce that had been there for years had learned to communicate by telepathy. We’re talking about cabin crew. You only had to look down the cabin, and you knew what the other person wanted. All of these new hires that had just come in, young kids, clearly hadn’t had the telepathy chip in schools when they were recruited. The breakdown in the crew functioning was, if it weren’t funny, it would be quite awful. But it was something that we tend not to really think about. The fact that a low churn rate is almost as bad as a high churn rate. We’ve got to reflect on the fact that we need to keep reminding ourselves of how we do the job. And then when someone new comes along, they’re not going to know how we do the job, and therefore, training and communication are all the more important.

Even if you think about 2008, there was very little hiring in the airline industry or most industries in general. The same thing happened around COVID, with very little hiring. All of this has an impact from a system standpoint because there’s less experience. People weren’t flying as much. We weren’t recruiting at the same pace as usual. And then suddenly, you might have the scenario you talked about about the Southern European airline, where you’ve got a huge influx of new talent, and that creates more stretch on the existing resources. Yeah, it’s a problem. Fascinating topics. Any closing thoughts on the system side and encouraging people to really start exploring that side of safety?

It was It is the next frontier. Partly, that’s why I’ve always been interested in how the organization works. So, in the European CRM regulation, there was always this one-line entry about organizational factors. I’m thinking, well, what are those organizational factors? Because it doesn’t tell you anywhere in the curriculum document, it’s just there. And that tacit recognition that the organizational behavior has an effect. And that’s why I became interested in it. But it’s always seemed to me to be, it’s the final frontier. We’re just scraping at the surface of how the business works and the implications of the way it does business. If I was going to say, well, one thing, at the worker level, the natural tendency is to get resentful and to blame the then. Management. Whichever floor they work on, it’s that floor that is the problem. If it’s operational management, the flight Ops Department Is the same as line pilots. They think the same, they act the same, and they have the same problems. The non-operational managers have a different focus, so understand what their different focus is. Don’t get angry with them.

They’re just trying to do a different job from yours, but they’re still trying to make sure that everyone gets paid at the end of the day. So, part of the problem is that people tend to get defensive rather than trying to understand why the other bit of the organization behaves the way it does. And then that’s from the bottom, looking up. From the top, looking down, it’s an awareness of the fact, as we’ve just said, that whatever you do will have an outcome you didn’t anticipate. So, try to understand how that might be and appreciate that the workforce, like you, are just trying to do its job. To the best of its ability. But the fact remains, unless we understand how these factors work and what the relationships between decision-making and outcome are, then we’re never going to make this system as safe as it ought to be. It is safe because people behave in a safe manner. It’s not necessarily safe because of how the organization has designed the work process and equipped the workforce to do its job to the best of its ability. That’s the bit we got to get sorted out.

Thank you, Norman. I really appreciate your insights, and your tangible examples really bring this to life. So, thank you very much for joining us.

You’re more than welcome.

And if somebody wants to get in touch with you, Norman, what’s the best way to do that?

I’m on LinkedIn. I don’t know. Maybe you can post my email address. I’m happy to go out. I’m out there somewhere.

Thank you, Norman. Cheers.

Yes. Bye.

Thank you for listening to The Safety Guru on C-suite Radio. Leave a legacy. Distinguish yourself from the past. Grow your success. Capture the hearts and minds of your teams. Elevate your safety. Like every successful athlete, top leaders continuously invest in their safety leadership with an expert coach to boost safety performance. Begin your journey at Come back in two weeks for the next episode with your host, Eric Michrowski. This podcast is powered by Propulo Consulting.

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Norman MacLeod served in the Royal Air Force for 21 years in the Training and Education specialization. During that time, he was involved in a number of pilot training projects, the most extensive of which was his involvement in C-130 transport aircraft crew training.  On leaving the RAF, he worked for 17 years as a consultant delivering CRM to pilots and cabin crew in over 25 countries around the world. In 2011 he joined Cathay Pacific in Hong Kong as the Human Factors Manager. Returning to the UK in 2019, he is now employed as a Patient Safety Partner in the National Health Service. He has written 2 books on aspects of instructional systems design in aviation, and in 2021, his third book was published, which takes a systems view of aviation and explores what that means in terms of pilot competence.

He can be contacted at [email protected]

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Alone and Not Unseen: Profound Strategies for Lone Worker Safety with Dr. Ryan Olson

Alone and not unseen: profound strategies for lone worker safety



In this must-listen episode of The Safety Guru, we’re focusing on the critical yet often overlooked topic of lone worker safety. While they have fewer interactions with leaders and coworkers, their decisions are still shaped by the safety climate and priorities set by their organization. Join us to dive deeper into this topic with Dr. Ryan Olson, who will share his invaluable insights, groundbreaking research, and profound strategies for lone worker safety. Tune in!


Real leaders leave a legacy. They capture the hearts and minds of their teams. Their origin story puts the safety and well-being of their people first. Great companies ubiquitously have safe yet productive operations. For those companies, safety is an investment, not a cost, for the C-suite. It’s a real topic of daily focus. This is The Safety Guru with your host, Eric Michrowski, a globally recognized ops and safety guru, public speaker, and author. Are you ready to leave a safety legacy? Your legacy success story begins now.

Hi, and welcome to The Safety Guru. Today, I’m very excited to have with me, Dr. Ryan Olson. He spent many years with Oregon Health and Science University and is about to start a new program in occupational health psychology. Really exciting at the University of Utah. Ryan, welcome to the show. Really excited to have you with me. You have some amazing work that you’ve done over the years, particularly around lone workers, which is really what we’re going to talk about today.

Well, thanks so much, Eric, for having me. It’s a pleasure to be here and have this conversation about my work and about safety, health, and wellbeing in general.

Excellent. And so, the work you do on lone workers is quite unique in terms of the research and such a critical, important area. So, tell me a little bit about your story. Obviously, you’ve studied occupational health psychology. Tell me a little bit about your story and your interest in loan workers.

Yeah. Well, if we cut to the initial interest in loan workers, we’d probably start at graduate school at Western Michigan University, where I had a class with John Austin, who was my mentor, and we read a case study in a book that had bus operators self-monitoring their safety driving behaviors. They reported a… The authors reported a reduction in injuries by 66 %. And I just was skeptical. To me, that sounds like a change from three to one injury. And I just don’t know. I was skeptical, and I wanted to replicate or partially replicate and see if this actually worked, if it actually changes behaviors. So, my thesis turned into a small study of four bus operators for a long period of time with observers on the process of monitoring actual driving behavior. And to my surprise, using behavioral goal setting, and self-monitoring, and feedback type approach, one of the drivers showed a very large improvement in one particular behavior, complete stopping at stop signs. And so that’s really how I got involved with so-called lone workers, was just by chance that I read this study, and I thought, I don’t know if I buy that, and I wanted to get in, and I used it as a thesis topic.

And then it was a very interesting, informative experience. I did a bunch of extra safety work with that transit authority, doing a safety assessment of their historical injury and collision experience. However, my success with the thesis led to an opportunity to work with new flight students at the School of Aviation at Western Michigan. And that project really got me deeply involved in brand new folks learning how to fly a plane. Definitely a high-risk task. Definitely. And the big initial benchmark is when do you fly on your first solo? So, how well are students being prepared for that? When do they go on their first solo? We study predictors of success doing that quickly and videotape landings, and we could talk a lot about that dissertation. Still, it was a deep experience thinking about those new people, learning a high-risk, complicated skill set, and the system trying to do this safely with minimum risk to the students and instructors was the next step. And so, after my graduate training, when I moved to Oregon and was thinking about starting to pursue a grant-funded research program, it was really data that drove me next to truck drivers.

So elevated injury rates, a range of elevated health issues, including obesity and high blood pressure, and got going with work with truck drivers, and then from there, it built out to home care workers. So, I think I can trace it all back to that chance of reading a little case study in a graduate school classroom, and now here I am 20 years later.

In this space and one of the few researching this area is so important because a lot of the interventions around occupational safety, particularly in the culture space, heavily focused on interventions that work well in a shop floor setting, an environment where you’ve got teams, but it’s much more different in terms of how do I connect with somebody who’s working independently day in and day out? A lot of these methods do work, but these are often overlooked pieces. I think of your base safety as an example; it does not work particularly well when you’ve got only one person alone. So, tell me a little bit more about why loan workers are overlooked and some of the unique concerns that relate to the work and the interventions in that space.

I think the core reason is that the workers are dispersed. They tend to work unusual schedules or in unusual places. And so it’s just challenging to find, get with the workers, and get involved to study and work with them in a way beyond just doing survey research. Just that barrier results in fewer studies being done with groups like bus operators, commercial truck drivers, and home care workers. And that’s probably the fundamental issue. It has been tremendously effortful over the years to conduct, for example, a large randomized controlled trial with truck drivers. We couldn’t do it without the support of amazing companies who basically volunteered to partner with a researcher out of the goodness of their hearts, and maybe the hope that our health research will encourage workers to stay with the company or to have good positive feelings about the company. So, both employers and unions really donate a lot of their time and service to help us get the work done. But I think it’s really about the effort of getting involved with these folks. I think technology and wearable technology should help us tremendously now and into the future to get more work done with isolated and dispersed workers.

Absolutely. And so, tell me a little bit about some of the most exposed workers that are lone workers and maybe some of the tactics that you’ve seen work in those environments.

Yeah. I’m not sure I can say the most exposed. Maybe it depends on what hazards we’re talking about. But in the spaces where I’ve worked, there are people truly alone, like a commercial truck driver, but there are also small construction crews. For example, just at my house, I had all my windows replaced last year and it was a two-person crew, and we had a huge front-picture window. And watching that two-person crew handle that big picture window and have a near, a close call, that’s lone work there too. You don’t have a team around you. It’s just you and your partner, and they do a lot of things alone during their workday. So, I think I might add construction and utilities into the mix just because they’re doing a lot of things alone, and they do experience elevated fatality rates and injury rates, as well as all the commercial drivers and the home care workers that we work with.

And I think when you talk about that construction crew with two people, similar to pilots as an example, where you’ve got two pilots, there’s also the element, or you talked about utilities where you can have a small crew doing a job, is there’s a true lone worker. Still, in a small team, I can keep what went wrong, my near-misses, and my close calls to it within our group, in which case that accident operates like a lone worker crew and can work in very remote, isolated environments. So very much, that similarity of how we speak, because that was one of the big advances in aviation, is how do you get those two people to realize that there’s value in sharing what went wrong in a flight? Yeah, and.

To look out for not just each other but also the broader workforce. So, I don’t know, off the top of my head, I don’t know about the company that installed our windows specifically, but let’s imagine they’ve got 20 employees who all do this at work. The crew that was working at my house, if there’s a safety committee that meets regularly, hopefully, there is, and lessons learned could be shared through that process so that other workers can approach similar types of tasks in a safer, less risky fashion. And so, but yet that communication is a challenge. I think with lone workers, I do think a lot about this concept in behavioral psychology, which is the free operant. The behavior studied by Skinner and many other behavioral psychologists was named the free operant because the organism was really free to behave any way it would like in the environment. And then the research was to study, well, how is that free behavior shaped by its antecedents and its consequences. And lone workers are really quite free when they’re out on their own doing the work to do the work how they want. But they do have working conditions as well that are shaped by the employer and the design of the work.

Going back to my window crew, one of the first things he said after touring our house, the lead worker, was that this was a three-day job, and I’d been given two days to do it. So, right off the bat, I knew this working crew would be dealing with safety productivity pressure because of the schedule for the work.

Sure. So, I remember when we were talking originally, you touched on new employees and the onboarding of new employees. And you had done, I believe, a study around how you onboard a new loan worker because of the vulnerability of different shifts, all sorts of different complexities.

Yeah, well, specific to onboarding a new loan worker, like going back to the flight students, the question is, well, when do you let them really go out on their own? So, there’s some assessment if they have been trained, they are skilled and knowledgeable in their work, and that they themselves feel confident that they’re ready to go and work on their own, in bus operations in the transit industry, where we’ve been working for the past five or six years on a trial of an intervention for new employees. The bus operators have the chance to learn in the classroom together and on the road together, as a group or as a cohort, which is fantastic because they can bond with each other, get to know each other, and help each other out as they’re learning. And then, once they move into the workplace, there may be some monitoring of their driving with a coach or supervisor, maybe more frequently early on. But by and large, they’re on their own pretty quickly. But I do like, in that model, some type of mentor, coach, or a class, or a group that you can learn with. And most industries sort that out, and employers will do that in a more systematic, more rigorous way, or all the way in a…

We’ve had fatality cases here in Oregon where the story is particularly tragic, where somebody is quite new to the work site and killed within the first couple of weeks on the job. One potential contributing factor in cases like that is usually that training probably was not sufficient in terms of what are the hazards of the job and what are the ways that we protect ourselves against those hazards.

I think it’s pretty cool. The element I find interesting is when you talk about keeping the cohorts together, the mentoring aspects as well, how long—I don’t know if there’s an exact duration, but how long is it worthwhile to keep some of these elements in place?

Well, yeah, that’s a great question because it’s expensive to keep people in training. You’re not generating revenue or out in service. That’s a training expense. There’s a particular study I know by the first author’s last name, Breslin. I think it was done in Ontario, Canada, and it was a study of workers’ compensation claims for the first year of workers’ experience. And the first month stands out like a sore thumb. The elevated risk for injury in the first month is well above the rest of that first year. But it did take a full year for the relative risk to drop down to one. That study to me, if it plays out in the literature, suggests that the first month is a really important time for new people to be learning, coached, and trained, and not just what they need to do in terms of productivity or service, but also safety hazards, means of protecting themselves against hazards and safety procedures and processes, including what to communicate and when, so that employers know about hazardous working conditions that could or should be eliminated or reduced through engineering controls or design controls.

And so let’s think about some of the approaches that you’ve seen that work well for loan workers, some of the key principles. You talked a little bit about the onboarding, the mentoring, and the cohorts. I know when we connected, you touched on some elements around signals and the work environment. Tell me a little bit more about some of the tactics that organizations can take to better shape the decisions of that loan worker.

Well, I mean, working from top priorities and the hierarchy of controls downward, I would just want to mention that we have studied improving working conditions through physical environment changes in truck cabs, for example. So, to reduce fatigue and try to benefit workers’ sleep, we studied an active suspension seat that reduces whole body vibrations, which increases the risk for musculoskeletal disorders, but it’s also fatiguing to get bounced around in a seat all day. We also studied a therapeutic mattress that had the potential to alter vibration exposures for team truck drivers who sleep in a moving vehicle. And then we supplemented those cab enhancements, really job design changes, with a behavioral program. That’s an example of just trying to work from working conditions downward to more behavioral interventions. As a behavioral psychologist, I tend to specialize in behavioral approaches, but I do work with engineers like Peter Johnson in that study to address working conditions. Related to that, some of my current future plans are really focused on schedule, regularity, and consistency and how that might relate to sleep regularity, health, and safety. So, I just started there. If we work downward to behavioral interventions, I think Emily Wang’s safety climate research with truck drivers suggests that lone workers, like truck drivers, are still sensitive to safety-related communications.

What is my organization’s priority? Is it really productivity, or is it really safety, or is it tied? So, truck drivers do form safety climate perceptions of the priority in the organization. Those perceptions do relate to their safety performance and motivation. And those safety climate scores also predict future collisions and injuries in the trucking industry. So, what that tells me is that lone workers may have fewer points of communication, and that may be text messages, phone calls, or an occasional meeting. However, they’re still learning from leaders in those communications what’s really important, and that’s still affecting their approach to safety.

It’s interesting because it may actually skew the data. If I’m thinking about a team-based worker where there’s maybe a huddle every morning that talks about topics, then there could be some elements in terms of how we prioritize safety in the conversation, et cetera. But the lone worker is going to get probably significantly less data, and it may not be sorted in the same way. And so the signals might feel different.

Yeah, Emily and her team, in their discussion, argued that safety climate is still a valid measure in trucking, but the responses are less shared among the drivers. So, in a manufacturing setting, the perceptions of the safety priority in the organization are more shared because the workers are together. They look side to side and upward to leadership to judge the safety priority and to calibrate their perceptions of the safety priority. But for truckers and other lone workers they will communicate with each other, but the perceptions are less shared. However, those individual-level safety climate scores were still predictive of future safety outcomes. So that’s an interesting question, and that whole area of research is important and interesting. You know, it’s quite amazing, actually, the way we develop shared perceptions of the safety priority and how consistently that perception of the safety priority relates to safety outcomes at work sites. Safety climate is, as far as I know, the best leading indicator of future injuries, collisions, and incidents.

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It just speaks to me to intentionality because a lot of organizations, if you have a mix of… When you talk about truckers as an example, they may have truckers that are in a lone-work environment, but they may have distribution centers or logistics areas where people are working in a manufacturing-like environment, loading and unloading. And so, the intentionality of the messaging may need to be very catered to the audience if we want both of them to have the right message.

Yeah. And who are the leaders influencing each group? For truck drivers, the driver manager or dispatcher, who is helping assign loads to them, supports them when they have problems on the road. That person likely has up to 50, maybe more drivers on their board. So that’s a busy supervisor. They may not always be called a supervisor, always. Sometimes, they’re called a driver manager, but they are a leader and the main source of information about the company and its priorities for that truck driver. And I recall a study once I read that just popped out at me. Dispatcher responsiveness to driver concerns in a survey study had a 0.5 correlation with driver turnover. That’s a massive correlation. So, if I’m a trucking company and I’m having turnover issues, boy, are my driver managers important people? Their relationship with the drivers has a huge effect, potentially turnover. Of course, that’s one study, and that finding was particularly strong, but I would bet, on average, that would play out if you replicated it or studied it at other places.

It’s interesting because, in a traditional context, people are going to be thinking about the emails, the posters, the conversations, the huddles, the debriefs on safety, and all the various focal points that exist. But the truck driver may be hearing disproportionately compared to the environment that’s more with lots of workers working together. And so their interactions may be a dispatcher all the time saying, When are you arriving? All productivity, time base, follow through.

Yeah. And a driver might say, I’m feeling run-ragged. That was a super long day. I spent X number of hours waiting at the loading dock, and I could really use a little extra time before I pick up my next load tomorrow. And then if they get assigned a load, that’s another… Maybe it’s a little bit earlier in the morning or at an inconvenient time, but the message received is, oh, my driver manager, the company, doesn’t really care about my sleep fatigue because they’ve just given me a work assignment that isn’t consistent with my need to get rest. And in the real world, all sorts of pressures like that happen all the time. And it can be really challenging for someone like a driver manager to make these complicated choices. The freight’s got to move, and there may be only one person close to it. So, some realities constrain leader’s and workers’ choices in situations. But I think it’s up to researchers, companies, unions, all to do our best to work together, to understand where we can have levers for change, and where we can improve the lives of workers just so we can best support and protect them, especially the people doing jobs that are very hard on their bodies and their health, and put them at risk for safety incidents.

One of the things I know you talk about is a socially-connected lone worker. Can you share a little bit about what that means and some of the principles and ideals behind it?

Yeah, I think that would be a great segue to talk a little bit about our home care workers. I say our home care workers. They do feel like family after, or a part of your work team, at least after working with them for many years. But we’ve worked primarily with home care workers, who are independent contractors, to a degree caring for people who qualify for publicly funded in-home services. So, they don’t work for an agency, they work directly for a client, or in Oregon, they’re called consumer employers, who qualify for that in-home service through a state-funded program. So, these workers care for some of society’s most vulnerable or poorest citizens, but they themselves don’t make a lot of money, often struggle to get sufficient work hours, and sufficient work, and they perform a very physically demanding job in isolation on their own. And they’re navigating this unusual relationship, where their client is also their employer and can fire them or become unhappy with them. It’s a really complicated job and demanding job to do for 13 15 bucks an hour. So, for the home care workers, when I first moved to Oregon and started learning about their job, I reflected on an experience that was really beneficial to me as a new faculty member at Santa Clara University, which was a monthly faculty forum where faculty from all over campus would get together, and for a couple of hours, they would discuss a reading, share issues they were dealing with, and support each other, sorting through complicated or challenging work-related problems.

And I thought, boy, if anybody could use that support, it might be these home care workers who don’t get to see other people who do their job regularly.


So, with collaborators here in Oregon, an ergonomist and a sports medicine physician, we developed a peer-led and scripted group program for home care workers that brings workers together regularly to learn together, set goals, both group and individual and provide structured social support. And that program called COMPAS has been really well received by workers. It’s changed a bunch of safety and health outcomes in a randomized trial, and it was adopted by the Oregon Home Care Commission in Oregon. So, it’s available to workers as a paid training course, which is tremendous. So that’s a lot to say in response to the question of socially connecting, isolated workers. But it’s like a once-a-week meeting. We’ve also studied it once a month. But these isolated workers seem to really respond to and appreciate that chance to connect with other people who do the same work. And it doesn’t necessarily have to be applied only to in-home care, but it seems in particular for this type of worker. Their answers to surveys on how connected they feel with others and their profession do change and improve along with the safety and health outcomes.

And you touched on the connection once a week versus once a month. Was there a difference between both from a frequency standpoint in terms of how connected they felt with each other?

My memory is that the social connection is about the same for both schedules. The original monthly approach we were thinking of would get them started with a yearlong program, and then perhaps they might continue on their own as an informal, monthly, community, and practice process. And what we found, getting it ready to respond to the Oregon Home Care Commission’s needs, was they really needed a course that could be implemented in a short enough period that workers could take it really like a student taking a class. And so we changed to an every other week frequency. And so there are some trade-offs. The sustained longer-term access to a socially supportive group is great in that monthly growth for a year, but it’s a lot more feasible to run and to pay workers to do it if it’s like it has a start and stop of maybe a few months. And we’re currently studying it as a 10-week program for home care workers with chronic pain. We’ve tailored the program specifically for those workers, and it’s weekly for ten weeks. And so feasibility is better that way. But also, I would have to say goal setting, engagement with goals, and accountability for working on what you’re working on is probably better with the weekly approach.

Yeah, I see the applicability to this to a lot of other lone worker groups, where if there’s a sense of connection to each other, because there’s a loneliness to being alone, and it creates a common goal, bond, as a group, I would think.

Yeah, and I think these days, in the post-pandemic world with all the hybrid work, I think the isolation and how you generate that sense of team and collective purpose applies much more broadly than it ever did before. But you’d have to think that the basic common structure of a safety committee is a great opportunity for giving lone workers a chance to get together and communicate about safety concerns, what they’d like from leadership to support their safety on the job, what do they need in terms of tools, how is the work design and work hours working for them, things like that. It, and then also to communicate, close calls like we talked about earlier in the interview.

The last question I have is really in terms of the monitoring of lone workers. With technology, there are a lot more opportunities to do remote monitoring. There have been some successes. I’ve also heard of some disasters in that regard. Everything from telematics to understanding how your driving patterns are to all sorts of tools that connect workers. Any thoughts in terms of value and maybe the way to roll them out? Because there’s also this sense of big brothers watching that I’ve heard many times. Yes.

There is pretty good evidence that this technologically intensive surveillance is really stressful for workers. So, think of the warehousing workers who are on a really tight clock, filling orders in warehouses. We don’t want to stress out workers. Stress is bad. It’s associated with heart disease and work-related stress. I mean, stress is not a soft hazard. It really is a hazard that can kill people. It’s just a little sneakier and slower than perhaps an acute traumatic injury at work. So, yeah, monitoring. I have colleagues with stories of truckers evaluating these onboard monitoring systems, with cameras on their faces and things like that. I can’t share the specifics of the stories, but the stories indicate that they aren’t necessarily well-received by workers. So, I think the key is collaboration, especially with loan workers, supporting their autonomy and their participation and decision-making. So, their decision-making processes. It reminds me a little bit of a study by Tim Ludwig, and Scott Geller, of pizza delivery drivers. And they studied collaborative safety goal setting and assigned safety goals. And then they measured, I think, turn signal use and complete stopping behavior. In the collaborative goal-setting group, the goal behavior changed, but so did the other one.

So, the discretionary extra effort for safety was better. The workers improved safety in general. For the assigned group, only the assigned behavior changed. So, collaboration generates discretionary effort. And we’ve seen a similar thing with a study of behavioral self-monitoring of health habits. One group was assigned the health behaviors to work on, one group got to choose. And the group that got to choose engaged in the process 20 % more. So I think collaboration and choice are really important, especially with all the surveillance tech that’s out there so that the workers feel like they’re being, feel like and are really being listened to that this is not just a tool for the employer to keep their thumb on them and to control them, but it really is a resource and tool for their benefit and safety, and that they have a say with how it’s used. So yeah, I think that would be my comment on that great question.

It’s interesting. I remember one organization that chose, and there’s not a proper study unless you’ve seen one, where instead of using the monitoring, this was around heartbreaking. Hence, it was more the telematic side. Instead of using punishment as a result, they use it as the driver of the incentive. So, your access to the bonus pool was based on safe driving scores. And they had a mechanism to drive it. And they had had much more success than some of the companies I’ve heard of that have gone the other approach of punishment. It doesn’t mean you don’t address from an accountability person the person that’s always hard-breaking and so forth, but that they’re trying to turn in more of a reward as opposed to punishment.

Yeah, I think that speaks to maybe it’s a general human impulse to react to and respond to things we don’t want. Aubrey Daniels called it management, by exception, probably more than Aubrey. But I remember hearing from Aubrey about it, that you’re… Basically, it’s easy and less effortful to just not do much except react to and punish the bad stuff. It is a lot more effortful and requires a lot more thought to look for opportunities to provide constructive feedback and positive reinforcement and accentuate the positive. But I do think with the collaborative goal setting, there’s so much more potential for generating a positive safety climate and a spirit of shared purpose and a culture of caring with those more positive approaches that we’re all in this together. We care for each other. We don’t want anyone to get hurt on the job, and we’re going to help each other do our best to make sure that doesn’t happen.

Excellent. Well, thank you very much, Ryan. Really appreciate you doing the work you do in the lone worker space and also sharing this on our podcast.

Yeah, thank you very much, Eric. Appreciate you having me.

And if somebody wants to learn more, is there a way they can connect with you? Is there research that they should do to access the research that you do?

Yeah, you can find my laboratory page at Oregon Health and Science University, and that should stay active for some time. Also, you should be able to find me at the Rocky Mountain Center for Occupational and Environmental Health at the University of Utah. So, I should have descriptions of my work at both places for a while as I join Joe, Alan, and many others at the University of Utah to start the new Occupational Health Psychology program there.

Excellent. Thank you so much for joining us.

Thank you.

Thank you for listening to The Safety Guru on C-suite Radio. Leave a legacy. Distinguish yourself from the past. Grow your success. Capture the hearts and minds of your teams. Elevate your safety. Like every successful athlete, top leaders continuously invest in their safety leadership with an expert coach to boost safety performance. Begin your journey at Come back in two weeks for the next episode with your host, Eric Michrowski. This podcast is powered by Propulo Consulting.

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Dr. Olson is a Professor in Occupational Health Psychology at the Rocky Mountain Center for Occupational and Environmental Health at the University of Utah. His research has focused on safety, health, and well-being interventions for isolated or “lone” workers. Dr. Olson leads an internationally recognized safety and health intervention research program with commercial drivers funded by NHLBI and has also designed impactful supportive group interventions for home care workers with funding from CDC/NIOSH. Prior to joining the University of Utah, Dr. Olson was based at Oregon Health & Science University, where he was a founding investigator and past Co-Director (with Leslie Hammer) of the Oregon Healthy Workforce Center – one of ten Centers of Excellence for Total Worker Health® funded by CDC/NIOSH. He also directed the state of Oregon’s occupational health surveillance program funded by CDC/NIOSH for over a decade. His interventions have improved a range of outcomes for workers, including safety, diet, exercise, sleep, stress, and job satisfaction.

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Move Smart and Stay Safe: Proactive Steps for Injury Reduction and Prevention with Kelly Lynch Feldkamp

Move Smart and Stay Safe: Proactive Steps for Injury Reduction and Prevention



We are thrilled to feature a lively and perceptive conversation with Kelly Lynch Feldkamp, an expert injury prevention specialist and founder of ProVention Plus. Kelly passionately advocates using our body movements as a critical factor to stay safe and proactively reduce and prevent soft tissue injuries. Tune in as Kelly shares the many benefits of preventive physical therapy, highlighting how it can elevate safety for your team on and off the job site and improve their overall personal health with proactive injury prevention and reduction strategies. Don’t miss out on this dynamic conversation filled with invaluable insights!


Real leaders leave a legacy. They capture the hearts and minds of their teams. Their origin story puts the safety and well-being of their people first. Great companies ubiquitously have safe yet productive operations. For those companies, safety is an investment, not a cost for the C-suite. It’s a real topic of daily focus. This is the Safety Guru with your host, Eric Michrowski, a globally recognized ops and safety guru, public speaker, and author. Are you ready to leave a safety legacy? Your legacy success story begins now. 

Hi, and welcome to the Safety Guru. Very excited to have her with me, Kelly Lynch Feldkamp. She’s a specialist in injury prevention and reduction. Kelly, welcome to the show. Really excited to have you with me.

Thanks so much for having me, Eric. I’m excited to be here and talk to you guys. Excellent.

Let’s start out with a little bit about your passion for safety and the journey that got you in this space.

Yeah. So, my focus is really on injury reduction and injury prevention. It’s the soft tissue kind, right? So, I got involved in this world of injury reduction about 20 years ago. It started off with someone once telling me, hey, why don’t you stretch these people out? All these people. I had this opportunity to work with people in an industrial setting. I was like, Okay, well, I know fitness. I know the body. This should be no problem. And then someone came to me and said, my knee isn’t feeling great. And I first thought I had was like, well, how do I stretch a knee? And so, it got me totally delving into what I can do for someone who’s not feeling great in all of their body areas. And so, what that led me down is the area of massage therapy. So, where I realized I had to go from just stretching and movement to actually touching and working with people as well. So that’s where I started my journey of this whole idea. And I realized, man, there is a way to help people feel better when they’re not feeling great. And that just made me so excited.

And I started to work with all sorts of people: anyone sitting at a desk, anyone working out in exercise, anyone doing industrial work. And then, when I had that opportunity to work with the people in the industrial setting at that time, and now I started calling them the industrial athlete or the job site athlete, I realized I was working with a group of people that will not get the help unless either they’re forced to, or they’re bleeding out of seven different areas or for many different reasons, maybe they don’t know that they have an opportunity to get the help or they’re too afraid to talk about it. So, I had this opportunity, and my passion just blossomed. I realized I like working with everybody, but I love working with individuals who are working in manual labor or the industrial setting. That’s where it came from.

That’s awesome. Tell me a little bit about the case for strains and sprains because it’s one of the most common injury types. Tell me a little bit about it and how you could make a difference from a stretching standpoint, but other things as well, because I want to also go into the limitations of other approaches.

Yeah, sure. I think one of the things we have to remember is we have almost in many of these industries where there’s a lot of movement is we’ve accepted just there’s a certain percentage of strains and sprains that we’re going to have. We’re saying, Okay, well, and you know what? Each one, on average, costs about $34,000. That’s on average. I think the number is actually going up now because of our treatment of these injuries. Unfortunately, I think we’re moving more towards the surgery route in a lot of things, and that’s going to take our costs up even more than they are now. We’re at this juncture where we really, really have to look at the prevention side of things. My argument has always been if we can prepare the body for the movements that it has to do in its day or in, week or career, we can lessen the opportunity for strains and sprains. Strains and sprains come from repetitive motion, overuse, overextension, things that when the body isn’t ready for something that It happens. So, if we can, again, step back and say, how can we get each body better prepared for all the things it might have to do?

And the simple example for this, I would say, is if you’re doing something repetitive motion, so you’re moving to your left many, many times throughout the day. And then, out of the corner of your eye, you see, let’s just say, a screwdriver dropping. You go to grab it to your right. Well, your body has been set up by this movement you’re doing all day long, and maybe even days in a row to the soft side. And now you go to that right side. And gosh, it wasn’t even a hard or excessive movement. It was just a regular movement, but to a place that your body wasn’t ready for. So, my approach and my thought and with Prevention, and what we’re looking to do is Move the body in all the ways that it can move. Our spine is meant to flex. Our spine is meant to extend. Our arms are meant to reach up. Think about the person who has a little bit of pain in their shoulders. They stop reaching into that position. They don’t reach as high as they used to. And then all of a sudden, over the course of a couple of months, now you can’t even do it.

So, I think the strains and sprains that we’re experiencing, especially in the workplace, are not approaching this in the right way. We’re not saying, hey, if there’s something that you’re noticing, let’s just call safety folks into this. If we could educate safety folks a little bit more on the body, the actual body, not the proper place to lift from, not the proper lifting technique. Those are important, 100%. But if we can educate the safety folks on how the body is supposed to move and meant to move, maybe we can jump in there with our stretch and flex programs and be a little bit more thoughtful. It shouldn’t be just, Hey, hold this static stretch, this non-moving stretch for 10 seconds, and then move to the next one. It should actually be dynamic. We should be warming the muscles, the joints, and the areas that are going to be used in all of the ways they may be used that day, certainly in the way they are going to be used, but also in the ways that they could be used. We want to say that job task rotation is wonderful but not always available, depending on the industry that you’re in.

For sure. How do we prepare the person doing the job? Or suggest, rather. This is more of a suggestion. You are doing this motion to one side, or you’re flexing at the hips all day long. Can we give you a motion to do the opposite of that motion throughout the day many different times? The suggestion I would have is even ten times a day, you’re moving in the opposite direction. Nice and quickly, you’re not lifting a ton of weight, but you’re preparing your spine for maybe that right side rotation or that back from being bent over all day. Maybe you’re standing up and extending, again, 10, 20 times a day because it takes about three seconds at most. But again, you’re getting that blood flow. You’re getting that memory of your muscles. Your bodies can take it so that when you get home, for example, and your three-year-old runs up to you, and you bend over to grab them, and you throw them up in the air, and all of a sudden, your back is out because your body wasn’t ready for that. I mean, goodness gracious. I can’t think of a worse thing than that. And that didn’t happen at work, quote-unquote, right?

Sure. So, how does that person deal with it? So overall, my company’s goal is, how do we reduce injuries? My passion lies in how I make sure that that person never has an experience where they’re doing their outside-of-work things and they get hurt or they feel bad, or they can’t even do them because they don’t feel good. So that’s where my passion is at. And again, that was long-winded. I went a little bit on a tangent, but it’s like one lead into another leads into another for me. And that’s why I see the movement, the aspect, the physical movement of a human being doing these jobs to be so important and so missed. The only time we touch on it from our safety side, it seems most of the time, is through our stretch and flex. What I’m saying is we need to focus a little bit more on what it can bring, what stretch, and flex programs can bring if we do them correctly and add them more. Not just in the morning, but after lunch, after breaks, that thing.

Sure. I like the element of you saying the reverse of the task you’re doing is the same as when you’re talking about somebody working on a computer you tend to be hunched over, and you bend, so you’re trying to, how do you open up and do the opposite movement? Very similar.

Absolutely. One benefit that we’ve had in working with companies is they’re industrial companies, but they also have to have an office side, an admin side. So, we get to work with people that are sitting on the computer. Even on the construction site, there’s usually a trailer, and people are… I walk in there, and they’re like this for hours and hours on end. So, I’m doing exercise. It’s hunched over their computer. So, I’m giving them exercises all the time for that as well. I’m going to hit both sides. Anytime I see someone, there’s always something that someone can do better that they don’t even realize is an option. And that’s what it is. It’s like, how can I bring this to your attention so that you notice, hey, you know what? Sitting at your desk, you’re leaning on your right elbow the entire time. And then you come and see me, and you’re saying that you’re left lower back hurts. Well, let’s see what we can do about that. It’s There’s a connection there. They don’t see it. I see it. I can give them the input and say, hey, we could work together all day long, you and me, personally.

But if you don’t change the patterns that you have outside of this room with me, you’re still probably not going to feel that benefit because you need to be responsible. So, there’s some personal responsibility in there, too, which I’m not saying that people don’t take that, but if they don’t know that there’s something they can do about it, then how can they take personal responsibility for that part? For sure.

So, what you’re describing sounds very individualized in terms of focus. Tell me a little bit about the difference. A lot of stretch and flex are not individualized. It’s everybody doing the same thing at the same time. Pros and cons: something that’s more individualized versus something that’s more group setting.

Yeah. So, stretch and flex programming; group warm-up programming. However you want to name it, whatever you want to call it should always be with the group, right? We want to get the group out there. We want to do it as often as possible because that’s going to get some camaraderie. You can have a few laughs when you’re doing it, have some fun when you’re doing a hip circle, and everyone’s laughing because it’s hilarious. But we’re doing it, and laughing is good, too. So, there’s a benefit, right? The beauty of that is that you’re going to hit just basically, I would say 80 to 90 % of people are going to get a benefit from that. There is going to be a small percentage that’s maybe not going to feel great with it. But the thing I think about with that is that’s that moment. That’s that mind-body connection for that individual, that athlete, my job site athlete that says, hey, gosh, my shoulder wasn’t moving the way I wanted it. It didn’t feel great when I got up to that. Maybe I’m going to be a little thoughtful today in how I move.

Maybe I’m going to ask for a little bit more help with X, Y, and Z tasks because I’m now feeling that that doesn’t feel great. If the first time you move is at 17, when you’re done with all your safety stuff and all of your talks, and you just start moving, there’s no idea in your head that something’s not feeling great. So you might just, right off the bat, not be in a great spot. So first, that takes it from that group to that individual for that person, that actual person. But the approach that we have at Prevention Plus is we get to do that group work, and then we’re watching everybody during that time, and we’re taking note of what might be going on with individuals. We then, and it’s a beautiful opportunity, get the opportunity to actually work with folks one-on-one. So, our job site athletes can come in to see us 15 minutes a day, and we try to do a focus every week, every couple of weeks. Whenever we’re on the job site, people can come in on a voluntary basis. It is not just for the person who’s not feeling great.

It is for everybody because we create compensations and patterns in our movement that we are unaware of, and we may not have any discomfort or pain from that. But over the course of a career, we’re going to have some problems with it. We want to literally physically touch everybody. When they come in for a session, they get an assessment of what’s happening in their actual movement. We’re talking to them, hey, what are your previous injuries? What’s going on in your day-to-day life? What are your job activities? What are your activities outside of work? We gather all of that information. Do you have diabetes? Is there something else that we need to be concerned with? Then, we get some actual hands-on work. Some clinical manual therapy, massage therapy, that’s a short period of time that we get to work with them. We get to find out what’s happening in their muscles, and then we give them exercises. We’re doing work with them. They’re doing some movement with us. Okay, let’s try this out. Think physical therapy, but we’re doing prevention. We’re not doing rehab, right? Sure. And then right after those movements, then they’re going to get their homework.

So, they’re going to leave us with something. It may be, and this might sound funny because it’s not going to work for everybody, but it may be a breathing exercise. Okay, this is how you’re going to do this. And I really want you to focus on this for the next week until I see you again. It may be an exercise with a band. It may be an exercise on the floor before they get out on the job site or at work every day. Or it might be something that they’re doing that 20 times a day for three seconds throughout the day to balance out their bodies. So, we are so lucky to have that one-on-one time. I understand not every company can do that because it’s four larger companies. You got to have at least on the warehouse floor, there’s got to be at least 40 folks in the construction site, in the logistics center, whatever it is. There’s got to be a lot of people. But one thing that I will say is the warmups that we’re able to try to get out to other folks, other companies that are smaller, is we’re trying to focus on that individual.

So, what we’re doing is we have an app that’s in formation currently, where the person is going to be able to get their morning warmup. That’s going to be the traditional stretch and flex warmup, meaning it’s for everybody. And then, throughout the day, they can do their movement breaks. And in those movement breaks, they could say, hey, My shoulder wasn’t feeling great, and it was feeling achy, or it was feeling sharp. They’re going to get a funnel towards their particular exercises and their particular three-minute exercise movement break throughout the day. We’re creating other options for companies that have a smaller workforce, which is a lot of companies, right? There are a lot of people working in all of those small companies, and they need individualized care as well. That’s our main goal overall, is to reach as many individuals as possible because we see the benefit of getting to that minute level. Each person, each athlete, brings something to the table. However, you want to focus on thinking about it; if you think about it from a cost perspective, each of our athletes, if they are injured, man, they cost a lot of money.

It’s not just the side that I look at that I’m broken-hearted for what they’re going through, but from the side of replacing an injured worker, right? However, we can start to lower those two from the business side.

What I’m hearing is really a blend of group exercise with a lot of individualized because I’ve seen some approaches where it’s all individualized, and you have different people doing different things at the same time. That can get confusing, but also, the person who doesn’t want to do it can just play along because you can’t really see what’s going on.

100%, and I think that’s just it. I love the idea that individualized moments are great. But if you don’t have that group camaraderie about it, I think you’re right. I think more and more people are like, I’m good. I don’t need to do that. I’ll just move a little bit, but I’ll hide in the background, and no one’s going to notice me because everyone’s doing different things. I’ll just tell them I’m breathing.

Or I’ll drink my coffee as I’m stretching, and that’s my stretch.

Well, no. The most hilarious thing always to me is when I get this opportunity to go out to, this would be specific to construction, but go out to a construction job site before Prevention is working with them, and I watch them do their stretch and flex. And my most… I say favorite, but I say this in almost the most jokingly way because the leader got up to do the stretch and flex, and the first movement he did while I was watching all these people had cigarettes in their mouths and they have their coffee in their hand. And the first movement this guy does is the deepest squad I’ve ever seen. And I was like, oh, my gosh. And I just have to stand back and act like everything’s fine. And so, I take that moment. When I’m first new onto a job site, I’m always like, okay, guys, here we go. Let’s get together. Let’s spread out and make some room. But cigarettes out, coffee down. Let’s do this. Let’s bring it in. Let’s be focused for just literally five minutes on yourself and your body. But it isn’t taken seriously. And I still, even in my groups, because the groups can be anywhere from 40 to 200 people, which is fantastic.

It’s such a cool feeling. And I got to tell you, the times that we’ve had people come up, even from far in the back, that have said, gosh, that’s the best warmup I’ve had before work. And it’s just because it’s a little different. It’s actually warming the muscles. So, we get… Yeah. I just think it can be taken seriously, or it can be taken very non-seriously. Absolutely. And you can have some fun with it, even if you take it seriously. I think that’s the other point. You could do it with a smile on your face and have some fun and laugh a little.

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That gets me to the objection side. How do you handle objections? Because too many times I’ve seen people say, No, I’m good. I’m tough. I don’t need to do the stretch. I mean, that’s probably one of the most common ones you hear.

It is. Gosh, you hear that. What’s funny to me is you hear that from the 22-year-old, and you hear it from the 65-year-old. It’s like either the 65-year-old says, I’m good, or he says, I’m too far gone. There are two aspects. That, unfortunately, can come to the group. You can speak to the group about it. What I try to focus on when I have that opportunity is to say, Hey, the movement of your body, the better movement you have, the better work you have, the better life you have outside of work. I’m trying to create that connection to how you can actually move your body. nonwork-related will actually have a better effect on your work, but again, have that effect on your outside of work. So that’s the approach that I have on the grand scale. But if I have the chance to talk to an individual, the best I can do is meet that person where they are and try to give them a specific thing that’s going to be most helpful to them. If that person, if I can have that moment with them, and let’s just say it is that 65-year-old who has to drive.

I’m going to give him an example. Maybe he’s driving an hour and a half to work there and back in the morning, an hour and a half at night, or maybe two hours a night. I’m going to hit him with something he can do in his car and say, hey, give this I went in your car a chance over the next week or two weeks when I see you next. Then let’s talk about it. Did that make a difference in how you felt when you got out of the car when you got home, or when you got here in the morning? If I can win them over with something little, then maybe I can draw them in a little bit more. But that takes focus, that takes energy. And I will say not every person is totally passionate about it like I am, so I would never expect everyone to do that. But if you can hit someone with something specific for them, it will likely make that change. But then that person also, the most hesitant, becomes the biggest advocate when something’s worked for them. So, then they’re the ones out there going, hey, get in there.

Just try it. Or try this. Come on, folks, we’re here. Let’s not talk. Let’s do this. Kind of thing. Yeah, those are the ones we want to win over.

And what’s the role of the leader? And how do you see a leader really lean in? I think a big piece I’ve seen is some organizations, the leader is all bought in, brings the boom box and makes it a fun thing, or they are fitness fanatics, and then they speak with eloquence around it because they exercise all the time versus the others who just stay in the back and tune out. Yeah.

One of the things I have to say is the worst thing we can do is almost have a rotating, and this would be specific to your stretch and flex. I almost have a rotating stretch leader because there are so many folks that, A, hate being in front of people. It is their nightmare. And B, don’t know movement at all. Don’t care about it. Don’t think it’s important. So, if you throw someone in that situation, guess how that stretch and flex is going to go? It’s going to go pretty bad. And if you do enough of those, no one’s paying attention. So why don’t we find our advocates? Why don’t we find our champions for movement? You know them. You see them out there on the warehouse floor, the ones that are jacked and in the gym every day. And that’s what they love. So why not ask if they’ll be that person and have them bring in other people who would also be interested in doing that? Because they know it, they care about it, they think it’s important. And other people feed off of that, I believe. I think that’s true. So, I think if that’s what you’re asking for, the leader of warming up, that thing, get your champions.

For the leaders in the organization, this is where it gets a little difficult because you can have the, let’s just call the executives, they’re all in. They think it’s super important. They look at their manual laborers as their athletes. They look at this: the body is so important. This is great. But then you get a little bit further down, and those people, the foremen or the superintendent or whoever, they have a job to get done. And they’re just looking at like, hey, we got to get up to the seventh floor today. And if we don’t do it, we’re going to have these problems. So, they don’t necessarily see it. So, you really have to put some energy into winning them over. It helps when you have it coming from the executives, and the executives say, Unfortunately, some of the people are just to be told, this is important. You got to do it. I don’t care how you feel about it. I don’t care if you think seven minutes at the beginning of the day, seven minutes after lunch or four minutes after lunch is going to just ruin your whole week or your month or your project.

I don’t care what you think. We’re doing this. I don’t like that approach. But at the end of the day, that’s how it has to be: we got to get these people that are in front of our manual laborers, our craft, our athletes. They’ve got to buy in. They can’t stand by the side and be like, Okay, fine, do it, and look at their watch the entire time because that’s not going to be a winning combination for sure.

They’ve got to take part. They’ve got to show it matters to them.

They do. Even if they have to pretend, and if I have that opportunity to talk to someone who I know isn’t totally into it, I’ll be like, you know what? Just give it this. Give it this moment. Give it this time, this every day, because your guys are actually going to feel better for it, and they’re going to know that you care about them. If you can put it that way, maybe even two, that I think is helpful.

I love the message you were sharing about this. It is also about being able to lift your three-year-old child and link it to something personal. It’s not just about work, because I think that element also is very important. I know a lot of the branding around industrial athletes also helps because every athlete stretches. But even then, it doesn’t always become simple to explain.

Well, so yeah, and that’s it, too. Really going off on the athlete idea, again, are we, anyone, you talk to anyone, and they know, you look at a professional athlete, you know that the inputs into their body, whether it’s diet, like food, or whether it’s exercise, movement, whether it’s recovery, you know that those folks are doing that because they have a team of people helping them, and they know it’s important. But then you, let’s just say I’m the person out in the warehouse, and I’m lifting stuff all day long. Maybe I don’t think of myself as an athlete, even though I’m doing a ton of movement. I have no off-season. I’m moving all of the time, all of the days. But I don’t think of myself as an athlete. If someone came to me and told me, hey, you move like an athlete. Yeah, it’s not exactly the same. You’re definitely not getting paid like one. But you don’t have a team of people around you to help you with this, but you know what? The inputs going in will help you create that maximum output for work, but also, again, that movement that you want outside of work.

So, let’s do this moment and let’s talk about how stretching and movement prep before work is important. Let’s talk about how the things that you eat and consume are very important to you. But let’s also talk about that recovery, whether that means you get to sleep at night, if you can, depending on your world and your life, if you can even Again, also at night, taking those moments to do some of those movements, those stretches, those things. This is what athletes just… Their world. This is their world. Their body is their world. It just makes so much sense to think about a person who’s moving their body for their living, for their organization, for their team to win or to produce. That’s an athlete. So, let’s start thinking about ourselves if we’re in that situation or our manual labor as our athletes, and let’s take care of them as best we can. Of course, we cannot give them the ice baths and the saunas and the like. It’s a beautiful idea. I understand that that’s not going to happen anytime soon. But if we can give them the idea that there are things they can do for themselves and help them in the ways that our company, to whatever degree that is, that’s where we need to move our culture.

Because if we don’t, we’re going to be running into a problem we’re not going to have. We’re going to have such a shortage. We already have a shortage now, right? We’re going to have more and more of a shortage of individuals who will be able to do this. Then that means that our workers that are doing it are going to be older. That leads to even more problems when it comes to sprains, sprains, and beyond that because those injuries are going to be worse, and they’re going to keep people out longer. It can go down a bad path that we don’t want to.

Yes, for sure. I know when we first connected, you touched on a topic that I thought was quite interesting: power gaps and the links back to athletes. Tell me a little bit more, because that’s another frame that we need to reframe.

Yeah. And again, our perfect world versus what will be anytime soon. But okay, in all my research on athletes, because I’ve researched athletes, I looked into what the schedule is like. How much time are they spending with their warmups? How much time are they… I’m really looking at this because I want to have some thoughtfulness in how I speak about this and how I think about it. And so, time and time again, I don’t care if we’re talking about basketball players or professional runners. They They are taking naps. They are taking naps in the day. They’re getting so much recovery. And that nap might be in addition to the time they’ve spent on the table with an athletic trainer or a massage therapist or anything like that. So my thought is if you have the opportunity, the space, the time. Here’s an example. Oftentimes on construction sites, a construction worker has the ability to go to their car at lunch. Okay. Sure. So, let’s say they go to their car at lunch, they have a quick bite, or they take 10 minutes at the beginning of their lunch, and they take a quick nap.

Then they have a bite, and then they go back on the job. Then, they do their warmup before they get back on the job. Because the thought is here you are exhausted from the five and a half hours of sleep you got the night before, and you woke up at 4:00 in the morning to get to work again. That’s just saying that that was, on average, what you’re getting. It wasn’t even interrupted by the dog or the kiddos or by you waking up just randomly. We’re not starting off at a good spot anyway. You’re exhausted, and what you’re going to do is you’re just going to continue to drink caffeine all day long. And then by three o’clock, you’re like, I got to drive home, so I got to have another cup of coffee or a Coca-Cola at worst. You’re going to have 39 grams of sugar and caffeine. And then at 9:30, when you should be going to bed, you can’t because you’re exhausted and jacked up on caffeine. So, it’s a repetitive motion. So how do we say, hey, have that cup of coffee in the morning? And then at 10:00, if you have that break or that lunch or whatever it is, take 10 minutes of that moment and just rest, close your eyes, close your eyes, see if you sleep.

Set that alarm so you wake up. And my hope is, and my thought is, that just a power net brings you back and gives you that boost of energy that you need way more than another cup of coffee would. But then you pair that with that movement right after you’ve gotten out of that. And that’s what really will help boost the energy, as opposed to just having you walk back into the job site like a zombie. So again, I don’t know how often this is going to be available to people or if this is just totally a pipe dream, and depending on the industry that you’re In, this is my main goal. We could actually have a conversation where someone wouldn’t glance at someone that’s a manual labor, sleeping. They wouldn’t be like, oh, lazy. Actually, oh, that’s good. They’re getting the rest that they need to pop back out there and actually be energetic for the rest of the day.

In all it takes, I was reading the other day is 10 minutes. It’s not an hour nap. It’s not a siesta for 2 hours. No. It’s 10 minutes.

Yeah. It really is a 10-minute window where, again, even if it’s just breathing, closed eyes, breathing. But I can’t tell you what’s the worst. The thing that we do instead is we’ve got our Monster Energy Drink and our telephone, and we’re in the worst slouched, awful position. Our neck is cranked over our phone, and we’re watching that for 15 minutes. Oh, my gosh. You can’t tell me you come back from that feeling better than you would if you just put everything down and closed your eyes for 10 minutes. And that’s, unfortunately, a habit that also it’d be hard not only from the executive and upper-level people to say, hey, naps would be good, but also from the employee and the job site athlete person to say, put your phone down, because they can’t look at their phone all day long. So they probably want that moment to be like, I want to relax. And that’s probably what they’re saying. But it’s not relaxing to watch whatever you’re watching in a bad position. You’re not giving your mind a break. That’s going to come from all sides to try to change that idea, too.

There’s a pro as well for the executive. It creates more alertness. It’s much better than caffeine. There’s no withdrawal system, no withdrawal from sugar or anything like that after, but it’s just 10 minutes.

That’s the idea.

Excellent. Kelly, thank you so much for joining us today. Somebody wants to get in touch with you. What’s the best way to do that?

You can go to We are on Instagram and LinkedIn at Prevention Plus. It’s P-R-O-V-E-N-T-I-O-N, not prevention, prevention. Gosh, what I love about what we’re doing on Instagram is we’re sending out morning movements and ideas throughout the day about movement. I would suggest if you guys have a question about something that’s going on with you individually or something that’s happening on the job site, send a message. I’d love to get the input because we’re constantly trying to keep up with all of the movements that are happening and all of the things that need to be addressed through movement and movement prep. So please reach out. We’d love to hear from you.

Thank you so much, Kelly.

You’re so welcome. Thank you.

Thank you for listening to the Safety Guru on C-Suite Radio. Leave a legacy. Distinguish yourself from the pack. Grow your success. Capture the hearts and minds of your teams. Elevate your safety. Like every successful athlete, top leaders continuously invest in their safety leadership with an expert coach to boost safety performance. Begin your journey at Come back in two weeks for the next episode with your host, Eric Michrowski. This podcast is powered by Propulo Consulting.

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Kelly Lynch Feldkamp is the Founder of ProVention Plus, an onsite injury prevention company that is changing the way companies take care of their manual labor or craft employees. Kelly has a Master’s Degree in Exercise and Wellness and is the creator of the Move Better Program used by thousands of Jobsite Athletes over the last 20 years. Kelly has a passion for helping our Jobsite Athletes reduce the discomfort that many believe is an unfortunate but necessary part of the profession. 

Kelly and her team at ProVention Plus have been blessed to work with those who are most in need of injury prevention care but are also the least likely to seek it out for themselves. The evolving conversation around how we care for the Jobsite Athlete is a welcomed change for Kelly. She is playing an active role in moving the industry toward a place where pain is not an unfortunate by-product for the Jobsite Athletes who build the world we all enjoy.

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Vision 2024: Shaping the Future of Safety Culture & Leadership with Dr. Josh Williams

Vision 2024 Shaping the Future of Safety Culture and Leadership



We encourage you to join us for another engaging conversation with Dr. Josh Williams, a seasoned safety culture expert for over 25 years and partner at Propulo Consulting. Josh highlights five key, big-picture safety themes for 2024: structured governance and executive commitment, SIF prevention, human performance, why observations still matter, and attitudes, beliefs, and mindsets. You’re sure to gain indispensable insight as Josh provides a clear vision for successfully shaping the future of your organization’s safety culture and safety leadership this year!


Real leaders leave a legacy. They capture the hearts and minds of their teams. Their origin story puts the safety and well-being of their people first. Great companies ubiquitously have safe yet productive operations. For those companies, safety is an investment, not a cost, for the C-suite. It’s a real topic of daily focus. This is The Safety Guru with your host, Eric Michrowski, a globally recognized ops and safety guru, public speaker, and author. Are you ready to leave a safety legacy? Your legacy success story begins now. 

Happy New Year, and welcome to The Safety Guru. Today, we have a very special episode. It’s hard to believe how 2023 flew, but we have Dr. Josh Williams with me, joining me for a conversation on Vision 2024 some key ideas to shape the future of safety, culture, and leadership. So, as you’re exploring some topics to level up your strategy for 2024, we’re going to introduce five core themes. Josh, welcome to the show. Why don’t you give a quick introduction to yourself? This is not the first time you’ve been on the podcast.

Thank you, Eric. I appreciate doing this again. We always have fun doing these things, and I’ve been doing this safety culture and safety efforts for 25-plus years. I got a PhD years ago with a guy named Scott Galler, who is one of the foundational folks in the safety culture and behavioral safety space. I’ve been lucky enough to be with Propulo for five-plus years here and like doing these podcasts. This should be fun.

Okay. Well, the five topics we’re going to touch on today are work structure, governance executive commitment, and ideas around how you can level that up. We’re going to touch on CIF prevention. We’re going to talk about human performance. We’re going to talk about why observations still matter and how to level those up and then close off with attitude, beliefs, and mindset. Quite a few areas and themes, big picture ideas to look at for 2024. First, let’s touch on organizational structure, governance, and executive commitment. I think this is an area where a lot of organizations have huge potential opportunities. What does it mean? It’s one. Where does the safety report go? How do we make sure that safety has the attention of the right levels of executives, ideally reporting to the C-suite? That’s number one. Really making sure that safety is visible. We’ve seen too many organizations where safety is layered into the business or… We’re spread out across different functional areas, which simply doesn’t work. The second is really around governance and the importance of executives and how executives weigh in on safety. At the end of the day, employees know if the executives aren’t talking about safety on a regular basis, they can’t hide it.

We were doing some work in one organization. The executive team was not having a daily, weekly, or monthly conversation around safety. Frontline team members said that. They said senior executives don’t care. They saw it because they weren’t seeing the executives day in and day out in the field interacting with them. It does matter. So, four things to look at when you’re looking at the role of governance and executives is one, are they setting a vision? Are they motivating people around safety across different levels? Are they really looking at clear governance around safety, really trying to build a learning organization? The second one is are they showing personal commitment and role modeling safety? Are they really spending time in the field, visibly felt, role modeling safety, and really explaining the balance between safety and production? These are really key elements. We’re going to touch on something about listening to her soon. Decision-making is, are they looking at safety on a regular basis? Is the CEO and the top management team looking at safety, the safety culture strategy, and adapting it on a regular basis, ideally monthly or every second month? Are they talking about safety performance? But also, the strategy is to drive improvements.  

So, key areas to focus on. And then, the element of transparency and accountability, are they open to sharing successes and failures? It is a key area, really, in terms of how executives show up for safety. One area that I know, Josh, you talked a lot about is Listening tours. I’ve done this a lot with senior groups, getting them to go spend several days in the field listening, understanding what’s going on, but really there to listen about what are the things that are getting in the way of a perfect day for safety. Seeing some organizations do this they even bring people from different office functions that don’t normally understand their role with safety, people in HR and finance, and having them spend some time in the field. But what’s important is debriefing after. What are the things that you do in your corporate function that impact a perfect day in the field?

I think it’s a larger issue to me, Eric, of leadership and culture and establishing norms of excellence. For me, and I’m a big college football fan, and I’m not a huge Alabama fan necessarily, but you’ve got to respect any of your sports fans out there. What nick Saban has done over the years is not only to get to the top of the mountain top but to stay there for a long time. I was watching a game a couple of years ago, and I took notes, which means I’m pretty nerdy, but I was interested in what he said post-game in the press conference. He was talking about his team’s performance after beating New Mexico State 62-10, and he’s angry, and he’s thumping the podium, and he’s saying we didn’t play to our high standards for most of the game. We didn’t get any better this week compared to what we were last week. That leads to bad habits, which leads to trouble when you’re playing more competitive opponents. He finished with, you’ve got to play to your own high standards every day. I think there’s a lesson learned there in terms of safety leadership, which is we’re playing to our own standard of excellence, and the numbers take care of themselves on the back end.

Do everything right on the front end; things take care of themselves, but you’ve got to be vigilant. You’ve got to be focused on this every day. We’re going to talk about huddles in a minute. We’re going to talk about observations in a minute. Eric just mentioned listening to us is a great way of doing that. We’re staying sharp every day. And one of the things that I think is really important is what’s the scoreboard. So, in this case with Nick Saban, the scoreboard looks terrific, 62-10. But there were some underlying things there that weren’t quite right. And that scoreboard may not be so pretty next time if we don’t clean things up. One of the challenges, I think, is that we get so enamored with these numbers. It’s like our recordable rate went up 6.2 % and went down 3.61 %. I’ll go to a site and watch some of these presentations, and it’s like 12 slides of statistics on injury numbers of various things. I’m like, Good Lord, people are falling asleep. We have to be focused on not killing people. I think it’s high time, and I think we’re starting to get some momentum there.

The issue is stiff potential, serious injury, and fatality potential. We got to be looking at that. That should be our primary focus. Now, the little things matter, too, but sometimes we just go way overboard. The air precursors that predict smaller things are not the same ones that predict these catastrophic events that alter people’s lives forever. Bee stings don’t predict fatalities, you know what I mean? But we got three bee stings last month, and that’s not an exaggeration. That stuff people get dinged for, and we just get too enamored with the numbers. I think one of the things we should consider moving into 2024. There’s been some momentum there, but I think I encourage all of you who are listening to focus on the potential for really bad things to happen. That’s not to be negative. It’s just let’s keep our eye on the prize. Quick example: if you’re getting out of your vehicle and spraying your ankle, then it’s a recordable injury. It’s not the same thing as falling off a scaffolding 20 feet up. It’s a different deal. One thing can really change your life forever. We need to make those distinctions. We need to do things like risk registers with the top three or four things that are really seriously dangerous.

Pay attention to them with near misses. Pay attention to them with incident analysis. Pay attention to them on the front end with listening tours, learning teams, and peer checks. The sift prevention, I think, is really important. We need to keep our eye on the prize in terms of the big picture. Before we transition into talking more about some HP themes, some human performance themes, just a consideration. When we’re looking at this, we need to look at the big picture holistically. When I first started in this industry, it was all about attitudes. We’ve got to change our attitude. And then behavior-based safety comes along, it becomes a commodity that’s bought and sold and all this stuff. It was all behaviors. HP brought in more systems focus, which I think is a good thing. The problem is it’s not one or the other. It’s all of them. We need to focus on improving attitudes, behaviors, and systems so that we can do our best job to decrease the probability of something really bad happening to somebody. So, as we start talking about HP and human performance, one of the good things I think is that it has brought more attention to the system.

One more quick football analogy. I’ll turn it back over to you here in a second, Eric. But I think it’s important to consider the environment you’re in impacts what you’re doing. We all think we’re Clint Eastwood on the Wild West, Monolithic, whatever. We are shaped by our environment more than we realize. For example, Randy Moss, a wide receiver, one of the top five probably in history, was with the Minnesota Vikings years ago. Their culture wasn’t great, and I like the Vikings, but their culture was poor, and he had all kinds of problems on and off the field. He gets traded to the New England Patriots. At the time, the top in the cultural team, whether you like them or not, had their act together like Alabama football. All of a sudden, he’s a modeled citizen. He changes overnight. Maybe he grew up a little bit, but maybe he got into a better system. The same person in a different system operates differently. That’s why when we start talking about human performance and culture change coming up here, we’ve got to be really mindful of what we are doing with our systems to encourage the best behaviors and attitudes out of our people.

One last thing on the CIF prevention side: I think a lot of organizations are starting to look at it, but you need to be obsessed with a lot of the little details. As you said, the predictors are not necessarily high-frequency events. Hopefully, they’re not. But part of it is really understanding the near-miss is really getting a lot of visibility to it. I think when you look at Aviation, in 2010, there were 62,000 near-miss reports for 700,000 commercial flights. That’s what we’re trying to get a lot of potential things and then understanding which ones are going to be important, and then addressing those through the risk register that you talked about.

This episode of The Safety Guru podcast is brought to you by Propulo Consulting, the leading safety and safety culture advisory firm. Whether you are looking to assess your safety culture, develop strategies to level up your safety performance. Introduce human performance capabilities and re-energize your BBS program. Enhance supervisory safety capabilities or introduce unique safety leadership training and talent solutions. Propulo has you covered. Visit us at

You touched quite a bit on systems, HP, and human performance in general. I think the key component is really looking at the system besides the equation. But, like you said, it’s not about just doing HP. A couple of things I think I want to propose on the HP side is that HP is really about culture change. It’s not a thing, it’s not tools, it’s not training. Yes, those things are part of it. But I think that’s where a lot of organizations miss the opportunity on the human performance side, is they think it’s a thing, it’s a training program they need to do, rather than looking at it’s really culture change. And it’s culture change. I would even propose that it’s really the evolution of cultural models that we’ve seen in terms of ownership around citizenship. Some elements where I’m looking at a bigger piece, I’m driving continuous improvement on an ongoing basis, but it’s really about shifting the cultural norms. I think that’s what organizations really need to start looking at in terms of driving change.

Yeah, you know what? And the thing that interests me, and I really, like I said, I am happy to see more emphasis these days on system factors. The first response when somebody gets hurt shouldn’t be, would they do wrong? How did they screw up? The first question should be, where did the system fail? And in some cases, it didn’t. And it’s just a matter of personal accountability and responsibility. But our first instinct should be, was it the time pressure, lack of training, not enough people. There are a million things that are contributing factors when things go wrong, and that’s where our focus should be when these things happen. Let me just talk about a couple of principles of human performance. I think it will advance our dialog here today. But some of the fundamentals are things like workers trigger, late in conditions that already exist in the system. It’s like the stuff in the system is not where it needs to be, and it just so happens that workers may trigger some of those issues. Things line up a certain way, like the VP explosion years ago. It’s like all these little events happened at the same time, then you got that awful explosion.

And again, I like this quote: Safety should not be viewed as the absence of events but rather the presence of solid and consistent defenses against human error. And within this framework, human error is a predictable outcome of human beings operating in flawed environments. Again, we don’t want to take this too far. And sometimes people get into this thing where it’s like there’s never any accountability anywhere. That’s crazy. The nice thing about tightening up your systems is if you’ve got your systems really good and you still have someone operating outside those parameters, whether it’s repeated violations or egregious things, the discipline or punishment associated with it, it’s easier to do when you know you don’t have a ton of system factors contributing to it. So, you don’t want to take it too far and say there’s never any accountability. You’ve got to have positive accountability throughout your organization. But again, we want to try to stay away from that blame when things start to go wrong. And I also want to point out behaviors still matter. And this behavioral safety stuff, look, and I did years of research on this, did years of implementations on this.

I’ve seen some really good things and some not-so-good things, but behaviors matter. The National Safety Council said years ago that 90 % of all injuries are due in part to at-risk behavior or human error, but 80 something % of those risky behaviors are influenced by the system. I think both those percentages are low. I think it’s higher than 90 % of risky behaviors influencing incidents, but I also think it’s higher than 80 % that system factors contribute to these risky actions. But behaviors still matter. We still want to look at it. We want to set up behavioral expectations for leaders, for supervisors, for employees. This is our expectation here. This is what we do, and we’re holding people accountable for those behaviors. So, the challenges with, I guess, with behavioral safety and the way it has become a commodity where you can get all kinds of crazy stuff going on there. The checklist got way too long. They got way too complicated. It became a pencil-whipping, check-the-box exercise. Instead of asking the four or five simple questions, maybe seven or eight, like leadership listening tours. When we’re doing these listening tours, we should be asking things, and this could be part of a behavioral safety process as well.

We could have some associated behaviors. We’ve had great success with organizations that had behavior-based safety programs that were dying or dead, and we revamped them because there are some good benefits there. But in addition to looking at some high-risk behavioral categories, we’ve got things like, what scares you about the job? Where could somebody potentially get hurt? What can I do as a leader to help make your job safer? How would you do this job better moving forward? You’ve been here 25 years. You know the ins and outs and subtlety of this job. What do you want to do? By transitioning it, making it more simple and more conversational, and also advertising improvements when people bring stuff up with these behavioral observations or human performance observations, do something with it. Make changes, make improvements, and advertise it. All of a sudden, you’ve got more discretionary effort from your folks because they see stuff’s getting done. So, we’ve got to be really mindful, I think, when we’re talking about human performance and system factors that we look at it holistically. We’re also looking at attitudes. We’re also looking at behaviors because they still matter.

I think a couple of things as well on the observation side I would add. So, I agree with simplification. The other part is building this into your operating system with huddles. It’s a weekly huddle where, maybe even once or twice a week, you’re reviewing themes, you’re directing to particular risks that you want people to look out for. And you have those cascading across the organization to senior levels to really bring life to changes and what’s happening. It’s not about the checklist. One organization I’ve been working with, the huddles became something where they directed focus to key areas, which is really good. When you said direct to something, you could see a 300 % increase on the weeks where they said, look at this particular risk. And then you’d see the risk was high, and then it would decrease. So, they’re going after risks one at a time, week by week, looking, I think, across the system to see if those teams are happening in more than one location to make sure we’re addressing it. The other part is making sure that in those observations, yes, we’re looking at the behaviors, but we’re also looking at some of the system factors, some of the hazards that are present, the controls that are in place, because that can also inform some of the elements on the CIF prevention side as you’re going out, you’re looking at behaviors, but you’re also looking at system factors as you’re there.

Yeah, and what I like about that, too, Eric, and I’m glad you mentioned melding them together because we should be… That old expression, it’s not an observation without a conversation. We want to ask people what’s going on here. We’re learning through these conversations about what’s happening out there, and we can make adjustments and improvements, tighten up the systems, and become a more high-reliability organization by getting and using that feedback from folks in a more, again, holistic way.

And closing the loop, like you said before, is really, really critical. Observations matter, but the way they’re done in many organizations, system-focused from an IT standpoint, is not the way to do it. I think we’ve got to really make sure there are conversations flowing up and down the organization so that the change can be rapid. I’ve seen it in several organizations where we do it with huddles. Very rapid change happens because people are escalating issues all the way to a VP and fixing them. The last piece I think is really important to look at is attitude, beliefs, and mindset still matter. At the end of the day, I go back to my days when I was in aviation. The degree of safety ownership that people were taking was not coincidental. People felt responsible for 200 300 lives on a particular plane. And so, there was a very strong degree of ownership. A lot of organizations talk about hearts and minds. That comes through training. You can get people to reflect, like, why do I stay safe? Who do I stay safe for? And then really to influence from leaders, which is a higher order skill that you want your supervisors and your leaders to continuously reinforce and influence why you stay safe so you’re making the right choice that influences your behaviors.

Obviously, as you said, the system impacts it as well. But you really want people to start putting more ownership around and really reflecting and getting awareness around where is it that as a human, I’m more likely to make a mistake? If I’m fatigued, if I’m distracted, I have the awareness and tools to deal with it. But it also gets into how I design my work environment, the job, and how I create professional orientation. If you look at pilots as an example, there’s a lot that goes into the uniform to the stripes that goes in. It’s really about creating a strong professional orientation as you graduate. Really key. But you got to blend it with focus on observations. You got to blend on focus on behaviors and also on system factors. And I just want one thing, we didn’t talk about this earlier, but I think I want to jump in with recognition just for a moment because the attitude piece, they can shift, they can be influenced if we’re doing the right things and treating people right, and I think one of the best ways of doing that is appreciating the good things that we’re seeing. I think a lot of the frustration sometimes you’ve got people 20, 30 years asking, When’s the last time someone thanked you for something safety related. They laugh. It’s been 20 years. Recognition works. It influences future actions. If I’m being appreciated for something, I feel good at the moment, but I’m more likely to do it next time when nobody’s looking and it’s free. It doesn’t cost money. It takes time, but it doesn’t cost money. I think just wanted to throw that out there in terms of the attitude and mindsets, belief systems. We can influence that stuff by treating people right. Recognition, I think, is underappreciated. We should be doing it more often.

Thank you, Josh. To all our listeners, Happy New Year and Happy 2024. Hopefully, this gave you a couple of ideas in terms of how to level up your strategy for 2024.

Thanks, everybody. Thank you.

For listening to The Safety Guru on C-suite Radio. Leave a legacy. Distinguish yourself from the past. Grow your success. Capture the hearts and minds of your teams. Elevate your safety. Like every successful athlete, top leaders continuously invest in their safety leadership with an expert coach to boost safety performance. Begin your journey at Come back in two weeks for the next episode with your host, Eric Michrowski. This podcast is powered by Propulo Consulting.

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Dr. Josh Williams is a partner at Propulo Consulting. For more than 25 years, Josh has partnered with clients around the world to improve safety culture and prevent SIFs. Dr. Williams earned his Ph.D. in Industrial/Organizational Psychology at Virginia Tech and is a behavioral safety, human performance, and safety culture improvement expert. Josh is the author of Keeping People Safe: The Human Dynamics of Injury Prevention and co-editor of Keys to Behavior-Based Safety. He has published more than 150 book chapters, government reports, white papers, blogs, and articles in leading journals. Josh has also delivered hundreds of presentations at leading national conferences and is a highly regarded public speaker. He received the Cambridge Center National First Prize for his research on behavioral safety feedback.




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