How to Reduce Incidents When Stress is a Root Cause

In the course of investigating adverse events, we often find human error to be an important contributor. Many people misdiagnose human error as the root cause of problems, but this is a big mistake. Why? Because we can’t do anything about the error once it’s happened. You can’t put the toothpaste back into the tube. Instead, once we identify an error, we investigate further so we can understand the error precursors. In this sense, the investigation doesn’t end with the error – it starts with it.

How does this relate to stress? Stress is often found to be an underlying cause of workplace mistakes. But stress alone doesn’t automatically result in errors. In many cases, stress increases the likelihood that an error will be made. Likewise, someone who is relatively stress-free won’t necessarily be mistake-free, but they will be less likely to make mistakes.

“Up to 80% of workplace accidents come from stress or stress-related problems, like being too distracted or tired” says this Recovery Village article and, “65% of workers said that workplace stress had caused difficulties, and more than 10% described these as having major effects” 



So what does stress actually do to the body? And what signs should employers look out for?

“Some behavioral symptoms include anger, irritability, or restlessness, Feeling overwhelmed, unmotivated, or unfocused, difficulty concentrating, struggling to make decisions and being forgetful. Physical symptoms caused by stress include headaches or dizziness, muscle tension or pain, stomach problems including diarrhea and chest pain or a faster heartbeat. Employees should lookout for any of the behavior or physical symptoms listed above. Some people thrive on stress and may find it difficult to see that what they’re experiencing is actually unhealthy. Keep an eye out for your colleagues. If any of them seem to be exhibiting any of the behaviors listed above, a quick chat with them may help to establish that they are in need of some support.” says Consultant Psychiatrist, Dr Raheel Karim.

Not all stress is equal. A certain amount of stress might actually boost accuracy and productivity. The name for this kind of stress is “eustress.” For instance, if a person who normally does not speak publicly accepts an assignment to create and deliver a one-hour presentation to a group of professionals, they might experience a degree of anxiety over the project. The fear of failure in front of their peers might actually motivate them to spend extra time preparing, practicing, and soliciting feedback. And when the time came to deliver the speech, even if it wasn’t perfect, they pulled it off. The eustress associated with taking a risk by committing to something new and/or outside of their comfort zone actually helped them succeed. The relief and feeling of accomplishment may actually spur them towards taking on new risks in the future.



But too much stress is detrimental. For example, an electrician accidentally cut into a live high-voltage power cable while working in an underground vault. The resulting electrical arc could have killed him and possibly one of his coworkers. In a stroke of terrific luck, he wasn’t injured. In investigating the causes of the incident, it was found that the day before, his young son had received a devastating medical diagnosis. Did this cause him to commit the error? No, not on its own – however it certainly contributed to the error. One of the lessons learned as a result of the incident was to create a safe environment where workers can disclose that they are experiencing a high level of stress and therefore should not take on high-risk work. To be sure, changes like this don’t happen overnight. Even though the pre-job risk assessment was amended, the larger challenge was to change the culture to recognize stressful times as a fundamental part of being human that everyone experiences rather than as signs of personal weakness.



In another example, a program that manufactures sensitive electronic satellite components had experienced several instances of “dropped hardware.” These are events where the components are dropped while work is being performed or while they are being transported from one area to another. In examining why the hardware was being dropped, one supervisor shared that everyone was exhausted from working overtime. The project was behind schedule and there always seemed to be more work. This supervisor said that he had to pull over on the side of the road on the way home because he was concerned he might fall asleep while driving. He said the extra money made was fantastic, but that the duration was starting to weigh on everyone. And the repeated events made people nervous that it might happen to them next. This constant high level of stress increased the risk of a dropped hardware event. The manufacturer had held off on hiring additional staff in an effort to hold costs down and also because the sensitive nature of the work meant that the qualified labor pool was relatively small. It was a vicious cycle.



However, leaders can help solve stress-related problems in a few different ways:
Create a culture where periodic stress is recognized and accepted as a normal part of being human. There should be no stigma associated with stress. A supportive culture that allows employees to recognize and accept stress will make it less likely for them to hide it. Accepting stress as “normal” doesn’t mean that we accept that we will always be under excessive amounts of stress.  It means that we accept that stress, like getting the flu or the common cold, is part of being human. And sometimes we can’t just “power through it” – we need to take action to make sure the stress isn’t increasing risk to ourselves, our coworkers, or our projects. Mental health is just as important as physical health.  We wouldn’t expect a worker with a severely sprained ankle to move a stack of heavy boxes. Therefore, we shouldn’t expect a worker who is under an extreme level of mental stress to perform risky work when we know it could increase the risk of mistakes.
 
Include stress levels in pre-job risk assessments. Stress is a risk factor that should be considered before the job begins.  If the potential outcome of a job site failure includes death, serious injury, or significant risk to the job/project/product, then be sure to include a mental health check as part of the risk assessment.  Be supportive when a team member says “guys, I don’t think I’m up to this today.”  By doing so, they may have just saved their life or the lives of their team members.
 
Bring stress management into the “buddy system.” Many companies set the expectation that we should help each other stay safe and work together to keep from making critical mistakes.  Expand this to include stress. Check-in with your coworkers periodically.  “Hey man, how are you today? Everything okay?” And don’t be afraid to disclose if you are feeling excessive stress yourself.  This is more than just a “group hug.” It’s a serious, important, and professional action taken to recognize and minimize risk.
 
Encourage healthy risk-taking – but only when the risk won’t hurt or kill anyone!  A certain amount of risk-taking may be beneficial. Encouraging people to get out of their comfort zone and expand their boundaries may be stress-inducing in the short-term.  But it may also condition them to perform better under stress later on.  Of course, not everyone responds to stress the same way. What might be a healthy amount of stress for one person may actually be unbearable for another!

Solving stress-related problems is a three-part process:

1. Identify stress. People have to disclose when they are experiencing stress. You can’t fix what you can’t define.
2. Investigate the causes of the stress. What are the sources of stress? How do these sources result in stress?
3. Identify solutions that alleviate stress.  A person may not have control over every stress-inducing cause, but they will likely have control over some of them. Find ways of engineering the stress out of the job. And if this isn’t possible, find ways of limiting the downside impact of errors and mistakes.

1. Take regular breaks - breaks are there for a reason - we all need to take the time to step back from work, eat something, have a cup of tea, and return refreshed. Breaks make us more productive and give us a chance to recover.
2. Eat for health - You are what you eat! Eating a balanced meal of carbohydrates, protein plus fruit or vegetables will give your body the energy and nutrients it needs. It can be easy to turn the wrong foods and snacks when stressed, but this will just end up leaving your body in worse shape.
3. Learn to say ‘no’ - Push back on unmanageable tasks. This doesn’t mean you aren’t a team player – it means you recognize that by taking on too much you are putting the team goals at risk. It is okay to let your boss know if you cannot take on additional work. Suggest a meeting to discuss the workload so you’re not struggling on your own.
4. Don’t take your work home with you - Easier said than done in the current environment when many of us are working from home. However, if you’re feeling stressed, make sure you leave your work at your desk. It can be easy to pop back onto your computer during the course of an evening when you suddenly remember something, but try to keep your evenings for yourself and your family.
5. Talk to your boss and coworkers regularly - It is more important than ever to communicate with those around you, especially if you feel stressed or are struggling.

1. Identifying the signs of stress
2. Getting plenty of sleep and exercise
3. Practicing relaxation skills
4. Setting goals and establishing priorities
5. Spending time with people you love

In Summary:
Stress is a common cause of many adverse events in that it increases the risk of mistakes, which can result in serious problems. Recognizing and managing high stress levels in the moment will help prevent stress-induced problems. This requires a cultural shift to recognize that stress is normal and that controlling stress needs to be included in our formal risk management efforts. But best of all is to proactively eliminate the root causes of stress at their source before they take hold.