Breakthrough Change Case Study Series

What does it take for organizations to make large improvements in health and safety?

Past research has identified the characteristics distinguishing workplaces that do well in injury and disability prevention from those that don't. But not much is known about how low performers in health and safety become good performers.

Each of the four case studies in the Breakthrough Change in OHS series tells the story of an Ontario organization that achieved firm-level, sustained improvement in health and safety performance. Each illustrates the factors critical to making large improvement in health and safety, based on an evidence-based model of breakthrough change developed through Institute for Work & Health research.

Grocery Store BTC capsule cover

Grocery Store

A large retailer was paying little attention to workplace health and safety until its owner became anxious about the safety of the young people he employed, spurring him to spend time and money on OHS and leading to an impressive tale of ‘breakthrough change.

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Group Home BTC capsule cover

Group Home

Occupational health and safety was simply not on the radar of a social services agency—until its eyes were opened to the fact that improving OHS outcomes dovetailed with its pursuit of excellence, setting the agency on its admirable path of ‘breakthrough change.’

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Metal Parts BTC capsule cover

Metal Manufacturer

A metal manufacturer went from failing a government agency health and safety audit to creating an environment in which workers are empowered to raise safety concerns, knowing they’ll be acted on quickly—all part of its remarkable trajectory of ‘breakthrough change.’

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Plastics BTC capsule cover

Plastics Manufacturer

A production-first way of working at a plastics manufacturer gave way to a safer work environment after management responded to industry requirements for safety and quality, leading to its inspiring story of ‘breakthrough change.’

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Breakthrough Change Model

BTC Model diagram

The Breakthrough Change model illustrates the critical factors to large and sustained change experienced by the four case study firms.

Although the details differ, companies that go from being not-so-good to very good OHS performers tend to follow a similar path, as shown in the model on the right.

The change occurs in three phases: initiation, transformation and outcome.

Initiation

Breakthrough change begins with some kind of external influence acting on the organization, ranging from a Ministry of Labour order to a demand from a key buyer for improved OHS.

Whatever the source, this influence brings three things into play within the company: organizational motivation to do better at OHS, an influx of new OHS knowledge previously unknown to the organization (e.g. from a health and safety consult-ant or through the hiring of a new OHS specialist) and the integration of that new knowledge into policy and practice through the work of a knowledge transformation leader.

This leader—the OHS coordinator, human resources manager, owner or some other person inside the workplace—tends to be a ‘people person’ who is persistent, competent, trusted and organized.

Transformation

The organization’s OHS performance starts to improve because of five key elements. (1) The organization responds to OHS concerns (organizational responsiveness) and the workforce takes note, resulting in its increased participation in health and safety. (2) An energy develops within the workplace (positive social dynamics) involving management-worker collaboration, worker empowerment and individual passion for health and safety. This energy may be especially evident in a reinvigorated joint health and safety committee. (3) The workplace develops a continuous improvement pattern, in which improvements in OHS continue despite what has already been achieved. (4) At the same time, the organization makes improvements in areas other than OHS that also lower risk (simultaneous operational improvement)—e.g. engaging in lean, quality and organizational excellence initiatives. (5) Finally, there is a positive working environment (supportive internal context) characterized by good management-worker relations, low turnover, good communications and a supportive senior management team that allows both time and money to be spent on OHS initiatives.

Outcome

The organization reaps the rewards of its change efforts. What was once new OHS knowledge becomes integrated OHS knowledge. New OHS policies and procedures are in place. OHS training is ongoing. Both managers and front-line staff engage in new OHS practices, such as communicating regularly about OHS, and identifying, assessing and controlling hazards. And people at all levels of the organization are held responsible and accountable for health and safety. This results in decreased OHS risk, which in leads to decreased injury and illness related to work.

The organization reaps the rewards of its change efforts. What was once new OHS knowledge becomes integrated OHS knowledge. New OHS policies and procedures are in place. OHS training is ongoing. Both managers and front-line staff engage in new OHS practices, such as communicating regularly about OHS, and identifying, assessing and controlling hazards. And people at all levels of the organization are held responsible and accountable for health and safety. This results in decreased OHS risk, which in turn leads to decreased injury and illness related to work.

About the breakthrough change study

Past research has identified the characteristics of firms that perform poorly or well with respect to work-related injury and illness prevention, but it hasn’t shown what it takes to go from one to the other. This study, led by Dr. Lynda Robson, a scientist at the Institute for Work & Health, aimed to help fill that gap. Robson and her team defined ‘breakthrough change’ (BTC) as large, intentional, firm-level improvement in the prevention of injury or illness. To find BTC firms, the team used records from Ontario’s Workplace Safety and Insurance Board (WSIB) to identify organizations that, in just 10 years, went from being among the 50 per cent in their sector with the highest claims rates to among the 20 per cent in their sector with the lowest claims rates. The improvements had to be sustained for at least three years and not result from restructuring, claims management or by chance. Health and safety consultants from Workplace Safety & Prevention Services and Public Services Health & Safety Association then approached the BTC firms and, ultimately, four agreed to take part as case studies. For each case study, the research team interviewed 10 people in various roles, as well as collected additional information such as WSIB claims records, Ministry of Labour enforcement records, joint health and safety committee minutes and other OHS-related documents.

You can read the full results of this study in the July 2016 issue of Safety Science (doi: org/10.1016/j.ssci.2016.02.023).