The 3M’s: meaningful, manageable, manual tasks – managing the risks of musculoskeletal disorders (Dr Sara Pazell)

Chris Bombolas: Hello everyone. I'm Chris Bombolas. I'm your MC for today.

On behalf of Workplace Health and Safety Queensland, welcome to our Work Well presentation.

Can I firstly begin by acknowledging the Traditional Owners or Custodians of the land on which we meet today and pay my respects to their Elders past, present, and emerging. I'd like to extend that respect to Aboriginal and Torres Strait Islander peoples watching today.

Just a little bit of housekeeping. If you are having any technical problems, please make sure the sound on your computer is turned on and try refreshing your browser. If that doesn't work, contact us via the Q&A chat box on the right of your screen. You can also make this presentation full screen by selecting the four small arrows next to the volume bar at the bottom of your screen.

I'm delighted to introduce you to today's special speaker, Dr Sara Pazell. Sara is the managing director and principal work design strategist for a human factors and ergonomics consultancy practice, ViVA Health at Work. Sara is affiliated with five Australian universities, including an Industry Fellow position within the Sustainable Minerals Institute at the University of Queensland.

Sara's presentation today will focus on how a manual task risk management program is a central part of good work design. You'll learn the three M's, the meaning of the worker experiences, how to interpret the findings so that work can be manageable, and an action plan to design better manual tasks.

If you have any questions for Sara today, please type them into the Q&A chat box on the right of your screen at any time, and we'll get to them at the end of Sara's presentation. It's time now to welcome in, Sara. G'day.

Dr Sara Pazell: Hi. Thanks, Chris. I am really excited to present this, the three M's, meaningful, manageable, manual tasks and an integrated risk management approach through a work design lens. Now, I appreciate you've done the acknowledgement of country. I am speaking today from the Sunshine Coast, so I just wanna also pay attention and acknowledge the home of the Kabi and the Jinibara peoples, the Traditional Custodians here whose lands and waters we all now share. So thank you for that, Chris.

I'm gonna start today first with a poll, a poll to the audience, and I'll read this. There is a QR code and a hyperlink that you can use to respond to this. The question for everybody today, and we'll review this answer in a moment, but the question is, how do you manage manual task and psychosocial risk programs in your organisation? You can select more than one answer, and the options are that these are either separate programs. These are deeply embedded in well integrated task-based human performance, good work design approaches. That's pretty loaded. That's a big one. <laugh> uh, we use outside hired consultants to audit our hazards loosely. It's not well structured or organised. We manage one program well, or not the other, uncertain or none of the above.

So take a moment to really digest this, to think about this. Please be honest. We want some high fidelity authentic responses to understand a little bit more about the landscape of what people experience and how things are being truly managed. You won't be identified in your responses, so we'll have a chance to reflect on that in a few moments. But first, I really wanna take you on a new horizon in a completely different direction when we talk about meaningful and manageable manual tasks instead of a conventional risk management program or prevention based thinking, which is important.

But I'd also like to take you on this tangent to think about invention, right? An integrated work design approach that appreciates the whole of the person as they perform the whole of their work within a dynamic system. And you'll hear me use this phrase that there are adaptive systems that in an adaptive system, and there are emergent properties, and we'll talk a little bit about that because things are variable.

Things change. The nature of work changes and the human experience and their welfare, their state, their health, their wellbeing changes in those types of systems. So we're gonna continuously chat about design strategy and the fact that design itself needs to continuously be adopted to, to observe, regulate, and redesign when new circumstances arise. So what are we talking about today?

And while we're talking about the three M's, meaningful, manageable manual tests, and we will talk about service design partners, which is a new term, a new phrase that I'm using today. I'm keen on some of your reflections and your thoughts. We'll talk about design discovery tools that are used conventionally in design circles and in human factors. And then I'll talk a little bit more about the injury, causation of the biomechanics. I'd like to also propose something that I'm working on in a paper about temporal enduring design strategies, design strategy that will make a big impact and provide you all with an aspirational statement that is evolving in my work and, uh, what I share with businesses also. So let's talk a little bit about the people.

What's a day in the life of our service design partners, right? So listen to the term that I'm using, a design partner and the service that they provide, because if we think conventionally about the term an employee, what is that? It's a person who's hired by another to perform a service, especially for wages or salary, and it's usually under the other person's control or the person conducting a business or undertaking. Uh, that already sounds like that's not too empowering. If we talk about being under somebody else's control and as workers, okay, I, we use those terms, we might have to slog away at our work. And I've even used the term, uh, human asset, and I've referred to this when I talk about a human asset action plan, and the acronym for me spells happy <laugh>.

And I've not tried to use that to think about the utility and the value of humans in a work system. Yet that too seems to pertain to ownership. So if we're even thinking about the tasks, the manual tasks that should be meaningful to people because we value them, then maybe we just start to shift this thinking and refer to the people, our team members as service design partners. That's the term I'll, I'll use today in most of this presentation because we have legislation that says we need to consult people, but we wanna do more than consult. We also wanna engage and involve them to participate in the design of their work. And so they can be architects of superior work design and they can give some very meaningful results.

So it's important to also reflect on what is a designer, and I like to use this term, intentional design and work is the medium of international organisational strategy. You know, our intentional organisational strategy, especially if we're looking at meaningful and manageable tasks that people must do, and we must make decisions about what people do. And if we're making these decisions on somebody's work or their job, what they do, where it occurs, how it happens, we might become accidental designers if we are not using this cogent design strategy.

So I'd like us to start thinking about becoming intentional designers, applying a very disciplined design approach to prop performance. Because if we're looking at the workings of what somebody does, uh, and preparing plans for this work, that's our medium, work is that medium of design, and it involves developing our skill literacy and our capacity for good work design. I'll say that again. Our skill, our literacy, which we're developing today, this understanding, this language, these approaches and our capacity for good work design, which seems to signify the need to have people that know what they're doing to facilitate this process.

Chris Bombolas: Sara, can I just jump in there quickly?

Dr Sara Pazell: Absolutely.

Chris Bombolas: Um, you talk about accidental versus, uh, intentional designer, uh, that were all involved in that process. Uh, can you explain that to me? I, I'm not even sure that I'm an accidental, uh, designer yet. alone an intentional one. So how do we transition? How do we get there?

Dr Sara Pazell: Oh, fantastic. This is exactly what I'll be talking about, Chris, and, and the fact that you are even speaking today and involved in this presentation means you're influencing the design of the presentation. So if I use the most simple example right now, anytime that there is a decision made that impacts on somebody's experience at work, the person who's making that decision, contributing to that decision, I'm gonna frame, I'm gonna challenge and posit that they're a designer, but if they're not aware of it and they're not using cogent design strategy, they might fall into that category of being an accidental versus an intentional designer. Like we hear about intentional leadership. Now, I think we have a chance to have a look at the results of the poll. Are they, are they available to us? Can we have a look at how people responded to that question about how they're managing their manual and, uh, psychological psychosocial risk programs?

I've just gotta look at that large screen. Can you put that, let's see if I can see that large screen.

Chris, I can't see that very well. Can you read out some of that to me?

Chris Bombolas: I can, I can read it out to you. Loosely, not well structured or organised is around, uh, just under 35%. Uh, there are separate programs is around 27.5%. We manage one program well, not the other is around 16%. Uh, we use outside, um, consultants around 7.3%. Same for uncertain. Uh, and then, uh, there are deeply embedded, uh, inter, uh, integrated, uh, task-based is around 6.3% and none of the above, just under a percent.

Dr Sara Pazell: Right? So the number one, repeat number one to me, again.

Chris Bombolas: Not well structured or organised is 34.2%.

Dr Sara Pazell: Not well structured or organised. Okay? So what does that mean to us? Great opportunity. Okay. Really good opportunity this month, <laugh> with all the education that's occurring. Uh, and hopefully we can, uh, then translate that. We need to develop business cases in our organisation so that the C-suite, the executive teams really understand this and can embed this in everything they do. So this is what I'm hoping to influence today. Also, this, this is exciting. I'll be keen to hear from people at the end of the survey.

Chris Bombolas: Mm-hmm.

Dr Sara Pazell: If it's stimulated some new thought. Thank you for that. So when we're talking about human-centered design, and particularly as we were talking about work design, a design aspiration is, you know, can we come, can we play and, and can we stay? Uh, we want a design for diversity so that we can enact inclusivity policies. When people tell me that they have an inclusivity policy, I ask about whether they have a design for diversity and architectural roadmap, a very detailed task-based plan for this. And that's usually when I stump people as they go blank.

And, and in my mind, there's very little value in holding onto detailed policies without enacting these and the design of our daily tasks that are meaningful, because this is what we're engaged in day in and day out is a really great place to start. We wanna know, can we, can we come, can we access this work? Can we remain at work without injury or assault? And then can we thrive at work? Are we involved, engaged, inspired, and is it, is it meaningful to us? Do we value this? Um, and is it designed in ways that we have a voice that we can contribute in effective manner? So that's a design aspiration. An intentional designer will keep that design aspiration to think about these meaningful and manageable tasks.

Now, let's talk a little bit about some case examples. Let's make it real. Make it live. Chris prompts me often to, you know, keep it real. So we, we'll be thinking about case examples and also considering some design discovery tools. So I wanted to select a task that's familiar to all of us, right? We all do laundry at some point. We all have some connection to this routine task of washing, folding, sorting, and organising clothes. And, uh, you know, mine's backed up. I've just been traveling last week, so I've got plenty to do. And who cleans our clothes commercially and at scale though, laundry staff. And this is mostly a female precarious workforce that was older. They must sort, clean, fold, iron, package, linen, clothing, uh, and other items and laundries dry cleaning, established at private residences, for example. Let's just take a look at this.

I like to look at some of the labour stats around this. So, you know, this is from your labour market detail. You know, uh, we've got, again, I said female, a precarious workforce.

They may be casual and part-time and not have secure full-time work. Less than half have full-time secure work and the weekly earnings. And that's, you know, before tax and benefits and, and salary sacrifices are lower than the average in Australia, and it's an older workforce. So we start to understand who are, are we designing for, for whom are we designing?

So you have to do a little bit of research and understand these job cohorts. Then we start to go, okay, let's have a look at a persona, and you typify somebody who may be working in this work. And personas are techniques used to help designers create empathy with users, identify their characteristics. It's a human-centered approach, and to develop knowledge about that person and share a collective frame for decision making. They can humanise some very complex information. So we can take a look at this, this, uh, you know, fictional persona of Irene, the laundry service design partner.

And following those steps, she's an older worker with a lower level of education, trying to secure good work, you know, supporting her children, caring for an aging parent, uh, what are her challenges? She might need recognition, and she might feel invisible being in the back laundry room. She may have difficulty with language literacy and numeracy and balancing her work and family obligations and her own health needs. And if we look at her motivations, there we go. There's employment opportunity with securing regular and full-time work. At the same time needing to juggle prevention of injuries. But more than that, maintaining our health, right? So you start to do this, you can use this also in, in marketing and brand strategy. So you can grab those partners in your team and start to identify this among job cohorts.

So I love looking at, you know, personas and if you're feeling like they're, the stereotype is not where you want to be in your business, well, that's still useful too. You may have several personas related to a job role, and then it prompts you to think, well, how am I gonna design this job to attract more variability? Because in this role, and in many roles, there are skills and, and staffing shortages that must be accounted for. So we really start to challenge and prompt, you know, who have we got now in our business and where do we want to go in the next 5, 10, 20 years?

Then I start to look at case law, right? So here's some recent case law. This is a great source of information, your scientific literature and your case law in Golding versus Sippel and The Laundry Chute. Uh, recently, uh, 6th of August, 2021, Industrial Court of Queensland ordered a sexual harasser to pay $130,000 in damages and more funds for economic loss because of Mrs Golding's experience of being tormented, humiliated, and demeaned for 14 months. Importantly, she was, uh, a migrant, uh, survivor of domestic violence, a single mother and no financial support. And this is important to pull out when boundaries of work are tested by law and what could be affecting this type of workforce. What are we aware of? So we really understand what protections must be in place.

And originally, these damages were closer to, you know, $30,000, uh, for the general damages, et cetera, and, and they were contested and appealed. So this has gone up. So I would implore you look at, look at case law, start to understand why, what could be the worst case scenario, boundaries tested that caused you to think about design improvements. And in this case, you've got a lot of psychosocial, uh, experiences that could cause stress, trauma, depression.

And if we bring this back into what happens when I go out on site, when I go out on site, I like to do a task-based review, right? Human factors is very much about what's the reality of what people do. I look at scientific papers and in scientific papers in the literature, I find studies on laundry workers that tell me that exposure to these type of manual tasks affect shoulders, elbows, small joints of the hands, the back, the legs from standing all day. The laundry workers are exposed to slips, trips, falls, environmental exposures with heat, humidity, dust and noise, biomechanical hazards like chemical or, uh, fungal infections and detergents.

You know, so you start to understand what are people really exposed to? And I ask, I go out, empirical evidence means the observations and the interviews with people, the onsite investigations, and gather information. And in this case, there was aspects like, well, you know, I've heard comments like my low back had a twinge and a sharp pain when I was pulling clothes out from the dryer. It's a very deep industrial dryer. Uh, I've had some stress of late, and my low back pain has been radiating to my inner groin after lifting these laundry bags, uh, a resident pushed a trolley into a staff member and hit them in the abdomen.

So now you start to think about, hang on, this work also involves walking down hallways, having family members in a busy environment, residents, nursing aid staff, that you rely on this upstream downstream kind of effect, and how the, the nursing aid staff actually compile these laundry bags will affect the workers. So there's a chain of responsibility here in the way work has happened and, and managed. And I hurt my lower back after slipping on a container on the floor. So if the space is too small, this is cluttered. Uh, another worker told me they had tenosynovitis, uh, which is like inflammation ex at their extensor, carpal ulnar, ulnaris tendon, which is essentially inflammation on the pinky slide side of the wrist.

And what they have to do, they reach in and out of these deep laundry, uh, baskets and industrial washing and drying machines, they sort laundry into bins and stack this. They have to reach overhead, reach down low, reach sideways, uh, things get tangled. Uh, this is repetitive work involves standing and walking, and they're in a, a hot environment with this machinery. You can see evidence right now is that fan in the background. So anything you see in the environment starts to become part of your design discovery, and then work might be monotonous or overwhelming if you're working in isolation.

So I go in and then do conduct the conventional, uh, risk assessments. And we start to say, okay, so with these exposures in their work, the exertions, the postures, the, the duration of time, what happens at an acute level where you have this moderate risk to the back and the arms, or at the cumulative over time exposures, particularly if you have workers that have been there for a while doing the same job, where it becomes extreme to the back and the arms.

And this is really important. Notably, an assessment should determine the two differences, the acute and cumulative risks to the whole of the body, but also consider the cognitive environmental demands. And that helps guide your action planning of what do you address? You know, it's an inexact, but a very useful science that's determined by what we call a triangulation of data, or you get this from different sources, the video, the photo imagery, the observation, the interviews of workers, the scientific literature, the case law, uh, and notably, it's this is important too.

It's not just about putting sensors on a muscle belly or setting up a video remotely and examining awkwardness of postures with indicators of this. It's so much more than that because you really have to understand the context of work and the experiences at work. So when I think of context, I think, oh, a body does not work in isolation of its mind or its mood or its emotions. So I start to look at cognitive demands too. And you know, there's will, motivation, emotional experiences impacting on the tasks that we do.

We need to make sure these are well regulated so that the work is manageable. The other m in this meaning of work and is it manageable? And the cognitive assessments when we look at baseline data of workers against their job profiles, is that there are demands on sustained attention and concentration that are moderate, and then a lot of tactile, a lot of touch. And there's a cognitive aspect to just organising and planning the work that we do. Now, there were few demands on social interaction, communication, uh, being flexible and adaptive, learning and memory, vision and hearing. Few demands in this case does not necessarily mean that it's great or it's good. It has to be to the just right degree of challenge.

So I just wanna be very cautious when we interpret the data that we find. Few demands, if you are a person who likes social activity, then you want more demands on social activity, right? Similarly, when we look at the psychosocial material and the experience of this, emotional experience, the mind, will, mood and, and body working together again, we have this need that's predominantly significant for the, the need to continually protect oneself from physical safety, which we seems fairly well, uh, established and rational given the description of work we just described.

And the workload management, right? So the volume of work and the workload can vary and fluctuate, and the service needs or demands might increase in times of short staffing, skill shortages. Or interestingly, we find research that talks about the workload demands for laundry during times of communicable disease and concern about infection. Well, that rings true. That was pretty recent. There were a few demands in this case on being involved at work or having some influence and shaping workplace culture, being engaged. The demands on the, uh, method that you employ, your own psychological competencies, your ability to regulate, you know, the mood of others, and the need for recognition and reward.

And I state, again, few demands does not necessarily mean good. It means you need to assess for the workers in that task. Is that right for them? And is that right for who you're recruiting into the workplace? Because if somebody really values having an opinion at work, this might be an avenue for design improvement immediately even involving them.

That process of involving somebody and redesigning those manual tasks can start to address some of these psychosocial hazards of not being involved, not having influence or being isolated. So you engage people, the process as much as the outcome is very, very important.

The other aspect I like to look at is human factors. The demands on people, these knowledge, skills, abilities that people must have to do their job, but also the intra and interpersonal requirements. So how you regulate yourself or how you must relate to others in the relation of your work to be effective. What are the tactics, the things people do, and all the varieties of work, what you do that's prescribed. And what you do is your workarounds, which is a new term I use in Australia, uh, what are the decisions? And the heuristics. The heuristics are like the, you know, those rule of thumb kinds of decisions that you must make in the heat of the moment that's not necessarily prescribed or written out in a protocol, but you're making little decisions all the time. How you do your work, how you organise your work, and the situation awareness or distributed awareness of knowing what's happening with all the machinery too.

And this might include things like for the service design partner, you know, something like, I need to understand and know about chemical and electrical safety. I need to have some knowledge about manual task risk management and identify these hazards like exertion, repetition, awkward postures, my sustained duration, but also how that interacts when I'm feeling isolated. Uh, when my threshold tolerance lowers because my management of work is excessive, I feel, it's my perception. I feel that there are excessive demands that can cause worry, anxiety, stress or depression. When I'm having, you know, difficulty relations at, at home, and that I carry that into my workplace and what decisions I need to make about reporting these hazards, can I trust that they'll be listened to that, uh, something will happen if I report this? Do I feel safe if I'm in a casual or part-time role to convert this and feel like I can, uh, still secure full-time work? So all these interacting risk factors are significant.

Then we think about what's this just right degree, Goldilocks principle, my friend and colleague, Anjum Naweed, a professor, that talks about, we want the need for these, these physical, these emotional, these cognitive psychosocial stressors and the challenges in our job to be met to the just right degree. They are harming us. We want the exposures at work to condition us, the experiences at work, this Goldilocks principle you'll hear, uh, used in human factors terms. So that already starts to set us on a trajectory of thinking about design.

Another design tool that I use is something called an empathy map. You know, I capture what people say, think, do, and feel. And in the design of work, this is a conventional, a thematic analysis of data for the researchers. It's used in design circles, again, to help you empathise. You wanna know what's what matters to you, not what's the matter with you, right? That change in focus.

So let's, let's go back to this laundry case. Some of the things that were said, these are just extracts. Well, my physio taught me how I should be loading and unloading, and the nursing staff often put the wrong items in the wrong bags. It causes me double work. Well, that stimulates design thought for me. If you have a belief, a resilient belief, that your behaviour is going to change all of these exposures, then think again, because we know it's been, been chatted about in regulatory meetings and discussed in scientific literature, that behavioural-based manual handling approaches will not change that risk profile for industrial risk management and work cohorts, right?

So if that's a pervasive idea, then we need to challenge this and think about redesign. There's the impact of what the nursing staff do and how that might shift. And that's an evaluation. It's all the way through the chain of that task. And then you might be looking at what people think, a nursing staff overload the bags, place 'em in the wrong bags. It's difficult for me to untangle washing items. And there are really few power outlets that causes me delays and awkward reaches, right? So there's another design opportunity. How I feel. I feel isolated, challenged when the laundry, uh, is left to me and I'm working alone. And also, there's an overwhelming amount of work to do. So these job demands seem excessive. And here we are thinking about the psychosocial relationship of that work, the, the isolation, the need for psychosocial report, and that insurmountable job demand. So that perception about that.

And then what people do. Well, we know all the tasks that they do, but we also notice that they were, you know, had a fan in the background, or they had, they, one worker had a right elbow neoprene sleeve. Well, that is indicative of a disorder. And one worker regularly saw the chiropractor, but this wasn't yet reported as a hazard. And we go back to the reasons why, we understand this job cohort.

Chris Bombolas: If I can just jump in here, um, I'm just gonna encourage everybody to, uh, if they have a, a question for you, uh, to use the chat box, uh, at the right of the screen. I can see a number of questions already, which is great, and we'll get to them at the end of your presentation. Um, can I just ask here, I'll take an opportunity, question without notice, um, whether people are using personas and empathy maps in their businesses to define job roles of their workers. It's a little bit of a different approach, uh, and I was just curious whether this is, uh, now being used by businesses.

Dr Sara Pazell: I'll look forward to seeing some of those, those results when we conclude. You might, Chris, you might reflect on some of the information that comes up in the chat room for me. Thank you.

Chris Bombolas: I’ve got.

Dr Sara Pazell: The other part of the empathy map.

Chris Bombolas: Yep. No, you go.

Dr Sara Pazell: Is to, yeah. The other part of the empathy map is to talk a little bit about pains and gain. You know, this also starts to frame the design strategy. So some of these pains might be the actual work, like overreaching and the high volume or the few power outlets untangling the laundry, the isolation and fatigue. But then this part is really important, the ability to work with autonomy, your gains, right? We like this and we like creating our own workflow or monitoring our own times and developing some quality relationships, some friendships. The gains are an aspect of work that you wanna prop and support and enhance these features.

So this also leads to design strategies, that's part of resilience engineering with human factors, creating a resilience system so people can stay in these job roles and perform well. Again, that's part of intentional design, is trying to prop this, make sure it happens and there are more opportunities so that work becomes more meaningful. Now, Chris, you were gonna say?

Chris Bombolas: Uh, no, I was just gonna, uh, mention that, um, uh, that poll is continuing.

Uh, the results are still fairly, uh, much the same, loosely not well structured or organised, uh, in how they manage them. Uh, is it around almost 36% now. And, uh, and then these are separate programs at 28%. So we've got around 63%, uh, 64% in that top bracket.

Dr Sara Pazell: Excellent. Let's hope that we can think about how to make those more enduring and integrated in our approaches. I'm keen to hear from others at the end of this. Thank you for that. So if we look at this, go back to the laundry task and think, okay, so what might we do differently? Are there any design strategies? We just start the dream phase, the ideation, the hypothetical, and evaluate with predictive analytics on risk reduction, likely a significant for these cumulative exposures, more than 50% for the, uh, back and the arms. And there is a reduction also for the legs and the shoulders.

Now, uh, this is just the early ideation. Using a robotic folding machine may or may not be an effective strategy. And I also found, uh, an example of robotic arms where there would be cobots, you'd be working side by side, but it requires evaluation. So to evaluate this, you'd certainly need space. You'd need extra powerpoints, you'd need to regulate the heat that's generated in the room. Uh, you'd need some sitting options, some perches for people. You'd have to look at how often they're leaning low and how this is positioned. So you wanna be looking at this for efficiency and effectiveness.

And when you make a change, any change in your business, that's only the beginning. You are ideally a custodian of design. I'll use that Indigenous scene thinking about a Custodian. When you adopt a new practice, a tool, a piece of equipment, you need to sponsor it, you need to use it, test it, look at it in different situations among different people in context of use environments or repair needs, operations, transit, recyclability, the environmental impact. How does its use align with our values?

So I'm throwing a lot at you, but I, I, I want to think about design does not stop with a tick a box of a control strategy. It means we continually evaluate it. In human factor circles, we call that design in use, because too often new technology is adopted and it just becomes a dust collector. And then, so you also must do this, uh, analysis of predictive analytics to evaluate the risk factors and then look at perhaps product analysis and human interface terms and ideas that might be used by your industrial design partners.

For example, with any of this equipment that you adopt or any new tool, is it visible and intuitive to use? Are there affordances? Uh, are there feedback? You know, if you understand which button to push and it lights up, is there some consistency in the way the design is structured so it matches your mental models? Are there signifiers and constraints that control the way the uses to be most effective? You've gotta test this with users. So that's another aspect is learn far much more about human interface with products and bring that into your design strategy.

So we might think about organisational values. I love to bring this back to company literature before I make any recommendations and go back and examine what values are stated and the mission statements, the aspirational content. Ask, how is the company actually enacting these values throughout the business and through their daily tests, which is a really, uh, anchored way to consider this. Any design change must adhere to these philosophical precepts, or you challenge the precepts and maybe they need to be revised. So this becomes a very live dynamic process.

There's a few examples on this slide. Uh, a person-centered approach being our best at work, culture of care, developing future leaders. These might be terms you hear and use.

Chris Bombolas: Sara, I just wanted to check in with you here, that surely this is, uh, really effective when we circle back and connect our work strategies to the ethos and initiatives, uh, you know, created by a board and an executive team so that it's all rounded out nicely.

Dr Sara Pazell: Yeah, absolutely. That's, that's my hope. Thanks for pointing that out Chris and I progress the consideration of these values then to, to generate problem-based design statements so that are also live dynamic and continually change. So when you're designing in a person-centric way, it's also common to consider problem-based design statements that convey empathy for the users, right? It's common in design circles and it helps translate the design needs. So you've got your values, which is that company ethos. You've got your concepts. In this case, I wanna be physically well as an example. Uh, and that is, that starts to inform a design brief or the scope of work. And then the design statement, the problem-based design statements are granular, person centered, and they prop prompt opportunities for improvement. They need to be detailed. So I've just given some examples.

This is just an extract, you know, I want an efficient approach to laundry sorting. I want to be conditioned, and I want my energy to be prompted. Now notice that that's energy management or, and conditioning is very different than just a downward factor of managing fatigue. I actually wanna be conditioned, right? It's a little upstream there. I want efficient and easy access to set up my equipment and work area.

So, you know, some of those strategies might be, uh, you know, the power board, the automatic or robotic and cobots folding machines, providing some sit stand options, maybe having some dissolvable laundry bags that the nursing staff use and help reduce some of the, uh, lifting, sorting, pulling and entangled kind of laundry. So the physical is absolutely inextricable from cognitive psychosocial and environmental and involving people and helping them create these design statements mean that you've really listened to them, which is part of your obligation in law is to consult with workers and then take it another step further, more than just the laundry service design partner, you wanna be thinking about, okay, what's a different point of view?

The same task, the same experience from the view of the manager. Well, maybe the manager wants staff retention, better communication, more support, uh, and report of the hazards, right? So you look at those design statements, the maintenance supervisor wants to maintain the room, the equipment, what's the experience of the nursing aide? So you build a better system of design when you've take in those opinions from everybody affected and influencing or influenced by a single task, right? A task-based approach.

And this now leads us to think about lifecycle ergonomics from hire to retire. I'm showing you briefly what I create in my business for companies to think about the entire lifecycle. Now, at any point, a journey map like this, it describes your significant touch points of a worker's experience during their lifecycle. It is not actually linear in real life. You know, there's affected by seasonal design changes, business rhythms, attitude shifts, habit changes.

A linear depiction is only for the purpose of a graphic display, but it could be a spider web where one effect causes a reverberation all the way throughout the system. But you've gotta think about everything from designing the job role, recruitment onboarding, training, right through to what we're talking about this human factors re-engineering to injury. And, uh, the transition towards some sort of retirement.

Chris Bombolas: There's a lot to consider here in, in that, even though it's linear and you say it's just a guide, there's a lot to take into consideration. For me, I'm at that, uh, retirement cycle. So I've been through that entire role, so I'm quite happy to be at that end. But there's a lot of people who, you know, are just starting out careers and have a long way to go.

Dr Sara Pazell: You know, thanks for saying that. And Chris, I love that you talk about you being at this, this retirement end, because in fact, we talked earlier today about this being a transition for you. It's not stop start, here you are today working, and, uh, and I really appreciate your presence, and I think that's important. So the skill, the mentoring, the knowledge that can still end of the spectrum is brought into design ideation. And at the same time, maybe you have a youth shadow board. So we've got wisdom from, from all areas going into look at the design, and now we're talking about the job role, the design of that job role. So, so great, thank you for that.

So this means a lot of commitment when you start looking at a single laundry task. And then you go back to understand the entire job role and their experience throughout the lifecycle. And what, uh, we will talk in, in human factors is this may be a human systems integration plan of what you do as an organisation throughout this to affect both the physical tasks and their cognitive and psychosocial experiences, right? So a lot can be done, but you need to identify who's vulnerable. You can't do everything at once. You must understand who's vulnerable and focus your energies.

So I'm gonna just talk about briefly a couple of other roles outside of laundry, right? Um, recently out at a mine control, uh, centre, a control room that's a service design partner.

And mine control workers may have, you know, 14 hour shifts from FIFO to LILO, from flying and fly out to log in and log out, right? More computer based, but excessive long work hours and in a room without sun, right? So there's cognitive requirements, decision making, judgment, organisation, planning. They've gotta be flexible, adaptive, responsive. There can be extreme demands on memory, attention, concentration, of course, vision and hearing too and work life balance.

Obviously working this type of shift work is, is significant. Then you've got demands on your technical expertise, your sensory processing, your emotional regulation, or you're supporting others on calls and giving advice and making decisions to help the entire operation's function. You might have a hard time even getting a break spontaneously to go to the loo.

So let's just talk about the realities of this work. Uh, you've gotta protect from trauma, manage the erosion of your capabilities during shift work where you may be fatigued. Uh, what are your high demands and specialised work. It could be isolating and there's a need for psychosocial, uh, protections when workers make mistakes and wish to submit their ideas for work improvements.

So in, in that room, and we had one worker who had a, a sensory profile, we did an examination of their sensory profile, a psychometric tool to look at their preferences of working in a sensory experience, you know, how do they respond to light and sound and the need for touch. And this person had low registration or difficulty discerning a sense type against a backdrop of other senses. And if they're a sensory seeking person, contrasted with population norms, norms as in the case of one of these assessments, they, they need to move. And if we're asking 'em to sit still for a long period of time, that's probably not gonna help them thrive or do the job that we want to do incredibly well. And that agitation can be felt also in the back, in the shoulders, in the head as headaches, back pain, shoulder problems.

So we start to think about the innovation, maybe follow the sun in interventions and keep it more log in, log out, LILO type of work, a little less FIFO, and give people a little more flexibility in their work and support in the built environment. The environmental design is important.

You know, another case example is the finance service design partners. So people working in what used to be conventional banks, now they're kind of cafe culture, cool, really great for the customer, the external customer where they have, uh, you know, uh, 20 minutes of time in that, that business, for example, they're called relationship centres more than they are banks. And there's a lot of effort put into journey maps to design for the customer experience.

Workers as design partners, however, have an all day exposure in this space. They no longer have their private office. They no longer have customer, uh, customised workstations with adjustments. Uh, and they need to move if they're responding to concierge demands. So the concierge might have back pain standing all day, fatigue, risk of varicose veins, edema, swelling, shoulder risk pain from working at desks that were not designed properly for their keyboard interaction.

Or you may have a loan officer doing paperwork because it's due at the end of that same day, very important paperwork, and they are hiding in a back room that's cluttered, that's got poor ventilation, poor lighting, they could be subject to experience of back pain, uh, headaches, migraines, or the manager who used to use one room, you know, consistently and has to move as well. When we've got short space or they might use the room that's actually doubles as the team meeting room and their computer monitor is a TV screen and it's not well suited to what they need to do or their visual needs.

So this is a perfect example of where we need a task-based review of work demands and a double, a mirrored shadow journey map. A journey map for the customer experience, and one for the employee experience and the intersection of all those needs stimulates redesign, right? They look cool, but think about being exposed to these places all day long when you may have a hard bench to sit on. Okay?

Another one. Uh, the tire technician is a service design partner. The manual tasks and mechanics is important. So off the road tires, like in mining, I've been working a lot on this project. At all of these design strategies that I've talked about today have used in some of this research. The personas, the empathy maps, the journey maps, and the manual tasks of mechanics to work with things like rattle guns and move jack stands and elevated work platforms, trolleys, split rims, stools, ladders, hoses.

But at the same time, these are workers who consider themselves to be gladiators where they have 10 times the risk of a fatality than other tire servicing roles, uh, in mining. So there are staffing and skill shortages. Tire handling equipment is already difficult to operate, but the staff are unlikely to be in their prime state. And this is something we wanna get back feedback to conventional equipment designers and suppliers or mining managers, right? So you've got a lot of opportunity to do a very integrated approach, starting with the day-to-day tasks that they do and expanding this to the entire system of work.

Alright, so let's talk a little bit now about meaningful, manageable, manual tasks. Very briefly, we'll just encapsulate injury, causation, temporal design strategies. And I'll leave you with an aspirational statement. When we think about the body and physical work, and we're talking about manual tasks and managing the risks of musculoskeletal disorders, automatically, we even think, all right, we need to conventionally think of the statistics.

I can walk into a business and say, let me guess, your serious claims for manual tasks are round about 30%, and probably for non-serious claims, 40% to 70%, you know, rule of thumb. And people go, oh, how did you know? It's been like that across most industries, right? I have been in some businesses in construction, for example, where the claims have been as high as 70%. Just general claims. Serious claims mean that you, you've had an accepted workers' compensation claim for incapacity takes you outta work for at least a week, right? And those, in the recent stats, body stressing still rates at about 32%, right? So it's very significant.

And the human body is another example of system affected by design. And the soft tissues, these muscles, these ligaments, the tendons, connective tissue, nerves, nerve sheath, circulatory vessels, they're, they're what help animate it. They cause movement. They animate as they engage, help us engage in life. And without these structures enlivened and functioning, we would collapse like a bag of bones on the ground. So although these structures have different vascularisation and different healing, muscles, for example, heal better than ligaments, they are interactive and interdependency exists, but they're also associated with our brain and our nerves, the cognition, the mood, the emotion affecting them. And this can lower our threshold tolerance if, uh, we're not feeling well in this regard, yeah. There's a relationship among these structures, our tactics, what we do with our body, it reflects our will, motivation, attention, concentration, and sense making at work.

So like workplace system design, there are emergent properties of these adaptive human systems. There's a very messy reality of health with physical, cognitive, psychosocial, environmental influences. And there are systems of detection and regulation in the body, just like we need to use in work design. We can learn from this. Allostasis and homeostasis are those terms. It's a very complex regulation of our cardiovascular, respiratory, uh, all of our systems. Endocrine, neurological, lymphatic, uh, our digestive, excretory, musculoskeletal, myofascial. And this semblance of some functional stability when faced with changing, uh, conditions requires a very holistic view, just like work design.

So if you are thinking about an assessment tool in manual test risk management, and in your occupational psychosocial programs, you need to consider this very integrated, holistic approach. You know, does it involve a complete range of tasks that people do? Will it consider that? Will it be integrated with biomechanical risk factors with things like cognitive overload or overload? Uh, is it an independent assessment of injury risk, uh, to different but associated body parts? You've gotta look at the whole body.

And will it provide you information, both acute and cumulative risks, threshold tolerance that can affect that? So it does not provide you with a false level of presumed precision. And does it indicate the severity of different risk factors associated with that task exposure?

I also like to use tools that are suitable for use by generalist safety and health team. Should reassessment be required to contrast the changes in the design, like systems where you have an ergonomist in your back pocket, and I thank Robin Burgess-Limerick for some of this theory on threshold tolerances that help inform that tool assessment. So if we wanna talk, uh, Chris, about, and to everybody about enduring design strategies, there are 12 stages that I want us to think about.

If you're looking at an integrative design approach. You've got governance built environment infrastructure. Your capital equipment might involve modeling, simulation, and planning. And the impact of this is decades. If you get this right, the impact is significant and enduring, but if you get it wrong, the workarounds and adjustments must be made for a very long time.

So involve our built environment designers and our capital equipment designers. You've got tool selection technologies and workstation layouts and procurement agreements, environmental controls. The impact of this could be years. Significant also, senior leadership that impacts on the decision making and the job design, the job requirements, the staffing levels, the task analysis, risk assessment, the workarounds, the, the impact of all of this can be years to months.

Then you get to this next layer of things like recruitment, onboarding, training, mentoring. You wanna go high fidelity and impactful, but the impact is about months to weeks. Generally. You've got middle and frontline leadership strategies, your health and wellbeing initiatives, communication plans. The impact might be months, weeks, and days.

There's job self-crafting, all the workarounds and skills and staffing management you do on a daily basis. And that's days to shift impact. You may have toolbox talks, pre-starts, uh, mentoring, event records. Take five, your safe work method statements, but that review might impact you for a shift or for hours. You've got some user awareness way finding, uh, strategies and maps that to help people can have their orientation and that can affect you from minutes to seconds.

Then there's things like your alarms and alerts and that can affect you, uh, for seconds to milliseconds, all the display cameras, all the, uh, learn, uh, detection systems, right?

There's a lot of focus on some of these areas that have a brief impact. And then of course, there's your latent strategies, like your risk review, latent reviews, learning teams, event analysis, your occupational health rehabilitation, when somebody's already got an injury.

These are months to weeks of impact. Uh, and the transition, the exit strategies that you spoke about earlier, Chris, the retirement support that you might impact for weeks and days. So I'm gonna focus on those, those top tier kinds of intervention. So you can have a really enduring impact in the business.

Chris Bombolas: My guess is you'd have to, uh, tweak or adjust your priorities at times to ensure that the changes are effective and enduring so that they are meaningful.

Dr Sara Pazell: Absolutely. It's a change in strategy. If all of our focus is down the tail end, you're unlikely to get the resounding change of innovation and change your entire risk profile unless you go back to the most enduring kinds of impactful design strategies. So I'd like to talk about an aspirational statement and, and go back to the audience, the participants, and understand what they can dream when we talk about a work design strategy. I'd love to do follow-up sessions with any of you on how you manage the ongoing review of these projects using human factors and resilience engineering approaches to be a custodian of effective design strategy.

This infinity sign means that design is ongoing. It, it never ceases. You've always gotta test the impact of design strategies. This is a, an aspirational statement. It's rare that I read from slides, but this is one I would like to read. Uh, it's something I'm working on my business and I continue to, to change this. But a work design aspirational statement for organisations. I wonder how this would fit in your organisation. Uh, we recognise that work is a design medium in which continual learning occurs.

We consider our people as valuable service design partners. They can contribute to our understanding of variable and authentic nature of work. We invite their participation and ideation about work improvements and involve them in the evaluation of work redesign.

We do not cease our efforts to identify who's most vulnerable in our workforce, and these discoveries will shape our decisions on resource allocation.

Design for diversity as a philosophy that we adopt to enact our inclusivity goals. We consider human performance, safety and health as emergent properties of good environmental, physical, and psychosocial conditions. We embed well-integrated task-based human performance programs in our management of work. We assign custodians of design strategy to continually evaluate the impact of work on workers, maintainers, supply chain partners, and consider this a live dynamic ever-changing phenomenon to prompt ongoing design improvements. We owe it to our people to consider their experiences, our internal customers.

And this is as significant as the considerations that we make of our external customer experiences. We recognise the many layers of design strategy that may be employed, invest in these aspects that are most impactful and enduring. We curate design partnerships with many conventional designers, and we cultivate design thinking in our organisation. It is embedded in all layers of our literature and messaging, and it influences our group. Think also our strategies in our activities. It must be a business that tolerates experimentation, should we adopt this?

So if you wanna learn more about these kinds of ideas, there's a couple of podcasts I would recommend. One I speak in with a couple of colleagues, and we look at the boundaries of when work is tested by case law and redesign. Uh, I've also spoken on the Dart Lindsley uh, Work for Humans podcast. And there's some great strategy, uh, from many different speakers about the design of good work. And also if you wanna learn more about human factors, the Human Factors Ergonomic Society of Australia has this, uh, hub with podcasts of great speakers. So please, here, here's where you can go if you wanna keep thinking about this and sharing these ideas.

So where to now, what will you do differently? Why, how, what do you dream? What's your new destiny and how will you make it so? Today we talked about personas, journey maps, empathy maps, all these types of strategies, these conventional design tools that can be coupled with human factors and resilience engineering and your health, safety and really business performance strategy. We've looked at using scientific papers, case law, risk assessment, a very multi-dimensional design intervention strategy. It's about intentional design, focusing on people and performance.

Chris Bombolas: I can tell you, Sara, that we've got a number of questions if you want to head to questions okay?

Dr Sara Pazell: Okay.

Chris Bombolas: Alright. Um, thanks everyone for your questions. Uh, if you do have a question for Sara, don't forget, use the Q&A chat box on the right of your screen. The first of these is from Luke. Uh, and Luke says, great presentation Dr Pazell.

Dr Sara Pazell: Thank you Luke.

Chris Bombolas: Uh, why is redesign of jobs and tasks not done often, nor well? We know it works when it's done, but it's so rare in organisations of all types to undergo the process.

Dr Sara Pazell: Look, you, you heard me speak. Thank you for that, Luke. I really appreciate that. And, and we, you heard me speak about the amount of design discovery that is required to do this incredibly well. And we have some great guidance documents, the codes of practice I've got listed here from Queensland about manual tasks and also your psychosocial hazards at work. But a lot of the times our approaches are fragmented, a program either or, and we haven't yet integrated this.

So I think it would be great to continue to look at how you integrate this in your workplace. We have human factors and service design specialists. I'd love to see a c-suite, a, a chief work design strategist appointed to this executive team, see new materials specifically on good work design and how you employ some of these conventional design strategies. I just don't think it's been an approach that we have, uh, focused on. There seems to be so much coming at us and it's hard to go right, what's, what's the priority? And I've been arguing that we really need to understand who's most vulnerable in our workplace, and then go through a very detailed review of tasks, job roles, governance, leadership, strategy, the environment, the equipment. And I think with more information like this, more conversation, hopefully Luke, it'll, it'll compel you to, uh, try and adopt this.

And definitely it could be some more work on how to develop a business case on this. I think that would be a great follow up. How do you develop a business case that this is really essential and needed and that's why I've shared my aspirational statement. So you've got something to take back into your organisations and challenge senior managers. And people on the ground usually go, yes, great. I've been waiting for somebody to pay attention to my work. I find it's, it's uh, that combination of that senior guidance, the middle management approving this and not feeling like, um, we can tick a box and walk away and the job's done.

Chris Bombolas: Um, along the si, similar lines, uh, this comes from Ingrid, uh, Sara, for small to medium companies where there are already struggles to just feel like you are keeping up with compliance requirements. What's the best way to start to integrate work design practices into the business?

Dr Sara Pazell: Yeah, great. Ingrid. Thank you. Look, a small business actually can be quite agile and make decisions and take actions that don't require too many layers of approval. So you've, you're in a really good position, uh, as a small business.

I think number one, that entire aspect of consulting your workers and understanding what their experience of work is, then involving them, engaging them, and helping them, uh, you know, feel that they are welcome to participate, no idea's a bad idea, then, then you're really going to start understanding how do we make things better? And if people report a hazard, do they get feedback on this? I hear this all the time that we reported. We thought we were complying, but we're not, we're not getting any feedback. And it's not just what hurts you, what ails you, it's what do you love, what do you enjoy, that we can prop and support people get involved in that. What, what would you like to be more efficient? A lot of times workers will come to me about a manual task and in, in fact they've been trying to solve the problem of how to be more efficient at work, not just solve an ailment.

So Ingrid, hopefully, uh, you're in a really good position to do this. Uh, you're gonna have brief notes. You don't have to have long paperwork on this. You just need to show good action.

Chris Bombolas: Thanks Sara. This is our last question for today.

Dr Sara Pazell: Sure.

Chris Bombolas: It's from Rebecca, uh.

Dr Sara Pazell: Hi Rebecca.

Chris Bombolas: And she says, it's interesting using an infinity sign to explain work design strategy. It seems like these practices have no end, which is different to most projects that must have a sign off and an endpoint. Uh, is this correct? Is it infinite in your, uh, idea?

Dr Sara Pazell: Absolutely. Thank you for asking that. And you know, it goes back to Luke's original question because, uh, it means that you've got design in use, you've got resilience engineering, you've gotta have, uh, detection systems. It means that once you've implemented something, you don't just sign off on it and walk away. You've gotta continually test how is any idea, strategy, equipment, environment being used? What happens in different contexts of work? What happens with the element of detection? How do we know when performance is being eroded? That's a design opportunity.

What's your system of detection and what's your level one, level two, level three, should any of those other levels fail? And is the information getting to the right person at the right time who can make adequate decisions and has the power and authority to make a, a reasonable change? All of those are design opportunities. So you never stop learning from the investigations at work. It, it needs to stay alive. Hence, I really think it would be great to have a chief work design strategist. I'll never stop advocating for that.

Chris Bombolas: Alright, Sara, we need to wrap it up now. Time on the wing.

Dr Sara Pazell: Thank you.

Chris Bombolas: Uh, just quickly, uh, a question without notice, one final, uh, message for everyone to take home.

Dr Sara Pazell: Uh, I go back to this, what will you do differently tomorrow? How and why and what can you dream? The final message is please, please use this concept to think about creativity, to think about how I can create a new destiny through involving people as service design partners. Please use that aspirational statement. I'd love to hear from you about what you are doing differently tomorrow.

Chris Bombolas: Thanks very much, Sara. Really enjoyed the presentation and we had some, uh, great feedback and great questions. So thanks again.

Dr Sara Pazell: Thank you.

Chris Bombolas: And thank you for joining us, uh, today. Um, before we go, we'd love to hear your feedback on today's presentation. So please grab your phone and scan the QR code on the screen. Uh, to take a short survey, only take a couple of minutes.

Key takeaways, uh, from Sara's presentation will be available on the WorkSafe.qld.gov.au website in the coming days, along with her presentation. You can also rewatch today's, uh, session via the watch live link you are using today. If you are eager to share or catch up straight away.

And while we're talking about our website, check out our full range of case studies, podcasts, speaker recordings, webinars, and films to help you take action to improve your WHS and return to work outcomes. Uh, these resources are free, which is fantastic, uh, to download. So I encourage you to share them with your staff and throughout your networks. Uh, on behalf of Workplace Health and Safety Queensland, I hope you enjoyed our Work Well presentation, uh, presented by Dr Sara Pazell. As always, work safe, home safe. We'll see you soon.