UNION PACIFIC’S FATIGUE RISK MANAGEMENT SYSTEM (FRMS)

Dennis W. Holland, Ph.D.Jackie Keenan, M.B. A.

Hierarchical Input Process Output HIPO

OperationRedBlock

Prevention

Education

Health Promotion

Local Committees

Prevention

Education

Critical IncidentTeam

DomesticViolence

WorkplaceViolence

Behavioral HealthPromotion

Fitness for Duty

CISD

Suicide Prevention

Depression

Stress Management

Resiliency

Peer Intervention

Sleep Disorders

Risk Management

Countermeasures

Education

Alertness ManagementProgram

Fatigue Safety Productivity

Increased Focus

ReducedAccidents

ImproveProductivity

ReducedAbsenteeism

Reduced MedicalCosts

Improved OverallHealth

Return to Work

Reduced Stress

Improved Morale

EmployeeRelations

Work LifeBalance

Health Human Relations

Peer Intervention

IncreasedAttention

ALERTNESS

Safe Alert Focused Employees

Workforce Utilization

Fatigue Risk Management System ModelLevel One (L1)

Level Two (L2)

• Continuous Improvement Process

•FAID Analysis•Measurement

• Behavioral Symptoms•Screening Tools•Peer Identification

• Corporate Responsibility• Ensuring Adequate Sleep Opportunity • FAID Analysis /Action Plans

Concept Taken From “Managing The Risks Of Organizational Accidents” by James Reason

Level Three (L3)

Critical Incident!!

Level Four (L4)

• Individual Responsibility•Using Time off for Rest

UNION PACIFIC’S FRMS

• Broad comprehensive plan to manage the human resource.

• Integrated and Interdisciplinary approach to managing manpower, fatigue and quality of life issues.

• Safety & Health Priorities.• Evidence-based

– Theory and research

FRMSRisk Management Model

Identify, measure and prioritize risk and develop and implement controls

Addresses Critical Challenges 24/7 Operations & 24/7 Society Unsupervised TE&Y workforce Aging/new workforce Unhealthy workforce

Scientifically based “toolbox” approach

KEY ELEMENTS OF FRMSPolicy

Corporate & Local PoliciesTraining and EducationEnsuring adequate average sleep

opportunity Company responsibility Software analysis & Measurement (FAID)

KEY ELEMENTS OF FRMSEnsuring employee preparedness: ensure

that individuals who received an adequate average sleep opportunity have achieved sufficient sleep to ensure safe level of alertness [SLA] Education on signs & symptoms Education & policy regarding minimal sleep and

reporting Shared Responsibility partnerships with employee,

labor organizations and government

KEY ELEMENTS OF FRMSAdditional Countermeasures (Toolbox)

Planned Nap Program Lodging Families Alternative to Discipline Sleep Disorder Screening Measurements Technology Review Process

Research - ongoing process of pertinent research to ensure FRMS is evidence-based.

IMPLEMENTING FRMS

UNDERSTANDING THE FRMS LEVELS OF

CONTROL

Fatigue Risk Management System Model

Qualitative Level One Controls

10-hour Undisturbed Rest/AM Mark-Up Completed

Proactive Notification Completed Ongoing Enhancement

Work/Rest Cycles & Call Windows Magic bullet mentality not justified -- Comprehensive

and integrated process More than just Crew Scheduling

Example - Seattle Example - North Platte/Marysville

Quantitative Level One Controls

FAID Process FAID Analysis -- Software package to identify the extent

of any fatigue problems (i.e. locations or times of reduced average sleep opportunity)

System identification of where reduced sleep opportunity may lead to work-related fatigue

Assess whether interventions have increased sleep opportunity

Used in conjunction with the Board Game software for simulating the impact of changes at the board/pool level

Fatigue Scores are Indicators Only

• Fatigue scores are indicators only of the impact of sleep deprivation.

• They are based on a statistical analysis of research performed into fatigue levels over a broad sample of population and provide guidance on the fatigue of an individual.

Level Two ControlsLevel 2 controls are designed to ensure that individuals who

received an adequate average sleep opportunity have achieved sufficient sleep to ensure safe level of alertness [SLA]

This requires a high level of shared responsibility This will require significant cultural change and time and is

likely to be the most difficult element to implement effectively

Labor will play an important role in shaping the employee attitudes. Labor/management consultation will be essential

Implementation: Employee, Management and Family education and awareness.

Level Two Implementation Plan

Stage 1 - Initial Awareness Minimum Sleep/Wake Needs - 5/12 rule Commenced -- Q1 2004

Stage 2 - Personal Management tool Introduce Prior Sleep/Wake Model and behavioral scale Used to manage personal behavior and ensure SLA No reporting requirement Proposed Completion

Stage 3 - Organizational Integration Introduce Scoring System Reporting of non-zero scores Develop local decision matrices Mark off

Additional Level Two Controls Proposed

Industry collection of US Sleep/Wake Data Ensure Level One Models are valid Link L1 -> L2 -> L3 frequencies to ensure evidence-

based policy Establish industry benchmarks/policy guidelines for

Sleep/Wake behaviorResearch projects

Projects collecting Work/Rest, Sleep/Wake, Behavioral data Kansas City [WR,SW, Actigraphy, PVT] Des Moines/St. Paul [WR,SW, PVT] San Antonio [Diaries, Actigraphy]

Level Three Controls

These reflect a general organizational shift in philosophy and policy Increased focus on employee involvement in fatigue

hazard identification and self-management of fatigue i.e. self and peer education leading to self assessment Clear policy guidelines on managing pre-defined

unacceptable levels of fatigue-related behavior) Example: Alternative to Discipline

Discipline vs. Peer Intervention

Level Three Controls

Physiological Monitoring Systems Ongoing internal technological review process No current systems with acceptable Cost/Benefit Analysis

Self and Peer Identification of Fatigue-Related Behaviors Generic symptom checklists (developed) Task-specific symptom checklists

Sleep Disorders Screening Certification process FRA/UP Assessment Research Project

Voluntary Program (OHNS) Education and Awareness Related Health Issues

Overall Research Program

Level Four & Five Controls

Identifying fatigue as a cause of errors or incidents Evidence of L1-3 data consistent with fatigue Nature of incident is consistent with fatigue-related

errorNeeds to be an industry initiative to ensure level

playing field UP willing to collaborate with industry initiatives

Model and Boardgame Analysis CIT

FATIGUE, SLEEP DISORDERS ANDRELATED HEALTH ISSUES

UNION PACIFIC RESEARCH UPDATE

RESEARCH AGENDA

• Assess the relationship between safety and risk factors such as: fatigue, sleep disorders, stress, depression, obesity, etc.

• Part of UP FRMS • Create evidence-based interventions• Partnerships with Labor and Regulators• Bottom-line Implications: Improve

employee health and safety while reducing medical costs, absenteeism and presenteeism.

INTRODUCTION

• Behavioral Health: 2003 WHO study (Wang, et al) suggests that depression most highly significant factor in accident and injury.

• Depression expected to become #1 cause of disability world-wide.

• Wellness Inventory (Pfizer) UP studies indicate behavioral issues (depression, stress, anxiety) are most costly in presenteeism, absenteeism and medical costs.

• Fatigue: Sleep Deprivation & Sleep Disorders are a societal issue impacting the work place: NSF reports 74% of Americans do not get enough sleep each night.

FATIGUE & SLEEP DISORDERS

• Sleep Disorders - Uservices– Objectives:

• Assess percentage of TE&Y at risk for excessive daytime sleepiness

• Demonstrate viability of sleep assessment as part of re-certification process

– Methods• N= 437• Epworth Sleepiness Scale• Scores > 10 categorized at risk

SLEEP (cont’d)

– Results• At risk employee is > 35% (95% CI 35.4-44.8%)• Willingness to participate (confidentiality maintained)• Confirmation Study

– Scores > 10 offered opportunity to wear a device to determine presence of OSA

– 20 tests ordered, 10 completed– 9 confirmed positive for OSA

• Recommendations– Additional research– Continued voluntary screening– Continued education and awareness

SLEEP (cont’d)

Actigraph - DU Objectives

Determine fatigue levels Behavioral implications of feedback Data for biomathematical validation

Methods Sleep Diaries/Self Report Two Types of Actigraphs Epworth Sleepiness Scale & PSQI N (Questionaire) = 180 (60.4% response rate) N (Actigraph) = 36

SLEEP (cont’d)

– Results• Lower mean sleepiness score than other sites

(match approximate national average)• Behavioral outcomes (actigraph):

– No statistical difference between those with feedback actigraph and those with non-performance actigraph

– Those with self-efficacy more likely to use data to change behavior

– Those without self-efficacy (external locus of control) unwilling to change behaviors

• Implications for changing behaviors and providing concrete change

Behavioral Health

Joint Projects and Funding UPRR/FRA Coping Mechanisms – HIS Depression – DU Obesity – HIS Integrated Health Improvement Initiative - HIS

BAA – FRAAdditional proposals currently under

consideration.

CONCLUSION

• Pilots assessed for system implementation• Evidence-based development of programs

and interventions to reduce or eliminate risks

• Informed discussions, communications and programs

• Implications for the industry• Safety, health and productivity focus• Additional safety research needed in all

associated areas.