“What gets measured gets managed.”
You’ve heard that before, right? This is the old adage that is continually referenced in business, consulting, or anywhere else we are trying to make sense of things. If you do a quick Google search for this statement, you’ll find variations of it, such as “If you can’t measure it, you can’t manage it.” It’s basically the same sentiment. Notably, it’s difficult to figure out where exactly this sentiment came from, but we usually attribute it to Drucker or Deming or some other brilliant thinker onto whom executive leaders hitch their wagons.
What leadership wants usually trickles down. This is especially true for workplace safety. Management and regulatory agencies want you to manage injuries and fatalities. To manage them, we needed to measure them. So, we started measuring injuries and fatalities. We even standardized the way we measure them and how we calculate them. We incentivized our workers and our supervisors based on these measurements in an attempt to manage the end result.
In the safety profession, we talk a massive game about “systemic safety” and “capacity building” (mostly in response to those big sexy conference ideas), but when it comes time to measure it, we default to the same lagging metrics that have failed us for fifty years. We are trying to measure 21st-century safety management with 1970s tape measures. Don’t get me wrong, we are managing those standard metrics very well, but there’s a big problem.
Eventually, we [should have] noticed that those numbers were going down, but the same bad stuff was still happening. People were still getting hurt. Property was still getting damaged. Workers were still dying.
Many safety professionals have probably experienced the phenomena known as case management.
This is the process we follow, not to prevent bad things from occurring, but to prevent bad things that have already occurred from becoming worse. A worker gets hurt, we send them, and sometimes follow them, to a designated medical treatment facility, and we manage the paperwork. On the surface, this process seems like a great way to ensure workers are getting the best care possible, right?
Instead, case management amounts to the best possible means to protect the business after a worker gets injured. We not only ensure the worker gets care, but we observe and control that care to the best of our ability to make sure that care results in the least amount of recordability possible. We go back to 29 CFR 1904.7, and we start to micromanage the provider’s methods of care. We try to keep treatment at a level of first aid or below.
Stitches? Why not butterfly bandages?
Prescribed painkillers? Why not ibuprofen over the counter?
Light duty? Well, how much of the worker’s job can we change before it becomes restricted work?
An IV? Can we just give them this electrolyte sports drink?
Then, if we keep running into these questions, we start shopping around for clinics that know what recordability means and how to manage it. We find the medical providers who will help us keep that number down. If we do this process right, we succeed it keeping that recordable injury number down to as low as possible while our workers keep getting hurt.
That’s the thing though, isn’t it? People keep getting hurt. We keep chasing that lower number after the injuries occur.
We managed the number because we were measuring the number, but why did it feel like we were getting it wrong?