Effect Chains – A Method for Analysing Qualitative Effects in Occupational Health and Safety at Work

7/30/2019 Effect Chains A Method for Analysing Qualitative Effects in Occupational Health and Safety at Work

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15 Effect Chains A Method for Analysing

Qualitative Effects in Occupational Health

and Safety at Work

Martin Schmauder, Hanka Hoffmann

1 Introduction

The starting situation for activities related to health and safety at work in compa-

nies is characterised by a great deal of latitude for interpretation as regards the

statutory outline conditions, with which companies respond individually to

changes in the world of work and thus are able to open up potential in differentways. The flexibilisation of the world of work brings with it for example fresh

demands on the skills and resources of employees. The intensification of work and

expansion of responsibility leads to increased psychological stresses on employ-

ees. And not least, KRUEGER (2008) also highlights the significance of demo-graphic change, particularly for SMEs: in the next two decades, we may anticipate

an ageing (working) population across Europe. It is true that each worker agesdifferently, but the generally increasing mental and sensory deficits, above all the

decrease in the capacity to adapt to changing circumstances, have to be compen-

sated if even complex work tasks are to be performed through to pensionable age.

Maintaining the health of employers is thus gaining increasing importance. This isachieved not only by avoiding or reducing absences, but by improving the state of

health through improved conditions in the organisation, the work itself, and thedevelopment of personal qualities (Fig. 15.1).

C.M. Schlick (ed.),Industrial Engineering and Ergonomics,DOI 10.1007/978-3-642-01293-8_15, Springer-Verlag Berlin Heidelberg 2009


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198 Schmauder & Hoffmann

Fig. 15.1: Possible connections between organisation, work conditions, state of health and

work behaviour. Source: based on B. Badura, in: BERTELSMANN STIFTUNG (2000,p. 25)

In the meantime, in accordance with the law on health and safety at work, in

many companies workplace health and safety measures and health promotion

measures are being implemented in order to safeguard human resources in a last-

ing way. These measures also contribute to a positive internal and external corpo-

rate image, as well as to service quality. The following illustration provides an

overview of the problem areas and objectives that are most frequently addressed

within the framework of company health promotion (Fig. 15.2).

Main themes

0 10 20 30 40 50 60 70 80 90 100

Stress management

Organisation development

Management style

Autonomy

Health & Safety topics

Workplace design

Communication

Reducing sickness levels

Company atmosphere

Physical s tresses

N=212 companies

Fig. 15.2: Measures in contemporary health and safety at work and health promotion

(AOK-BUNDESVERBAND 2007)

The spectrum of measures shows the breadth of contemporary health and safety

at work, which includes health protection and health promotion. In addition to the

question How can illness be prevented?, increasingly the question that is also

Physical well-being

Mental well-being

Self-confidence

Irritability

Anxiety

...

State of health

Organisational conditions, incl.:

Corporate culture

Transparency of decisions

Degree of division of labour

Working conditions, incl.:

Time pressure

Leeway for action and creativity

Work interruptions

Person-related conditions, incl.:

Social competence

Identification with work

Personal effectiveness

Readiness to perform

Quality of work

Readiness for innovation

Attendance record

Fluctuation

Willingness to cooperate

...

Work behaviour


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Effect Chains 199

asked is: What needs to be done in order to preserve and improve the health of

the workforce?

If one wishes to record and represent the productivity of workplace health and

safety, it is not enough to limit oneself to looking at just the pursuit of safety andhealth objectives and local optimisation of work systems. With the perspective of

results-oriented health and safety at work, the intention is to see the effects of

workplace health and safety and health promotion services on the business results.The intention is that the overall benefit to the company can be illustrated, and that

the contribution towards achieving diverse corporate goals is clear. We have re-

sults-oriented performance in health and safety at work and health promotionwhen these are shown to have contributed towards lowering overall costs or to-

wards increasing the revenue of a company, and towards the long-term existenceof the company by securing competitive product sales and by securing the neces-

sary resources for adding value.The need for concrete argumentation aids to illustrate the business economic

benefits of preventive workplace health and safety is growing. The central ques-

tion for companies whether health and safety at work is worthwhile for them

can still only be answered unsatisfactorily (FROBSE et al. 2008, LANGHOFF2002, BRAUN et al. 1999). In this respect, the method of effect chains attempts toclose a gap in a practical way: health and safety at work and health promotion

make a contribution towards improving profitability. This contribution cannot

always be measured in monetary terms. However, with the aid of the effect chains

method, the indirect effects can now be described plausibly, and the benefits of

health and safety at work and health protection can thus be made clear.

2 The Principle of Effect Chains

On the one hand, the effects of measures in preventive workplace health and safety

cannot always be determined precisely beforehand. On the other hand however,

even in retrospect it is not possible to establish a clear relation between measuresand effects. There is thus no proven causality between a measure and an effect.

So for example in the case of mechanical factors, causality is clear. If a protec-

tive grille is fitted at a feed point, injuries are avoided here. It is also undisputed

that for example back problems are reduced by ergonomic measures, but one can-

not say with certainty to what extent this is so, nor is it clear whether the ergo-

nomic measures were the cause of this, or whether other effects played a role, too.

The only thing that is undisputed is that the ergonomic measures have made a

contribution towards reducing back problems.

It is precisely here where the method of effect chains comes into play. It is not a

matter of identifying causal relations; rather, the diverse and interlinked effects of

the workplace health and safety and health promotion measures are illustrated.Effect chains are consequently complex constructions of causes and effects, as

described for example by GOMEZ and PROBST (1995). In this sense, what is meant


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fering and encouraging) external influences. In such complex webs, effects them-selves become causes, one cause can have many effects, just as one effect can

have many causes. We describe these characteristics of the cause/effects web as

multifinal and multicausal.Workplace health and safety measures, too, have various effects. These effects

in turn have other effects, which ultimately in a positive case are noticeable as

effects that increase revenue or reduce costs (Fig. 15.3). Both have a positive

influence on company profits (PIEPER & VORATH 2005).

Effect chains are accordingly intended to describe the contribution made by

workplace health and safety and health promotion to the business result, and this

can be differentiated via several sub-levels into partial indicators on both the reve-

nue and costs sides.

Effect/Cause

Effect/Cause

Effect

Effect/

Cause

Effect/

Cause

Effect / Cause

Effect/ Cause

Effect/ Cause

Effect/ CauseEffect/

Cause

Effect

Reduction of costs Increased revenue

Measure/ Cause

Effect/ Cause

Fig. 15.3: Connections between causes and effects

3 Possible Uses of and Limits to the Effect ChainsMethod

As we have already explained, the effect chains method can be used to illustrate

the effects of measures. It is therefore suitable for the following applications:

Prospective application to work out goals and indicators prior to implementinga measure: Here, possible consequences can be estimated in the planning

phase. Objectives can be established (That is what we want to achieve in con-

crete terms!). It is also possible to identify potential unwanted effects through

prospective application of the method. Through the representation of the effect

structure, aspects can be identified to which particular attention must be paid.

is webs of causes and effects, which take account of mutual influences and (inter-


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Effect Chains 201

In general, it is possible at the start of the project to exchange views within the

group about the objectives, to plan the measures, and to set priorities.

Retrospective application to represent the observed effects: After workplacehealth and safety and health promotion measures have been implemented, a

network of effects can be developed by means of the effect chains method. It

is possible to show which positive (and also negative) effects a measure had,

and how they are related. A contribution towards illustrating the benefits of

the measure can be made here. However, no effects that are measurable di-

rectly in monetary terms are calculated here; rather, they are shown qualita-

tively. Since in general it is hardly possible to evaluate the success of work-

place health and safety measures in monetary terms, it is precisely here that

the strength of the method lies: It can be shown which benefits could be ob-

served in the case of a concrete measure. When working out the effect

chains, care must be taken to ensure that the effects that are actually ob-served are recorded. There is a risk that speculative effects, i.e. ones that are

desired but did not actually occur, may be listed.

The method provides stimuli for a structured exchange of opinions, and as anargumentation aid it can also form the basis for discussions about the effectsof measures.

Well-illustrated effect mechanisms enable the company to select the mostsuitable measures for achieving objectives, to optimise company procedures

thereby, and to reduce the corporate risks in this connection.

The limits of the method lie in the fact that effect chains can also go nowhere orend up in dead ends. Furthermore, it is not possible to demonstrate the achieve-

ment of concrete goals in an evaluation process.

4 Participative Effect Chain Processing

Having explained the principle of effect chains, in the course of a brief look at the

principles of facilitation we shall explain how effect chains in health and safety at

work can be identified.It is advantageous to work out effect chains in a facilitated team workshop. In

practice, one finds typical discussion types which can be distinguished according

to their objectives: In information discussions, the participants are to be instructed

about something, given an overview, or receive instructions. In problem and deci-

sion discussions, solutions are worked out together, and measures are also co-

ordinated. More interactions take place here, and also more emotion is shown. Bycontrast, the method of effect chains is more a form of brainstorming, in which

ideas are found and above all experience can be gathered.

It is precisely in this quite open form of discussion that the role of the facilitatoris of decisive importance. The facilitator leads a discussion and should simultane-

ously be a specialist in the methods of communication. The facilitators task lies in

leading the group to a result by using appropriate methods, during the course of

which he directs the process methodically but remains neutral as regards content.


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Besides the actual content of the individual contributions, he must also take ac-

count of the relationships between participants, which can have an enormous

influence on the result of a discussion (WATZLAWICK et al. 1974). It is thereforeadvantageous if the facilitator assumes an independent position in relation to the

participants in the case of analysis of the effect chain, he acts as an externalparty in the company. He should know about the 4 aspects of a message (factual

information, appeal, reference and self-disclosure) (SCHULZ VON THUN 1981)and also must not underestimate group dynamic processes.

In its discussion, a group brings to light more than the sum of its individual

members. DAMMER and SZYMKOWIAK (2008) go so far as to say that the wholeis more than and different from the sum of its parts (p. 30). This more than and

different from results from the group dynamic, from that which the group con-

veys non-verbally or scenically in terms of content, and ultimately from the

greater breadth and unity of the work on the topic, simply through mutual stimula-tion and reflection in the group.

The starting point for the effect chains workshop is a workplace health and

safety or health promotion measure that has actually been implemented or

planned. It is important to include representatives of all the protagonists involvedin the measure in the group discussion, in order to depict the cause/effects web

from different perspectives and thus as completely as possible. The various per-

spectives of the participants give rise to various expectations and aims. All havean entitlement and are part of the system to be dealt with. Gomez and Probst there-

fore suggest, in the spirit of a holistic procedure, putting together an interdiscipli-

nary group of people with expertise, in order jointly to describe connectionsand/or to derive suitable possibilities for action. They also refer to the ethical

aspect of such a procedure including all legitimate interests in so-called claimgroup teams right at the start of a holistic problem-solving process (GOMEZ &PROBST 1995).

The formulation of the problem is important for the success of an effect chains

workshop. What we mean by this is the initial question with which the participants

are confronted. This should be considered carefully as a preliminary step a good

question is decisive for a good result. The question serves to prompt the partici-

pants to express everything that they would like to express in other words, to setthe process of finding the effect chains in motion. Each contribution is important

here, and can stimulate the other participants to discussions or other contributions.

In order for a complete network of effects to be depicted, all contributions need to

be visualised.

Three steps follow on from the initial question:

1. Requesting anonymous cards, with pin-board techniqueIn the most favourable case, the participants in an effect chains workshops are

very heterogeneous, including as regards the position of individual people within

the hierarchy (see above). Although this is important for producing a complete

representation of all effects, it is precisely because of this that difficulties can arise

at the start of a brainstorming session. For this reason, the written form of brain-


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Effect Chains 203

storming so-called brainwriting, or requesting cards is more appropriate in this

phase. The advantage here is that a great deal of information can be assembled

within a short space of time, and possible inhibitions on the level of relationships

or losses through production blocks (DIEHL & STROEBE 1991) are excluded. Forexample, the contributions made by a shy colleague are collected in the same wayas those of an eloquent superior, something which cannot necessarily be achieved

when such a procedure is carried out verbally. All the participants write down inparallel their experiences and opinions concerning the problem defined at the

outset on cards (one aspect per card). It must be specified beforehand whether the

number of cards is to be limited, which on the one hand restricts creativity, but onthe other hand ensures a manageable quantity of cards.

The cards are collected in by the facilitator and pinned to the display board.

Cards whose contents are similar are grouped together (thematic clusters) with the

aid of the participants. Writers of cards can remain anonymous. Cards can besupplemented during the discussion, too. In the discussion, generic terms are

sought for thematic groups, which can be used for further work.

2. Guiding questionsIn the second step, with the aid of the generic terms the web of effects is

worked out. For this, we use a system of co-ordinates (Fig. 15.4). The use of this

procedure is intended to achieve comparability of different group discussions. In

the system of co-ordinates, those factors are shown which according to our un-

derstanding, based on DAMMER and SZYMKOWIAK (2008) ensure functionalrepresentativeness of the results of the survey.

Based on the system of co-ordinates, and starting from the generic terms found

in the first step, by means of guiding questions additional observed or suspected

effects are determined and placed in relation to one another. Here, visualisation inthe form of a mind map can be helpful (main branches with offshoots and secon-

dary offshoots).

Particular importance is accorded to the questions about the effects on the par-ticipant. In the sense of the theory of planned behaviour (AJZEN & FISHBEIN

1980), behaviour can change only if as a preliminary step, the intention and itspredictors attitude to a particular behaviour (the sum of expectation and evalua-tion), subjective norms (corresponding to the social pressure that people close to

the person exert in relation to the performance or non-performance of the particu-

lar behaviour), and perceived behaviour control (a persons conviction about

how easy or difficult a behaviour is for him to carry out). For workplace health

and safety measures, this means that they have to act on precisely those predictors,

in order ultimately to achieve a change in peoples behaviour. According to Ajzen,

action that takes account of workplace health and safety must be assessed positively

by the person himself and must be assessed as easy to implement. Furthermore, the

person has to believe that other people who are important to him likewise assessthe performance of this behaviour positively. Depending on how far-reaching the


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effects of workplace health and safety measures are, they will also result in long-

term changes in behaviour.

Fig. 15.4: System of co-ordinates for producing functional representativeness

The following example guiding questions originate from a workshop carried

out by the trade association for health provision and welfare (BGW). With repre-

sentatives from hospitals and clinics that took part in the competition BGW

health prize 2005, effect chains to represent the benefit of workplace health and

safety and health promotion measures in hospitals and clinics were worked out.

The facilitator names the measure under consideration, and asks for example:

What was different afterwards?

What happened then? What effect did that have

o externally (society, customers)?o internally (colleagues, other departments, administration)?o on the private sphere/family?

Do outsiders notice any of this?

Have there been any effects on other areas?

Have there been any effects on the company as a whole?

What has changed in:

o work tasks, workplaces/premises, work tools, work procedures, workingenvironment (physical, social)

o ecology

Measure / Event

What effects did the measurehave...?

internallyexternallyon the private sphere

To what extent did themeasure have an effecton colleagues in respectof...?

skillsbehavior

performance

Economy :

desired effects

unwanted effects

What significance do the individual

effects have?

Time horizon:

When did the effects occur?How long did the effects last?

Participants and those affected :

Who triggered it?Whom did the effect affect?

increased turnover/reduction of costs

increased costs/decline in turnover


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Effect Chains 205

o safetyo behaviour?

The respective answers are visualised in turn. The following illustration shows an

example of this (Fig. 15.5).

Fig. 15.5: Example of visualisation when working out effect chains

When an effect has been identified, then additional effects are requested, so that

a network of effects is produced. When identifying additional effects, the same

questions can be used, but one can also ask for example:

What can be deduced from that?

What else resulted (additional effects)?The individual effects are placed in relation to one another and linked with ar-

rows, which at the end will ideally lead to the field Reduction of costs and/or

Increased revenue.

3. Weighting by means of pointsFor the purpose of structuring, finally the main effects of a workplace health

and safety measure are identified, in that the workshop participants apply adhesive

spots (e.g. 3, a maximum of 2 on one effect) to the effect which in their opinion isthe strongest. This last work step, which creates transparency, makes sense, since

it is only in this way that a measure can be evaluated in terms of its content, and


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the results that have been achieved can be compared with the actual goals of

workplace health and safety at the company.

5 Application of the Method Experience so Far

In our experience, effect chains workshops are successful where the event that isto be discussed lies no more than 2 years in the past.

The discussion takes place within the framework of a 90-minute facilitated

workshop.Allowing for complete representation of the protagonists, group size should be

between 8 and 12 people. Smaller groups do not provide sufficient anonymous

protective space, and larger ones are no longer suitable for getting the groupmembers to talk to one another and discuss a common topic.

The event is facilitated by two facilitators, ideally male and female. Co-facilitation is necessary in order to be able to fulfill all the requirements with re-

gard to visualising the discussion during the workshop, and to provide adequate

documentation of the contextual facts of the discussion in the facilitator logs,

whilst simultaneously guiding the discussion in a satisfactory manner. The co-

facilitators switch between the roles of guiding the discussion and taking minutes

at least once in the course of the discussion.

6 Examples of Effect Chains

Two examples of effect chains are shown below. These effect chains were worked

out, amongst many others, in the BGW workshop mentioned above, and in the

framework of the PAGSmonitor project. The first effect chain shows the diverse

effects in connection with back training (Fig. 15.6).


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Effect Chains 207

Fig. 15.6: Back training effect chain

The second effect chain documents the interlinked effects that can be estab-

lished as the result of carrying out a health day (Fig. 15.7).

Bonus stampreceived from healthinsurance scheme

Back training


Financial bonusat year end

Image boostfor the company

Pleasant balancein relation to

seated workplace

Ideas to use at home

Fewer daysoff work for

back problems

Faster communication

BUT: no new participants

Demonstration ofsome exercises

Bonus stampfrom company-training record

Loosening andfirming of

musculature

CORRECT performanceof exercises / movements

More movement / sportin private life too

Asking othercolleagues

Information,providing knowledge

Health awarenesshas increased

Getting to knowcolleagues from

different departments

Fun, motivationthrough the group


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Fig. 15.7: Health day effect chain

7 Conclusion

With the effect chains method, a method is presented for representing the bene-fits of corresponding measures that is new in health and safety at work and health

promotion. What is new is that the previous approach of assessing the workplace

health and safety and health promotion measures in purely monetary terms isreplaced by a qualitative illustration of the effects. This is associated with goal-

oriented company management. Using the method, it can be shown that health and

safety at work and health promotion make an active contribution to the achieve-

ment of corporate goals. The method is also suitable for the planning and optimi-

sation of workplace health and safety and health promotion measures. It can be

used in small groups, and creates transparency in discussions about the effects of

measures within the company.The method is currently being used and developed in the project PAGSmonitor:

Economic health and safety at work through benchmarking. Thus for example the

relations between the individual effects, based on GOMEZ and PROBST (1995),should be described in greater detail in three respects:

According to their time horizon: do they act over the short term, mediumterm or long term (lines of different thicknesses or colour of arrows)?

According to their intensity: is the influence weak (1), moderate (2), or strong(3)?

According to their effect: reinforcing (+) or damping or stabilising (). It ispossible to indicate the strength of influence by means of arrows of different

thicknesses.


Health dayImage

Revaluation of

the theme of health

and safety at work

Movement

Dialogue between

the individualwork groups

Understanding for

one another /communication

Increased

work satisfaction

Health benefits

in the holistic sense

Creation of new jobs

Transfer to

behaviour at the

work place

Public attention

Rise in demand

Information

about possibilities

Contributionfor employees

(reward)

Qualification

of health promotion

Fixed component

of training plan

Staff development

Change in behavior

Business sectorsare created


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Effect Chains 209

The research project PAGSmonitor: Economic health and safety at work through

benchmarking runs until September 2009 and is supported by the Federal Ministry

of Education and Research.

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Effect Chains – A Method for Analysing Qualitative Effects in Occupational Health and Safety at Work