Do Incentives Programs Lead to Injury Hiding?

We doubt it. Working "hurt" allows some to get the recognition and positive affirmation they need from their peers.

AS a safety manager, you have probably spent enough time in the trenches to see the ill effects of poorly designed safety incentive programs. I'm speaking of programs that merely reward employees for reaching an injury-free milestones without changing underlying employee behavior.

Understandably, programs like these might lead you to conclude that all safety incentive programs are ineffective in creating a safer work environment. You might even believe they do just the opposite: encourage injury hiding. However, we have recently uncovered a case where injury hiding occurred on a construction site not using any incentive program. Which leads us to a new understanding of injury hiding.

To prove my point, consider the following story. We speak with 5,000-plus safety managers yearly, but this anomaly regarding injury hiding and safety incentives was a new one for me. Here's what happened:

A certain non-profit charitable organization builds houses for underprivileged people. (We cannot reveal the name of the organization because of confidentiality issues). The work is done by volunteer laborers who receive housing and support from the organization. During a particularly massive building campaign, the organization placed an extra emphasis on safety and established a goal of achieving 200,000 hours without an injury. There was no incentive or recognition program involved (because there was no budget to pay for one). There was only the common goal shared by 1,000 workers of setting a new safety record.

During this construction project, one worker was injured with a broken arm. He had it reset at the infirmary and returned to work the next day so his crew wouldn't "blow the record" for everyone else. (Of course, the concerned safety staff placed him in a light-duty assignment.) Why did he return to work? The answer leaps off the page: He wasn't trying to win a prize, he was trying to be a hero.

The Human Desire to be Heroic
Human beings are goal-oriented. We crave recognition and a sense of "being on the team." From an early age, we are taught that being a hero is admirable--that giving 110 percent when our bodies are functioning at only 50 percent is having "the right stuff."

Consider these stories:

Cyclist Lance Armstrong (a cancer survivor) wins his fifth consecutive Tour de France, all the while suffering from the flu during the first few stages of the grueling race. Olympic gymnast Kerri Strug nails a perfect landing on the vault with a severely sprained ankle, winning the gold medal for the USA team.

Teenage surfing champion Bethany Hamilton loses an arm to a shark attack during a competition. Surprisingly, she heads back to the surf within a month of her injury.

The newspapers are filled with stories like these, pulled from the sports arena, battlefields, and the like. News reporters can attest to their wide appeal among the general public. So is it any wonder then that we seek to imitate such heroic behaviors?

The bottom line is that human beings inherently want to be heroes. Which leads me to my next point: Often, the root cause of injury hiding may not involve an incentive program at all. Instead, it is driven by the need that all of us have for recognition. Some employees want to be heroes and seek to establish themselves as the toughest guy on the crew: someone who can work through any pain or trauma.

We have heard of many employees who proudly show off a lost finger or hand. We have heard co-workers tell stories like this: "After his arm was cut off, he picked it up with the other hand and walked to the ambulance." (Consider the recent news story of Aspen mountaineer Aaron Ralston, who cut off his own arm with a pocketknife when it became hopelessly pinned under a 800-pound boulder. After his rescue, he spoke of how he couldn't wait for his next hiking adventure.)

In short, we are convinced many behavioral safety experts have missed a major reason people hide their injuries in the workplace. Being a hero and working "hurt" allows them to get the recognition and positive affirmation that they need from their peers. Along this same line of thinking, is it possible that employees like these might fake an injury, stage one, or even create one at home to gain the recognition they crave? It may sound far-fetched, but perhaps some of the injuries employees "hide" are actually created by them to gain hero status, after news of the injury "mysteriously" leaks out.

Numerous industry surveys have shown that employees rate the need for recognition as the number-one factor in job satisfaction, while money ranks a distant fifth. You may be surprised to learn that 73 percent of all employees report they are not thanked or praised enough.

We submit that in work environments where employees are thanked and praised regularly for positive behaviors, responsible management is meeting their need for support and recognition. These environments don't just "happen," they are created with the help of a well-planned recognition program. Neanderthal companies that cling to the misconception that "a paycheck is recognition enough" have created a culture where employees will hide injuries to be a "hero" or "help" the team.

Done Right, Incentive Programs Work
In the ongoing debate of whether incentive programs can lead to injury hiding or not, we would like to assert that yes they can--if misused or abused. (Keep in mind, there is a difference between incentive programs and recognition programs. The former focuses on prizes, while the latter focuses on recognizing behavior changes.)

When properly designed using the experience of a qualified recognition consultant, recognition programs can take a company's safety program to the next level without injury hiding. As a matter of fact, we help many clients to achieve this success every day. Finally, regardless of where you sit on the issue of injury hiding, I would caution all of us to accept the humbling truth that nobody is the master of human behavior. There are no easy answers or quick fixes. Anyone who supposes otherwise will always find himself proven wrong.

This article originally appeared in the June 2004 issue of Occupational Health & Safety.

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