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Standard Operating Policy

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Work Related Fatigue Mitigation and Management Policy

Document No.

File No.

Date issued Contents Policy Statement Work Related Fatigue Mitigation and Management Policy

Guideline G1: Definitions of Fatigue Mitigation and Management Options

Protocols P1: Assessment of fatigue level P2a: Notification of fatigue (no on call component / corporate) P2: Notification of fatigue P3: Return to full availability P4: Post-fatigue Management

Examples E1: Sample Timesheet

Appendices A1: Rostering Protocol E4 (Notification of Fatigue) A2: Rostering Protocol E5 (On Duty Planned Leave)

Author Branch General Manager Operations

Branch Contact Ken Pritchard

Division Operations – State Headquarters

Summary The purpose of this policy is to set out the fatigue mitigation and management framework for Ambulance employees.

Applies to All Ambulance staff and Volunteers

Review Date June 2014

Previous Reference SOP2008-005

Status Active

Approved by Chief Executive

Related Documents Rostering Protocols and Procedures Fatigue-related Control Centre Protocols and Procedures WorkCover Code of Conduct Work Health & Safety Act 2011

Revision History Version (Circular Review V0.1 Sept 13 ) Amendment notes

Sept 13 SOP2012-xxx

Approval for issue

Compliance with this policy directive is mandatory



Policy Statement: Work Related Fatigue Mitigation and Management PURPOSE The purpose of this policy is to set out the fatigue mitigation and management framework for Ambulance employees. The management of fatigue is a shared responsibility between Ambulance and its employees. The objective of this policy is to:

• promote a safe and healthy working environment free of work related injury or illness; • minimise the risks of employees presenting for work or conducting work while impaired; • establish appropriate steps to manage employees who are affected by fatigue; and • encourage employees affected by fatigue to seek assistance.

WHAT IS FATIGUE? Work related fatigue is a state of mental or physical exhaustion that can affect a person’s ability to function normally at work. More than feeling tired and drowsy, work related fatigue is a physical condition that can occur when a person’s physical or mental limits are reached. Fatigue is cumulative and directly correlates to periods of sleep and activity. Where employees are ‘on call’ and do not get adequate rest and sleep between periods of activity, they may experience mental or physical tiredness. This may manifest as:

• difficulty in concentrating and becoming easily distracted; • poor judgment and decision making; • reduced capacity for effective interpersonal communication; • reduced hand-eye coordination and visual perception; • reduced vigilance; • slower reaction times; and • reduced memory.

Fatigue related impairment is an identifiable workplace hazard. The most effective means to manage fatigue is to have adequate restorative sleep. RESPONSIBILITIES FOR MANAGING FATIGUE Employees Are responsible for commencing a shift, or a series of shifts, in a fit and proper physical and mental state. Rostered days off provide an opportunity to rest and employees should ensure that activities undertaken while off duty do not leave them fatigued at the commencement of a rotation of rostered shifts. Employees are also responsible for:

• Participating in education and training as provided in order to gain an understanding of fatigue; • Avoiding behaviours and practices that contribute to fatigue, and which could place themselves and others at

risk – for example, secondary employment, or not using time off work to recuperate; • Recognising signs of fatigue that could place the health, safety and well-being of themselves or others at risk

and reporting this to their manager or supervisor. Supervisors & Managers Have a responsibility to monitor access to fatigue mitigation and management strategies. These responsibilities include:

• Applying risk management strategies in consultation with staff; • Providing opportunities for employees to obtain adequate rest from work; • Monitoring workloads, work patterns and rostering arrangements; • Providing information, instruction and training about risks to health, safety or welfare of employees involved

with shift work, extended hours and on-call arrangements; • Ensuring employees performing shift work have proper supervision and that tasks are undertaken safely; • Assisting employees with non-work fatigue related issues.

Control Centres



Have a responsibility to consider fatigue in dispatching resources and to monitor access to fatigue mitigation and management strategies. These responsibilities include:

• Communicating at handover staff who have or are accessing fatigue options • Providing opportunities for employees to obtain adequate rest from work, for eg; Providing crib breaks and

minimising unnecessary extension of shift • Proactive management of demand during on duty and on call periods, in particular consideration to responses

at near or end of shift • Applying risk management strategies in consultation with staff and relevant supervisors & managers;

FATIGUE IN EMPLOYEES ROSTERED WITH NO ON CALL COMPONENT Fatigue management is an essential component of work and health safety and patient safety. The Operational Ambulance Officers Award provides for a minimum 10 hour break between shifts except in case of an emergency and by agreement between the Service and the employee (Clause 22(e)(i)). The Award also provides that an employee who works so much overtime after the completion of their shift on any day that results in less than eight consecutive hours off duty before the commencement of their next shift will be released after the completion of such overtime until they have had eight consecutive hours off duty, with no loss of pay for ordinary working time occurring due to such absence (Clause 22(e)(ii)). Employees who work according to a roster which does not have an on call component, and who experience fatigue should refer to Fatigue Protocol 2a in consultation your duty supervisor. FATIGUE IN EMPLOYEES ROSTERED WITH AN ON CALL COMPONENT Employeesrostered with an on call component and who have identified that they are fatigued are able to access a sleep in, reduced availability or rest in order to mitigate and manage their fatigue. There is no objective measure of fatigue for employees, and fatigue affects individuals differently. Employees rostered with an on call component are encouraged to continually assess their fatigue levels during periods of duty. Work arrangements for individual employees who experience ongoing fatigue when fulfilling on call duties may be reviewed by their supervisor/manager. This review may include temporary or permanent options to alleviate the impacts of fatigue. The fatigue mitigation and management options for employees rostered with an on call component are Sleep-in, Limited Availability and Rest (refer Guideline G1 for definitions and Fatigue Protocols 1-4 for application).



G1 Work Related Fatigue Mitigation and Management Guideline DEFINITIONS 1. Assessment of Fatigue

• Employees should monitor and assess their fatigue level by: − Monitoring their own alertness and checking for fatigue related symptoms (such as difficulty in

concentration, loss of energy and initiative, lethargy, weariness, memory lapses and errors in decision making);

Using an Individual Assessment Tool • An Individual Assessment Tool (IAT) is a provided in this policy as a guide for all employees Sleep-in (up to

50% of the next shift length) • Sleep-in is a fatigue management strategy for employees rostered with an on call component. This allows an

individual paramedic to return to station and commence duty up to half way through their next rostered shift. • During the sleep-in period, the paramedic is an available resource and following a risk assessment by the

Control Centre may be tasked for all levels of responses. • In instances of repeated recall to duty whilst on sleep in the paramedic can extend the sleep in if necessary

2. Limited Availability (From time of notification and up to 50% of the next shift length ) • Limited availability is a fatigue management strategy for employees rostered with an on call component. This

allows an individual paramedic to return to station and commence duty up to half way through their next rostered shift.

• During the limited availability period, the paramedic is an available resource and following a risk assessment by the Control Centre may be tasked for 1A, 1B, 1C and other immediate responses.

• In instances of repeated recall to duty whilst on limited availability the paramedic can extend if necessary • Rest (From time of notification and up to 50% of the next shift length ) • Rest is a fatigue management strategy for employees rostered with an on call component. • It provides undisturbed rest from the time of notification and up to 50% of the next rostered shift.

NOTES

• Increased rest time: Where employees require an increased rest time greater than that provided in this policy supervisors &/or managers will make arrangements to reallocate subsequent on call wherever possible to provide employees time to recover from fatigue.

• Vehicle access plan: During a period of Limited Availability or Rest, operational continuity must be maintained by ensuring that the vehicle is accessible when necessary.

• Specialist Skills: Employees who are certified with specialist skills, such as Rescue, Special Operations and SCAT, are not to be used for specialist or technical deployments for up to 24 hours following the completion of a period of Limited Availability or Rest unless a comprehensive risk assessment is undertaken and documented.

• Repeated access to Limited Availability and Rest: Employees are not to be considered by supervisors & managers for overtime or additional on call duties in the first 24 hours of their days off.

• Staff welfare: Where employees have repeated instances of repeated access to limited availability or rest provisions then the supervisor/manager will conduct a welfare check and document this action. This provides employees time to recover from fatigue before returning to any type of duty.

• Recording access to fatigue mitigation and management options: Each Control Centre is responsible for recording instances of Sleep In, Limited Availability and Rest and updating this record when advised of changes.

• Crib penalties: Employees who access Sleep in, Limited Availability or Rest over their crib period may not claim crib penalties.



Work Related Fatigue Mitigation and Management Procedure ASSESSMENT OF INDIVIDUAL FATIGUE LEVEL Purpose The purpose of this protocol is to guide employees rostered with an on call component in assessing their fatigue level. The assessment tool below utilises a matrix system to provide an indication of a person’s likely fatigue state. It works very similar to that of the Severity Assessment Code (SAC) scores used in the IIMS system. To determine a fatigue score the employee determines the amount of sleep obtained in 24hrs across the top, then determines the amount of sleep obtained in 48hrs down the side. Where these two scores intersect determines the overall fatigue score. Each matrix box is labelled with the recommended course of action to take however individual requirements may vary.



P2a (No on call component) Work Related Fatigue Mitigation and Management Procedure NOTIFICATION OF FATIGUE Purpose The purpose of this protocol is to establish the activities, roles and responsibilities required to manage the identification and notification of fatigue in employees who undertake on duty activities.

Fatigue Protocol 2a (No on call component): Notification of fatigue

Fatigue Protocol 2a (Corporate): Notification of fatigue

Paramedic DOM Employee Manager

Paramedic feels fatigued and

cannot continue working

Call sick phone (Duty DOM)

Follow Protocol Rost E5 for on duty unplanned

leave

End

Employee feels fatigued and

cannot continue working

Call manager Authorise sick leave

End



P2 Work Related Fatigue Mitigation and Management Procedure NOTIFICATION OF FATIGUE Purpose The purpose of this protocol is to establish the activities, roles and responsibilities required to manage the identification and notification of fatigue in employees rostered with an on call component.

Fatigue Protocol 2: Notification of Fatigue

Paramedic Duty Operations Manager Control Centre

Is IAT >5?

Do you need to mitigate fatigue?

Continue to monitor

Yes

Yes

No

No

Paramedic has conducted IAT

Is DOM on duty? Yes Call Duty DOM

No

Contact Control

Follow Protocol Rost E4

Request access to fatigue mitigation or management

option as per IAT; discuss vehicle

access plan

Ensure mitigation or management

option is recorded

Exercise fatigue mitigation or management

option

End



P3 Work Related Fatigue Mitigation and Management Procedure RETURN TO FULL AVAILABILITY Purpose The purpose of this protocol is to establish the activities, roles and responsibilities required to manage a paramedic returning to full availability after accessing a fatigue mitigation or management option (for employees rostered with an on call component).

Fatigue Protocol 3: Return to full availability after accessing fatigue mitigation and management option

Paramedic Control Centre

Record sleep-in/Limited Availablity/Rest on timesheet and sign-on book

Paramedic is ready to return to

full availability

Contact Control Check paramedic welfare

End



P4 Work Related Fatigue Mitigation and Management Procedure POST-FATIGUE MANAGEMENT Purpose The purpose of this protocol is to establish the activities, roles and responsibilities required to manage employees post-fatigue.

Fatigue Protocol 4: Post-Fatigue Management

Duty Operations Manager

End

Follow Protocol Rost E4

Contact control centre supervisor for fatigue update

Are roster changes required?

Yes

No

End

Confirm paramedic time of return to duty is

correct in myShift; check next on call,

check next overtime

Contact paramedic to check welfare

Run myShift fatigue report at

commencement of shift


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E1 Work Related Fatigue Mitigation and Management Example SAMPLE TIMESHEET FOR EMPLOYEES WHO PERFORM ON CALL ACTIVITIES

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A1 Paramedic Rostering – Fatigue Notification (Protocol Rost E4) (Protocols and Procedures for Paramedic Rostering, p. 52)

PARAMEDIC ROSTERING – FATIGUE NOTIFICATION PROTOCOL ROST E4

The purpose of this protocol is to establish the activities, roles and responsibilities required to manage paramedic fatigue notifications.

Paramedic Duty Operations Manager Control Centre Supervisor

There is a need to exercise a fatigue

mitigation or management option per the Fatigue

Policy

Notify the Control Centre Supervisor

of the change to the roster

Notify the dispatcher of the

instance of fatigue, note change to the

roster

Follow Procedure Rost D6.1 Backfill

vacancy

1 hr prior to day shift, review

operational need & contact the Zone

Manager if required

Are additional resources

authorised?

Notify the DOM and Control Centre upon

return to duty

End

Is the time of return different to

the myShift record?

No

Update the myShift record with the actual

shift start time

Yes

Notify the Control Centre Officer of the

outcome

Notify the Control Centre Supervisor of

the outcome

Log the instance of fatigue in myShift per Procedure Rost E4.1


of the outcome

Exercise Rest Option as agreed

with the DOM

Is DOM on duty?

YesYes

NoNo

Call the duty phone to speak to

the DOM

Contact Control Centre Supervisor

Is DOM aware of paramedic

fatigue?YesYes

NoNo

Contact DOM at commencement of

shift

YesYes

NoNo

Notes Where, due to overtime commitments, a continuous break of 8 hours between shifts has not occurred prior to shift commencement, an amended re-commencement time needs to be confirmed with the paramedic and the Duty Operations Manager in accordance with Ambulance Officers (State) Award Clause 22(e)(ii). * As per the Ambulance Officers (State) Award Clause 23 (c), an employee who is called out for duty totalling 4 hours or more actual work within 8 hours of the scheduled commencement of their next rostered shift is entitled to exercise the Rest Options provision of the Service’s Fatigue Management Standard Operating Policy (SOP2008-005 or its replacement).



A2 Paramedic Rostering – On Duty Planned Leave (Protocol Rost E5) (Protocols and Procedures for Paramedic Rostering, p. 53)

PARAMEDIC ROSTERING – ON DUTY UNPLANNED LEAVE PROTOCOL ROST E5

The purpose of this protocol is to establish the activities, roles and responsibilities required to manage situations where a paramedic reports that he/she requires on duty unplanned leave, e.g. due to sickness or injury.

Note: At times when the Deployment Officer is off duty, the Duty Operations Manager should carry out the activities of the Deployment Officer.

Paramedic Duty Operations Manager Deployment Officer Control Centre

Supervisor

Contact the DOM on the Duty Phone

Check on the welfare of the

Paramedic

Identify the need for on duty unplanned leave

Yes

No

Is a replacement

resource required?


Update the Unplanned Absences register in

myShift per Procedure Rost D1.3

Follow Procedure Rost D6.1 Backfill

vacancy

Notify the Control Centre Officer of the

change to the area staff sheet

Notes

• If a paramedic does not attend training due to sickness, the training instructor should notify Sector Office. Refer to Protocol Rost D2 Training Change Requests.

• The Duty Operations Manager should review operational needs to determine whether replacement resources are required.

• The DOM should advise the paramedic to submit Form 243 and other necessary paperwork to the Officer in Charge as soon as possible.