"Decision-critical" work: a conceptual framework.

Area of Science:

• Occupational Health
• Human Factors Engineering
• Psychology

Background:

• Safety-sensitive workers undergo fitness-to-work assessments due to direct safety risks from performance errors.
• Existing assessments do not adequately address a distinct group of workers whose impairment has indirect but significant consequences.
• The concept of "orbit of harm" extends beyond immediate safety incidents to encompass broader workplace disruptions.

Purpose of the Study:

• To differentiate "decision-critical" workers from "safety-sensitive" workers.
• To highlight the unique risks associated with impairment in decision-critical roles.
• To propose a novel approach for fitness-to-work assessments tailored to decision-critical personnel.

Main Methods:

• Literature review and conceptual analysis to define "decision-critical" workers.
• Comparative analysis of risk profiles between safety-sensitive and decision-critical roles.
• Development of a framework for fitness-to-work assessments for decision-critical workers.

Main Results:

• "Decision-critical" workers are identified as a distinct occupational category.
• Impairment in decision-critical roles can negatively impact workplace performance, relationships, attendance, and quality.
• The "orbit of harm" for decision-critical workers involves subtle but pervasive workplace disruptions.

Conclusions:

• "Decision-critical" workers represent an under-recognized group in occupational health literature.
• Current fitness-to-work assessments may be insufficient for evaluating decision-critical personnel.
• A specialized approach to fitness-to-work assessment is required for decision-critical workers to mitigate potential harms.