Stress Audit Process

Audit in medical practice is now an accepted part of established procedure and is a tool which can be applied to all aspects of practice.

Audit can be performed in two main ways:

• External: An outside auditor examines how work is being carried out and
• Internal: Those who actually are employed in the workplace carry out the assessment.

There are advantages and disadvantages to both of these and the tool which is used depends on several factors including the purpose of the audit, the competence of those carrying it out and available finance.

A stress audit may be carried out by someone who is medically trained or by someone with a different background. Management consultants are increasingly involved in stress because of the close links between management style and stress problems. Other specialists and non-specialists may also offer audits and treatment services.

Stress Audit

Stress might affect job performance either because working conditions are stressful or because of personal stress factors outside work. A stress audit should be designed to differentiate between these. There are several reasons why a company may decide to tackle stress. Many organizations take action without having first established whether or not stress is a problem or indeed whether or not work-related stress occurs. An analogy might be made with prescribing medication without having made a diagnosis. A wise employer should endeavour to find out whether or not stress is a problem in their working environment, identify whether or not such stress is primarily due to working conditions and quantify the extent of the problem before deciding on any measures to combat the effects of stress. This means carrying out a stress audit

There are several levels at which a stress audit may be conducted:

• Evaluation of organizational dysfunction;
• Identification of work stressors such as work overload, job insecurity, poor channels of communication, ineffective management, constant change and frustration;
• Measurement of stress-related illness in employees and
• An evaluation of indicators such as absence or staff turnover

Significant stress is often associated with organizational dysfunction and a stress audit should concentrate on management style and gain an overall picture of the health of the organization and the way in which it is run in order to be effective.

Even when they recognize that there is a problem, some employers are reluctant to agree to an audit because they fear that this may expose their deficiencies. The situation is particularly delicate when senior executives are aware that management style is likely to be a major factor in stress causation.

Methodology for carrying out a stress audit

The first task is to decide on a clear objective for the audit This might be to ascertain whether or not stress presents a problem, the extent of stress-related illness in the organization or identification of the causes of stress in a particular work environment.

Most audits are carried out using a questionnaire distributed to a study population. There are those which have already been validated (such as the Occupational.

Stress Inventory and the Occupational Stress Indicator) and it is sensible to use one of these. Otherwise, it will be necessary to carry out a pilot exercise to validate the questionnaire. The study population may be the entire workforce or may concentrate on a specific department or problem area.

Alternatively, one-to-one interviews may be carried out with a sample population. These will give a more in-depth view of staff feelings regarding stress but, realistically, only a small number of staff can be interviewed in this manner because the process is time consuming.

Evaluation and feedback

Computer-based scoring systems are increasingly used. These allow ease of collating results and have the particular advantage that, depending on the programme which is used, comparisons of different departments and other key issues can be accessed.

A report should include recommendations which give the employer action points and goals to achieve within a certain time-frame and which lead to the development of a stress policy if the employer does not have one already.

Feedback to the employer is vital. This may be the hardest part of the exercise if issues need to be raised which are not likely to find favour. However, the auditor must give an honest appraisal of the findings and encourage a positive viewpoint. The consequences of not being honest are that the auditor may be held responsible if the employer is subsequently found negligent for not tackling stress and can show that he was not aware of the audit findings. Ideally, there should be the opportunity to repeat the audit after a period of time (for example, one year) in order to evaluate what measures have been put into place and their effectiveness.