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4
Factors Influencing Workforce Effectiveness
and Resilience
This chapter includes sessions that examined work-related stressors
from both workshops. These presentations and discussions were used to
provide a broad understanding of workforce stressors and how they af-
fect individual and organizational resilience.
In the September 2011 workshop, Dr. Bryan Vila from Washington
State University presented the effects of sleep and fatigue on the resilience
of law enforcement personnel.
The November 2011 workshop includes a series of presentations de-
voted to exploring workforce issues and stressors that affect resilience.
These presentations looked at organizational level factors that influence
resilience, and several include descriptions of possible interventions to
address this concerns.
Dr. David Woods presented an overview of issues common in high-
reliability organizations (HROs)1 and complex adaptive systems that dis-
rupt organizational resilience. Dr. Ellen Kossek’s presentation discussed
how job structures affect employees’ ability to balance their professional
and personal obligations, as well as decrease workforce productivity. Dr.
Kimberly Smith-Jentsch presented information on how team stress influ-
ences both organizational and individual effectiveness.
The role of leadership in promoting and supporting resilience was a
theme of many presentations at the September 2011 workshop. In order
to explore this issue in more depth, the planning committee invited
Col. Paul Bliese to discuss the evidence demonstrating the effect of lead-
1
High-reliability organizations (HROs) perform extremely well despite high difficulty
and hazards where the consequences of failures are high (Sutcliffe and Vogus, 2003;
Weick et al., 1999).
61
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62 BUILDING A RESILIENT WORKFORCE
ership on resilience and Stephanie Lombardo to describe DHS’s new
Leadership Development Program.
The last two presentations in the chapter include an overview of the
National Security Agency’s (NSA’s) health and wellness program design
by Rebecca Pille, and a health and wellness framework developed by the
Defense Centers of Excellence for Psychological Health & Traumatic
Brain Injury (DCoE) by Dr. Mark J. Bates.
Although these presentations range broadly they are tied together by
cross-cutting themes that illustrate the interrelationship between organi-
zational and individual stressors and resilience (see Box 4-1).
BOX 4-1
Themes from Individual Speakers on Factors Influencing
Workforce Effectiveness and Resilience
The role of leadership
Relationship between team/unit effectiveness and individual
resilience
Relationship between physical and mental well-being in resilience
Balance between personal and professional obligations on
resilience
Understanding organizational cultures in designing interventions
Role of evidence and performance measurement in developing
and improving interventions
SLEEP AND PERFORMANCE
Dr. Bryan Vila is currently a professor of Criminal Justice and Direc-
tor of the Simulated Hazardous Operational Tasks Lab in the Sleep &
Performance Research Center at Washington State University in Spo-
kane. Prior to his research career Vila served as a police officer for 15
years, first in the Los Angeles County Sheriff’s Department, then as di-
rector of law enforcement and security for the Trust Territory of the Pa-
cific Islands in Micronesia. He also worked for 2 years as chief of the
Department of the Interior’s Emergency Preparedness Branch. Vila’s
research has focused on the impact of fatigue on police officer perfor-
mance, health and safety issues, and other factors that affect police per-
formance in a work environment.
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
In starting his presentation, Vila noted that there has been a steady
decline since 1980 in the proportional number of police officers killed
annually. The same is true for accidental deaths. Although the Centers
for Disease Control and Prevention (CDC) collected national occupational
mortality statistics for police officers only from 1984 to 1998, information
during that time suggests that suicide rates among police officers tend to
be as high as felonious or accidental deaths. Additional information
about DHS concerns with sleep and fatigue can be found in Chapter 2.
Fatigue and Resilience
Vila stated that human beings are built to work during the day and
sleep at night. Fatigue associated with sleep loss, work hours, and circa-
dian factors affect the ability to form sound judgments, deal with com-
plex and stressful situations, and assess fatigue-related impairments.
Fatigue narrows an individual’s perceptions, increases anxiety and fear-
fulness, reduces his or her perspective and understanding, and degrades
cognitive ability. Fatigue also increases irritability, hostility, and the ten-
dency to shift blame. Vila contends that fatigue reduces resilience
There is a persistent struggle for law enforcement managers to bal-
ance the demands for services with the resources available. Often the
managers’ ability to push back when the demands exceed the capacity of
the available resources is limited. As a result, managers are then forced
to increase work load on the staff, which leads to increased job stress.
Although everybody likes being able to do their job, nobody likes being
tasked with the impossible.
Vila presented a model from the new edition of Principles and Prac-
tices of Sleep Medicine that characterizes the impacts of fatigue for first
responders, the military, and police. This model includes the standard
medical model for thinking about resilience. There are three central fac-
tors within the model (1) how much sleep you get, (2) what is the circa-
dian phase, and (3) what is the domestic life like (Kryger et al., 2005).
Those factors together affect the ability to cope with challenges.
Day-to-day fatigue reduces the ability to handle change. Short-term
sleep loss affects performance, leading to on-duty events that most fre-
quently kill or seriously harm law enforcement officers such as traffic
crashes and confrontations.
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64 BUILDING A RESILIENT WORKFORCE
Chronic Fatigue
Career-long fatigue or chronic fatigue elevates the risk of cardiovas-
cular, gastrointestinal, and metabolic diseases, such as diabetes. Chronic
fatigue increases the risk of chronic insomnia, sleep apnea, and psycho-
logical disorders such as depression, suicide, and family dysfunction.
There are many causes of chronic fatigue such as sleep disruption due to
shift work, schedule changes, overtime, and extra shifts. Additionally,
during their hours off of work many officers moonlight or choose family,
personal, and recreational activities over sleep. They may have personal
obligations such as watching their children, and/or choose to use their
time off for leisure activities like fishing. Addressing these issues re-
quires a cooperative effort between labor and management. Both manag-
ers and employees bear responsibility for part of the solution, but if
either side does not address its piece, the solutions will fail. To increase
everyone’s understanding of the importance of this issue, it is necessary
to educate both groups. Although one size does not fit all, the process
can translate across many environments.
Fatigue fuels a vicious cycle for the organization as well as the indi-
vidual. Because fatigue decreases attentiveness, impairs physical and
cognitive functioning, and worsens mood, it increases absenteeism,
which results in the need for other staff to pick up the load, which then
cycles back to increased fatigue.
Fatigue Research
A number of studies examine the effects of fatigue on law enforce-
ment officers and first responders. The National Institute for Occupation-
al Safety and Health (NIOSH) has a cohort study in Buffalo, New York,
including more than 80 percent of the police officers in the Buffalo po-
lice department. About 500 participants and nearly a thousand measures
look at the impact of police work and job stress on cardio-metabolic fac-
tors. The National Institute of Mental Health (NIMH) and the National
Institute of Justice also are funding a 6-year prospective study of post-
traumatic stress disorder (PTSD), starting with police recruits and mov-
ing forward across their careers. Another good example is the NIOSH-
funded Safety & Health Improvement: Enhancing Law Enforcement De-
partments (SHIELD) program at the Oregon Health and Science Univer-
sity, which is developing a novel peer-based health promotion education.
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
Another tool under research involves using wrist actigraphs to pro-
vide an objective measure of how much sleep an individual has gotten.
Actigraph data are then entered into a mathematical performance model,
which was developed by the Department of Defense (DOD) and Depart-
ment of Transportation to identify when people are at risk, and when
they are better able to perform their jobs safely. Although existing mod-
els examined these issues at the organizational level, they are now being
adapted to predict fatigue at the individual level.
Vila noted that there are many knowledge gaps. How do you meas-
ure resilience? What are your baseline measures? How can you measure
fatigue risks for law enforcement officers? Is it best to look at the effect
of fatigue on situational resilience? What are the maximum safe hours on
duty for different assignments? What is the ideal timing of shift changes?
Can you measure staffing and distraction in patrol vehicles? The research
is continuous.
HIGH-RELIABILITY ORGANIZATIONS AND COMPLEX
ADAPTIVE SYSTEMS
Dr. David Woods is a professor in the Institute of Ergonomics at
Ohio State University, and he leads the university-wide initiative on
Complexity in Natural, Social and Engineered Systems. He provided an
overview of issues common in HROs and complex adaptive systems and
how they relate to Department of Homeland Security’s (DHS’s) organi-
zational resilience. Woods discussed systems-level resilience and brittle-
ness and made observations about the challenges DHS faces in
developing an overall resilience strategy. Reiterating a common theme
throughout the workshop series, Woods noted there is a language prob-
lem between different communities involved in resilience and resilience-
related work. The languages in these various fields of research have
evolved in different ways, and often the same words are used to mean
very different things, and different words are used to mean exactly the
same things.
High-Reliability Organizations and Resilience
Woods summarized the five basic characteristics of HROs: preoccu-
pation with failure, reluctance to simplify, sensitivity to operations,
commitment to resilience, and deference to expertise. For example, pre-
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66 BUILDING A RESILIENT WORKFORCE
occupation with failure means that at every level within HROs, people do
not rest on past successes but recognize that the future may hold surpris-
es as well as new vulnerabilities and risks. Thus, research on HROs has
revealed some of the components of proactive safety management. Pro-
active safety management within HROs and other complex systems is
more than just rebounding from a stressful event. HROs are able to antic-
ipate and prepare for new threats. The commitment to the characteristic
of resilience involves both aspects. To be able to anticipate and recognize
emerging threats requires information flowing within the HRO. The
characteristics of sensitivity to operations and deference to expertise are
critical to interpreting incoming information to recognize new threats.
Woods provided examples of organizations that have failed because
of a lack of resilience—otherwise known as brittleness (Woods, 2005).
Some factors that can increase brittleness of a system include intense
short-term efficiency and productivity pressure. Increasingly autonomous
machines also tend to be brittle unless the system design provides mech-
anisms that make the machine a team player with other groups, roles, and
people. When the joint system of people and automated machines is
poorly designed, people become a generic source of adaptive capacity to
make up for the brittleness because they must develop work-arounds that
stretch the ability of the system to handle variations to plans and surprise
events. Unlike automated systems, people are able to adapt to handle
conditions outside their standard model (Woods and Hollnagel, 2006).
Woods pointed out an irony about organizations that seek ultrahigh
reliability even though employees perform difficult and risky tasks.
HROs need to encourage sharing of information about weaknesses and
problems in the system, but exposing and sharing information about
weaknesses is sometimes interpreted as indicating the organization is not
performing well. To encourage information sharing, HROs should resist
blaming individuals as the source of the exposed weaknesses. Infor-
mation about weaknesses is essential to diagnose system issues that the
organization needs to learn about and change before the weaknesses
grow and combine to create an accident or adverse event (Woods et al.,
2010).
The basic characteristics of HROs reveal that weaknesses are not
simply a problem residing in individual people or specific human groups;
rather the difficulties are symptoms of complexity that resides in what
the organization does, the variations around the situations it confronts,
and the environment that surrounds it. Complex systems are networks of
highly interdependent nodes, roles, groups, and activities; the perfor-
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
mance of the complex system emerges from the interactions and inter-
play across the network and not simply from a single node. World events
can challenge these networks and produce cascades of effects that can
overwhelm the organization. Even more difficult is that our understand-
ing of the network is always going to be incomplete because the interde-
pendencies change structurally and dynamically (Hollnagel et al., 2006).
Woods used the example of effects from extreme weather when recent
events in one part of the world cascaded in unpredictable ways across
multiple industries and organizations around the world.
As people have begun to recognize the importance of resilience in
systems, Woods indicated that there has been a progression of concepts.
Historically, resilience was approached as the idea of rebound and recov-
ery in the aftermath of a traumatic event. Others focused on expanding
the range of challenge events and disruptions a system could handle (ro-
bustness). The concept progressed to focus on the factors that allow a
system to continue to operate or to degrade gracefully when difficulties
surge and cascade, challenging the normal responses of that system. Re-
cently, there have been advances in fundamental theories about complex
adaptive systems that capture the basic properties that (1) allow systems
to adapt to surprising events and (2) allow systems to better manage
basic trade-offs from competing goals.
Complex Adaptive Systems Approach to Resilience
Woods discussed three basic patterns of how complex systems break
down in the face of challenges and how these patterns apply across mul-
tiple scales (Hollnagel et al., 2011). In other words, these patterns can be
seen at the level of an individual, team, organization, or industry. The
three patterns are:
1. Decompensation—Exhausting capacity to adapt as disturbances
or challenges grow and cascade. Decompensation refers to
breakdowns that occur because of complexities in time.
2. Working at cross-purposes—Behavior that is locally adaptive
but globally maladaptive. Working at cross-purposes refers to
breakdowns that occur because of complexities that operate
across scales.
3. Getting stuck in outdated behaviors—The world changes, but the
system remains stuck in what were previously adaptive strate-
gies. Getting stuck in outdated behaviors refers to breakdowns
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68 BUILDING A RESILIENT WORKFORCE
that occur because of complexities in the process of learning
from and about experiences.
Woods used results from a study on urban firefighters to demonstrate
these three forms of adaptive breakdown. Urban firefighting includes
people in multiple roles at different echelons, trying to balance multiple
goals and sharing responsibility for outcomes. Interdependencies stand out
between different roles, different teams, and different echelons, and these
all depend on how the demands of the situation change and evolve.
He used an example from incident command that illustrated the risk
of falling into the trap of decompensation. Commanders noted that if
they waited to call in extra resources until the need was definitive, it was
too late to avoid breakdown. They had to anticipate the need before they
had run out of capability to respond to events even though sometimes the
pace of events would recede and new resources might not be needed.
Incident commanders needed to be able to deploy resources to keep up
with the current events while maintaining the ability to respond to and
keep pace with possible future events. This ability to anticipate and re-
spond to the next challenge event is called the margin of maneuver. Mar-
gin of maneuver is a simple, central parameter that can be defined and
controlled across scales and types of organizations. Do you have suffi-
cient margin to maneuver to handle future events? If you do not or can-
not maintain that extra margin, the system in question will be too brittle.
However, if you maintain lots of extra margin, you are going to be too
inefficient, and the extra resources will dwindle away. In advance of cri-
ses it has proven quite difficult to discriminate between sources of resili-
ence that sustain margin of maneuver and true inefficiencies.
Woods used other results from studies of critical incidents in fire-
fighting to illustrate the breakdown pattern of working at cross-purposes.
This happened when the actions of one group inadvertently increased the
threats to another group. As firefighters advance they should always
maintain a line of retreat or identify a safe haven should a threat occur. In
other words, they act to have sufficient margin to maneuver to protect
themselves should dangers increase suddenly. In a subset of critical inci-
dents, one group moved forward, relying on a line of escape, but another
group fought the fire in a way that inadvertently cut off the first group’s
line of retreat. When the fire situation deteriorated suddenly, the planned
line of retreat was not open to the firefighters, increasing their risk of
injury or death.
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
Woods noted how concepts about resilience, such as the three pat-
terns of breakdown and the general parameter of margin of maneuver,
apply to systems across scales ranging from human physiology all the
way to large organizations such as DHS. Units, organizations, and people
create, sustain, and defend their margin to maneuver to meet their re-
sponsibilities in the expectation that surprises can and will occur. In the
process, there are collisions between different units where one unit, to
sustain its margin, squeezes and reduces another unit’s ability to sustain
its margin, as occurred in the firefighting critical incidents Woods used
as examples. If a role, group, or unit must struggle intensely to maintain their
margin of maneuver, it has a high risk of experiencing decompensation fail-
ures. If a unit regularly but inadvertently squeezes another unit to sustain or
defend its appropriate margin, these units are at high risk for working at
cross-purposes. If units do not study and share information about how the
organization brings extra adaptive capacity to bear beyond standard pro-
cedures and plans, they will be overconfident and miscalibrated, and, as a
result, will suffer from high risk of getting stuck in an outdated model of
the world.
Woods also noted how people bring special properties to the opera-
tion and regularities of complex adaptive systems. People can reflect on,
model, and learn about the systems in which they operate or are stake-
holders. When individuals, groups, or units are constantly struggling to
sustain some margin of maneuver as they carry out tasks so as to forestall
possible failures, they are under a form of stress. Because of the reflec-
tive capability of people, their recognition that events regularly risk loss
of margin of maneuver is also a form of stress. When systems operate in
ways that have a high risk of falling into the three patterns of adaptive
breakdown, challenge events are experienced as stress.
The basic properties of HROs, such as deference to expertise, reluc-
tance to simplify, and sensitivity to operations, are correlates of process-
es in organizations that can obtain information about weaknesses, such as
the risk of decompensation, and that stimulate learning about ways to
avoid such traps as working at cross-purposes. But systems that violate
the basic properties of HROs appear to operate with higher risk of falling
into one or another of the three basic adaptive traps. And people working
in such systems will experience cases of near loss of margin of maneuver
as stressful events as they are aware of how precarious these situations
can be, even if other levels or parts of the organization continue unaware
that events with near loss of margin of maneuver are occurring (Woods
and Wreathall, 2008). Woods then posed the question, “What organiza-
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70 BUILDING A RESILIENT WORKFORCE
tional, team work, and learning processes help the different units, and
people working within them, relieve that stress?” Many of the desired
processes are encouraged only when an organization has an effective
safety culture that values information sharing and adaptive learning
(Sutcliffe and Vogus, 2003; Weick et al., 1999), that is, when the organ-
ization creates a climate that avoids the risk of falling into the third adap-
tive trap of getting stuck in stale tactics.
As a result of the results briefly noted above, Woods identified work-
force resilience as one aspect of how DHS is a complex system and how
DHS is an organization that manages a set of complex systems. He suggest-
ed that the work on complex adaptive systems, including modeling tools
such as multi-agent simulations and measures of brittleness, has progressed
to the point that it can provide a framework for DHS. This framework
could unify a diverse set of issues needed to meet the mission, such as
human capital and workforce stress. It can also include other critical is-
sues involving collaboration across units, anomaly recognition, and crisis
response.
ORGANIZATIONAL AND CULTURAL CHANGES FOR
EMPLOYEE WORK–FAMILY EFFECTIVENESS
Dr. Ellen Kossek is a professor of human resource management and
organizational behavior in the School of Human Resources and Labor
Relations at Michigan State University, and she is a member of the
Work-Family Health Network.2 She presented research on the reduction
of work–family conflict as a pathway to building resilience. Kossek men-
tioned that one issue in this field has been a focus on work–family con-
flict rather than work-life enrichment. Instead of focusing on negative
relationships, she suggested the focus should shift to positive relation-
ships and the ability of work and family to enrich each other.
Kossek suggested that organizations have not figured out how to im-
plement and adapt work processes to structure flexible schedules. Com-
panies have avoided redesigning work systems to better adapt to family
life because it seems “messy” and because of concerns over economic
pressures. Companies want employee engagement at work, but they are
not going to get that engagement if they do not focus on engagement off
the job. Engagement on and off the job are increasingly intertwined, but
2
The Work-Family Health Network is an interdisciplinary initiative funded by the Na-
tional Institutes of Health.
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
culturally in the United States there is a lack of recognition for how help-
ing employees with their personal needs ultimately helps productivity.
Work–Family Connections to Health and Productivity
Kossek asserted that stress from work–family conflict negatively af-
fects worker health and that it is not confined to the workplace or worker.
When the effects of the workplace on the worker are felt by the worker
even when he or she is not working, it is called spillover. For example, a
worker may be too tired to engage in family life because of work stress.
When others feel the effects of the workplace on the worker, it is called
crossover. For example, family members or coworkers may be stressed
because an employee experiences work–family stress. Spillover and
crossover can be both positive and negative. Integrating findings from a
number of studies, Kossek found that
participants reported that fewer employees say they want jobs
with more responsibility (Galinsky et al., 2009);
seventy-five percent of parents report they do not have time for
their children (Galinsky et al., 2011);
married and partnered employees report strain on their relation-
ships or partners (Neal and Hammer, 2007);
fifty percent of all children are living in a single parent house-
hold at some period before turning 18 (Cohen, 2002); and
dual-earner families are now the American model (Kossek, 2006).
These findings suggest that organizations need new ways to think
about implementing and co-managing work–family cultures and relation-
ships. Although flexibility and work-life policies are becoming more
common in the U.S. workplace, conflicts are continuing to grow. Kossek
suggests that policies need to be better implemented through leadership
acceptance and alignment with organizational culture.
Employers also face dilemmas based on work-life imbalances. A
2010 survey by the Society for Human Resource Management found that
obtaining human capital was cited as the biggest investment challenge
facing companies. Kossek noted that there are cost savings associated
with attracting and retaining better human capital. For instance, there are
lower rates of dysfunctional behaviors, and employees are more willing
to trade some earnings for flexibility. She suggested three tactics for at-
tracting and retaining the best human capital: (1) providing workplace
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84 BUILDING A RESILIENT WORKFORCE
more aggressive stance on this issue and has put in place a requirement
that managers and supervisors complete 12 hours of continuous learning
annually. In addition to the 12 hours of continuous learning, there is a
12-hour giveback requirement where managers and supervisors will be
tasked with participating in coaching, mentoring, and/or speaking at con-
ferences to share their knowledge.
Capstone
The Capstone Program is still in development. It is designed to be
similar to the DOD model and will be required for new members of the
SES within their first year. The program will focus on helping them be-
come effective leaders across a large-scale operational environment. The
training may be dovetailed with the OPM’s SES Onboarding program.
WELLNESS AND RESILIENCE IN THE
NATIONAL SECURITY AGENCY
Rebecca Pille is the director of the National Security Agency’s
Health Promotion and Wellness, Occupational Health, Environmental
and Safety Services. The planning committee invited Pille to the work-
shops to learn more about NSA’s health and wellness programs and to
see if they are potential models for DHS to consider. The NSA was es-
tablished in 1952. In 1972 the agency became a joint operation with the
Central Security Service, which was the military intelligence service.
The agency has two main missions. The first is to provide vital infor-
mation, and the second is to protect it. The primary users of the NSA’s
information are policy makers and war fighters. As an organization, the
NSA is diverse demographically and culturally. There are four genera-
tions of military, former military, civilians, and contractor personnel.
These groups also include first-generation Americans and naturalized
citizens.
Almost everybody that works at the NSA has the Top Secret/Sensitive
Compartmented Information (TS/SCI) clearance. During the Cold War
the work pace was slower because of the type of opponent the NSA
faced. The landscape changed after 9/11, however, and the pace and
stress of work has increased, forcing the agency to adapt. The NSA em-
ploys about 17,000 civilians, many of them overseas or in satellite organ-
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
izations throughout the country. Pille noted that some stressors are as
mundane as having to clear security to enter NSA headquarters.
Although supporting the physical and mental health of employees is
the right thing to do, it is also important to the mission. The mission
needs every individual to be fully engaged. Resilience is a key part of
this principle. For everyone to be able to focus and be engaged in their
job, they need to have balance between their work and family.
About 3 years ago the Deputy Secretary of Defense drafted a memo-
randum about the need for workforce engagement, wellness, and satis-
faction. Wellness is a multidimensional and dynamic state that includes
more than just physical health. It also includes emotional, mental, spir-
itual, and social well-being. There is a long history of wellness at the
NSA. In 1955 the NSA became a front-runner in offering health services
for the workforce when it created a medical center. The medical center is
accredited by the National Accreditation Association. Over time the cen-
ter’s services have become more focused on health promotion and occu-
pational health.
The NSA’s health and wellness programs are designed to focus on
the whole person and take a cross-disciplinary approach. The health team
includes psychologists, fitness trainers, nurses, doctors, the chaplain’s
office, and disability staff. The medical center has an occupational health
clinic with four or five doctors, two nurse practitioners, and a dozen li-
censed nurses. It offers both acute and urgent care as well as an ambu-
lance service to three local hospitals. Additional services include a travel
medicine clinic, a pharmacy, a leave bank, and workers’ compensation
services.
The health program uses a health risk assessment tool that addresses
the top health risks, which consistently include weight management, can-
cer, fitness, nutrition, heart health, and stress. The assessment also in-
cludes screenings and lab work.
A continuous consideration for the agency is the use of technology.
Given the type of work most NSA employees do on a daily basis, they
would probably not be comfortable with online tools. As a result, the
health risk assessment has been brought inside the agency and is hosted
on NSA servers. This was a difficult and labor-intensive process, but
Pille noted that it was worth it to the agency.
Since 2005, the agency has offered a full-engagement program that
mirrors that whole-person approach. The health program offers immun-
izations, Weight Watchers@Work, and a tobacco-cessation program.
There is also a Healthy Tip of the Week and a dietitian that works with
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86 BUILDING A RESILIENT WORKFORCE
the cafeteria to make sure healthy options are offered. All six fitness cen-
ters on the NSA’s campus are staffed with professional personnel.
The NSA’s Employee Assistance Program
The NSA’s employee assistance program (EAP) is accredited by the
National Accreditation Association. All of the EAP psychologists, clini-
cal social workers, and counselors have security clearances. Their offices
are not housed in the medical center, and they have separate systems.
Pille noted that before 9/11 a lot of stigma was associated with seeing a
counselor. In her experience, stigma is less of a concern since 9/11. The
counselors are also integrated into the workforce. They are out in the of-
fices, teaching classes, and interacting with the staff. Pille commented
that people feel more comfortable talking with the counselors because
they are seen as part of the NSA team, and they feel like they know
them.
With the changes in technology, actions taken at someone’s desk at
NSA headquarters can have significant impacts around the world.
Forward-deployed psychologists regularly interact with employees in
high-risk and high-stress groups that are involved in critical decisions.
Additionally, military personnel are also able to visit the civilian psy-
chologists, and these visits are not part of their military record. The only
exceptions are if there is a risk to self, others, or national security. Civilian
staff are also able to visit the military chaplains. Work-life services offer
robust programs such as financial coaching, elder and childcare, and
support telework options. They also have services for deployed personnel
and their families.
CHAIRMAN’S TOTAL FORCE FITNESS FRAMEWORK
Mark J. Bates is the director of Resilience and Prevention within the
Defense Centers of Excellence for Psychological Health & Traumatic
Brain Injury (DCoE). The DCoE was created 3 years ago to address the
need to provide better services for injured service members at Walter
Reed Army Medical Center. The mandate has expanded and now also
includes ensuring optimal support for psychological health and traumatic
brain injury within the DOD. The DCoE is an agency under the Office of
the Assistant Secretary of Defense for Health Affairs and includes a dep-
uty from the Department of Veterans Affairs. Although the core of the
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
DCoE organization is primarily clinically focused, the DCoE Resilience
and Prevention (R&P) Directorate focuses on R&P activities across the
continuum of care including before and after deployments to support
well-being and minimize the need for medical care. The post-deployment
focus includes a wide range of reintegration concerns, which is especial-
ly important with the upcoming drawdown of forces.
There are many challenges with resilience including the lack of
standard definitions, limited evidence about what interventions are effec-
tive, and limited integration of this information into an actionable sum-
mary. As a major first step to address these gaps, the DCoE helped
develop an evidence-based conceptual framework that is relevant to the
military in support of the Chairman of the Joint Chiefs of Staff’s
(CJCS’s) Total Force Fitness (TFF) initiative. The first step involved an
interdisciplinary and interagency collaboration to review the current state
of the evidence and develop a holistic model of fitness very similar to
resilience. Summary articles about the overall model and the evidence
supporting each of the eight mind-body domains and potential metrics
were published in a supplement issue of the Journal of Military Medi-
cine. In addition, this evidence-based framework was also translated into
operational doctrine and published as CJCS Instruction 3405.01. Bates
suggested that the TFF framework might also be applied to some federal
agencies. The eight TFF mind-body domains are:
1. The social domain includes family cohesion, social support, task
cohesion, and social cohesion.
2. The physical domain includes strength, endurance, flexibility,
and mobility.
3. The environmental domain includes heat/cold, altitude, noise,
and air quality.
4. The medical domain includes access, immunizations, screenings,
prophylaxis, and dental care.
5. The nutritional domain includes food quality, nutrient require-
ments, supplement use, and food choices.
6. The spiritual domain includes service values, positive beliefs,
meaning making, ethical leadership, and accommodating diversity.
7. The psychological domain includes coping, awareness, beliefs
and appraisals, decision making, and engagement.
8. The behavioral domain includes substance abuse, hygiene, and
risk mitigation.
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88 BUILDING A RESILIENT WORKFORCE
Bates proposed that there were several aspects of TFF and comple-
mentary efforts at the DCoE that may help DHS in its efforts going for-
ward. The framework was built to be broad and inclusive with the
objective of supporting each service’s effort. The DCoE looked at each
of the programs in place with the different military services and worked
to incorporate the best of each program into the framework.
The DCoE is also working to develop a common language across the
DOD. Creating a common language will better allow people to share best
practices and reduce redundancies. This can be challenging because it
requires interdisciplinary collaboration.
In developing a holistic approach to this task, the focus reaches
across the different mind-body domains and across the entire life cycle of
the program. It is important in a developmental model to find ways to
teach some of the skills early on and then build upon them over time.
It is also important to consider the type of resources needed such as
policies, leadership, and training programs. The model must include lev-
eraging resources across the program to optimize effectiveness.
General Peake noted that this model is compelling and possibility in-
teresting to DHS because it is a broad overarching framework. Perhaps
this type of model can address some of DHS’s challenges related to the
varieties of organizations, tasks, and skill sets within the organization.
FACTORS INFLUENCING WORKFORCE EFFECTIVENESS
AND RESILIENCE PANEL DISCUSSION
Picking Priorities
Brinsfield asked the panelists if they had ideas about how best to
translate the concepts discussed in the workshop into next steps for DHS.
Pille responded that DHS is not going to be able to tackle everything at
once. Perhaps the first step for DHS is to consider how to classify all the
issues and identify where the need is the greatest. She added that the
NSA’s programs are impressive, but it is important to remember they
have been developing over 50 years. The key theme of the session, in
Bates’ perspective, was the need for an organization needs assessment
and an evaluation system to continuously improve and monitor the pro-
cess. Jentsch commented that working with the team leaders and teams
can be a key leverage point.
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
Woods noted that as an incredibly large and complex organization,
DHS must consider two possible approaches. The first is to identify what
can be done definitively, quickly, and in a relatively cost-effective man-
ner. The other option is to look at what and where are the key leverage
points. He noted that several of the workshop presentations looked at the
interaction between the individual and the organization. If DHS is only
thinking about individuals and how they cope, then that requires a differ-
ent set of interventions than if it is looking at the organizational level.
Where these two sets of issues converge could provide leverage to pro-
duce a major impact in the long term.
Committed Leadership
Bliese noted that in his experience in the military, sound science is
not enough. A successful program implementation requires absolute buy-
in from the senior leadership. It is also important to have the resources
and infrastructure in place to make it happen. Soldiers are introduced to
the resilience program in basic training, and it is repeated through non-
commissioned officer (NCO) and officer courses, pre-deployment, and
post-deployment. This was only possible by getting very senior people in
the organization to commit to the effort.
Fundamental Values
Wood noted that change must be driven from the very top of the or-
ganization in a visible and sustained way. The leadership has to be will-
ing to change at all levels or the effort will not be sustainable. By
framing the issue as a fundamental characteristic of the organization that
applies at all levels, rather than to a few people who are having a rough
time, leadership will be more inclined to buy in. As an example, he noted
that in patient safety, Paul O’Neill’s work created a list of key items that
the top echelon of every organization should follow. These items demon-
strate to everyone that the leader is visibly and tangibly driving this fun-
damental values issue throughout the organization.
Pille noted that having a program champion in leadership increases
support for the program more broadly as well. To heighten awareness,
the NSA’s chief of staff shared her own health story of struggling with
three different types of cancer over 9 years. She is an unabashed advo-
cate for self-care and pushes this issue whenever possible.
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90 BUILDING A RESILIENT WORKFORCE
Demonstrating Effectiveness
A lot of important issues are competing for leadership support,
Barbera noted. How can resilience programs demonstrate their value to
the organization through objective measures? Bliese commented that a
good deal of science has been focused on how to measure program effi-
cacy. However, showing impact is difficult. For instance, rather than try
to target a particular group, the Army chose to roll out a universal pro-
gram. About two-thirds of the individuals in resilience programs may not
directly benefit from the programs. As a result the effects of the interven-
tion are going to be very small. It can be a struggle to communicate that
small effects are valuable. These programs teach people skills that will
help them both in their family and in work relationships and that accu-
mulate over time. Although individuals can participate multiple times,
currently no good statistical models capture these cumulative effects.
Bates added that various groups are looking at well-being as a good univer-
sal single metric that looks at system functioning. Well-being can then be
tied to more hard objectives such as readiness, retention, and performance.
Barbera is concerned that in lieu of other evidence, it is easy for peo-
ple to fall back on looking just at suicide rates. Bliese replied that his
group has intentionally avoided using the number of suicides as a meas-
ure. The principal reason being that the suicide rates are so low it would
be hard to design an intervention that could show efficacy. Instead
Bliese’s group uses metrics such as depressive and PTSD symptoms.
Lombardo agreed that it is difficult to isolate and measure the effects
of a training intervention. DHS is looking at standard evaluation models
in training, and she hopes DHS can also demonstrate success through
qualitative methods such as storytelling. Success stories should be shared
to increase engagement and interest.
Leveraging Social Media
Bates noted that in the age of efficiencies DHS may want to consider
leveraging technology and social media. The military has an ambitious
social media campaign targeting stigma. The campaign includes a broad
range of service members from generals to privates sharing their personal
experiences. They discuss the wounds of war, how they reached out for
help, and how they benefited from it. There are also pieces from family
members talking about what it was like to provide support, and from
leaders saying how they trusted these people more after they came for-
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FACTORS INFLUENCING WORKFORCE EFFECTIVENESS AND RESILIENCE
ward with issues. The campaign was based on evidence from the Nation-
al Institutes of Health (NIH) Real Men Have Depression Campaign. It is
a social marketing strategy that could be used in a variety of ways, not
just with stigma specific to combat injuries.
Peer Support and Cohesion
Bates noted that peer-to-peer social engagement can be important.
The DOD has produced review papers on its programs that summarize
the current best practices. Bliese added that the literature suggests that
group cohesion supports resilience. In the Army, soldiers who have been
deployed together are highly cohesive and know each other very well. He
noted however that peer cohesion or bonding between peers is a critical
aspect of resilience programs but not necessarily sufficient by itself.
Culture
Peake noted that in the commercial world there are issues with align-
ing cultures as organizations change due to market pressures or mergers.
In some ways this paradigm is closer to the situation DHS faces than
does the military, where the culture is more homogeneous. He asked the
speakers if they could comment on lessons learned from the commercial
world that DHS could apply.
Although the workshop had discussed trauma and its effects on the
individual, Woods noted that it is also important to look at how the or-
ganization responds to trauma. In the case of NASA, it approached the
aftermath of the mission tragedies with brute force resources rather than
a tailored tactical reserve. Unfortunately, NASA’s strategy is not sustainable
under the pressure within the system to do work faster, better, and cheaper.
Inevitability the organization ends up cutting corners, which inadvertently
create new and completely different types of failure mechanisms.
Peake commented that NASA is similar to the Army in that there is a
common culture, mission, and focus. DHS is in a different situation be-
cause multiple cultures are forced together, and it is not always a com-
fortable fit. How can DHS build cohesion in order to shift the culture to
be more supportive of resilience? The health care field is also diverse,
noted Woods, and perhaps offers a better perspective to the issues faced
by DHS. Although what is going on in telemedicine and outreach to rural
areas is very different than critical care in urban areas, a common
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92 BUILDING A RESILIENT WORKFORCE
approach can be developed to assess innovations and then tailor those
common approaches within parts of the portfolio of activities and settings.
Woods also noted that NASA’s Ames Research Center affected in-
dustry by bringing all of the diverse elements together to cooperate and
collaborate in innovation-oriented work. Perhaps thinking of DHS more
like an industry with coordination and oversight mechanisms can create a
platform of general agreement across all of the different stakeholders
within that “industry.” He added that the question is how can DHS facili-
tate innovation, proper testing, vetting, and participation among all the
different component organizations with their histories of different cul-
tures that in part derive from their different submissions?
Woods commented that how DHS leadership views this initiative is
critical. Does it envision a one-time program with definitive and “for-
sure” results and payoffs? Or does it envision a program that is adaptive
and sustained? These issues will affect how DHS leadership sets up the
infrastructure, information gathering, and feedback exchange. All of these
properties are needed to develop a program that is agile and tailored for
maximum utilization of the resources that are being invested.
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