Worksite International Ergonomics Process Readiness Survey

Instructions:

Your Information

Take this quick, discovery survey to see how your program compares to a lean, participatory, best practice approach to ergonomics process design and management. Answer the question as it applies to your workplace. If you have a component, but it is only partially implemented or not effective in its current state, select "no". If you are unsure whether you have the component, select unsure/don't know. Submit your response. I'll score your survey so we can then discuss your results.

1.

Your Name: *

2.

Your Job Title: *

3.

Your email *

4.

Company Name *

5.

Best Phone Number *

6.

How many employees work for your organization (includes full time, part time, onsite, hybrid, and remote) *

7.

Are you the person responsible for the ergonomics program at your organization? *

Yes
No
If not you, then who? Please indicate. If not you, then who? Please indicate.

8.

About how many ergo evals do you do annually? *

9.

Describe your current ergonomics program or process. What components do you have in place? Be specific to all aspects. *

10.

Are you able to make financial decisions and investments in your ergonomics program? Select the best response that depicts how financial decisions are made. *

Yes, I have a budget and make decisions on spending associated with our ergonomics program.
No, I must report to my manager and convince him/her of the required investment.
Our CFO decides on how we invest in ergonomics.
Human Resources decides how we invest in ergonomics.
If none of the above apply, please explain: If none of the above apply, please explain:

Your Ergonomics Policy and Leadership's Role

11.

Our company has a written ergonomics policy. Typical policy content defines the purpose and goals of your ergonomics process; who is impacted; management and employee roles, ergonomic analysis, training, control measures, change management, budget process, roles of critical support teams, and more *

Yes. We have a policy and it has all the components listed Yes, we have a policy but it needs to be better defined. It doesn't go far enough. No, we don't have a policy and we need one. No. We don't have a policy. We don't want to have one. Explain your policy: Explain your policy:

12.

Our company has a "Sit to Stand Workstation" policy or guideline to refer to when an employee requests a standing workstation or needs guidance. *

Yes No Unsure/Don't Know Unsure/Don't Know

13.

Our company has an ergonomics chair standards program that features the specific chairs our organization buys to fit all sizes, not just one chair. *

Yes No Unsure/Don't Know Unsure/Don't Know

14.

In our company, ergonomics is part of many organizational decisions: leadership supports it morally, financially, and legally! *

Yes No Unsure/Don't Know Unsure/Don't Know

Facilities (Real Estate), Purchasing and IT

15.

Our Facilities, Purchasing, and IT employees have attended ergonomics training so they can make decisions with ergonomics in mind. *

Yes No Unsure/Don't Know Unsure/Don't Know

16.

Our company has an approved ergonomics purchasing program with quality products selected by Purchasing and our internal ergonomics specialist *

Yes No Unsure/Don't Know Unsure/Don't Know

Workers' Compensation, Ergonomic Assessments, and Training

17.

Our employees and supervisors participate in mandatory live or online, on-demand office ergonomics training to support office or remote work, at least once during their employment. *

Yes No Unsure/Don't Know Unsure/Don't Know

18.

Our organization has at least one "in-house ergonomics specialist" who has a recognized ergonomics certificate (i.e. COESp, COEE, CEAS, CEES or CPE) to perform ergonomic evaluations for us. *

Yes No Unsure/Don't Know or If Yes, Indicate the certificate: Unsure/Don't Know or If Yes, Indicate the certificate:

19.

I'm privy of workers' compensation loss information and follow our claims and costs. I review our loss runs. I routinely engage with management about our cases and what they cost. *

Yes No Unsure/Don't Know Unsure/Don't Know

Budgets, Cost-Benefit, and Measuring ROI

20.

Our company has a line item in our annual budget dedicated to our ergonomics program needs and costs. *

Yes No Unsure/Don't Know Unsure/Don't Know

21.

Our company measures and tracks metrics related to our ergonomic program activities. We can demonstrate a cost-benefit for our investments and an ROI (Return on Investment) for management when asked. *

Yes No Unsure/Don't Know Unsure/Don't Know

How Do You Think You Did?

22.

What areas do you want to target as a priority for your organization? *

23.

Would you like to learn more about our Ergonomics Process Consultation service to help you achieve your organizational health, safety, and performance goals? *

Yes, I'd like to learn more. Send me details.
Yes, I'd like to speak with you. Please send a calendar invite.
No, I just wanted to take the survey.
Other, please specify Other, please specify

Let's Unpack Your Results

All done! I am looking forward to unpacking your results with you and identifying strategies to help you maximize employee health, safety, and performance using the science of ergonomics.

Ready for the next step?

Press "submit" so I can create your Ergo Process Readiness Scorecard and share your results with you.

See you soon,

Alison Heller-Ono PT, MSPT, CPE
President and CEO
alisonh@worksiteinternational.com
www.worksiteinternational.com
831-648-8724

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