New Year, new approach to RTW

Hopefully you found the holidays to be enjoyable, now it’s back to work!  If you’re one of the many resolution-ers out there, you may want to read this before going public with your resolution.  According to a study cited in a Forbes.com article, about 40% of Americans make resolutions and only 8% of them keep them. 

Resolve to improve your company’s workers’ compensation program.  Why? Because unlike a short stint at the gym or week or two on the South Beach Diet, improving your workers’ compensation program doesn’t require any special diets or new clothing.  Nope, you simply need some groundwork and a good team of people to support you.

The process of setting your goals has a direct impact on the likelihood of successfully attaining them.  Some simple considerations can go a long way.  Goals should be simple, attainable and measurable.

Simple

Stick to one or two goals for your RTW program.  A simple starting point for employers without a RTW program could be to identify 10 modified duty tasks for each department in your organization.  Creating a modified duty job bank is an essential step in achieving successful RTW outcomes.  Review your loss history to decide where to start if it seems overwhelming.  Try not to reinvent the wheel – use existing job descriptions for ideas. 

Attainable

Sure, every organization would like to eliminate all injuries or all lost time days, but that might not be very realistic.  You can’t prevent everything, so make sure you have a plan to deal with an accident when it occurs.  Review your past loss histories to identify trends and to set reasonable goals.  You can also look to the Bureau of Labor Statistics (BLS) for comparison data.  Periodically re-assess the goals to determine where you are and if they need to be adjusted.

Measurable

As the old adage goes, you manage what you measure.  Once you’ve determined your simple, attainable goal, you must be able to measure it.  Some examples include:  reducing lost time days by 20%, reducing the number of lost time claims by 80%, getting every injured worker who has restrictions back to work within 7 days of their release to return to work.  If part of your goal focuses on providing training for supervisory and management staff on the importance and benefits of modified duty, consider setting a goal to require each staff member to attend training.  You could go the extra step and require them to score a 95% or higher on a post-training quiz.

Other considerations

Announce your goal to the organization.  Divulge your plans and then demonstrate the progress you make toward those goals.   Make it extremely clear how each employee contributes to this goal as well as how your workers’ compensation premiums impact the financial results of the company.  If your company has quarterly meetings, add this to the agenda.  Regularly post your progress in a visible area such as your mandatory postings board or break room.  If you don’t reach your goal, determine an objective reason why.  Use this information to realign your goals for the following year. 

We’re here to help you successfully implement a return to wellness program.  Check out our resources on www.eains.com/ecovery or contact us directly.

Best of luck in whatever resolution you take on this year, and if you’re one of the nearly 60% of Americans who don’t make New Year’s resolutions, we still wish you all the best for 2014.

Safety in Numbers: Lapp Electric Slide presented by PRiMA Theatre

If you’ve ever been part of a flash mob, you know how much fun they can be.  One of our valued clients, Lapp Electric, in conjunction with PRiMA Theatre Company orchestrated a flash mob of over 100 people in Lancaster city’s square.  As part of Lancaster County Community Foundation’s Extraordinary Give event, Lapp and PRiMA, via the flash mob, provided entertainment, crowd appeal, and fun for everyone who participated or just stopped and stared.  It was a rainy night, but that didn’t dampen the spirits of these dancers, nor the community.  As a result of the 24-hour day of giving, the event raised $3,239,566.07 for over 260 local organizations.

Why you should care about RTW for direct-care workers

According to US News and World Report, it is estimated that in 2013, roughly 3.3 million Americans called a nursing home their place of residence.  For these millions of residents, there must also be millions of people to care for them. 

Productive modified duty for nursing staff

Nursing homes are rated on various aspects of their operations by Medicare.  Nursing homes are rated on health inspections, staffing, and other quality measures.  One element of staffing criteria that is measured is the number of staffing hours per resident.  A facility reports the number of hours of care on average provided to each resident, each day, by its nursing staff.  It is important that RNs and LPNs, for example, are providing care to residents as opposed to “non-care” hours.  This is important when considering modified duty opportunities for long and short term care facilities.

When considering modified duty options for health care staff, a great place to start is their job descriptions.  What aspects of their jobs fit, or can be modified to fit, within their work abilities?  Consider other areas or departments for opportunities.  While there may be some initial resistance, some of the duties that other health care employees perform may also yield modified duty opportunities.  An example of this would include having an RN perform duties that an LPN could do.  Another great source of modified duty suggestions is to ask the injured worker what they believe they could do.  This will provide suggestions, but also foster support of the return to work process.

Keeping injured workers at work doesn’t just help your workers’ compensation insurance costs

When an employee is injured, the repercussions are felt throughout an organization and the community.  Maintaining a staff of qualified and skilled employees is a challenge in any industry, but is particular evident in the health care field.  According to one study, the cost of turnover in the direct-care industry was found to be 25% of an employee’s total annual compensation.¹ The Bureau of Labor Statistics estimates in 2003 that costs associated with turnover in this industry ranged between $4,200-5,200.

            Direct costs:

·          separation

·         vacancy, replacement, training and injuries

Indirect costs:

·         lost productivity

·         reduced service quality

·         lost clients revenues due to lost existing and potential clients

·         impact on the culture, morale, facility reputation and service quality

Service delivery level costs:

·         Consumers/Clients

o   quality of care

o   quality of life

o   care hours not provided

·         Employees

o   increased work injuries (doing more with less)

o   increased physical and emotional stress

o   reduced working conditions may lead to higher turnover

Suggested resources

There are many resources available to employers who wish to offer modified duty to one of their injured workers.  The Job Accommodation Network (JAN) is a great resource for ideas and modification suggestions.  We previously wrote about it in this post.   Our website also has a variety of tools to help, in addition to lists of suggestions for health care employees who are given restrictions as the result of a work injury.

You can also check out the studies and resources referenced in this post by clicking here.

1.  Seavey, D. (Oct., 2004).  The cost of frontline turnover in long-term care. Washington, D.C.:  Better Jobs Better Care.

Complimentary Webinar: Using Not-for-Profit Organizations as a RTW option

Are you or your clients interested in learning about a new and innovative RTW solution?  Sign up for a complimentary webinar being offered by Eastern Alliance Insurance Group's Return to Wellness Specialist, Sarah Tayts. 

WHO:     This presentation is open to all EAIG agency partners and EAIG clients.  Please feel free to forward this post via email to anyone you believe would benefit from attending this presentation.  You can do this by clicking on the envelope icon located at the bottom of this post, or simply copy/paste the URL to this post into a separate email.


WHAT:     The presentation will highlight how to strategically use NFPs to solve even your most challenging RTW situations, as well as address the most common questions regarding the process. 

WHEN:     Wednesday, December 4, 2013 @ 10 am EST

HOW:     Register for the webinar by clicking here and completing a basic registration form.  For more information on how to get the most out of the GoTo Webinar session, you can click here to view a brief PowerPoint tutorial.               

In the past, this presentation has been very well attended, so be sure to register now to reserve your spot!

Guest post! Physical Therapy may assist in recovery from a musculoskeletal injury, and depression, in the injured worker by Dr. Joseph Brence, DPT

As you know, we’re always interested in hearing others’ perspectives regarding the rehabilitation of an injured worker. We’re excited to share this guest post written by Joseph Brence, DPT, COMT, DAC.  Dr. Joseph Brence is a physical therapist practicing in Pittsburgh, Pennsylvania.  When he is not busy treating patients, he is involved in several, large clinical research projects.  He has a large interest in the brain's involvement in the pain experience as well as the neurophysiological effects of manual therapy techniques. You can read more from Dr. Brence at www.forwardthinkingpt.com

Physical Therapy may assist in recovery from a musculoskeletal injury, and depression, in the injured worker
Joseph Brence, DPT, COMT, DAC

Work-related injuries affect almost 500,000 individuals annually in the United States.  Over half of these cases are related to sprains, strains and other musculoskeletal pathology.  In addition, musculoskeletal injuries are the leading cause for work-related disability and lost productivity, and estimated direct and indirect costs range from 45 – 215 billion dollars.

Work-related injuries can lead to the development of chronic pain as well as changes in societal status and psychological variables such as depression. Research has suggested that one out of every three individuals who suffer from chronic pain also suffer from depression.  Research has also suggested that elevated levels of depression are associated with an increased risk for a poor response to Physical Therapy and are associated with elevated levels of pain and disability.  A recently published article examined the effects of Physical Therapy on depressive symptoms in individuals with work-related musculoskeletal injuries.

The authors in this prospective cohort study recruited patients who were between the ages of 18 and 65; had sustained a work-related, musculoskeletal neck or back injury (3-12 weeks since onset); were not currently working; and were receiving benefits from Worker’s Compensation.   The participants also had to have clinically relevant levels of depression (measured on a Beck Depression Inventory of 14 or higher) and had to state that they were not being treated for depression throughout their course of Physical Therapy (often the case in Workers Compensation).  The participants completed a course of seven weeks of Physical Therapy treatment interventions.

The outcomes of this study demonstrated that depressive symptoms resolved in 40% of patients who entered into a Physical Therapy program, following a work-related accident. This outcome is not unusual because of the neurological and hormonal changes that we know to occur with exercise.  The authors further reported that a reduction in depressive symptoms was related to a decrease in pain and disability at the one-year follow-up, which improved the likelihood for return to work.   For those who did not get better, it appears that combined elevated levels of depression and pain catastrophizing thoughts (ex. The pain is killing me) pre-treatment, predicted persistence of depressive symptoms post-treatment.  

So what does this mean?

These findings indicate that Physical Therapy can have a profound effect in decreasing depressive symptoms in a subgroup of individuals.  The authors go as far as suggesting that in certain instances, we may want to include a reduction in depression as a realistic and important goal of treatment.  Psychosocial variables, such as this, have been correlated to long-term disability and can often restrict an individuals ability to recover from a musculoskeletal injury (thus decreasing the likelihood for return to work).  Despite the notion that many in Workers Compensation field want to steer away from the assessment of these variables, I suspect they are important prognostic indicators for recovery and we should encourage early screening, detection and intervention.  In the end, we interact with the complex "human" and acknowledging the influence of biological, psychological and social variables, will only better enhance recovery and return to work. 
 

Dunning KK, Davis KG, et al. Costs by industry and diagnosis among musculoskeletal claims in state workers compensation system: 1999-2004. Am J of Indust Med. 2010: 53; 276-284.

Wideman TH, Scott W, et al. Recovery from depressive symptoms over the course of physical therapy: a prospective cohort study of individuals with work-related orthopaedic injuries and symptoms of depression. JOSPT 2012: 42; 957-968.

Kroenke K, Spitzer RL, et al. The Patient Health Questionnaire-2: Validity of a 2 item depression screener. Medical Care. 2003: 41; 1284-1294.