Nurses Provide Frontline Care
Discussions about physician performance and its impact on claims is a frequent workers’ compensation topic. But spend time around a hospital and you witness nurses providing more of the frontline care and comfort. They interact with patients more than doctors.
Yet I have rarely heard workers’ compensation observers discuss current nursing-profession challenges. That contrasts with the attention paid to selecting treating physicians, discussions on a doctor shortage impacting claims outcomes, physician pay and so on.
Sure, doctors make treatment decisions that largely determine how injured workers mend and recover. But the level of care and compassion hospital nurses provide also impacts an injured worker’s overall experience.
As it goes with all employees, there are always a few not suited for the job. Fortunately, there are many different roles for them.
That experience shapes their attitudes about their medical recovery. It also affects their views on returning to the job and whether they should call the attorney 1-800 numbers pitched on TV commercials.
Most nurses I’ve encountered in hospitals exhibit great care about their roles and their patients. They are competent professionals.
As it goes with all employees, there are always a few not suited for the job. Fortunately, there are many different roles for them.
You have noticed, for example, the growing number of nurses employed by the insurance industry. Some of those roles still require patient empathy, while others are more administrative, analytical or company leadership positions not requiring direct patient care.
While most hospital nurses I’ve encountered bring their compassion and professional acumen to the job every day, many are leaving the profession.
Some are retiring baby boomers. Others are leaving because of the stress of too large a patient load. A nationwide R.N. shortage and hospital systems attempting to control labor costs can strain their abilities.
Nursing burnout is a much studied and written about topic. It’s a point of contention in nurse labor union disputes with hospitals and it’s evident when talking to nurses.
The challenge is evident in other ways.
Only 168 out of 3,544 hospitals received a five-star rating while more than 600 received one or two stars in a recent, albeit controversial, U.S. Centers for Medicare & Medicaid Services survey of patient satisfaction with hospitals.
The nationwide survey asked about communication with nurses and the responsiveness of hospital staff.
Perhaps this means it’s time for workers’ comp claims payers to expand the discussion about the people caring for injured workers.
Personally, when I accompany friends or family to a hospital I make sure that the caring and compassionate nurses I see get my appreciation. &
Workers’ Compensation Conference Program Released
Savvy employers have increasingly adopted injured-worker advocacy and engagement strategies to help employees overcome fears and challenges encountered when navigating workers’ compensation systems.
“The workers’ compensation claim process can be confusing and intimidating,” said William Wainscott, manager, workers’ comp and occupational health at International Paper.
“For the injured employee there are a lot of unknowns. An advocate helps alleviate the fears and guides them through all the issues.”
Wainscott will speak on an employer panel discussing injured-employee advocacy and engagement programs at the 25th Annual National Workers’ Compensation and Disability Management Conference® & Expo scheduled for Nov. 30 to Dec. 2 in New Orleans.
Minimizing a workplace injury’s impact on employees, their families and employers requires helping the injured worker access the right resources and understand their role in the recovery and return-to-work process, he said.
Wainscott is an NWCDC program co-chair and helped develop the conference’s 2016 agenda.
The agenda highlights other planned presentations featuring employers discussing leading-edge strategies for mitigating workers’ comp and disability challenges.
“We have put together a really strong agenda with topics that are meaningful for employers and other payer groups like insurance companies and third-party administrators,” said Denise Algire, who is also an NWCDC program co-chair and director of managed care and disability corporate risk at Albertsons Cos.
Addressing mental health factors impacting the recovery of workers’ comp and disability claimants is another focus of conference sessions developed to help meet growing employer and claims payer interest in the topic.
“Mental illness affects both workers’ comp and non-occupational disability,” Algire said.
Historically, there has been tremendous stigma around the topic, but more employers now understand that mental health issues impact absenteeism and productivity.
“There is more emphasis on this as organizations realize that the No. 1 reason for short-term disability claims is either depression or some other mental illness,” Algire added.
“So talking about it and understanding what solutions and options are available for employees, and how to implement those programs within your organization is an important conversation.”
Algire will also speak as part of the NWCDC panel discussing injured-employee advocacy programs.
In addition to Algire and Wainscott, the panel will include Kimberly George, senior VP and senior healthcare advisor at Sedgwick Claims Management Services, and Scott Daniels, director of disability at Comcast.
Daniels will also speak as part of another panel titled “Mental Matters: How Mental Health Impacts Productivity and Performance.”
That is not the only conference presentation on mental health issues.
Donna Morrison, corporate healthcare director at UPS, will join Michael Lacroix, associate medical director of behavioral health at Aetna Life Insurance and Coventry Workers’ Comp Services, to deliver a presentation titled “Advances in Behavioral Health Disability Claims Management Strategies.”
In total, the conference features 31 breakout sessions, two general sessions, and a keynote address delivered by Tim East, director of corporate risk management at The Walt Disney Co.
During his presentation titled “Fueling Injury Recovery with Engaged Workers,” East will discuss how technology trends impact workers’ expectations for how employers engage them.
Worker engagement and solutions for mental health’s impact on claim duration are not the only topics awaiting NWCDC attendees.
Other sessions will offer strategies to address opioid prescribing, Medicare set-aside requirements, Americans with Disabilities Act mandates, and insurance arrangements.
The conference will also present several case studies including:
- A look at the multidisciplinary approach applied by manufacturer Mohawk Industries to launch a health and safety program.
- The strategies Columbus Consolidated Government employed to develop an award-winning return-to-work program.
- How American Airlines fostered a claims-closure culture to resolve complex legacy claims.
Those are only a few of the topics employers and service providers will present at this year’s conference, recognized as the workers’ comp industry’s must-attend event of the year.
Your Workers’ Safety May Be at Risk, But Can You See the Threat?
Deadly violence at work is covered extensively by the media. We all know the stories.
Last year, ex-reporter Bryce Williams shot and killed two former colleagues while they conducted a live interview at a mall in Virginia. In February of this year, Cedric Larry Ford opened fire, killing three and injuring 12 at a Kansas lawn mower manufacturing company where he worked. Also in 2015, 14 people died and 22 were wounded by Syed Farook, a San Bernardino, California county health worker, and his wife, who had terroristic motives.
Active shooter scenarios, however, are just the tip of the iceberg when it comes to violence at work.
“Workplace violence is much broader and more pervasive than that. There are smaller acts of violence happening every day that directly impact organizations and their employees,” said Bertrand Spunberg, Executive Risks Practice Leader, Hiscox USA. “We just don’t hear about them.”
According to statistics compiled by the FBI, the chance that any business will experience an active shooter scenario is about 1 in 457,000, and the chance of death or injury by an active shooter at work is about 1 in 1.6 million.
The fact that deadly attacks — which are relatively rare — get the most media attention may lead employers to underestimate the risk and dismiss the issue of workplace violence as media hype. But any act that threatens the physical or psychological safety of an employee or that causes damage to business property or operations is serious and should not be taken lightly.
“One of the core responsibilities that any organization must fulfill is keeping employees safe, and honoring that duty is becoming more challenging than ever,” Spunberg said.
“Workplace violence is much broader and more pervasive than that. There are smaller acts of violence happening every day that directly impact organizations and their employees. We just don’t hear about them.”
— Bertrand Spunberg, Executive Risks Practice Leader, Hiscox USA
Desk Rage and Bullying: The Many Forms of Workplace Violence
Bullying, intimidation, and verbal abuse all have the potential to escalate into confrontations and a physical assault or damage to personal property. These violent acts don’t necessarily have to be perpetrated by a fellow employee; they could come from a friend, family member or even a complete stranger who wants to target a business or any of its workers.
Take for example the man who killed three workers at a Colorado Spring Planned Parenthood in April. He had no affiliation with the organization or any of its employees, but targeted the clinic out of his own sense of religious duty.
Companies are not required to report incidents of violence and many employees shy away from reporting warning signs or suspicious behavior because they don’t want to worsen a situation by inviting retaliation. It’s easy, after all, to attribute the occasional surly attitude to typical work-related stress, or an office argument to simple personality differences that are bound to emerge occasionally.
Sometimes, however, these are symptoms of “desk rage.”
According to a study by the Yale School of Management, nearly one quarter of the population feels at least somewhat angry at work most of the time; a condition they termed “chronic anger syndrome.” That anger can result from clashes with fellow coworkers, from the stress of heavy workloads, or it can overflow from family or financial problems at home.
Failure to recognize this anger as a harbinger of violence is one key reason organizations fail to prevent its escalation into full-blown attacks. Bryce Williams, for example, had a well-documented track record of volatile and aggressive behavior and had already been terminated for making coworkers uncomfortable. As he was escorted from the news station from which he was terminated, he reportedly threatened the station with retaliation.
Solving Inertia, Spurring Action
Many organizations lack the comprehensive training to teach employees and supervisors to recognize these warning signs and act on them.
“The most critical gap in any kind of workplace violence preparedness program is supervisory inertia, when people in positions of authority fail to act because they are scared of being wrong, don’t want to invade someone’s privacy, or fear for their own safety,” Spunberg said.
Failing to act can have serious consequences. Loss of life, injury, psychological harm, property damage, loss of productivity and business interruption can all result from acts of violence. The financial consequences can be significant. In the case of the San Bernardino shootings, for example, at least two claims were made against the county that employed the shooter seeking $58 million and $200 million.
Although all business owners have a workplace violence exposure, 70 percent of organizations have no plans in place to avoid or mitigate workplace violence incidents and no insurance coverage, according to the National Institute for Occupational Safety & Health.
“Most companies are vastly underprepared,” Spunberg said. “They don’t know what to do about it.”
Small- to medium-sized organizations in particular lack the resources to develop risk mitigation plans.
“They typically lack a risk management department or a security department,” Spunberg said. “They don’t have the internal structure that dictates who supervisors should report a problem to.”
With its workplace violence insurance solution, Hiscox aims to educate companies about the risk and provide a solution to help bridge the gap.
“The goal of this insurance product is not so much to make the organization whole again after an incident — which is the usual function of insurance — but to prevent the incident in the first place,” Spunberg said.
Hiscox’s partnership with Control Risks – a global leader in security risk management – provides clients with a 24/7 resource. The consultants can provide advice, come on-site to do their own assessment, and assist in defusing a situation before it escalates. Spunberg said that any carrier providing a workplace violence policy should be able to help mitigate the risk, not just provide coverage in response to the resultant damage.
“We urge our clients to call them at any time to report anything that seems out of ordinary, no matter how small. If they don’t know how to handle a situation, expertise is only a phone call away,” Spunberg said.
The Hiscox Workplace Violence coverage pays for the services of Control Risks and includes some indemnity for bodily injury as well as some supplemental coverage for business interruption, medical assistance and counseling. Subvention funds are also available to assist organizations in the proactive management of their workplace violence prevention program.
“Coverage matters, but more importantly we need employees and supervisors to act,” Spunberg said. “The consequences of doing nothing are too severe.”
To learn more about Hiscox’s coverage for small-to-medium sized businesses, visit http://www.hiscoxbroker.com/.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Hiscox USA. The editorial staff of Risk & Insurance had no role in its preparation.