Not long out of college, Elizabeth Ruff arrived at Peerless Industrial Group in June of 2011, tasked with taking control of workers’ compensation for the company. She soon discovered that the company had a culture of lost time and that really bothered her.
“She said, ‘We’ve got to put a stop to this hemorrhaging,’ ” recalled her boss, Vice President of Human Resources Barbara Breza.
Ruff was intent on getting employees back to work, in some capacity, as soon as possible.
“One of the first things I initiated is that whenever somebody was injured on the job and they required immediate medical attention, either myself or Barb would actually go with the employee to the health care provider’s office and sit with them,” said Ruff.
“The reason that was really key was because we were able to talk to the doctor about the fact that Peerless accommodates almost every type of light duty or transitional option,” Ruff added.
Before Ruff began her new approach, Peerless had 40 lost-time claims, multiple years in a row.
“In 2012-2013, with a total of 386 employees in the company, we had it down to less than 25 claims,” said Ruff.
At the company’s main plant in Winona, Minn., which has 287 employees, Peerless has gone 700 days without a lost-time claim.
“It’s a pretty heavy-duty industrial manufacturing plant, so that’s a huge accomplishment, which we’re extremely proud of,” said Ruff.
“The head of underwriting at a major insurance company recently said that he has never seen anyone like Elizabeth at a company, big or small. She is truly one of a kind and a major difference-maker in our industry.” — Josh Warren, senior vice president of Equity Risk Partners
Josh Warren, senior vice president of Equity Risk Partners, Peerless’ broker, said, “They do have some additional lifting machines that make it easier on the employees, but the main difference is that Elizabeth and her colleagues in the HR department pay attention to their employees, learn from workplace injuries in order to avoid repeat situations and get people back to work.”
Warren added: “The head of underwriting at a major insurance company recently said that he has never seen anyone like Elizabeth at a company, big or small. She is truly one of a kind and a major difference-maker in our industry.”
Other accomplishments Ruff has initiated at Peerless include bolstering the company’s safety program. Safety is particularly important at Peerless because it is the largest manufacturer and distributor in North America for industrial and consumer chain and tractor products.
“One of the things I created was regular training programs,” Ruff said. “Each month, there is some type of training program project I am organizing, whether it is bringing in an external expert or coordinating with an internal supervisor.”
Another thing Peerless has done is to spend more money on capital each year to be proactive rather than reactive.
“Each year since 2011, we’ve been adding $20,000 per year just in capital for hoists,” she said.
Under Ruff’s direction, Peerless has also been aggressive in implementing ergonomic improvements, Breza said.
Ruff still works 20 hours a week at Peerless, while also working at BIC Graphic, which she joined in June.
“What I value most about Elizabeth is her knowledge and expertise and professionalism in the field of HR and how broad-based she is and that she came in that way to Peerless when she was so young,” said Breza. “She is just so intelligent.”
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Ending Unnecessary Accidents
With accidents piling up at a rate of nearly one per week, Convergint Technologies suspected its drivers were distracted, possibly by their cell phones.
One clue was the proportion of accidents in which Convergint drivers rear-ended other vehicles, said Michael Gross, national safety director for the Illinois-based company, which installs and services safety and security systems for commercial, industrial and institutional customers.
In 2012, the company recorded 44 claims for such accidents, representing 75 percent of total accident claims and a cost of $214,550.
Backed by senior and local management, Gross unveiled a cell-phone ban in November 2012 that got drivers’ attention — and slashed company losses.
In 2013, Convergint faced 12 claims for rear-end accidents in which its drivers were at fault. The number is even lower in 2014, with only one or two rear-end accidents in the first six months, Gross said. The company has 555 vehicles, mostly small vans, on track to cover 10 million miles this year.
“I never in a million years would have dreamed that you could reduce the accident rate at the rate that they did,” said Fred LeSage, senior risk engineer with XL’s North American construction business.
“Personally, I rarely talk on the phone while I’m driving any more, and it’s more a result of this than anything else.”
But it wasn’t just a ban that made Convergint’s policy effective, said Gross, who is based in Houston. It also required buy-in from company managers and an effective enforcement mechanism.
And by trusting employees to do the right thing, rather than install devices that blocked calls, the policy stayed true to Convergint’s principles, Gross said.
“Everybody understood that it would be based on our [core] value and belief, that we expect you to have integrity and you’re going to follow the policy when nobody’s looking,” Gross said, noting there is verification alongside the trust.
If a Convergint driver is at fault in an accident, the company pulls phone records from 60 minutes before to 30 minutes after to see if a phone was in use, Gross said. If it was, the driver faces disciplinary action. The first offense draws a written reprimand and a day off without pay. A second offense could lead to termination.
Drivers don’t have to worry about ignoring a call from a supervisor or vendor. Under the policy, they recorded new voicemail greetings indicating they were away from the phone or behind the wheel. In meetings to introduce the policy, managers emphasized the importance of safety over instant communication.
“A big part of the policy’s success is that leaders and managers supported it, and our drivers understood that,” Gross said.
After Convergint’s drivers put down their phones, they began noticing all the other drivers who had not. Now, Gross is exploring training opportunities that will keep the company’s drivers from falling victim to other people’s distractions.
“We’re actually the ones getting rear-ended a lot because, I guess, everybody else is texting and not paying attention to what they’re doing,” he said.
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The Re-Invention of American Healthcare
Consolidation among healthcare providers continues at a torrid pace.
A multitude of factors are driving this consolidation, including the Affordable Care Act compliance, growing costs and the ever-greater complexity of health insurance reimbursements. After several years of purchasing individual practices and regional hospital systems, the emergence of the mega-hospital system is now clear.
“Every month, one of our clients is either being bought or buying someone — and the M&A activity shows no signs of slowing down,” said Brenda Osborne, executive vice president at Lexington Insurance Co.
This dramatic change in the landscape of healthcare providers is soon to be matched by equally significant changes in patient behavior. Motivated by growing out-of-pocket costs and empowered with new sources of information, the emergence of a “healthcare consumer” is on the horizon.
Price, service, reputation and, ultimately, value are soon to be important factors for patients making healthcare decisions.
Such significant changes bring with them new and challenging risks.
Although physicians traditionally started their own practices or joined medical groups, the current climate is quite the opposite. Doctors are now seeking out employment by health systems. Wages are guaranteed, hours are more stable, vacations are easier to take, and the burdens of running a business are gone.
“It’s a lot more of a desirable lifestyle, particularly for the younger generation,” said Osborne.
Brenda Osborne discusses the changing healthcare environment and the risks and opportunities to come.
Given the strategic importance of successfully integrating acquired practices into a larger healthcare system, hospitals are rightfully focused on how best to keep doctors happy, motivated and focused on patient safety.
A key issue that many hospitals struggle with is how to provide effective liability insurance for their doctors. Physicians who previously owned their practice are accustomed to a certain type of coverage and they expect that coverage to continue.
Even when operators find comparable liability insurance solutions for their doctors, getting buy-in from their staff is often an additional hurdle to overcome.
“Physicians listen to two things — physician leaders and data,” said Osborne. “That’s why Lexington provides assessments that utilize deep data analysis, combined with providing insights from leading doctors to help explain trends and best practices.
“In addition, utilizing benchmarks against peers helps to identify gaps in best practices. It’s a very powerful approach that speaks to doctors in a way that will help them improve their risk.”
Focusing on the “continuum of care”
There’s been a fundamental shift in how healthcare providers care for patients: Treatment is becoming more focused on a patient’s overall health status and related needs.
A cancer patient, for example, should have doctors in a number of specialties communicating and working together toward a positive patient outcome. But that means a change in thinking: Physicians need to work collaboratively with one another — not easy for individuals or groups that are used to being independent. Healthcare is a team sport.
“If there isn’t strong communication, strong leadership, and the recognition of proper treatment procedures between physicians, healthcare providers can increase the risk of error,” said Osborne. “The provider has got to treat the whole patient rather than each individual condition.”
That coordination must extend from inpatient to outpatient, especially since the ACA has led to a rapid increase in patients being treated at outpatient clinics, or via home health or telehealth to reduce the cost of inpatient care
“Home health is going be a growing area in the future,” Osborne continued. “Telehealth will become an effective and efficient way of managing and treating patients in their home. A patient might have a nurse come in and help the healthcare provider communicate with a physician through an iPad or computer. The nurse can also convey assessment findings to the physician.”
Metrics matter more than ever
Patients have not always thought of themselves as healthcare consumers, but that’s changing dramatically as they pay more out of pocket for their own healthcare. At the same time, there’s an increase in metrics and data available to the public — and healthcare consumers are drawing upon those metrics more and more when making choices that affect their health.
“Consumers are going to start measuring physicians against physicians, healthcare systems against healthcare systems. That competition will force everyone to improve the quality of care.”
– Brenda Osborne, Executive Vice President, Lexington Insurance
Think about all the research a consumer does before buying a car. Which dealership has the best price? Who provides the best service? Who’s offering the best financing deal?
“Do patients do that with physicians? No,” said Osborne. “Patients choose physicians through referrals from friends or health plans with minimal information. Patients may be putting their lives in the physicians’ hands and not know their track record.
That’s all going to change as patients’ use of data becomes more widespread. There are many web based resources to find information on physicians.
“Consumers are going to start measuring physicians against physicians, healthcare systems against healthcare systems,” said Osborne. “That competition will force everyone to improve the quality of care.”
Effective solutions are driven by expertise and vision
The rapidly evolving healthcare space requires all healthcare providers to find ways to cut costs and focus on patient safety. Lexington Insurance, long known as the leading innovative and nimble specialty insurer, is at the forefront in providing clients cutting-edge tools to help reduce costs and healthcare exposures.
These tools include:
- Office Practice Risk Assessment: To support clients as they acquire physician practices, Lexington developed an office practice assessment tool which provides a broad, comprehensive evaluation of operational practices that may impact risk. The resulting report, complete with charts, graphs and insights, includes recommendations that can help physicians reduce risk related to such issues as telephone triage, lab results follow-up and medication management. .
- Best Practice Assessments: High risk clinical areas such as emergency departments (ED) and obstetrics (OB) can benefit significantly from external, objective, evidence-based assessments to identify gaps and assure compliance with best practices. In addition to ED and OB, Lexington can provide a BPA for peri-operative care, prevention of healthcare-acquired infections, and nursing homes. All assessments result in a comprehensive report with recommendations for improvement and resources along with consultative assistance and support. .
- Continuing Education: In an effort to improve knowledge, decrease potential risk and support healthcare providers in the use the most current tools and techniques, Lexington provides Continuing Medical Education credits at no cost to hospitals or their physicians.
- Targeting the Healthcare Consumer: With Medicare reimbursement impacted by patient-satisfaction surveys, assuring a positive patient experience is more critical than ever. Lexington helps hospitals understand and improve the patient experience so they can continue to earn the trust of healthcare consumers while preserving their good reputation. .
To learn more about Lexington Insurance’s scope and depth of the patient safety consulting products and services healthcare solutions, interested brokers may visit their website.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Lexington Insurance. The editorial staff of Risk & Insurance had no role in its preparation.