By Jared Shelly
As America's workforce ages, companies that offer physically demanding jobs face a conundrum: how to keep employees on the job without getting hurt. If they can't keep older workers safe, they could face a workers' comp nightmare or be forced to hire less experienced -- and less knowledgeable -- workers.
At Community Health Systems, a network of 135 hospitals in 29 states with 98,000 employees, lifting patients onto beds, tables and chairs had become an area of concern since such tasks can produce neck, back, shoulder and arm strains -- especially for older workers. So CHS started the Safe Patient Handling and Transfer Program, which utilizes mechanized, sling-like devices to lift patients who may have varying degrees of trouble with mobility.
What once may have taken the brute force of five hospital workers now takes just one or two.
The addition of the lifts not only means fewer injuries but it's also helping CHS keep its aging employees at work.
"We want them to be able to meet the physical demands of the job," said Bruce Jones, director of insurance and Texas plan administrator at CHS. "We really want them on the job as long as they want to be here. This can prolong their careers."
The staff members seem to love it, noting that it not only gives their bodies a break, but it leads to fewer patient falls and higher patient satisfaction. One hospital in the system is even using it as a recruiting tool -- thinking that prospective nurses may be excited about the prospect of minimal heavy lifting. Perhaps just as importantly, the program saved more than $22 million over the past five years, Jones said.
But the lift program is just one part of a large and robust workers' comp and disability management program at CHS. The hospital system also conducts management peer reviews on workplace safety and prescription drug information. It also focuses on lag-time reduction and has developed an online loss tracking system, all of which helped the company win the 2012 Theodore Roosevelt Workers' Compensation and Disability Management Award in the for-profit category.
Between 2007 and 2011, CHS reduced its average cost per claim from $4,308 to $2,688, a reduction of nearly 38 percent. The company's injury frequency rate dropped from 2.61 per $1 million of payroll to 2.03 per $1 million of payroll over the same period, the company also reported.
"We've seen a downward trend in the frequency and severity of injuries," said Jones. "The number of loss days has dropped by 50 percent."
Those numbers are even more impressive considering that CHS has been in "acquisition mode" for years, said Jones -- adding five new hospitals in Pennsylvania, Texas and Illinois in just the past year. That means adding new employees who come from differing employment cultures and attempting to instill in them a culture of safety and diligence.
Never was that task more daunting than in 2007, when CHS acquired Triad Hospitals, adding as many as 50 hospitals and increasing its workforce from 39,000 to more than 80,000. But rather than rushing the new employees, CHS slowly rolled them into their program -- first showing them online charts and graphs about cost savings then training them to report claims to reduce lag time.
"Through the stresses of major acquisitions they never lose focus," said Sharon D. Brainard, senior managing director of the National Casualty Practice at Beecher Carlson, CHS' insurance broker.
Brainard said she's particularly impressed with the way CHS has been able to keep its downward trend in workers' comp costs even after adding so many new employees each year. "It's surprising, you just don't see that," she said. "I almost expect to see [the trend] go in reverse."
She said CHS has been able to incorporate new hospitals into its programs "pretty easily" and that new workers "seemed appreciative of the focus and effort."
CREATING A CULTURE
In a recent study of more than 600 hospitals, CHS reported 94 percent of all claims within the first seven days, while the group as a whole achieved an 81 percent rate over a 10-year period. Jeff Mlinarich, assistant vice president at claims manager Gallagher Bassett, said he's impressed that lag time has not increased considering the new employees as well as the nature of the business.
"For a company that's open 24 hours a day, seven days a week, 365 days a year -- that's really impressive," he said. "It's especially different since it's a hospital, which employs many different types of professionals and caters to many different types of people. There are lots of moving parts."
"They have so many hospitals [which requires] ... well-orchestrated, organized systems to make sure goals and strategies are carried out properly," she said.
The company also utilizes monthly peer initiation reviews where the department heads and directors get together to discuss injuries and workers' comp information. The 10-month-old program is not designed to scold or ridicule the departments for shortcomings, but instead allows everyone to share ideas and solutions to similar problems.
"It gets you to think about what happened and how to prevent it from happening again," said Jones.
And the results have been impressive. In the past seven months of the program, CHS has seen a 38 percent reduction in claims frequency and more than $1.2 million in reduced costs.
Risk management also holds quarterly conference calls with adjusters and workers' comp coordinators at each hospital to emphasize using occupational health rather than sending employees to the emergency room since a visit to the ER can increase the cost of treatment 10-fold.
Transitional assignments are another valuable tool for the hospital system. Offering employees social time with co-workers and letting them become acclimated to the routine of reporting to work each day can pay huge dividends. If a nurse suffers a knee injury, for example, he or she can do modified duty assignments like making phone calls for appointment reminders or follow-up care. The hospital system also offers Light Duty Sharing, a program in which two employees on modified duty can share a job to make up one full shift. CHS is even exploring the idea of allowing employees to work light-duty assignments with volunteer organizations in their communities.
CHS is also targeting prescription drug costs, encouraging employees to take generics and receive home delivery -- both traditionally cheaper options. It also developed an online loss tracking system that creates tables, charts and graphs for comparing losses with those at other hospitals or across a particular state.
Mlinarich, from Gallagher Bassett, said he enjoys working with Jones and his team because they have backgrounds in claims.
"They know what to expect from the adjusters and know the best outcomes they are looking for," he said. Jones and the CHS team, he said, are in "constant communication" with Gallagher Bassett adjusters. In one instance, they even showed off the patient lift equipment to an annual adjuster meeting.
CHS' robust workers' comp initiatives and ability to get newly acquired employees entrenched into the program allows Beecher Carlson's Brainard to get best-in-market prices from insurance carriers.
"It's a dream to represent someone like CHS when you go into the marketplace," said Brainard. "Year after year, we have compelling story to tell."
JARED SHELLY is senior editor/Web editor of Risk & Insurance®. He can be reached at firstname.lastname@example.org.
November 1, 2012
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