Download - Introduction to Synergee & CHESS
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Introduction to Synergee & CHESS
By Dr Andy ThomsonMBChB(UCT), DOH(UCT), DIP PEC(SA), AMP (Manchester)
Occupational Medicine Specialist
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Risk Management Limb
PromotiveLimb
Support ServicesLimb
StrategicLimb
Incapacity / Disability
EAP
Health Education
Wellness
Quality / ISO Alignment
HIV / AIDS
Benefit Management
Environmental Management
Rehabilitation
Specialist Services
Emergency Services
On-Site Primary Healthcare
Medical Surveillance
Training & RecruitmentSafety Mx &
Risk ControlHealth Risk Assessment
Organisational Health Overview
Chess Medical Surveillance Systems
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Consulting
Organisational Health Service
Employee Benefits &
Curative CarePrimary Health
CareOccupational
HealthEmployee Assistance Programme
Health Promotion
Programme
Medical Aid
Pension / Provident Fund
COID Administration
On-Site Curative Care
Emergency Services
Chronic Condition Monitoring
Health Education
Health Risk Assessment
Occupational Hygiene
Programme
Occupational Safety
Programme
Medical Surveillance Programme
Job Profiling & Standard Setting
Hazard Education &
Training
Troubled Worker Support
Performance Management
Support
Wellness Programmes
Voluntary Medical
Screening
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Corporate Health Risk AssessmentCorporate Health Risk Assessment
Structures Outcomes MeasurementStructures Outcomes Measurement
Information interchange through Data WarehouseConfidentiality & Legal/Ethical Process
Medical Scheme Risk AssessmentMedical Scheme Risk Assessment
Outcomes MeasurementOutcomes Measurement
Integrated Care Model
Health Risk AssessmentsHealth Risk
Assessments
Knowledge, Attitudes,
Perceptions & Behaviour
(KAPB)
Knowledge, Attitudes,
Perceptions & Behaviour
(KAPB)
Actuarial Impact
Assessment
Actuarial Impact
Assessment
Occupational Health
Analysis
Occupational Health
Analysis
Absenteeism & Incapacity
Analysis
Absenteeism & Incapacity
Analysis
Total Employee Health & Wellness Strategy Development
Total Employee Health & Wellness Strategy Development
Identification of all Health & Wellness related risks within organisation
Identification of all Health & Wellness related risks within organisation
Managed Care Interventions
(Wellness & Disease Management)
Managed Care Interventions
(Wellness & Disease Management)
Beneficiary Management according to health risk status
Beneficiary Management according to health risk status
Total Health Risk Management Programme Implementation
Total Health Risk Management Programme Implementation
Occupational Health &
Safety Incl. Medicine
hygiene & safety
Occupational Health &
Safety Incl. Medicine
hygiene & safety
Employee Assistance Programme
(EAP)
Employee Assistance Programme
(EAP)
Absenteeism & Incapacity Management
(AIM)
Absenteeism & Incapacity Management
(AIM)
Wellness interventions
incl. HIV, Execs, PHS’s
Wellness interventions
incl. HIV, Execs, PHS’s
Primary Health Care
Incl. HIV Disease
Management & Chronic Rx
Primary Health Care
Incl. HIV Disease
Management & Chronic Rx
Communi-cation
Awareness & Training
Communi-cation
Awareness & Training
Scheme Benefit Design & Risk Management Strategy
Scheme Benefit Design & Risk Management Strategy
Identification of all Clinical & Financial risks within the medical scheme
Identification of all Clinical & Financial risks within the medical scheme
Health Risk
Assess-ments
Health Risk
Assess-ments
Demo-graphic Analysis
Demo-graphic Analysis
Claims AnalysisClaims
Analysis
Data W
arehouseD
ata Warehouse
Strategy Review
Differentiation – Integrated Wellness Model
Occupational Health | EAP | Wellness | Executive Health | Consulting
Corporate Health Risk AssessmentCorporate Health Risk Assessment
Structures Outcomes MeasurementStructures Outcomes Measurement
Information interchange through Data WarehouseConfidentiality & Legal/Ethical Process
Medical Scheme Risk AssessmentMedical Scheme Risk Assessment
Outcomes MeasurementOutcomes Measurement
Integrated Care Model
Health Risk AssessmentsHealth Risk
Assessments
Knowledge, Attitudes,
Perceptions & Behaviour
(KAPB)
Knowledge, Attitudes,
Perceptions & Behaviour
(KAPB)
Actuarial Impact
Assessment
Actuarial Impact
Assessment
Occupational Health
Analysis
Occupational Health
Analysis
Absenteeism & Incapacity
Analysis
Absenteeism & Incapacity
Analysis
Total Employee Health & Wellness Strategy Development
Total Employee Health & Wellness Strategy Development
Identification of all Health & Wellness related risks within organisation
Identification of all Health & Wellness related risks within organisation
Managed Care Interventions
(Wellness & Disease Management)
Managed Care Interventions
(Wellness & Disease Management)
Beneficiary Management according to health risk status
Beneficiary Management according to health risk status
Total Health Risk Management Programme Implementation
Total Health Risk Management Programme Implementation
Occupational Health &
Safety Incl. Medicine
hygiene & safety
Occupational Health &
Safety Incl. Medicine
hygiene & safety
Employee Assistance Programme
(EAP)
Employee Assistance Programme
(EAP)
Absenteeism & Incapacity Management
(AIM)
Absenteeism & Incapacity Management
(AIM)
Wellness interventions
incl. HIV, Execs, PHS’s
Wellness interventions
incl. HIV, Execs, PHS’s
Primary Health Care
Incl. HIV Disease
Management & Chronic Rx
Primary Health Care
Incl. HIV Disease
Management & Chronic Rx
Communi-cation
Awareness & Training
Communi-cation
Awareness & Training
Scheme Benefit Design & Risk Management Strategy
Scheme Benefit Design & Risk Management Strategy
Identification of all Clinical & Financial risks within the medical scheme
Identification of all Clinical & Financial risks within the medical scheme
Health Risk
Assess-ments
Health Risk
Assess-ments
Demo-graphic Analysis
Demo-graphic Analysis
Claims AnalysisClaims
Analysis
Data W
arehouseD
ata Warehouse
Strategy Review
Differentiation – Integrated Wellness Model
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General Requirements OHSAS 18001
OHSAS18001
OH&S PolicyContinuousImprovement
Planning
Implementation & Operation
ManagementReview
Checking & Corrective Action
1
2
34
5
6
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Policy and Commitment X
Hazard Identification, Risk assessment, Risk classification & Risk control X
Legal Compliance X
Objective & Target Setting X
Development & Implementation of Appropriate Health and Safety Programmes X
Organization and Deployment of Staff X
Training, Communication & Consulting X
Operational Controls X
Emergency Preparedness & Response Plans X
Measurement & Monitoring X
Synergee and OHSAS 18001
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The Ten Steps for Occupational Health Implementation
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System Structure
Data MxSystem
Document MxSystem
Contact MxSystem
Information Mx System
Occupational Health MX System
Medical Surveillance Training RecruitmentOcc. Hygiene Safety
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Hea
lth
Req
uire
men
tsHigh
HighExposure Risk
CriticalOccupationsCriticalOccupations
GeneralOccupationsGeneralOccupations
High RiskOccupationsHigh RiskOccupations
LiableOccupationsLiableOccupations
Liability Risk Vs. Hazard Risk
Physical Risk & Liability Risk
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What is an OREP?
A summary of:
The key inherent requirements of a jobThe key hazards (risks) to which the job (employees) are exposed
Key legal imperatives include:Inherent Requirements: Employment equity act & codes of practice as well as many statutes specific to occupations (Aviation, Drivers, Divers, Construction workers, etc.)Hazards/Risks: Occupational Health & Safety Act & Regulations, including Hazardous Chemical Substance Regs.
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Data MxSystem
DocumentMx System
Contact MxSystem
Health Risk Assessment
Occupational Hygiene
Qualitative & Quantitative
By Location / Position
By Agent (HCS, HBA)
Inherent Requirements of the job
Creation of OREPS
System Structure
Medical Surveillance TrainingOcc.
Hygiene Safety Recruitment
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Risk Management Elements of CHESS
Company Profile & Matrix of Hazard Exposures (incl chemicals)
Company Profile & Matrix of Inherent Requirements of the Jobs
Company inventory of Hazardous Chemical substances and details of their effects
Company inventory of Hazardous Biological Agents and details of their effects
Hazard Matrices of all hazards and of employees exposed, and degrees of exposure
Automatic generation of OREPS and WASPS
OREP linked to the individual medical surveillance record
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Connecting Risk Assessments to Medical Surveillance
Links the following directly to the Individual Employee Medical Record1. Risk Assessments including documents
2. Occupational hygiene measurements
3. Relevant Safety Datasheets
4. Inherent Requirements of the job, including specified standards
5. Required Medical Surveillance
6. Absenteeism
7. All other medical records, test results, examinations, medical illnesses, Injuries on duty etc.
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Data MxSystem
DocumentMx System
Contact MxSystem
Medical Surveillance
Programs Outcomes
Medical Surveillance Training
Activities
Recruitment
Activities
Analysis
Trends
Occ. Hygiene Safety
Injuries on Duty
Special Investigations
Activities & Meds
Analysis
Trends
Primary Health Care
System Structure
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Data MxSystem
DocumentMx System
Contact MxSystem
Policies & Procedures
General ReferenceCompany Reference Legislation
Forms, Templates
Articles, e- docs
Useful tables of reference (Differential
Diagnosis)
Codes of Practice
Statutes & Regulations
System Structure
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Data MxSystem
DocumentMx System
Contact MxSystem
Forward & Backward
CommunicationCommunicationSchedulingScheduling Case ManagementCase Management
Automated emailing (triggers such as due dates, outcomes, etc.)
Tracks cases that are not “closed off”
System Structure
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Medical Surveillance Elements of CHESS
Scheduling of various medical surveillance, examinations and tests
Overview & Analysis of company medical surveillance programs
Capture and detailed analysis of all OH, PHC and IOD visits
Capture and detailed analysis of tests such as biological monitoring, lung function, audiometry etc.
Central Reporting
Multi-level drill down reporting, including top-end graphing tools.
Export to other programs such as MS word, MS Excel
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Wellness & Absenteeism
Individual absenteeism calendar attached to patient record.
Powerful absenteeism analysis and management tools
Individual and company cardiac risk profile from consults including personal health and executive medical assessments
Detailed disease pattern & profile monitoring
Chronic Disease compliance assessment tools
Profile of company HCT/VCT program (and export to Bizwell)
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Primary Health Care & IODs
Tracking & analysis of IODs
Detailed disease patterns analysis of visits
Chronic Disease compliance assessment tools
Dispensed medication tracking and analysis, including medicine registers and dispensing patterns.
Dispensary and stock management
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Impacts of Illness on Business
From an apparently healthy workforce of 1000 people
35 to 50 will be absent due to illness or injury
150-200 will be suffering from a common mental disorder
100 will have an alcohol or drug related problem
90 will suffer from migraine
20 from diabetes
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The Financial Costs of Absence
Absences have three areas of financial impact:
1. Direct costs for the benefits or wages paid to employees while absent,
2. Indirect costs for lost productivity or the replacement worker expenses to “cover” absences and minimize loss of productivity, and
3. Administrative expenses, whether due to internal staffing and overhead, or to vendor services.
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The Financial Costs of Absence
Seccombe (1995) lists other less identifiable costs which can be attributed to absence, including:
Lost production or service provision
Interrupted work flow
Loss of customers
Lower productivity from temporary employees and returning employees
Added costs of meeting slipped deadlines
Reduced employee morale.
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The Financial Costs of Absence
Combined total costs for incidental and extended absences —the kinds of absences employers try to minimize — add up to
9.2% of payroll.
The average total costs of incidental unplanned absences amount to 6.0% of payroll, and
Those for extended absences average are 3.2% of payroll.
Mercer Survey 2010
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Financial Impact of Absenteeism
Consider Manufacturing Company - 1000 staff & using basicsalary data (i.e. excluding Management time etc), this company'sraw absence costs look like this:
Staff work a 40 hour week for average R35 per hour, wage bill = R1,400,000 per week = R72,800,000 per annum
Total sick leave costs are estimated to be 9.2% of payroll = R7.6 million (ref. Mercer)
The average total costs of incidental unplanned absences amount to 6.0% of payroll = R4,4 million pa
Those for extended absences average are 3.2% of payroll = R2,3 million
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Managing Employee Attendance
Attendance Management
Program
Monitoring Evaluation Reporting – Policies – Information Education Communication
Detailed collective agreement with trade unionFormal negotiating committeeBusiness partnership forumRoles & responsibilities of shop stewardsWork organisation & flexibilityPeople management
Flexible labour poorAttendance incentive scheme
Performance based reward (PBR)Absenteeism modifier – monthlyAbsenteeism penalty factor – annual
Social investment agreements
On-site counselling servicesFormal referralSelf referral
24/7/365 (Free) counselling call centreCounselling services & referralAdvisory services & referral
Interactive websiteInformation / documents & formsE-learningRisk profiling
TrainingEmployeesManagers
Management consulting
Comprehensive IR manualDetailed incapacity guidelines and rules
Management trainingEmployee training
IR SpecialistCompulsory incapacity counselling
Standardised counselling documentsStandardised enquiry documents
Electronic tracking & prompting systemFormal referral to medical – counselling
Extended sick leave managementTemporary lay-off management
Integrated health-safety management(ergonomic-chemical-physical-
psychological-biological)Medical screening and monitoring
HIV voluntary counselling & testingFirst aid & medical emergencies
On-site primary careHealth promotion (inc Biokinetics)
Disability managementRehabilitation
Peer educator networkCorporate sport & fitness clubs
Compulsory membership health insurance
LabourAgreement
Incapacity Management
Counselling & Well-being
Health, safety & well-being
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Managing Employee Attendance
Example of Incapacity Counselling System
Poor performance / 3 occurrences sick leave in 12/12
First Incapacity Counselling
Ongoing poor performance / 6 occurrences sick leave in 12/12
Second Incapacity Counselling
Formal Referral to Medical -Counselling
Formal Referral to Medical -Counselling
Incapacity Enquiry
Performance difficulties, behavioural problems, stress, conflict, etc.
Performance difficulties, behavioural problems, stress, conflict, etc.
Termination OR Disability Claim
Ongoing poor performance / 9 occurrences sick leave in 12/12
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Supportive SlidesScreen Views
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Absenteeism Snap Shots
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Identifying Employees to Focus On
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Hyperlink to Employee Medical Record
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2010
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2009
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2008