introduction to synergee & chess

Occupational Health | EAP | Wellness | Executive Health | Consulting

www.eohhealth.co.za

Introduction to Synergee & CHESS

By Dr Andy ThomsonMBChB(UCT), DOH(UCT), DIP PEC(SA), AMP (Manchester)

Occupational Medicine Specialist


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


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


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


General Requirements OHSAS 18001

OHSAS18001

OH&S PolicyContinuousImprovement

Planning

Implementation & Operation

ManagementReview

Checking & Corrective Action

1

2

34

5

6


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


The Ten Steps for Occupational Health Implementation


System Structure

Data MxSystem

Document MxSystem

Contact MxSystem

Information Mx System

Occupational Health MX System

Medical Surveillance Training RecruitmentOcc. Hygiene Safety


Hea

lth

Req

uire

men

tsHigh

HighExposure Risk

CriticalOccupationsCriticalOccupations

GeneralOccupationsGeneralOccupations

High RiskOccupationsHigh RiskOccupations

LiableOccupationsLiableOccupations

Liability Risk Vs. Hazard Risk

Physical Risk & Liability Risk


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.


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


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


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.


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


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


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


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


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)


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


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


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.



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.



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


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


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


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


www.eohhealth.co.za

Supportive SlidesScreen Views


Absenteeism Snap Shots


Identifying Employees to Focus On


Hyperlink to Employee Medical Record


2010


2009


2008

introduction to synergee & chess

Documents

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phss primary health

phss wellness interventions

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