mwcea conference ocean city, md ocean city, md september 23, 2003 presented by: jayne gribble, pt...
TRANSCRIPT
MWCEA ConferenceMWCEA Conference
Ocean City, MdOcean City, Md
September 23, 2003September 23, 2003
Presented by: Jayne Presented by: Jayne Gribble, PT PFSGribble, PT PFS
New Perspectives in New Perspectives in Work Injury ManagementWork Injury Management
The single most powerful The single most powerful and sensible strategy for and sensible strategy for
decreasing the cost of decreasing the cost of ‘‘doing businessdoing business’ and ’ and
managing work injuries is managing work injuries is PRIMARY PRIMARY
INTERVENTIONINTERVENTION……
The PROACTIVE Prevention of the The PROACTIVE Prevention of the Initiation of InjuriesInitiation of Injuries
Injuries CAN be Prevented…Injuries CAN be Prevented…
You Break It You Buy It You Break It You Buy It $$
Primary Intervention can Reduce Lost Primary Intervention can Reduce Lost Time Days 60-70% - a Significant Time Days 60-70% - a Significant
Return on InvestmentReturn on Investment A Kemper Insurance study revealed 68% A Kemper Insurance study revealed 68% savings when direct therapy costs and lost savings when direct therapy costs and lost time are calculatedtime are calculated
The Cost of Breaking It…The Cost of Breaking It…Show Me theShow Me the MoneyMoney
$ Direct cost of workplace injuries increased by 2.5% in 2002 (Liberty Mutual Work Place Safety Index)
$ Between 1998 and 2000 the direct costs grew faster than the rate of inflation (Consumer Price Index)
$ The frequency of disabling injuries fell by 1% for the same period (Bureau of labor statistics)
$ Indirect costs total between $3 and $5 for every $1 of direct cost.
With costs rising the way With costs rising the way they are, shouldn’t there they are, shouldn’t there be a renewed emphasis be a renewed emphasis on services that provide on services that provide value above and beyond value above and beyond
traditional clinical traditional clinical services??services??
Value PropositionsValue Propositions• Identifying risks on an ongoing Identifying risks on an ongoing
basis…basis…• Reduces the frequency and severity Reduces the frequency and severity
of injuries…of injuries…• Lost time is reduced because injuries Lost time is reduced because injuries
don’t have the opportunity to don’t have the opportunity to progress to the point of significant progress to the point of significant tissue damage and inability to tissue damage and inability to perform dutiesperform duties
The current clinical model is like…The current clinical model is like…Pushing the Rocks up the HillPushing the Rocks up the Hill
A Relatively Small Number of Injuries A Relatively Small Number of Injuries Consume the most ResourcesConsume the most Resources
$ The top three injury categories accounted for 51% of the direct costs in 2000…up from 46% in 1998.
$ The top 10 categories accounted for 89% of the direct costs in 2000…up from 86% in 1998.
The Top Three Injury Categories Increased in 2000
17% increase in slips & falls
12% increase in lifting injuries13% increase in
body position/use
TheThe GoldenGolden Rules for Rules for SupervisorsSupervisors
Learn to identify unsafe work practices and workstations – be a good role model
Communicate with and support yourhuman resources
Improve new worker selection and hiresmarter
Identify power struggles and adversarial interactions early and learn to resolveconflicts
Primary Intervention StrategiesPrimary Intervention Strategies
• Worker safety Worker safety checkcheck
• Work risk Work risk analysisanalysis
• Education and Education and empowermentempowerment
• Wellness Wellness programsprograms
• Job task Job task analysisanalysis
• Pre-placement Pre-placement screen as Fit For screen as Fit For Duty/WorkDuty/Work
Worker Safety CheckWorker Safety Check
• IndividualizedIndividualized• Proactive – prior to a report of injuryProactive – prior to a report of injury• Worker or supervisor initiatedWorker or supervisor initiated• Looks both at work practice/behavior Looks both at work practice/behavior
and the specific work flow/set upand the specific work flow/set up• Specific recommendations and follow Specific recommendations and follow
upup
Work Risk AnalysisWork Risk Analysis• Comprehensive look at a job class or
a specific group of workers
• Worker, supervisor or data initiated (i.e. injury trends)
• Specific recommendations regarding work flow, set up and risks by body part/region
• Worker education must be stressed
Worker SelectionWorker Selection
• Concept: we all use our bodies to earn a living
• When being fit is a basic job requirement or is inferred by the description doesn’t it make sense to establish a minimum standard for fitness and ability?
• Do we want workers who are capable of performing their duties without undue risk of injury or fatigue?
Worker SelectionWorker Selection• We can relate fitness to the ability to
perform essential job functions• We can also educate individuals to
relate fitness to work and know their health risks.
• Job tasks such as lifting/carrying and pushing/pulling require components of health such as strength (both absolute and dynamic), endurance and cardiac fitness.
Fitness Trivia – the Bad Fitness Trivia – the Bad News News
Americans continue to deteriorate –this effects general healthcare as
well as workers’ compensation costs
1. 64.5% are officially overweight/obese according to BMI (25-30% is overwgt., >30% obese)
(BMI = wgt. x 703 / hgt. squared)
2. Type 2 diabetes has reached pandemic proportions
3. CVD remains # 1 killer for both males and females
Worker SelectionWorker SelectionA Job Task Analysis is CRITICAL to A Job Task Analysis is CRITICAL to
the selection process.the selection process.
1. Identify essential/core tasks
2. Determine frequency and criticality
3. Determine the fitness factor behind each task
4. Screen MUST be job-related but does not have to be simulated
Worker SelectionWorker Selection
• Tests, standards and programs are meant to and can discriminate if job relatedness is established and documented.
• Are companies ethically responsible for hiring and retaining employees who are physically capable of performing essential functions?
Worker Selection - Worker Selection - ConsiderationsConsiderations
• Combine with education, wellness and empowerment
• Adverse impact may occur but is not illegal since the skills are job-related
• Implies emphasis on fitness post-hire as well – change in company culture
• What are the consequences of being ‘unfit for duty’??
The ProcessThe Process
• Informed consent -employment contingent• Fitness assessment – part of pre-employment
physical• Musculoskeletal factors such as flexibility and
body mechanics cannot be used to discriminate but are useful for education and motivation
• Absolute, dynamic strength and aerobic fitness tests can discriminate
The Results – OptionsThe Results – Options
• Reported to Human Resources• Response based upon established
company policy• Hire without bias based upon results• Hire with bias – retest near end of
probation period• Offer placement in more appropriate
position if available• Reasonable accommodation may apply
Fitness Trivia – the Fitness Trivia – the Good News Good News
• Exercising to increase your heart rate 30
minutes a day three days per week will reduce your risk of death from CVD and cancer by 50-58%
• Increasing the intensity of your current workout by 50% will improve your fat loss by 53%
Source: Cooper Aerobics Institute
If you keep doing what you have If you keep doing what you have always done you will keep getting always done you will keep getting what you have always got.what you have always got.Do you like what you have been Do you like what you have been getting?getting?
If Your PRIORITY the creation and maintenanceIf Your PRIORITY the creation and maintenanceof a fit and healthy workforce you can…of a fit and healthy workforce you can…
1.1. Decrease costs associated with work injuriesDecrease costs associated with work injuries
2.2. Decrease costs associated with general Decrease costs associated with general healthcare and disability BUT…healthcare and disability BUT…