THE JOURNEY TORETURN TO WORK

Angeli Mancuso, RN, COHN‐S/CMManager, Employee Health & SafetyCottage Health

About Cottage Health

3rd largest employer in town– 3,700 employees

3 hospitals– Santa Barbara Cottage Hospital 

(450 licensed beds)– Goleta Valley Cottage Hospital 

(52 licensed beds)– Santa Ynez Valley Cottage Hospital 

(11 licensed beds)

1 laboratory– 25 locations between Fresno and 

Westlake Village

Objectives

Costs behind absences for work‐related injuries Encouraging a rapid return — promising practices and approaches– Alternate positions– Reasonable accommodation– Other means of support

Manager/Employee engagement before an injury occurs

Definitions Lost time

– OSHA recordable days away from work

Modified duty– Not performing a piece of your job

Transitional alternate work (TAW)– Performing work that is completely different than your job

Reasonable accommodation– Performing your job differently

Interactive process– The dialogue necessary to coordinate return to work and may 

involve all of the above

Why Early Return to Work?

Improved health care outcomes Improved employee/manager relationships Increased staff morale Decreased disability costs Decreased medical costs

Our Lost‐Time History

Lost Days

2017 560 (goal)

2016 622

2015 1298

2014 1953

2013 871

2012 1264

83 cases (average 7.5 days each) 5 outlying cases

– 101 (Corp)– 78 (PDL) – 71 (SB)– 63 (GV)– 46 (SB)

2016 Lost Days Employees Recordable  Injuries

Lost Time Injuries

SB 312 3,036 155 42

GV 73 309 18 5

SY 27 100 11 3

PDL 97 328 22 4

Corp. 113 551 9 2

Comparing Multiple Factors

Injury Frequency

Claim Cost

Medical Cost

2012 164 $10,811 $6,710

2013 126 $9,743 $5,725

2014 138 $9,766 $4,839

2015 138 $6,345 $3,217

2016 152 $6,518 $3,017

Our Disability Costs

2016622 days lost x 8‐hour daysx $39.20 avg. hourly wage$195,059

2014 1,953 days lost x 8‐hour daysx $39.20 avg. hourly wage$612,460

$417,401

How Did We Get Here?

Culture

Communication

Persistence

How Did We Get Here? (cont.)

Early Case Management Open and clear dialogue  Physician partnerships Diagnostic and imaging referrals without delay

How Did We Get Here? (cont.)

3 Tiers of Return to Work Tier 1 – TAW or modified duty assignment within the home department

Tier 2 – TAW assignment in a different department within the organization

Tier 3 – TAW assignment outside of the organization

How Did We Get Here? (cont.)

DepartmentOrganizationReEmployAbility

Where We Are Now Effectively managing absence after a work‐related injury 

On the road to better non‐work‐related absence management– Initiating  the interactive processes early– Employee Health & Safety and Employee Relations coordinate 

communication– Encouraging manager support and communication 

directly with employees

What’s Next?

Increased management training and support

Working throughremaining “lengthy” leaves —how long is too long?

TAW for disabilities not related to work injuries

Key Messages

Absence management is a complicated aspect of health care

The psychosocial aspect of being at work improves health outcomes

There are $$$ to be saved in this process

Education and support for managers will make this process easier

Messages need to be consistent throughout theorganization