2222222222

2017 Teddy Award Winner

Carrots, Not Sticks

At Rochester Regional Health, the workers’ comp and safety team champion employee engagement and positive reinforcement.
By: | November 1, 2017 • 6 min read

When Monica Manske does rounds at Rochester Regional Health’s five hospitals and six long-term care facilities, she looks at shoes, among other things.

Her interest is safety — not fashion. However, offering employees more fashionable options helped increase the compliance rate in RRH’s mandatory safety shoe program from 35 percent a few years ago to 85 percent in 2016, said Manske, RRH’s senior manager of workers’ compensation and employee safety.

Advertisement




Safety shoes are an important factor in preventing slips and falls, which are a major loss driver for health care facilities, especially for employees in food service, environmental and housekeeping and direct patient care.

In the five years since its inception, the safety shoe program contributed to a 42 percent reduction in lost-time claims and a 46 percent reduction in employee injuries.

That change came only with deliberate and concerted use of one-on-one communications, surveys, budget adjustments and historical claims data, Manske said.

By virtue of mergers and acquisitions, RRH grew during the past decade from about 10,000 employees to almost 17,000.

As it grew, the workers’ comp and safety team — three employees dedicated to workers’ compensation, two for ergonomics, plus physical therapy and clinical education staff partners and 150 safety champions — educated waves of new employees in safety protocols, including the shoe program.

The team is strategic in its approach to shoe compliance. Rather than punish non-compliant employees, it launched a survey asking workers to disclose why they chose not to wear the safety shoes. The responses helped facilitate program refinements.

Monica Manske, senior manager of workers’ compensation and employee safety, Rochester Regional Health

As a result of the feedback, the shoe subsidy grew substantially, as did the quality and variety, including more-fashionable Sketchers and Reeboks. Compliance now approaches 90 percent, Manske said.

When she does rounds and sees a non-compliant employee, “I introduce myself in a friendly way and ask about the shoes.” Maybe they don’t fit right. Maybe the employee is new and hasn’t been fitted yet.

The same process applies to other programs, she said, such as direct patient care where soft tissue and musculoskeletal disorders are common and largely avoidable. Housekeeping is a key focus as well due to its potential factor in infections such as MRSA.

Frequent, direct employee contact is essential to spreading the safety gospel, said Laurie Muratore, injury prevention clinic manager, RRH. “We don’t just train at first hire and then cut them loose. It takes daily involvement.”

Sometimes she puts on scrubs and spends a few days on a unit to immerse herself in the staff’s struggles and challenges. “If you’re not out there in the mix, it’s hard to teach and preach and be accepted.”

“I like to be the carrot. Not the stick. We don’t punish mistakes. This is fact finding, not fault finding.” — Monica Manske, senior manager of workers’ compensation and employee safety, Rochester Regional Health

The safety team works hard to cultivate its image as “good cops” rather than “bad cops.” It encourages individuals to report mistakes so the precursors to errors can be better understood to fix system issues.

“I like to be the carrot. Not the stick,” said Manske. “We don’t punish mistakes. This is fact finding, not fault finding.”

“When they see me coming, they say, ‘Here’s the back lady!’ ” said Muratore, who has a background in physical therapy. Back injuries are the scourge of nurses, who lift, pull, push and shift patients, often in 12-hour shifts.

Sometimes Muratore shows up with new safety devices, such as slings and straps that RRH is thinking of buying. “They say, ‘Got any new toys for us?’ ”

What Gets Measured

A measure of a good workers’ compensation safety program is how quickly claims are reported, said Charles Bolesh, senior account executive, PMA Management Corporation, the health system’s TPA.

Delays, he said, are understandable since each hospital’s first priority is to care for patients. But delays are often symptoms of stretched resources and lack of leadership focus. They’re a red flag for weak injury prevention. “Delays can lead to bad outcomes.”

Advertisement




For example, he said, injured workers facing a long reporting delay may not have a return-to-work plan, let alone testing, medical care and therapies. They may retain an attorney.

“There’s a direct correlation between reporting delays and higher-cost claims,” he said.

When PMA first partnered with RRH in 2000, claims reporting could take a full month. Bolesh offered some advice: Report faster. “They ran with it,” he said. Now, reporting to PMA takes place within a few days, and injured workers get treatment and a return-to-work plan in short order.

Incident reports are detailed, Manske said. RRH measures every department, the day of week, the shift, the time of the event.

“Do weekend nights appear to have more injuries? Where do we lose money and time? That’s where we focus time and effort.”

Marsh, RRH’s broker, performs a gap analysis to measure the company’s practices against industry best practices. PMA reports back to RRH and provides monthly and quarterly benchmarks to executive committee, line managers and supervisors.

Laurie Muratore, injury prevention clinic manager, Rochester Regional Health

Initial analysis of incident reports showed two primary loss leaders: slips and falls and safe patient handling. The data then identified the departments and shifts with frequent incidents.

To effectively communicate the data as well as its implications, RRH managers meet with supervisors and employee groups of affected cohorts and train them to use the safety tools available. When necessary, RRH adds internal float pool personnel and/or equipment to help reduce claims.

Communication and collaboration are essential to creating a safe workplace, Manske said. “We’re high-engagement leaders.” Daily department huddles address safety issues, as well as other concerns. And rather than delegating communications responsibilities to department leaders, the safety team meets one-on-one with supervisors and staff. “We want to hear what the issues are. I want to see and hear.”

“What gets measured gets done.” — Charles Bolesh, senior account executive, PMA Management Corporation

Manske said she’s not always “the solutions person.” Often that role goes to the front-line manager in a department or a staff member.

“We collaborate. If a remedy doesn’t work, we reconvene. It’s a check-back cycle.”

These communications and a willingness to learn from failure, Manske said, are best practices among high-reliability organizations, those that avoid catastrophes in high-risk and complex areas.
And RRH reduced claims dramatically over the years, Bolesh said. “What gets measured gets done.”

ROI on Safe Patient Handling

RRH utilizes a different species of technology — some very low-tech — for safe patient handling. It may use slide boards, friction-reducing sheets and air mats to reduce wear and tear on staff involved in direct patient care, said Muratore.

Most equipment is close at hand, outside patients’ rooms, in accordance with fire code.

Typically, hospital floors are equipped with one patient lift per eight patients. Some rooms are equipped with expensive overhead lifts for safe transfer of heavier patients, and every intensive care unit has at least one.

Advertisement




Nursing homes, where patients are more dependent, may have two or three lifts per unit.

Is this prohibitively expensive for leaner facilities? No, said Muratore.

RRH, a community-based hospital system, shops strategically to find equipment that’s well within budget while still achieving safety goals.

Even cash-poor hospitals “do have funding but don’t realize it,” Muratore said. Yes, they must invest in the equipment, but “ROI is very quick. We realized savings in patient and staff safety right away.”

Do some staff skip safety steps because of time pressure or old habits?

“Yes, and then we participate with them,” Muratore said. She may perform patient care alongside the resistant staff member to demonstrate. “Once they practice the safe way, a lightbulb goes off.”

With luck, the lightbulb goes off before injury, she said, but “sometimes an injured colleague is the best safety advocate on the floor. We want staff to work smarter, not harder.” &

_______________________________________________________

More coverage of the 2017 Teddy Award Winners and Honorable Mentions:

Advocacy Takes Off: At Delta Air Lines, putting employees first is the right thing to do, for employees and employer alike.

 

Proactive Approach to Employee SafetyThe Valley Health System shifted its philosophy on workers’ compensation, putting employee and patient safety at the forefront.

 

Getting It Right: Better coordination of workers’ compensation risk management spelled success for the Massachusetts Port Authority.

 

Carrots: Not SticksAt Rochester Regional Health, the workers’ comp and safety team champion employee engagement and positive reinforcement.

 

Fit for Duty: Recognizing parallels between athletes and public safety officials, the city of Denver made tailored fitness training part of its safety plan.

 

Triage, Transparency and TeamworkWhen the City of Surprise, Ariz. got proactive about reining in its claims, it also took steps to get employees engaged in making things better for everyone.

A Lesson in Leadership: Shared responsibility, data analysis and a commitment to employees are the hallmarks of Benco Dental’s workers’ comp program.

 

Susannah Levine writes about health care, education and technology. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Risk Report: Manufacturing

More Robots Enter Into Manufacturing Industry

With more jobs utilizing technology advancements, manufacturing turns to cobots to help ease talent gaps.
By: | May 1, 2018 • 6 min read

The U.S. manufacturing industry is at a crossroads.

Faced with a shortfall of as many as two million workers between now and 2025, the sector needs to either reinvent itself by making it a more attractive career choice for college and high school graduates or face extinction. It also needs to shed its image as a dull, unfashionable place to work, where employees are stuck in dead-end repetitive jobs.

Advertisement




Added to that are the multiple risks caused by the increasing use of automation, sensors and collaborative robots (cobots) in the manufacturing process, including product defects and worker injuries. That’s not to mention the increased exposure to cyber attacks as manufacturers and their facilities become more globally interconnected through the use of smart technology.

If the industry wishes to continue to move forward at its current rapid pace, then manufacturers need to work with schools, governments and the community to provide educational outreach and apprenticeship programs. They must change the perception of the industry and attract new talent. They also need to understand and to mitigate the risks presented by the increased use of technology in the manufacturing process.

“Loss of knowledge due to movement of experienced workers, negative perception of the manufacturing industry and shortages of STEM (science, technology, engineering and math) and skilled production workers are driving the talent gap,” said Ben Dollar, principal, Deloitte Consulting.

“The risks associated with this are broad and span the entire value chain — [including]  limitations to innovation, product development, meeting production goals, developing suppliers, meeting customer demand and quality.”

The Talent Gap

Manufacturing companies are rapidly expanding. With too few skilled workers coming in to fill newly created positions, the talent gap is widening. That has been exacerbated by the gradual drain of knowledge and expertise as baby boomers retire and a decline in technical education programs in public high schools.

Ben Dollar, principal, Deloitte Consulting

“Most of the millennials want to work for an Amazon, Google or Yahoo, because they seem like fun places to work and there’s a real sense of community involvement,” said Dan Holden, manager of corporate risk and insurance, Daimler Trucks North America. “In contrast, the manufacturing industry represents the ‘old school’ where your father and grandfather used to work.

“But nothing could be further from the truth: We offer almost limitless opportunities in engineering and IT, working in fields such as electric cars and autonomous driving.”

To dispel this myth, Holden said Daimler’s Educational Outreach Program assists qualified organizations that support public high school educational programs in STEM, CTE (career technical education) and skilled trades’ career development.

It also runs weeklong technology schools in its manufacturing facilities to encourage students to consider manufacturing as a vocation, he said.

“It’s all essentially a way of introducing ourselves to the younger generation and to present them with an alternative and rewarding career choice,” he said. “It also gives us the opportunity to get across the message that just because we make heavy duty equipment doesn’t mean we can’t be a fun and educational place to work.”

Rise of the Cobot

Automation undoubtedly helps manufacturers increase output and improve efficiency by streamlining production lines. But it’s fraught with its own set of risks, including technical failure, a compromised manufacturing process or worse — shutting down entire assembly lines.

Advertisement




More technologically advanced machines also require more skilled workers to operate and maintain them. Their absence can in turn hinder the development of new manufacturing products and processes.

Christina Villena, vice president of risk solutions, The Hanover Insurance Group, said the main risk of using cobots is bodily injury to their human coworkers. These cobots are robots that share a physical workspace and interact with humans. To overcome the problem of potential injury, Villena said, cobots are placed in safety cages or use force-limited technology to prevent hazardous contact.

“With advancements in technology, such as the Cloud, there are going to be a host of cyber and other risks associated with them.” — David Carlson, U.S. manufacturing and automobile practice leader, Marsh

“Technology must be in place to prevent cobots from exerting excessive force against a human or exposing them to hazardous tools or chemicals,” she said. “Traditional robots operate within a safety cage to prevent dangerous contact. Failure or absence of these guards has led to injuries and even fatalities.”

The increasing use of interconnected devices and the Cloud to control and collect data from industrial control systems can also leave manufacturers exposed to hacking, said David Carlson, Marsh’s U.S. manufacturing and automobile practice leader. Given the relatively new nature of cyber as a risk, however, he said coverage is still a gray area that must be assessed further.

“With advancements in technology, such as the Cloud, there are going to be a host of cyber and other risks associated with them,” he said. “Therefore, companies need to think beyond the traditional risks, such as workers’ compensation and product liability.”

Another threat, said Bill Spiers, vice president, risk control consulting practice leader, Lockton Companies, is any malfunction of the software used to operate cobots. Then there is the machine not being able to cope with the increased workload when production is ramped up, he said.

“If your software goes wrong, it can stop the machine working or indeed the whole manufacturing process,” he said. “[Or] you might have a worker who is paid by how much they can produce in an hour who decides to turn up the dial, causing the machine to go into overdrive and malfunction.”

Potential Solutions

Spiers said risk managers need to produce a heatmap of their potential exposures in the workplace attached to the use of cobots in the manufacturing process, including safety and business interruption. This can also extend to cyber liability, he said.

“You need to understand the risk, if it’s controllable and, indeed, if it’s insurable,” he said. “By carrying out a full risk assessment, you can determine all of the relevant issues and prioritize them accordingly.”

By using collective learning to understand these issues, Joseph Mayo, president, JW Mayo Consulting, said companies can improve their safety and manufacturing processes.

“Companies need to work collaboratively as an industry to understand this new technology and the problems associated with it.” — Joseph Mayo, president, JW Mayo Consulting

“Companies need to work collaboratively as an industry to understand this new technology and the problems associated with it,” Mayo said. “They can also use detective controls to anticipate these issues and react accordingly by ensuring they have the appropriate controls and coverage in place to deal with them.”

Advertisement




Manufacturing risks today extend beyond traditional coverage, like workers’ compensation, property, equipment breakdown, automobile, general liability and business interruption, to new risks, such as cyber liability.

It’s key to use a specialized broker and carrier with extensive knowledge and experience of the industry’s unique risks.

Stacie Graham, senior vice president and general manager, Liberty Mutual’s national insurance central division, said there are five key steps companies need to take to protect themselves and their employees against these risks. They include teaching them how to use the equipment properly, maintaining the same high quality of product and having a back-up location, as well as having the right contractual insurance policy language in place and plugging any potential coverage gaps.

“Risk managers need to work closely with their broker and carrier to make sure that they have the right contractual controls in place,” she said. “Secondly, they need to carry out on-site visits to make sure that they have the right safety practices and to identify the potential claims that they need to mitigate against.” &

Alex Wright is a U.K.-based business journalist, who previously was deputy business editor at The Royal Gazette in Bermuda. You can reach him at [email protected]