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2016 Teddy Award Winner

Improve the Well-Being of Every Life

Excela Health changed the way it treated injuries and took a proactive approach to safety, drastically reducing workers’ comp claims and costs.
By: | November 2, 2016 • 6 min read

Excela Health, a health care network operating three hospitals in western Pennsylvania, abides by its mission to improve the health and well-being of every life it touches.

“When we wrote that mission statement about 10 years ago, ‘every life we touched’ was supposed to encompass not only our patients, but our employees and everyone who is here,” said Chief Medical Officer Carol Fox.

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Taking extra care of its employees comes with an added bonus — it helped Excela deeply reduce workers’ compensation claims in the process.

Excela’s across-the-board efforts earn the hospital a 2016 Teddy Award. The numbers speak for themselves: Excela lowered workers’ compensation paid claims costs to $124,076 last year from $859,515 in 2008.

The hospital managed injured employees with a creative and robust return-to-work program and added around-the-clock support from an on-call nursing team. Then it bolstered employee wellness programs and attacked the top causes of workplace injury.

Carol Fox, chief medical officer, Excela Health

Carol Fox, chief medical officer, Excela Health

Excela was formed in 2004 with the merger of three regional Pennsylvania hospitals: Frick Hospital in Mount Pleasant; Latrobe Hospital in Latrobe; and Westmoreland Hospital in Greensburg. The combined health system is the largest employer in the region with more than 4,500 employees.

Excela also runs a home health care and hospice company with 206 workers making more than 275 home visits each day. And there’s a physician practice that employs another 900 people in 98 locations.

That’s a lot of opportunity for accidents and yet just 62 employees filed an OSHA recordable claim in the fiscal year ending June 30, 2016, down from 233 in fiscal year 2008.

Return to Work Program

A big part of  Excela’s efforts is its Temporary Transitional Return to Work Program, launched in 2010 to encourage employees to remain productive after a work-related injury or illness.

“We keep them working and keep them engaged and we care about them,” said Laurie English, Excela’s chief human resource officer.

Excela has been able to put about 95 percent of injured workers in this program. “That’s truly where the cost reduction has happened,” English said.

Take for example cardiac nurse Ruth Ann Martin. She snagged her foot on a computer cord while getting up to answer a patient’s call a few years ago. She tumbled and her kneecap — taking the brunt of the fall — shattered.

After four decades of working at the hospital without so much as a scratch, the injury sidelined her for a month. After she fell, Martin was met in the emergency room by Eileen Kantorik, an occupational health coordinator, who opened a worker’s compensation case for her.

“We keep them working and keep them engaged and we care about them.” — Laurie English, chief human resource officer, Excela Health

Kantorik has stayed by Martin’s side ever since. She found Martin transportation back and forth to the hospital once she was cleared to return to work. She arranged assistance for Martin, who initially needed a walker, to her desk once she arrived. Kantorik checked in on Martin throughout her recovery and was accessible by cell phone after-hours.

“It made me feel better,” Martin said. “They walked me through everything. It helped a lot because you have the fear of the unknown and without that support it would have been a lot harder.”

As she recovered, Martin was approved to perform scaled-back jobs at the same rate of pay. She has since fully recovered and returned to her previous nursing job. Excela recently celebrated her 45th anniversary at the hospital.

“Where there is an unsafe working condition we feel we owe it to our employees to get them back to 100 percent as quickly as possible,” English said.

“We found having the employee in their department, with the people around them that they normally socialize with, helped to keep them engaged and back to full duty quicker.”

Nurse on Call Program

A Nurse on Call program is another new way Excela captured big cost savings by directing employees to its Employee Health department immediately after an injury. Certified occupational health coordinators such as Kantorik advise employees with significant injuries how best to navigate the workers’ compensation process.

This approach gets employees the most appropriate and cost-effective treatment. If an employee’s injury happens after business hours, or on a weekend or holiday, a Nurse on Call (NOC) initiates the process.

In the past, since Excela runs hospitals, its injured employees instinctively walked to the emergency department for treatment, adding unnecessary expense to the claim.

Excela changed that behavior and got staff comfortable with working with an employee health coordinator using best workers’ comp practices.

Employee Health gets employees seen by the appropriate medical specialist and then back on the job, at full pay, as quickly as possible.

This helps the employee avoid using unnecessary vacation or sick time off, said Mary Blackburn, supervisor of employee safety.

“People who have been injured at work have come to really appreciate that program because they have somebody that’s watching after them and ensuring that things are happening the way things are supposed to be happening,” Fox said.

Tackling the Top Hazards

Excela didn’t just improve the way they cared for employees after an injury. They also established a team that would spring to action to study what caused the accident and how to prevent it in the future.

“We are looking at keeping injuries from ever happening,” said David Byers, director of support services and safety.

“If we can keep that from happening in the first place, we don’t have the injury and we don’t have any of the costs to go along with it.”

After Ruth Ann Martin, the nurse, tripped on the extension cord and busted her knee, Excela’s safety team tied up every cord at every work station off the floor throughout the entire health network. They even redesigned all conference rooms to eliminate cord clutter.

Laurie English, chief human resource officer, Excela Health

Laurie English, chief human resource officer, Excela Health

Of all the risks, Excela’s research initially ranked exposure to blood and body fluids (BBFs) as the No. 1 occupational hazard — that’s needle sticks and other sharp-related injuries which can potentially expose workers to blood borne pathogens such as hepatitis or HIV.

In one case, a phlebotomist was in the middle of the blood draw when a nurse quickly entered the room. The phlebotomist flinched, causing the needle to dislodge and stick her.

When the safety team studied the event, they realized there was no mechanism in place to alert staff when a blood draw is under way.

They set to work to create a broad solution with a program called “Get the Point.” It involves staff training and a hospital-wide flag system on all patient rooms with colored signage indicating the safety hazards within.

What’s on Your Feet?

When digging into other top injuries, Excela discovered employees were getting hurt on their way to and from work. Falls and fractures spiked during inclement weather.

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The Safety and Occupational Health Department launched “What’s On Your Feet?” They greeted arriving employees with safety materials and LifeSavers candy at the entrances as a fun way to encourage appropriate footwear. It worked. Entering work became a red carpet moment as employees playfully showed off shoes to safety advocates each morning.

It all falls under their mission to improve the health and well-being of every life Excela touches.

“That’s the Holy Grail,” Fox said. “We want everybody to be at least as good, and hopefully better, when they leave here.” &

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Read more about the 2016 Teddy Award winners:

target-150x150Bringing Focus to Broad Challenges: Target brings home a 2016 Teddy Award for serving as an advocate for its workers, pre- and post-injury, across each of its many operations.

 

hrt-150x150The Road to Success: Accountability and collaboration turned Hampton Roads Transit’s legacy workers’ compensation program into a triumph.

 

excela-150x150Improve the Well-Being of Every Life: Excela Health changed the way it treated injuries and took a proactive approach to safety, drastically reducing workers’ comp claims and costs.

 

harder-150x150The Family That’s Safe Together: An unwavering commitment to zero lost time is just one way that Harder Mechanical Contractors protects the lives and livelihoods of its workers.

 

More coverage of the 2016 Teddy Awards:

Recognizing Excellence: The judges of the 2016 Teddy Awards reflect on what they learned, and on the value of awards programs in the workers’ comp space.

Fit for Duty: 2013 Teddy Winner Miami-Dade County Public Schools is managing comorbid risk factors by getting employees excited about healthy living.

Saving Time and Money: Applying Lean Six Sigma to its workers’ comp processes earned Atlantic Health a Teddy Award Honorable Mention.

Caring for the Caregivers: Adventist Health Central Valley Network is achieving stellar results by targeting its toughest challenges.

Advocating for Injured Workers: By helping employees navigate through the workers’ comp system, Cottage Health decreased lost work days by 80 percent.

A Matter of Trust: St. Luke’s workers’ comp program is built upon relationships and a commitment to care for those who care for patients.

Keeping the Results Flowing: R&I recognizes the Metropolitan Water Reclamation District of Greater Chicago for a commonsense approach that’s netting continuous improvement.

Juliann Walsh is a staff writer at Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Cyber Resilience

No, Seriously. You Need a Comprehensive Cyber Incident Response Plan Before It’s Too Late.

Awareness of cyber risk is increasing, but some companies may be neglecting to prepare adequate response plans that could save them millions. 
By: | June 1, 2018 • 7 min read

To minimize the financial and reputational damage from a cyber attack, it is absolutely critical that businesses have a cyber incident response plan.

“Sadly, not all yet do,” said David Legassick, head of life sciences, tech and cyber, CNA Hardy.

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In the event of a breach, a company must be able to quickly identify and contain the problem, assess the level of impact, communicate internally and externally, recover where possible any lost data or functionality needed to resume business operations and act quickly to manage potential reputational risk.

This can only be achieved with help from the right external experts and the design and practice of a well-honed internal response.

The first step a company must take, said Legassick, is to understand its cyber exposures through asset identification, classification, risk assessment and protection measures, both technological and human.

According to Raf Sanchez, international breach response manager, Beazley, cyber-response plans should be flexible and applicable to a wide range of incidents, “not just a list of consecutive steps.”

They also should bring together key stakeholders and specify end goals.

Jason J. Hogg, CEO, Aon Cyber Solutions

With bad actors becoming increasingly sophisticated and often acting in groups, attack vectors can hit companies from multiple angles simultaneously, meaning a holistic approach is essential, agreed Jason J. Hogg, CEO, Aon Cyber Solutions.

“Collaboration is key — you have to take silos down and work in a cross-functional manner.”

This means assembling a response team including individuals from IT, legal, operations, risk management, HR, finance and the board — each of whom must be well drilled in their responsibilities in the event of a breach.

“You can’t pick your players on the day of the game,” said Hogg. “Response times are critical, so speed and timing are of the essence. You should also have a very clear communication plan to keep the CEO and board of directors informed of recommended courses of action and timing expectations.”

People on the incident response team must have sufficient technical skills and access to critical third parties to be able to make decisions and move to contain incidents fast. Knowledge of the company’s data and network topology is also key, said Legassick.

“Perhaps most important of all,” he added, “is to capture in detail how, when, where and why an incident occurred so there is a feedback loop that ensures each threat makes the cyber defense stronger.”

Cyber insurance can play a key role by providing a range of experts such as forensic analysts to help manage a cyber breach quickly and effectively (as well as PR and legal help). However, the learning process should begin before a breach occurs.

Practice Makes Perfect

“Any incident response plan is only as strong as the practice that goes into it,” explained Mike Peters, vice president, IT, RIMS — who also conducts stress testing through his firm Sentinel Cyber Defense Advisors.

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Unless companies have an ethical hacker or certified information security officer on board who can conduct sophisticated simulated attacks, Peters recommended they hire third-party experts to test their networks for weaknesses, remediate these issues and retest again for vulnerabilities that haven’t been patched or have newly appeared.

“You need to plan for every type of threat that’s out there,” he added.

Hogg agreed that bringing third parties in to conduct tests brings “fresh thinking, best practice and cross-pollination of learnings from testing plans across a multitude of industries and enterprises.”

“Collaboration is key — you have to take silos down and work in a cross-functional manner.” — Jason J. Hogg, CEO, Aon Cyber Solutions

Legassick added that companies should test their plans at least annually, updating procedures whenever there is a significant change in business activity, technology or location.

“As companies expand, cyber security is not always front of mind, but new operations and territories all expose a company to new risks.”

For smaller companies that might not have the resources or the expertise to develop an internal cyber response plan from whole cloth, some carriers offer their own cyber risk resources online.

Evan Fenaroli, an underwriting product manager with the Philadelphia Insurance Companies (PHLY), said his company hosts an eRiskHub, which gives PHLY clients a place to start looking for cyber event response answers.

That includes access to a pool of attorneys who can guide company executives in creating a plan.

“It’s something at the highest level that needs to be a priority,” Fenaroli said. For those just getting started, Fenaroli provided a checklist for consideration:

  • Purchase cyber insurance, read the policy and understand its notice requirements.
  • Work with an attorney to develop a cyber event response plan that you can customize to your business.
  • Identify stakeholders within the company who will own the plan and its execution.
  • Find outside forensics experts that the company can call in an emergency.
  • Identify a public relations expert who can be called in the case of an event that could be leaked to the press or otherwise become newsworthy.

“When all of these things fall into place, the outcome is far better in that there isn’t a panic,” said Fenaroli, who, like others, recommends the plan be tested at least annually.

Cyber’s Physical Threat

With the digital and physical worlds converging due to the rise of the Internet of Things, Hogg reminded companies: “You can’t just test in the virtual world — testing physical end-point security is critical too.”

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How that testing is communicated to underwriters should also be a key focus, said Rich DePiero, head of cyber, North America, Swiss Re Corporate Solutions.

Don’t just report on what went well; it’s far more believable for an underwriter to hear what didn’t go well, he said.

“If I hear a client say it is perfect and then I look at some of the results of the responses to breaches last year, there is a disconnect. Help us understand what you learned and what you worked out. You want things to fail during these incident response tests, because that is how we learn,” he explained.

“Bringing in these outside firms, detailing what they learned and defining roles and responsibilities in the event of an incident is really the best practice, and we are seeing more and more companies do that.”

Support from the Board

Good cyber protection is built around a combination of process, technology, learning and people. While not every cyber incident needs to be reported to the boardroom, senior management has a key role in creating a culture of planning and risk awareness.

David Legassick, head of life sciences, tech and cyber, CNA Hardy

“Cyber is a boardroom risk. If it is not taken seriously at boardroom level, you are more than likely to suffer a network breach,” Legassick said.

However, getting board buy-in or buy-in from the C-suite is not always easy.

“C-suite executives often put off testing crisis plans as they get in the way of the day job. The irony here is obvious given how disruptive an incident can be,” said Sanchez.

“The C-suite must demonstrate its support for incident response planning and that it expects staff at all levels of the organization to play their part in recovering from serious incidents.”

“What these people need from the board is support,” said Jill Salmon, New York-based vice president, head of cyber/tech/MPL, Berkshire Hathaway Specialty Insurance.

“I don’t know that the information security folks are looking for direction from the board as much as they are looking for support from a resources standpoint and a visibility standpoint.

“They’ve got to be aware of what they need and they need to have the money to be able to build it up to that level,” she said.

Without that support, according to Legassick, failure to empower and encourage the IT team to manage cyber threats holistically through integration with the rest of the organization, particularly risk managers, becomes a common mistake.

He also warned that “blame culture” can prevent staff from escalating problems to management in a timely manner.

Collaboration and Communication

Given that cyber incident response truly is a team effort, it is therefore essential that a culture of collaboration, preparation and practice is embedded from the top down.

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One of the biggest tripping points for companies — and an area that has done the most damage from a reputational perspective — is in how quickly and effectively the company communicates to the public in the aftermath of a cyber event.

Salmon said of all the cyber incident response plans she has seen, the companies that have impressed her most are those that have written mock press releases and rehearsed how they are going to respond to the media in the aftermath of an event.

“We have seen so many companies trip up in that regard,” she said. “There have been examples of companies taking too long and then not explaining why it took them so long. It’s like any other crisis — the way that you are communicating it to the public is really important.” &

Antony Ireland is a London-based financial journalist. He can be reached at [email protected] Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at [email protected]