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.

Advertisement




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.

Advertisement




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.” &

_______________________________________________________

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

Risk Scenario

The End of Summer

A failure to purchase product contamination insurance results in a crushing blow.
By: | October 15, 2018 • 9 min read
Risk Scenarios are created by Risk & Insurance editors along with leading industry partners. The hypothetical, yet realistic stories, showcase emerging risks that can result in significant losses if not properly addressed.

Disclaimer: The events depicted in this scenario are fictitious. Any similarity to any corporation or person, living or dead, is merely coincidental.

PART ONE: THE HEAT IS ON

Reilly Sheehan, the Bethlehem, Pa., plant manager for Shamrock Foods, looks up in annoyance when he hears a tap on his office window.

Reilly has nothing against him, but seeing the face of his assistant plant operator Peter Soto right then is just a case of bad timing.

Sheehan, whose company manufactures ice cream treats for convenience stores and ice cream trucks, just got through digesting an email from his CFO, pushing for more cost cutting, when Soto knocked.

Sheehan gestures impatiently, and Soto steps in with a degree of caution.

“What?” Sheehan says.

“I’m not sure how much of an issue this will be, but I just got some safety reports back and we got a positive swipe for Listeria in one of the Market Streetside refrigeration units.”

Partner

Partner

Sheehan gestures again, and Soto shuts the office door.

“How much of a positive?” Sheehan says more quietly.

Soto shrugs.

“I mean it’s not a big hit and that’s the only place we saw it, so, hard to know what to make of it.”

Sheehan looks out to the production floor, more as a way to focus his thoughts than for any other reason.

Sheehan is jammed. It’s April, the time of year when Shamrock begins to ramp up production for the summer season. Shamrock, which operates three plants in the Middle Atlantic, is holding its own at around $240 million in annual sales.

But the pressure is building on Sheehan. In previous cost-cutting measures, Shamrock cut risk management and safety staff.

Now there is this email from the CFO and a possible safety issue. Not much time to think; too much going on.

Sheehan takes just another moment to deliberate: It’s not a heavy hit, and Shamrock hasn’t had a product recall in more than 15 years.

“Okay, thanks for letting me know,” Sheehan says to Soto.

“Do another swipe next week and tell me what you pick up. I bet you twenty bucks there’s nothing in the product. That swipe was nowhere near the production line.”

Soto departs, closing the office door gingerly.

Then Sheehan lingers over his keyboard. He waits. So much pressure; what to do?

“Very well then,” he says to himself, and gets to work crafting an email.

His subject line to the chief risk officer and the company vice president: “Possible safety issue: Positive test for Listeria in one of the refrigeration units.”

That night, Sheehan can’t sleep. Part of Shamrock’s cost-cutting meant that Sheehan has responsibility for environmental, health and safety in addition to his operations responsibilities.

Every possible thing that could bring harmful bacteria into the plant runs through his mind.

Trucks carrying raw eggs, milk and sugar into the plant. The hoses used to shoot the main ingredients into Shamrock’s metal storage vats. On and on it goes…

In his mind’s eye, Sheehan can picture the inside of a refrigeration unit. Ice cream is chilled, never really frozen. He can almost feel the dank chill. Salmonella and Listeria love that kind of environment.

Sheehan tosses and turns. Then another thought occurs to him. He recalls a conversation, just one question at a meeting really, when one of the departed risk management staff brought up the issue of contaminated product insurance.

Sheehan’s memory is hazy, stress shortened, but he can’t remember it being mentioned again. He pushes his memory again, but nothing.

“I don’t need this,” he says to himself through clenched teeth. He punches up his pillow in an effort to find a path to sleep.

PART TWO: STRICKEN FAMILIES

“Toot toot, tuuuuurrrrreeeeeeeeettt!”

The whistles of the three lifeguards at the Bradford Community Pool in Allentown, Pa., go off in unison, two staccato notes, then a dip in pitch, then ratcheting back up together.

For Cheryl Brick, 34, the mother of two and six-months pregnant with a third, that signal for the kids to clear the pool for the adult swim is just part of a typical summer day. Right on cue, her son Henry, 8, and his sister Siobhan, 5, come running back to where she’s set up the family pool camp.

Henry, wet and shivering and reaching for a towel, eyes that big bag.

“Mom, can I?”

And Cheryl knows exactly where he’s going.

“Yes. But this time, can you please bring your mother a mint-chip ice cream bar along with whatever you get for you and Siobhan?”

Henry grabs the money, drops his towel and tears off; Siobhan drops hers just as quickly, not wanting to be left behind.

Advertisement




“Wait for me!” Siobhan yells as Henry sprints for the ice cream truck parked just outside of the pool entrance.

It’s the dead of night, 3 am, two weeks later when Cheryl, slumbering deeply beside her husband Danny, is pulled from her rest by the sound of Siobhan crying in their bedroom doorway.

“Mom, dad!” says Henry, who is standing, pale and stricken, in the hallway behind Siobhan.

“What?” says Danny, sitting up in bed, but Cheryl’s pregnancy sharpened sense of smell knows the answer.

Siobhan, wailing and shivering, has soiled her pajamas, the victim of a severe case of diarrhea.

“I just barfed is what,” says Henry, who has to turn and run right back to the bathroom.

Cheryl steps out of bed to help Siobhan, but the room spins as she does so.

“Oh God,” she says, feeling the impact of her own attack of nausea.

A quick, grim cleanup and the entire family is off to a walk-up urgent care center.

A bolt of fear runs through Cheryl as the nurse gives her the horrible news.

“Listeriosis,” says the nurse. Sickening for children and adults but potentially fatal for the weak, especially the unborn.

And very sadly, Cheryl loses her third child. Two other mothers in the Middle Atlantic suffer the same fate and dozens more are sickened.

Product recall notices from state regulators and the FDA go out immediately.

Ice cream bars and sandwiches disappear from store coolers and vending machines on corporate campuses. The tinkly sound of “Pop Goes the Weasel” emanating from mobile ice cream vendor trucks falls silent.

Notices of intent to sue hit every link in the supply chain, from dairy cooperatives in New York State to the corporate offices of grocery store chains in Atlanta, Philadelphia and Baltimore.

The three major contract manufacturers that make ice cream bars distributed in the eight states where residents were sickened are shut down, pending a further investigation.

FDA inspectors eventually tie the outbreak to Shamrock.

Evidence exists that a good faith effort was underway internally to determine if any of Shamrock’s products were contaminated. Shamrock had still not produced a positive hit on any of its products when the summer tragedy struck. They just weren’t looking in the right place.

PART THREE: AN INSURANCE TANGLE

Banking on rock-solid relationships with its carrier and brokers, Shamrock, through its attorneys, is able to salvage indemnification on its general liability policy that affords it $20 million to defray the business losses of its retail customers.

Advertisement




But that one comment from a risk manager that went unheeded many months ago comes back to haunt the company.

All three of Shamrock’s plants were shuttered from August 2017 until March 2018, until the source of the contamination could be run down and the federal and state inspectors were assured the company put into place the necessary protocols to avoid a repeat of the disaster that killed 3 unborn children and sickened dozens more.

Shamrock carried no contaminated product coverage, which is known as product recall coverage outside of the food business. The production shutdown of all three of its plants cost Shamrock $120 million. As a result of the shutdown, Shamrock also lost customers.

The $20 million payout from Shamrock’s general liability policy is welcome and was well-earned by a good history with its carrier and brokers. Without the backstop of contaminated products insurance, though, Shamrock blew a hole in its bottom line that forces the company to change, perhaps forever, the way it does business.

Management has a gun to its head. Two of Shamrock’s plants, including Bethlehem, are permanently shuttered, as the company shrinks in an effort to stave off bankruptcy.

Reilly Sheehan is among those terminated. In the end, he was the wrong person in the wrong place at the wrong time.

Burdened by the guilt, rational or not, over the fatalities and the horrendous damage to Shamrock’s business. Reilly Sheehan is a broken man. Leaning on the compassion of a cousin, he takes a job as a maintenance worker at the Bethlehem sewage treatment plant.

“Maybe I can keep this place clean,” he mutters to himself one night, as he swabs a sewage overflow with a mop in the early morning hours of a dark, cold February.

Bar-Lessons-Learned---Partner's-Content-V1b

Risk & Insurance® partnered with Swiss Re Corporate Solutions to produce this scenario. Below are their recommendations on how to prevent the losses presented in the scenario. This perspective is not an editorial opinion of Risk & Insurance.®.

Shamrock Food’s story is not an isolated incident. Contaminations happen, and when they do they can cause a domino effect of loss and disruption for vendors and suppliers. Without Product Recall Insurance, Shamrock sustained large monetary losses, lost customers and ultimately two of their facilities. While the company’s liability coverage helped with the business losses of their retail customers, the lack of Product Recall and Contamination Insurance left them exposed to a litany of risks.

Risk Managers in the Food & Beverage industry should consider Product Recall Insurance because it can protect your company from:

  • Accidental contamination
  • Malicious product tampering
  • Government recall
  • Product extortion
  • Adverse publicity
  • Intentionally impaired ingredients
  • Product refusal
  • First and third party recall costs

Ultimately, choosing the right partner is key. Finding an insurer who offers comprehensive coverage and claims support will be of the utmost importance should disaster strike. Not only is cover needed to provide balance sheet protection for lost revenues, extra expense, cleaning, disposal, storage and replacing the contaminated products, but coverage should go even further in providing the following additional services:

  • Pre-incident risk mitigation advocacy
  • Incident investigation
  • Brand rehabilitation
  • Third party advisory services

A strong contamination insurance program can fill gaps between other P&C lines, but more importantly it can provide needed risk management resources when companies need them most: during a crisis.



Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at [email protected]