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

Emerging Risks

Stadium Safety

Soft targets, such as sports stadiums, must increase measures to protect lives and their business.
By: | January 10, 2018 • 8 min read

Acts of violence and terror can break out in even the unlikeliest of places.

Look at the 2013 Boston Marathon, where two bombs went off, killing three and injuring dozens of others in a terrorist attack. Or consider the Orlando Pulse nightclub, where 49 people were killed and 58 wounded. Most recently in Las Vegas, a gunman killed 58 and injured hundreds of others.

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The world is not inherently evil, but these evil acts still find a way into places like churches, schools, concerts and stadiums.

“We didn’t see these kinds of attacks 20 years ago,” said Glenn Chavious, managing director, global sports & recreation practice leader, Industria Risk & Insurance Services.

As a society, we have advanced through technology, he said. Technology’s platform has enabled the message of terror to spread further faster.

“But it’s not just with technology. Our cultures, our personal grievances, have brought people out of their comfort zones.”

Chavious said that people still had these grievances 20 years ago but were less likely to act out. Tech has linked people around the globe to other like-minded individuals, allowing for others to join in on messages of terror.

“The progression of terrorist acts over the last 10 years has very much been central to the emergence of ‘lone wolf’ actors. As was the case in both Manchester and Las Vegas, the ‘lone wolf’ dynamic presents an altogether unique set of challenges for law enforcement and event service professionals,” said John

Glenn Chavious, managing director, global sports & recreation practice leader, Industria Risk & Insurance Services

Tomlinson, senior vice president, head of entertainment, Lockton.

As more violent outbreaks take place in public spaces, risk managers learn from and better understand what attackers want. Each new event enables risk managers to see what works and what can be improved upon to better protect people and places.

But the fact remains that the nature and pattern of attacks are changing.

“Many of these actions are devised in complete obscurity and on impulse, and are carried out by individuals with little to no prior visibility, in terms of behavioral patterns or threat recognition, thus making it virtually impossible to maintain any elements of anticipation by security officials,” said Tomlinson.

With vehicles driving into crowds, active shooters and the random nature of attacks, it’s hard to gauge what might come next, said Warren Harper, global sports & events practice leader, Marsh.

Public spaces like sporting arenas are particularly vulnerable because they are considered ‘soft targets.’ They are areas where people gather in large numbers for recreation. They are welcoming to their patrons and visitors, much like a hospital, and the crowds that attend come in droves.

NFL football stadiums, for example, can hold anywhere from 25,000 to 93,000 people at maximum capacity — and that number doesn’t include workers, players or other behind-the-scenes personnel.

“Attacks are a big risk management issue,” said Chavious. “Insurance is the last resort we want to rely upon. We’d rather be preventing it to avoid such events.”

Preparing for Danger

The second half of 2017 proved a trying few months for the insurance industry, facing hurricanes, earthquakes, wildfires and — unfortunately — multiple mass shootings.

The industry was estimated to take a more than $1 billion hit from the Las Vegas massacre in October 2017. A few years back, the Boston Marathon bombings cost businesses around $333 million each day the city was shut down following the attack. Officials were on a manhunt for the suspects in question, and Boston was on lockdown.

“Many of these actions are devised in complete obscurity and on impulse, and are carried out by individuals with little to no prior visibility.” — John Tomlinson, senior vice president, head of entertainment, Lockton

“Fortunately, we have not had a complete stadium go down,” said Harper. But a mass casualty event at a stadium can lead to the death or injury of athletes, spectators and guests; psychological trauma; potential workers’ comp claims from injured employees; lawsuits; significant reputational damage; property damage and prolonged business interruption losses.

The physical damage, said Harper, might be something risk managers can gauge beforehand, but loss of life is immeasurable.

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The best practice then, said Chavious, is awareness and education.

“A lot of preparedness comes from education. [Stadiums] need a risk management plan.”

First and foremost, Chavious said, stadiums need to perform a security risk assessment. Find out where vulnerable spots are, decide where education can be improved upon and develop other safety measures over time.

Areas outside the stadium are soft targets, said Harper. The parking lot, the ticketing and access areas and even the metro transit areas where guests mingle before and after a game are targeted more often than inside.

Last year, for example, a stadium in Manchester was the target of a bomb, which detonated outside the venue as concert-goers left. In 2015, the Stade de France in Paris was the target of suicide bombers and active shooters, who struck the outside of the stadium while a soccer match was held inside.

Security, therefore, needs to be ready to react both inside and outside the vicinity. Reviewing past events and seeing what works has helped risk mangers improve safety strategies.

“A lot of places are getting into table-top exercises” to make sure their people are really trained, added Harper.

In these exercises, employees from various departments come together to brainstorm and work through a hypothetical terrorist situation.

A facilitator will propose the scenario — an active shooter has been spotted right before the game begins, someone has called in a bomb threat, a driver has fled on foot after driving into a crowd — and the stadium’s staff is asked how they should respond.

“People tend to act on assumptions, which may be wrong, but this is a great setting for them to brainstorm and learn,” said Harper.

Technology and Safety

In addition to education, stadiums are ahead of the game, implementing high-tech security cameras and closed-circuit TV monitoring, requiring game-day audiences to use clear/see-through bags when entering the arena, upping employee training on safety protocols and utilizing vapor wake dogs.

Drones are also adding a protective layer.

John Tomlinson, senior vice president, head of entertainment, Lockton

“Drones are helpful in surveying an area and can alert security to any potential threat,” said Chavious.

“Many stadiums have an area between a city’s metro and the stadium itself. If there’s a disturbance there, and you don’t have a camera in that area, you could use the drone instead of moving physical assets.”

Chavious added that “the overhead view will pick up potential crowd concentration, see if there are too many people in one crowd, or drones can fly overhead and be used to assess situations like a vehicle that’s in a place it shouldn’t be.”

But like with all new technology, drones too have their downsides. There’s the expense of owning, maintaining and operating the drone. Weather conditions can affect how and when a drone is used, so it isn’t a reliable source. And what if that drone gets hacked?

“The evolution of venue security protocols most certainly includes the increased usage of unmanned aerial systems (UAS), including drones, as the scope and territorial vastness provided by UAS, from a monitoring perspective, is much more expansive than ground-based apparatus,” said Tomlinson.

“That said,” he continued, “there have been many documented instances in which the intrusion of unauthorized drones at live events have posed major security concerns and have actually heightened the risk of injury to participants and attendees.”

Still, many experts, including Tomlinson, see drones playing a significant role in safety at stadiums moving forward.

“I believe the utilization of drones will continue to be on the forefront of risk mitigation innovation in the live event space, albeit with some very tight operating controls,” he said.

The SAFETY Act

In response to the terrorist attacks on Sept. 11, 2001, U.S. Homeland Security enacted the Support Anti-Terrorism by Fostering Effective

Warren Harper, global sports & events practice leader, Marsh

Technologies Act (SAFETY Act).

The primary purpose of the SAFETY Act was to encourage potential manufacturers or sellers of anti-terrorism technologies to continue to develop and commercialize these technologies (like video monitoring or drones).

There was a worry that the threat of liability in such an event would deter and prevent sellers from pursing these technologies, which are aimed at saving lives. Instead, the SAFETY Act provides incentive by adding a system of risk and litigation management.

“[The SAFETY Act] is geared toward claims arising out of acts of terrorism,” said Harper.

Bottom line: It’s added financial protection. Businesses both large and small can apply for the SAFETY designation — in fact, many NFL teams push for the designation. So far, four have reached SAFETY certification: Lambeau Field, MetLife Stadium, University of Phoenix Stadium and Gillette Stadium.

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To become certified, reviewers with the SAFETY Act assess stadiums for their compliance with the most up-to-date terrorism products. They look at their built-in emergency response plans, cyber security measures, hiring and training of employees, among other criteria.

The process can take over a year, but once certified, stadiums benefit because liability for an event is lessened. One thing to remember, however, is that the added SAFETY Act protection only holds weight when a catastrophic event is classified as an act of terrorism.

“Generally speaking, I think the SAFETY Act has been instrumental in paving the way for an accelerated development of anti-terrorism products and services,” said Tomlinson.

“The benefit of gaining elements of impunity from third-party liability related matters has served as a catalyst for developers to continue to push the envelope, so to speak, in terms of ideas and innovation.”

So while attackers are changing their methods and trying to stay ahead of safety protocols at stadiums, the SAFETY Act, as well as risk managers and stadium owners, keep stadiums investing in newer, more secure safety measures. &

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