Cover Story

The New Frontier of Care

Our Teddy Award winners in 2013 raised the bar yet again.
By: | November 1, 2013 • 10 min read

After nearly two decades of presenting the Theodore Roosevelt Workers’ Compensation and Disability Management Award, you might think the process of judging the awards would be more or less rote. In fact, the opposite is true. It has never been a more exciting time to witness the transformation of the industry, and to bear witness to how far employers have come, not just in their programs, but also in the way they think about injury prevention and management, and the value of a safe and healthy workforce.

A difficult economic climate has driven employers to double-down on their efforts to prevent incidents and injuries, and to be ever more creative in their efforts to rein in workers’ compensation and disability costs. If necessity is the mother of all invention, then workers’ compensation risk management is as inventive a field as you’ll ever encounter.

“Managing a successful workers’ comp program requires constant creativity to keep the bar moving in the right direction,” said Yolanda Romero, director of workers’ compensation for the Southeastern Pennsylvania Transportation Authority (SEPTA). “We often come up with what we believe is a great solution, however, eventually the program plateaus and new tweaks are needed to keep the momentum going.” Romero, who served as a Teddy Award judge for a decade after SEPTA won a Teddy Award in 2003, appreciates the accomplishments of this year’s finalists and winners, and knows what they’re up against. “The key is to keep the creative juices flowing constantly,” she said.

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There isn’t enough time — or pages — to give you every detail of this year’s exceptional Teddy Award applicants, finalists and winners. So in the spirit of Fantasy Football, Risk & Insurance® has drawn together a “dream team” of injury prevention, workers’ compensation and disability management programs, to highlight the areas where these programs shine brightest.

A Golden Ounce of Prevention

The only good injury is the one that never happens — no one would argue the point. Zero workplace incidents or injuries remains the holy grail for many employers. But for most, that is a perpetually elusive goal. Over time, safety professionals and risk managers began to see that it wasn’t enough to give employees safety gear and train them to work safely. It wasn’t enough to conduct accident investigations or job hazard assessments. They needed to reach further.

That need has led employers into territories that were once considered fringe, including ergonomics, which was widely perceived as “new age voodoo” only two or three decades ago. Thankfully, that has changed. Boston-based Teddy Award winner Partners HealthCare is one of many organizations that now has a comprehensive ergonomics program with dedicated staff to conduct evaluations and address issues. Partners’ ergonomics staff responded to more than 900 service requests in 2012.

R11-13p24-27_01teddy2.indd“Managing a successful workers’ comp program requires constant creativity to keep the bar moving in the right direction.”
— Yolanda Romero, director of workers’ compensation for the Southeastern Pennsylvania Transportation Authority

PHC also obtained a National Institute for Occupational Safety and Health grant to fund its “Be Well, Work Well” project in collaboration with the Harvard School of Public Health: Center for Work, Health and Well-Being. The project’s aim is to assess and address the work environment as well as personal factors associated with increased risk for musculoskeletal disorders, and to promote ergonomic principles through small group and one-on-one training.

Stretching and core strengthening programs are now earning respect, when they were once thought of as a little over-the-top. But over time, participating companies began to see results in reduced injury frequency. Then others started taking a more serious look.

Arizona Public Service, the largest affiliate of Teddy Award finalist Pinnacle West Capital Corp., launched a pilot stretching and core conditioning program in 2011. The program gives employees the skills they need to improve balance and coordination in order to reduce injuries. The program also puts a focus on mental awareness and attention control — key factors in incident prevention. The program has resulted in a noticeable drop in strain and sprain injuries for the Phoenix-based energy holding company.

Worcester, Pa. civil construction company American Infrastructure has a stretching program that’s companywide. AI’s philosophy is that all employees are industrial athletes. That’s why everyone — from workers on job sites to office staff — participates in a morning stretching program. According to AI, the program serves a dual purpose. The stretching helps prime employees to be physically ready for the tasks ahead. It also helps prime them mentally, getting them thinking about working and moving safely right off the bat.

Another type of initiative that’s gaining traction in recent years is wellness programs. Once thought of as a “nice to have” that was more the purview of HR, wellness programs were perceived strictly as a means to reduce health care costs. Today, executives are catching on to the fact that healthier employees are not only less likely to get hurt, they also bounce back faster if an injury does occur, and have fewer complications related to comorbidities such as diabetes, obesity or heart disease.

That said, companies actively connecting the dots between wellness and injury outcomes are still somewhat few and far between. That’s another reason Pinnacle West earned the attention of the Teddy Award judges.

Pinnacle West has taken an active approach to employee health and wellness, launching its internally branded “Health Matters” program. The Health Matters program includes free screenings and assessments for employees, helps them assess their risk for disease and helps them develop personal wellness goals and plans. Employees are invited to utilize online weight loss coaching, smoking cessation programs, discounts on gym memberships, a vast library of healthy recipes and more.

Pinnacle West also recognizes that it’s not enough to tack a flyer about available wellness programs on the company bulletin board. That’s why the company is actively tracking employee participation in its programs, setting annual target goals for participation in each stage of the program and devoting resources to getting the Health Matters message out.

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American Infrastructure’s wellness efforts are every bit as laudable. “Our focus,” the company wrote in its application, “has become not only to be America’s safest construction company, but America’s healthiest construction company as well.” Their commitment is clear. The company offers biometric testing for blood pressure, heart rate, cholesterol levels, blood sugar and more, and urges all employees to “know your numbers.” Employees can take their numbers and sit down with health coaches to develop action plans for improving their health. Among other initiatives, AI’s programs include a stepping program that helps employees track their steps throughout the day. Stepping challenges with prizes attached help keep people motivated. The company has also had great success with weight loss challenges.

“We’ve always been a company that goes beyond compliance. We wanted to take our safety culture to the next level,” said Bryan Schwartz, AI’s risk manager.

Working Toward Recovery

Incredible strides have been made in the area of return-to-work. Armed with a better grasp of the effect of lost time on both injury durations and the company’s bottom line, employers are more committed to keeping injured workers on the job and productive.

“Our focus has become not only to be America’s safest construction company, but America’s healthiest construction company as well.”
— American Infrastructure

Progressive companies are breaking free of the old mind-set of creating rigid transitional duty positions to accommodate work restrictions, and trying to fit all injured employees into those frameworks. Instead, they’ve shifted focus to the employee rather than the position, and on building customized transitional work around the injured employee’s capabilities.

Teddy Award winner PetSmart’s approach to return-to-work sets the right tone. All transitional duty jobs at PetSmart can be combined or modified to meet the needs of the associate’s restrictions. That focus helps guide managers to keep an open mind about transitional duties, and to look closely at what the injured employee is capable of doing. Injured employees at PetSmart are able to perform any number of essential store functions, from taking grooming appointments to helping with animal adoptions through in-store affiliate PetSmart Charities.

Teddy Award finalist Eisenhower Medical Center in Rancho Mirage, Calif., has taken a comprehensive approach. Three years ago, the organization took on the arduous task of assessing and cataloguing every job description, every essential and nonessential function of each position, and the skills or capabilities needed to perform each one of those functions. Initially, this database has been used to help identify the tasks most likely to cause injury. It is also used to guide treatment to help an employee resume the essential functions of his or her job faster. But during the recovery process, the database provides an invaluable, detailed body of information that helps the risk management and medical staff efficiently customize transitional positions based upon an injured employee’s specific abilities, and make adjustments smoothly as recovery progresses.

Solutions Large and Small

At Partners HealthCare, the best care for an injured employee is easy to find. The health system maintains eight Occupational Health Service clinics, staffed by occupational health nurse practitioners (OHNPs) experienced in evaluating and treating injured employees. OHNPs are the key point of contact for each case, coordinating treatment protocols, incident investigations and return-to-work plans. Dedicated claims specialists support the OHNPs. In turn, administrative assistants support the claims specialists — ensuring that they don’t become mired in paperwork and can focus on the needs of each injured employee. The OHS clinics are overseen by four medical directors — each one a board-certified and experienced specialist in occupational and environmental medicine.

Such a solution is unquestionably state-of-the-art. But the fact is that most employers outside the health care field don’t have the resources to follow that model. Nevertheless, plenty of employers are pulling out all the stops to get their people the care they need. Teddy Award-winning Miami-Dade County Public Schools, for example, uses a 24/7 call center for receiving notice of injuries. Injured workers are immediately directed to the best nearby specialty physician using a geo-access tool that identifies the providers nearest the injured worker’s location.

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Other employers are finding ways to maximize the resources they do have. And sometimes, the simplest and smallest of changes are the ones that will make the biggest impact. Phoenix-based PetSmart’s tetanus program is a perfect example. Because of the nature of its operations, PetSmart employees face significant risk exposure from animal bites. That means that an injured employee might need a tetanus shot in addition to treatment of the wound. As such, every bite, no matter how minor, required an office visit to ensure that the employee’s tetanus status was up-to-date.

But all of that changed when PetSmart began tracking the status of employees’ tetanus shots. With stores armed with that small, but vital piece of information, employees with minor injuries could be treated with standard first aid and sent back to work, with no need for a provider visit. This one small inexpensive change has made a tremendous impact on the company’s bottom line.

At American Infrastructure, one small change that has had a huge impact was a simple color change. As with other companies across a variety of industries, AI’s new employees faced a higher risk of injury than their more experienced counterparts. AI reasoned that ideally, everyone should be looking out for the well-being of new hires, not just their immediate supervisors. But it’s easy to lose track of who’s who on a busy job site. That’s why the company opted to purchase bright green hard hats for new recruits. That way everyone remains constantly aware of the location of employees who might need help, some extra guidance or a safety reminder.

Promising Teddy Award applicant Kimco Staffing of Irvine, Calif., faced a massive obstacle with workers seeking treatment outside of the company’s medical provider networks (MPNs) and receiving excessive and unnecessary treatments. Workers’ comp judges widely disregarded the company’s attempts to enforce its MPN rules if an injured worker claimed to be unaware of the requirement. Kimco took the solid first steps of providing the MPN requirements to each employee, at the time of hire and at the onset of each claim — and requiring employees to acknowledge it in writing. But then the company went one step further, heading off any doubts by taking a picture of each employee holding the signed document. Courts are now more inclined to honor Kimco’s MPN policy, and to release Kimco from the burden of paying for unauthorized treatment.

In addition, companies such as American Infrastructure and PetSmart are also leveraging the power of newer technologies, using iPads for everything from safety module training to capturing pictures of hazards instantly to distributing critical incident metrics to regional and district managers in the field.

Risk & Insurance® congratulates this year’s Teddy Award winners and finalists on their exceptional efforts to create safer workplaces and provide the best possible care for their injured team members.

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

2017 RIMS

Resilience in Face of Cyber

New cyber model platforms will help insurers better manage aggregation risk within their books of business.
By: | April 26, 2017 • 3 min read

As insurers become increasingly concerned about the aggregation of cyber risk exposures in their portfolios, new tools are being developed to help them better assess and manage those exposures.

 One of those tools, a comprehensive cyber risk modeling application for the insurance and reinsurance markets, was announced on April 24 by AIR Worldwide.

Scott Stransky, assistant vice president and principal scientist, AIR Worldwide

Last year at RIMS, AIR announced the release of the industry’s first open source deterministic cyber risk scenario, subsequently releasing a series of scenarios throughout the year, and offering the service to insurers on a consulting basis.

Its latest release, ARC– Analytics of Risk from Cyber — continues that work by offering the modeling platform for license to insurance clients for internal use rather than on a consulting basis. ARC is separate from AIR’s Touchstone platform, allowing for more flexibility in the rapidly changing cyber environment.

ARC allows insurers to get a better picture of their exposures across an entire book of business, with the help of a comprehensive industry exposure database that combines data from multiple public and commercial sources.

The recent attacks on Dyn and Amazon Web Services (AWS) provide perfect examples of how the ARC platform can be used to enhance the industry’s resilience, said Scott Stransky, assistant vice president and principal scientist for AIR Worldwide.

Stransky noted that insurers don’t necessarily have visibility into which of their insureds use Dyn, Amazon Web Services, Rackspace, or other common internet services providers.

In the Dyn and AWS events, there was little insured loss because the downtime fell largely just under policy waiting periods.

But,” said Stransky, “it got our clients thinking, well it happened for a few hours – could it happen for longer? And what does that do to us if it does? … This is really where our model can be very helpful.”

The purpose of having this model is to make the world more resilient … that’s really the goal.”Scott Stransky, assistant vice president and principal scientist, AIR Worldwide

AIR has run the Dyn incident through its model, with the parameters of a single day of downtime impacting the Fortune 1000. Then it did the same with the AWS event.

When we run Fortune 1000 for Dyn for one day, we get a half a billion dollars of loss,” said Stransky. “Taking it one step further – we’ve run the same exercise for AWS for one day, through the Fortune 1000 only, and the losses are about $3 billion.”

So once you expand it out to millions of businesses, the losses would be much higher,” he added.

The ARC platform allows insurers to assess cyber exposures including “silent cyber,” across the spectrum of business, be it D&O, E&O, general liability or property. There are 18 scenarios that can be modeled, with the capability to adjust variables broadly for a better handle on events of varying severity and scope.

Looking ahead, AIR is taking a closer look at what Stransky calls “silent silent cyber,” the complex indirect and difficult to assess or insure potential impacts of any given cyber event.

Stransky cites the 2014 hack of the National Weather Service website as an example. For several days after the hack, no satellite weather imagery was available to be fed into weather models.

Imagine there was a hurricane happening during the time there was no weather service imagery,” he said. “[So] the models wouldn’t have been as accurate; people wouldn’t have had as much advance warning; they wouldn’t have evacuated as quickly or boarded up their homes.”

It’s possible that the losses would be significantly higher in such a scenario, but there would be no way to quantify how much of it could be attributed to the cyber attack and how much was strictly the result of the hurricane itself.

It’s very, very indirect,” said Stransky, citing the recent hack of the Dallas tornado sirens as another example. Not only did the situation jam up the 911 system, potentially exacerbating any number of crisis events, but such a false alarm could lead to increased losses in the future.

The next time if there’s a real tornado, people make think, ‘Oh, its just some hack,’ ” he said. “So if there’s a real tornado, who knows what’s going to happen.”

Modeling for “silent silent cyber” remains elusive. But platforms like ARC are a step in the right direction for ensuring the continued health and strength of the insurance industry in the face of the ever-changing specter of cyber exposure.

Because we have this model, insurers are now able to manage the risks better, to be more resilient against cyber attacks, to really understand their portfolios,” said Stransky. “So when it does happen, they’ll be able to respond, they’ll be able to pay out the claims properly, they’ll be prepared.

The purpose of having this model is to make the world more resilient … that’s really the goal.”

Additional stories from RIMS 2017:

Blockchain Pros and Cons

If barriers to implementation are brought down, blockchain offers potential for financial institutions.

Embrace the Internet of Things

Risk managers can use IoT for data analytics and other risk mitigation needs, but connected devices also offer a multitude of exposures.

Feeling Unprepared to Deal With Risks

Damage to brand and reputation ranked as the top risk concern of risk managers throughout the world.

Reviewing Medical Marijuana Claims

Liberty Mutual appears to be the first carrier to create a workflow process for evaluating medical marijuana expense reimbursement requests.

Cyber Threat Will Get More Difficult

Companies should focus on response, resiliency and recovery when it comes to cyber risks.

RIMS Conference Held in Birthplace of Insurance in US

Carriers continue their vital role of helping insureds mitigate risks and promote safety.

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]