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

Robotics Risk

Rise of the Cobots

Collaborative robots, known as cobots, are rapidly expanding in the workforce due to their versatility. But they bring with them liability concerns.
By: | May 2, 2017 • 5 min read

When the Stanford Shopping Center in Palo Alto hired mobile collaborative robots to bolster security patrols, the goal was to improve costs and safety.

Once the autonomous robotic guards took up their beats — bedecked with alarms, motion sensors, live video streaming and forensics capabilities — no one imagined what would happen next.

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For some reason,  a cobots’ sensors didn’t pick up the movement of a toddler on the sidewalk who was trying to play with the 5-foot-tall, egg-shaped figure.

The 300-pound robot was programmed to stop for shoppers, but it knocked down the child and then ran over his feet while his parents helplessly watched.

Engaged to help, this cobot instead did harm, yet the use of cobots is growing rapidly.

Cobots are the fastest growing segment of the robotics industry, which is projected to hit $135.4 billion in 2019, according to tech research firm IDC.

“Robots are embedding themselves more and more into our lives every day,” said Morgan Kyte, a senior vice president at Marsh.

“Collaborative robots have taken the robotics industry by storm over the past several years,” said Bob Doyle, director of communications at the Robotic Industries Association (RIA).

When traditional robots joined the U.S. workforce in the 1960s, they were often assigned one specific task and put to work safely away from humans in a fenced area.

Today, they are rapidly being deployed in the automotive, plastics, electronics assembly, machine tooling and health care industries due to their ability to function in tandem with human co-workers.

More than 24,000 robots valued at $1.3 billion were ordered from North American companies last year, according to the RIA.

Cobots Rapidly Gain Popularity

Cobots are cheaper, more versatile and lighter, and often have a faster return on investment compared to traditional robots. Some cobots even employ artificial intelligence (AI) so they can adapt to their environment, learn new tasks and improve on their skills.

Bob Doyle, director of communications, Robotic Industry Association

Their software is simple to program, so companies don’t need a computer programmer, called a robotic integrator, to come on site to tweak duties. Most employees can learn how to program them.

While the introduction of cobots into the workplace can bring great productivity gains, it also introduces risk mitigation challenges.

“Where does the problem lie when accidents happen and which insurance covers it?” asked attorney Garry Mathiason, co-chair of the robotics, AI and automation industry group at the law firm Littler Mendelson PC in San Francisco.

“Cobots are still machines and things can go awry in many ways,” Marsh’s Kyte said.

“The robot can fail. A subcomponent can fail. It can draw the wrong conclusions.”

If something goes amiss, exposure may fall to many different parties:  the manufacturer of the cobot, the software developer and/or the purchaser of the cobot, to name a few.

Is it a product defect? Was it an issue in the base code or in the design? Was something done in the cobot’s training? Was it user error?

“Cobots are still machines and things can go awry in many ways.” — Morgan Kyte, senior vice president, Marsh

Is it a workers’ compensation case or a liability issue?

“If you get injured in the workplace, there’s no debate as to liability,” Mathiason said.

But if the employee attributes the injury to a poorly designed or programmed machine and sues the manufacturer of the equipment, that’s not limited by workers’ comp, he added.

Garry Mathiason, co-chair, robotics, AI and automation industry group, Littler Mendelson PC

In the case of a worker killed by a cobot in Grand Rapids, Mich., in 2015, the worker’s spouse filed suit against five of the companies responsible for manufacturing the machine.

“It’s going to be unique each time,” Kyte said.

“The issue that keeps me awake at night is that people are so impressed with what a cobot can do, and so they ask it to do a task that it wasn’t meant to perform,” Mathiason said.

Privacy is another consideration.

If the cobot records what is happening around it, takes pictures of its environment and the people in it, an employee or customer might claim a privacy violation.

A public sign disclosing the cobot’s ability to record video or take pictures may be a simple solution. And yet, it is often overlooked, Mathiason said.

Growing Pains in the Industry

There are going to be growing pains as the industry blossoms in advance of any legal and regulatory systems, Mathiason said.

He suggests companies take several mitigation steps before introducing cobots to the workplace.

First, conduct a safety audit that specifically covers robotics. Make sure to properly investigate the use of the technology and consider all options. Run a pilot program to test it out.

Most importantly, he said, assign someone in the organization to get up to speed on the technology and then continuously follow it for updates and new uses.

The Robotics Industry Association has been working with the government to set up safety standards. One employee can join a cobot member association to receive the latest information on regulations.

“I think there’s a lot of confusion about this technology and people see so many things that could go wrong,” Mathiason said.

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“But if you handle it properly with the safety audit, the robotics audit, and pay attention to what the standards are, it’s going to be the opposite; there will be fewer problems.

“And you might even see in your experience rating that you are going to [get] a better price to the policy,” he added.

Without forethought, coverage may slip through the cracks. General liability, E&O, business interruption, personal injury, cyber and privacy claims can all be involved.

AIG’s Lexington Insurance introduced an insurance product in 2015 to address the gray areas cobots and robots create. The coverage brings together general and products liability, robotics errors and omissions, and risk management services, all three of which are tailored for the robotics industry. Minimum premium is $25,000.

Insurers are using lessons learned from the creation of cyber liability policies and are applying it to robotics coverage, Kyte said.

“The robotics industry has been very safe for the last 30 years,” RIA’s Doyle said. “It really does have a good track record and we want that to continue.” &

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