2014 Teddy Award Winner

Quick to Act

Compass Group is lauded for its safety initiatives and for a return-to-work program that incorporates all of its business lines. 
By: | November 3, 2014

A housekeeper at Memorial Health Systems — part of the food service and support services company Compass Group North America — was hard at work mopping a patient’s room one day. He misstepped, and before anyone could react, he was down on the ground with an injured lower back, shoulder and wrist.

Normally, slip and falls of this kind — consistently one of the leading causes of injury affecting workers of all stripes — can keep an employee out of work for long periods of time.

Not in this case.

Advertisement




As usual, the employee received medical treatment and was given all of the following restrictions: No pushing. No pulling. No lifting more than five pounds, and no prolonged standing.

Fortunately, Compass Group — which boasts over 10,000 different locations across the country, offering corporate food services, facilities management, janitorial services, and more — had implemented an innovative return-to-work (RTW) program in early 2014.

That successful program and related safety initiatives are why the organization is one of the 2014 Theodore Roosevelt Workers’ Compensation and Disability Management Award winners.

The RTW initiative offers dozens of modified duties — tasks calling for minimal physical effort so that associates can get back to work in short order.

Ron Ehrhardt, vice president of operational safety, Compass Group

Ron Ehrhardt, vice president of operational safety, Compass Group

“A big part of the effort was to find different types of altered duty able to bring our associates back to work just as soon as possible — just not in their original capacity,” said Ron Ehrhardt, vice president of operational safety with Compass Group.

“They could be a cashier if not a grill cook,” in the food service units on a temporary basis, for instance, he said.

The housekeeper’s case presented a more difficult challenge, Ehrhardt said, since the Environmental Services Unit (EVS) at the worksite already had two employees on modified duty. With productivity strained, the organization was hard-pressed to provide modified duty for yet another worker.

Management was quick to act, however.

It identified a modified work opportunity with the company’s Patient Transport Division, another Compass Group business line, which includes companies such as Crothall Healthcare, Eurest Dining Services, Morrison Healthcare/Senior Living, TouchPoint, and Wolfgang Puck Catering and Events.

By moving the housekeeper and tasking him with administrative work in another unit, the company was able to maintain its productivity as well as return the man to work in an expedited fashion.

During subsequent doctor visits, the employee’s restrictions were expanded, to allow him to lift up to 15 pounds and engage in limited standing.

At the same time, one of the two employees in the EVS unit who’d previously been on modified duty was released to full duty, so management was able to move the housekeeper back to his home location to complete his modified duty roster.

The result: No loss of workdays for the injured worker or anyone else in the EVS unit.

Impressive Results

The proof of the pudding is in the eating, as they say.

“The policy we wrote on return-to-work was implemented in March,” Ehrhardt told Risk and Insurance®. And whereas Compass had been seeing a slight increase in out-of-work days prior to the new policy, the company has seen a 7 percent net improvement in this metric during the past fiscal year.

And unsurprisingly, thanks to a bonus structure which rewards Compass units that do not incur any injury claims in the course of a year, the company’s operating units are largely compensation claims free.

Advertisement




“A full 75 percent of our accounts had zero claims in the last fiscal year, 2014, which is just ending,” said Palmer Brown, chief corporate investment & risk officer with Compass Group NA.

The return-to-work program was initiated through collaboration between the company’s safety leadership team and its TPA, Gallagher Bassett.

As part of the initiative, Compass Group implemented a RTW coordinator program. Based on specific criteria (i.e., severity, injury type and work status), cases are assigned to a RTW coordinator, a registered nurse, or closed.

For less complex cases, a RTW coordinator is given the goal of managing the RTW process and monitoring each medical visit to ensure that an injured worker gets back to full duty. The coordinator’s role is to expedite this process and communicate all pertinent information to the employer and adjuster.

A nurse is assigned to more severe cases. Similar to the RTW coordinator, the nurse works with the adjuster to get the associate back to work.

Safe Storage

Compass Group also recently implemented a “safe storage” plan, designed to eliminate unsafe situations that result in poor ergonomic lifting positions in storage rooms, janitorial closets, supply rooms, and walk-in refrigerators, among other areas.

“No two storage areas are the same, so the safe stacking and storage plan are meant to be used as a guide” to mitigate or eliminate injuries caused by heavy lifting, Ehrhardt said.

“We looked at our loss data and some of our associates were clearly getting injured — not because they were doing anything wrong, but because they were grabbing for items stored at the wrong shelf height,” he said.

For example, the safe storage model for a four-shelf unit is as follows:

• Shelf No. 1 (The top shelf) should have lighter, lesser-used items, lighter than 20 lbs.;

• Shelf No. 2 (second from the top) can be used for heavier items, but should be used mainly for the most frequently used items;

• Shelf No. 3 (second from bottom) is to be used for the heaviest, bulky, and difficult to handle items. The shelf should be outlined in yellow tape or paint; to indicate caution while lifting a heavy item; and

• Shelf No. 4 (the bottom shelf) should store lighter, less frequently used items as well as items with handles, which have not been stored on the middle shelves due to the ease of grasping and position.

In addition, he said, employees were getting injured removing heavy bags out of trash receptacles. Previously, trash bags were as large as 55 gallons, with no airflows to ease the task of pulling trash up and out. Thus, Compass Group decided to go with smaller-size vented receptacles that eliminated suction by roughly 50 percent.

These initiatives were implemented over the course of this year and have received numerous positive comments from account managers for ease of implementation and reduction of injuries.

Mike Recker, executive director with broker Willis Ltd. in Birmingham, England, applauded the new safety practices — particularly Compass’ latest return-to-work initiatives.

“A big part of the effort was to find different types of altered duty able to bring our associates back to work just as soon as possible — just not in their original capacity.” — Ron Ehrhardt, vice president of operational safety, Compass Group

In the seven years that Willis has been Compass Group’s global insurance broker, he said, “the management of risk, and specifically the safety of employees, have ranked high on the agenda at each and every Compass Group PLC board meeting,” he said.

“Under Brown’s leadership, Compass Group NA has achieved a clearer understanding of its risk profile and its injury loss drivers,” Recker added.

“We have [also] seen a closer working relationship with stakeholders including Compass TPA Gallagher Bassett as well as Willis, with a greater focus not just on cost management but how that cost is expended to achieve better results for its associates,” he said.

Advertisement




“The return to work initiatives [Compass recently] implemented are prime examples of the kind of innovation that has been introduced,” said Recker.

“Clearly, having senior inspirational leadership who are out in the field working along associates and the importance of this kind of continued engagement will enable the continued development and deployment of still more fresh innovative ideas,” Recker said.

_______________________________________________________

Read more about all of the 2014 Teddy Award winners:

11012014_02_cs_honda_150x150Building Value with Trust: Honda of South Carolina boosted its involvement with injured worker cases, making a positive first impression on employees and health care providers.

 

11012014_03_cs_harley_150x150The TLC Behind the Roar: A proactive and holistic approach to employees’ well-being has resulted in huge reductions in work-related injury claims for Harley-Davidson.

 

11012014_04_cs_compass150x150Quick to Act: Compass Group is lauded for its safety initiatives and for a return-to-work program that incorporates all of its business lines.

 

 

11012014_05_cs_coldspring_150x150Healing the Healers: Teddy Award winner Cold Spring Hills Center for Nursing and Rehabilitation proved that even small organizations can make a huge difference in their employees’ lives.

Janet Aschkenasy is a freelance financial writer based in New York. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Risk Scenario

The Betrayal of Elizabeth

In this Risk Scenario, Risk & Insurance explores what might happen in the event a telemedicine or similar home health visit violates a patient's privacy. What consequences await when a young girl's tele visit goes viral?
By: | October 12, 2020
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: CRACKS IN THE FOUNDATION

Elizabeth Cunningham seemingly had it all. The daughter of two well-established professionals — her father was a personal injury attorney, her mother, also an attorney, had her own estate planning practice — she grew up in a house in Maryland horse country with lots of love and the financial security that can iron out at least some of life’s problems.

Tall, good-looking and talented, Elizabeth was moving through her junior year at the University of Pennsylvania in seemingly good order; check that, very good order, by all appearances.

Her pre-med grades were outstanding. Despite the heavy load of her course work, she’d even managed to place in the Penn Relays in the mile, in the spring of her sophomore season, in May of 2019.

But the winter of 2019/2020 brought challenges, challenges that festered below the surface, known only to her and a couple of close friends.

First came betrayal at the hands of her boyfriend, Tom, right around Thanksgiving. She saw a message pop up on his phone from Rebecca, a young woman she thought was their friend. As it turned out, Rebecca and Tom had been intimate together, and both seemed game to do it again.

Reeling, her holiday mood shattered and her relationship with Tom fractured, Elizabeth was beset by deep feelings of anxiety. As the winter gray became more dense and forbidding, the anxiety grew.

Fed up, she broke up with Tom just after Christmas. What looked like a promising start to 2020 now didn’t feel as joyous.

Right around the end of the year, she plucked a copy of her father’s New York Times from the table in his study. A budding physician, her eyes were drawn to a piece about an outbreak of a highly contagious virus in Wuhan, China.

“Sounds dreadful,” she said to herself.

Within three months, anxiety gnawed at Elizabeth daily as she sat cloistered in her family’s house in Bel Air, Maryland.

It didn’t help matters that her brother, Billy, a high school senior and a constant thorn in her side, was cloistered with her.

She felt like she was suffocating.

One night in early May, feeling shutdown and unable to bring herself to tell her parents about her true condition, Elizabeth reached out to her family physician for help.

Dr. Johnson had been Elizabeth’s doctor for a number of years and, being from a small town, Elizabeth had grown up and gone to school with Dr. Johnson’s son Evan. In fact, back in high school, Evan had asked Elizabeth out once. Not interested, Elizabeth had declined Evan’s advances and did not give this a second thought.

Dr. Johnson’s practice had recently been acquired by a Virginia-based hospital system, Medwell, so when Elizabeth called the office, she was first patched through to Medwell’s receptionist/scheduling service. Within 30 minutes, an online Telehealth consult had been arranged for her to speak directly with Dr. Johnson.

Due to the pandemic, Dr. Johnson called from the office in her home. The doctor was kind. She was practiced.

“So can you tell me what’s going on?” she said.

Elizabeth took a deep breath. She tried to fight what was happening. But she could not. Tears started streaming down her face.

“It’s just… It’s just…” she managed to stammer.

The doctor waited patiently. “It’s okay,” she said. “Just take your time.”

Elizabeth took a deep breath. “It’s like I can’t manage my own mind anymore. It’s nonstop. It won’t turn off…”

More tears streamed down her face.

Patiently, with compassion, the doctor walked Elizabeth through what she might be experiencing. The doctor recommended a follow-up with Medwell’s psychology department.

“Okay,” Elizabeth said, some semblance of relief passing through her.

Unbeknownst to Dr. Johnson, her office door had not been completely closed. During the telehealth call, Evan stopped by his mother’s office to ask her a question. Before knocking he overheard Elizabeth talking and decided to listen in.

PART TWO: BETRAYAL

As Elizabeth was finding the courage to open up to Dr. Johnson about her psychological condition, Evan was recording her with his smartphone through a crack in the doorway.

Spurred by who knows what — his attraction to her, his irritation at being rejected, the idleness of the COVID quarantine — it really didn’t matter. Evan posted his recording of Elizabeth to his Instagram feed.

#CantManageMyMind, #CrazyGirl, #HelpMeDoctorImBeautiful is just some of what followed.

Elizabeth and Evan were both well-liked and very well connected on social media. The posts, shares and reactions that followed Evan’s digital betrayal numbered in the hundreds. Each one of them a knife into the already troubled soul of Elizabeth Cunningham.

By noon of the following day, her well-connected father unleashed the dogs of war.

Rand Davis, the risk manager for the Medwell Health System, a 15-hospital health care company based in Alexandria, Virginia was just finishing lunch when he got a call from the company’s general counsel, Emily Vittorio.

“Yes?” Rand said. He and Emily were accustomed to being quick and blunt with each other. They didn’t have time for much else.

“I just picked up a notice of intent to sue from a personal injury attorney in Bel Air, Maryland. It seems his daughter was in a teleconference with one of our docs. She was experiencing anxiety, the daughter that is. The doctor’s son recorded the call and posted it to social media.”

“Great. Thanks, kid,” Rand said.

“His attorneys want to initiate a discovery dialogue on Monday,” Emily said.

It was Thursday. Rand’s dreams of slipping onto his fishing boat over the weekend evaporated, just like that. He closed his eyes and tilted his face up to the heavens.

Wasn’t it enough that he and the other members of the C-suite fought tooth and nail to keep thousands of people safe and treat them during the COVID-crisis?

He’d watched the explosion in the use of telemedicine with a mixture of awe and alarm. On the one hand, they were saving lives. On the other hand, they were opening themselves to exposures under the Health Insurance Portability and Accountability Act. He just knew it.

He and his colleagues tried to do the right thing. But what they were doing, overwhelmed as they were, was simply not enough.

PART THREE: FALLING DOMINOES

Within the space of two weeks, the torture suffered by Elizabeth Cunningham grew into a class action against Medwell.

In addition to the violation of her privacy, the investigation by Mr. Cunningham’s attorneys revealed the following:

Medwell’s telemedicine component, as needed and well-intended as it was, lacked a viable informed consent protocol.

The consultation with Elizabeth, and as it turned out, hundreds of additional patients in Maryland, Pennsylvania and West Virginia, violated telemedicine regulations in all three states.

Numerous practitioners in the system took part in teleconferences with patients in states in which they were not credentialed to provide that service.

Even if Evan hadn’t cracked open Dr. Johnson’s door and surreptitiously recorded her conversation with Elizabeth, the Medwell telehealth system was found to be insecure — yet another violation of HIPAA.

The amount sought in the class action was $100 million. In an era of social inflation, with jury awards that were once unthinkable becoming commonplace, Medwell was standing squarely in the crosshairs of a liability jury decision that was going to devour entire towers of its insurance program.

Adding another layer of certain pain to the equation was that the case would be heard in Baltimore, a jurisdiction where plaintiffs’ attorneys tended to dance out of courtrooms with millions in their pockets.

That fall, Rand sat with his broker on a call with a specialty insurer, talking about renewals of the group’s general liability, cyber and professional liability programs.

“Yeah, we were kind of hoping to keep the increases on all three at less than 25%,” the broker said breezily.

There was a long silence from the underwriters at the other end of the phone.

“To be honest, we’re borderline about being able to offer you any cover at all,” one of the lead underwriters said.

Rand just sat silently and waited for another shoe to drop.

“Well, what can you do?” the broker said, with hope draining from his voice.

The conversation that followed would propel Rand and his broker on the difficult, next to impossible path of trying to find coverage, with general liability underwriters in full retreat, professional liability underwriters looking for double digit increases and cyber underwriters asking very pointed questions about the health system’s risk management.

Elizabeth, a strong young woman with a good support network, would eventually recover from the damage done to her.

Medwell’s relationships with the insurance markets looked like it almost never would. &

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

Risk & Insurance® partnered with Allied World to produce this scenario. Below are Allied World’s recommendations on how to prevent the losses presented in the scenario. This perspective is not an editorial opinion of Risk & Insurance.®.

The use of telehealth has exponentially accelerated with the advent of COVID-19. Few health care providers were prepared for this shift. Health care organizations should confirm that Telehealth coverage is included in their Medical Professional, General Liability and Cyber policies, and to what extent. Concerns around Telehealth focus on HIPAA compliance and the internal policies in place to meet the federal and state standards and best practices for privacy and quality care. As states open businesses and the crisis abates, will pre-COVID-19 telehealth policies and regulations once again be enforced?

Risk Management Considerations:

The same ethical and standard of care issues around caring for patients face-to-face in an office apply in telehealth settings:

  • maintain a strong patient-physician relationship;
  • protect patient privacy; and
  • seek the best possible outcome.

Telehealth can create challenges around “informed consent.” It is critical to inform patients of the potential benefits and risks of telehealth (including privacy and security), ensure the use of HIPAA compliant platforms and make sure there is a good level of understanding of the scope of telehealth. Providers must be aware of the regulatory and licensure requirements in the state where the patient is located, as well as those of the state in which they are licensed.

A professional and private environment should be maintained for patient privacy and confidentiality. Best practices must be in place and followed. Medical professionals who engage in telehealth should be fully trained in operating the technology. Patients must also be instructed in its use and provided instructions on what to do if there are technical difficulties.

This case study is for illustrative purposes only and is not intended to be a summary of, and does not in any way vary, the actual coverage available to a policyholder under any insurance policy. Actual coverage for specific claims will be determined by the actual policy language and will be based on the specific facts and circumstances of the claim. Consult your insurance advisors or legal counsel for guidance on your organization’s policies and coverage matters and other issues specific to your organization.

This information is provided as a general overview for agents and brokers. Coverage will be underwritten by an insurance subsidiary of Allied World Assurance Company Holdings, Ltd, a Fairfax company (“Allied World”). Such subsidiaries currently carry an A.M. Best rating of “A” (Excellent), a Moody’s rating of “A3” (Good) and a Standard & Poor’s rating of “A-” (Strong), as applicable. Coverage is offered only through licensed agents and brokers. Actual coverage may vary and is subject to policy language as issued. Coverage may not be available in all jurisdictions. Risk management services are provided or arranged through AWAC Services Company, a member company of Allied World. © 2020 Allied World Assurance Company Holdings, Ltd. All rights reserved.




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