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Digital Edition2026 Theo Award Winner: Essentia Health
Kathy Tusken has a favorite metaphor for the kind of change Essentia Health has made over the past decade in its workers’ compensation program: “We’re up here in the Northland on the Seaway,” she shared, “so we always say it’s like turning a thousand-footer. It’s very slow and gradual — but once you see it, you see it.”
The image fits. The Duluth-based health system operates across Minnesota, Wisconsin, and North Dakota — 17 hospitals, dozens of clinics, and thousands of employees spread across a sprawling, three-state footprint. What began around 2012-13 as essentially a one-person claims processing function has become something far more ambitious: a multidisciplinary team that manages not just claims, but prevention, ergonomics, return-to-work, and the full arc of an injured employee’s recovery.
The transformation didn’t happen overnight. It happened systematically, one piece at a time.
Building the Team, Building the Program
The vision started with a question that is deceptively simple: What would it look like to run a workers’ compensation program that actually serves its employees, not just processes their paperwork?
The answer, at Essentia, has been a team built from complementary disciplines. A workers’ compensation claims manager came first, followed by employee safety specialists and ergonomic specialists. Occupational therapists were added to serve as case managers — chosen deliberately for their dual capability: guiding injured employees through recovery and conducting the ergonomic assessments that prevent the next injury.
“We always had in mind getting people back to work right away,” Tusken explained. “The occupational therapists work with employees to find out what works best for them throughout their treatment, and if there are accommodations we can make once they get back. And they also check workspaces, preventing the carpal tunnels, the back pain, the repetitive work injuries from occurring in the first place.”
That dual focus — claims and prevention working in tandem — became the structural logic of everything Essentia built. Over time, the program was centralized under Human Resources, with standardized processes deployed across all three states.
“We wanted it equal. We wanted it standardized. We wanted the support to be the same in all areas,” Tusken said, “so that every employee, whether they’re in Minnesota or North Dakota, is getting the same experience.”
From Reactive to Proactive
The ergonomics transformation is perhaps the most striking illustration of the program’s evolution. In the early days, ergonomic evaluations happened after injuries — reactive, case-by-case, limited in impact. The team rebuilt that model entirely.
Risk-based triage replaced blanket evaluations. Instead of waiting for an injury, Essentia began targeting high-risk roles and early discomfort reports — intervening before problems became OSHA recordable. Structured intake tools and multiple reporting channels allowed the ergonomics team to identify emerging patterns and respond quickly. During COVID, a remote assessment program kept the effort going for a distributed workforce when in-person visits weren’t possible.
Technology played a growing role. Partnering with IT, the team established standard ergonomic equipment available to all employees, developed remote-work guidance, and created self-assessment tools that reduced office-based strain injuries significantly.
Kathy Tusken, Senior Manager Emp Health/Safety /Work Comp/Workability, Essentia Health
The results have been striking. Ergonomic injuries dropped dramatically over a five-year span — and even as Essentia’s workforce has grown since, injury counts have remained near historic lows. The program’s maturity was confirmed when Minnesota introduced a new mandate requiring formal ergonomic programs for large employers: Essentia’s program was already fully aligned and operating beyond the required standards.
“Implementation required only creating a formalized reporting tool,” Tusken said. “All core program elements had been in place and consistently executed for years.”
The Return-to-Work Philosophy
Alongside ergonomic prevention, Essentia’s approach to transitional duty became a defining pillar of the program — and a meaningful shift in organizational culture.
Before the program was formalized, modified duty existed inconsistently across the system. Restrictions were interpreted narrowly. Employees stayed out of work longer than necessary, both because the infrastructure wasn’t there to bring them back and because leaders hadn’t yet internalized that keeping injured workers engaged was their responsibility.
The program changed that equation. A dedicated team member reviews medical restrictions in real time, translating clinical language into actual functional capabilities and identifying viable work alternatives immediately. Managers were trained to view transitional duty not as an accommodation burden but as care continuation — and held accountable for exploring options when restrictions existed.
Equally important, the light-duty options were built to fit the employee; not just the organization. An injured worker who can’t perform their usual role might find meaningful work in another part of the system. They stay on schedule, stay connected to colleagues, and often heal faster for it.
“They’re remaining active, and they’re remaining active in their employment,” Tusken said. “A lot of times, they might find that when they’re doing that other job, they really miss what they’ve been doing every day, or they discover something they like even more.”
Caring for the Caregivers
For Tusken, the program’s purpose is ultimately inseparable from Essentia’s broader mission as a health care organization. Caregivers, nurses, therapists, technicians, and support staff do work that is physically and emotionally demanding. They pour themselves into their patients. And they deserve the same level of care when they are the ones who are hurting.
“Especially after the pandemic, being in this profession is extremely difficult,” she said. “If we’re not putting our best foot forward in making our employees feel valued and cared for, it’s difficult for them to continue to feel passion at work. Caregivers need to know that they’re valued. They need to know that if they’re injured at work, they have the proper resources and that we do care and we do want them to come back to the job that they love.”
The results, measured over a decade of steady progress, speak to that commitment. Workers’ compensation costs have declined substantially and held, even as Essentia’s headcount and payroll have grown. Lost workdays have decreased. Repetitive work injuries — once a major driver of claims — have been dramatically reduced.
None of it happened fast. But like the thousand-footer slowly finding its new heading, the change is now unmistakable.
“It’s working very, very well,” Tusken said of the team she’s helped build. “Everybody has their key part — and yet everything we do affects each other’s role. That group dynamic has been extremely successful. We’re very, very lucky.” &
The Theo Award celebrates its sophomore year, honoring 28 workers’ compensation programs for their excellence and service to workers across the nation. To learn more about the award and amazing qualities each winner possesses, visit here.
