Risk Insider: Jeff Driver

A Failure of Trust

By: | December 1, 2014 • 2 min read

Jeff Driver is the Chief Risk Officer- Stanford University Medical Center and the Chief Executive Officer - The Risk Authority, LLC. He can be reached at [email protected]

‘Ebola-mania’ is my term for significant reactions to known public health and risk management issues associated with the Ebola virus.

The arrival of Ebola in the United States has been marked by fever-pitch reactions of alarm that ranged from cries for international travel bans, school closings, state-required quarantines of individuals, airport passenger health screenings, and even calls for national nursing union labor strikes over claimed unsafe hospital working conditions.

Now, let’s take a big collective national breath.  Could it be that what first appeared to be a public health crisis turned out to be more of a significant crisis in public confidence?

Could it be that for America, Ebola is not as significant a risk as it is for the far less advanced medical systems in West Africa where over 5,000 people have died after contracting the virus?

But this fall, in different ways, U.S. hospitals, the Centers for Disease Control and Prevention, as well as state and federal governments arguably failed to fully establish credibility with a hungry media and scared public, exacerbating what should have been a manageable Ebola outbreak.

A trifecta of public confidence shaking moves occurred when missteps were made in treating the first U.S. Ebola patient, accurately communicating with the public, and protecting treating medical providers from contracting the virus.

First, a patient with a history of fever and travel from West Africa was discharged from a hospital back into the community.  Then, information about the patient’s temperature being no greater than the CDC threshold of 101.5 degrees to trigger a serious Ebola concern had to be corrected; and once the patient was readmitted, officials failed to clearly explain delays in blood transfusion from an Ebola survivor and the administration of an experimental drug (Brincidofovir), both which had shown promise in treating Ebola.

Perhaps most alarming, the involved hospital has not been able to explain how two of its nurses contracted the virus, instead seeming to point the finger at the CDC for frequently changing protective gear guidelines and “frustrating” hospital employees and management.

Subsequent blows to public confidence stemmed from uncertainties around CDC guidelines on personal protective equipment (PPE) for health care workers and the 21-day quarantine guideline for individuals exposed to the Ebola virus.

First, with regard to PPE: After two nurses in Dallas tested positive for the Ebola virus, the CDC changed PPE guidelines to ensure there would be no ambiguity about leaving no skin exposure. It detailed step-by-step instructions to put on and take off the equipment safely, as well as the necessity of having a trained monitor to supervise the process.

Then, there are the still unresolved questions surrounding the necessity of a 21-day quarantine for individuals potentially exposed to the Ebola virus.

The several different approaches to contain the virus from individual states, the CDC and the military have not been resolved, and the current interim CDC recommendations at this point are based on transmission risk assessment.

In part II of this article on Ebola, I will focus on the way risk managers should reset the response to Ebola.

Read all of Jeff Driver’s Risk Insider articles.

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

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