For Safer Patient Handling, Northwell Health Hopped on the Bus
As Luke Skywalker flies towards the Death Star in Star Wars: Episode IV – A New Hope, chaos and explosions surround him. A fellow starfighter reminds the team to “stay on target,” words that remain with Skywalker and give him the mental focus needed to blow up the Death Star.
For the Northwell Health team in 2014, the chaos surrounding the health system’s workers’ compensation program might’ve made them feel like Skywalker in that crucial battle.
The health system’s experience mod was 1.146, and the projected budget impact of workers’ comp incurred expense and liability was approaching $100 million.
Senior leadership had serious concerns as to where to focus resources in order to get the program back on track: “Nobody could really tell senior leadership what was going on,” said Joseph F. Molloy, vice president of workforce safety at Northwell.
The company asked Molloy to serve as an internal consultant to get the workers’ comp program to “stay on target.” He began by interviewing everyone who was involved in the workers’ comp process. What he found was a communication disconnect.
There was no clear senior leadership to field questions when they arose, and managers were instructed not to contact injured employees — creating distrust within the workers’ comp process.
These concerns led to the creation of a new department at Northwell Health: workforce safety.
With senior leaderships’ endorsement and support, Northwell Health’s program transitioned from an adversarial approach to one based entirely on employee advocacy.
They identified nearly 800 projects in a two-year plan, which was completed in eight months, earning them a 2019 Teddy Award®.
Making Workers the Priority
From the beginning, the workforce safety team knew they needed to focus on initiatives that were shaped by worker advocacy, better outcomes and a culture of safety, while also being more cost-effective for the company in the long run.
But transitioning from an adversarial approach to an advocacy-based one proved difficult. Department managers pushed back, worried an advocacy model could encourage fraud.
“I told them, ‘You don’t build a policy and a program for the tail wagging the dog.’ You build a policy and a program for everybody,” Molloy said.
“We’re going to change the perspective from an adversarial role to one in which we assume the vast majority of employees are legitimately injured and want to pursue the best course of treatment and return to work.”
Part of changing the culture meant changing how people talked about processes, like return-to-work.
As part of their revamped workers’ comp program, workforce safety created a transitional return-to-work program that gave injured employees up-to-12-weeks-long assignments that met their medical and physical restrictions while helping them heal and get back to work.
Part of the success, Molloy said, was that the program allowed the staff to eliminate the phrase ‘light duty,’ changing the company’s culture dramatically.
“I said, ‘I do not want to hear the phrase light duty, because light duty has other connotations,’ ” Molloy said.
In addition to the difficulties of transitioning to an advocacy culture, Northwell Health faced staffing problems. There were only three nurse case managers who were managing more than 110 cases each — almost double the 60 cases that Northwell’s broker Marsh said they should each have.
“They weren’t able to really medically manage the cases. They weren’t interacting with the patients. They were responding to crises, and they were pushing paper,” Molloy said.
To fix that problem, workforce safety created two different positions: case coordinators and nurse case managers.
Case coordinators have taken on more of an initial response role by performing the initial triage and contacting an injured worker within 24 hours.
Nurse case managers, on the other hand, work with injured workers who may need a little more attention, such as those facing lost-time claims, those with complex medical conditions, or those who have had multiple claims.
“The RN case managers here treat the employees not as employees; they treat them as their patients,” Molloy said.
All Aboard the Safety Mobile
With 70,000 employees spread across 23 hospitals, it can be difficult to make sure everyone knows the best practices for staying safe on the job and reporting claims when they arise.
To help educate employees about the new programs, Molloy and his team distributed posters, mouse pads, desktop screensavers and other “swag” branded with the workforce safety department’s information.
Northwell Health is also implementing a system where, in the future, these items will include a QR code employees can scan with their phones to report an incident as soon as it happens.
Giveaways have also played a role in Northwell Health’s workplace safety educational campaign. During the winter, the computers display “Walk like a Penguin” screensavers to give employees guidance on how to walk on slippery floors and icy walkways. The health care system also analyzed the slipperiness of its floors in high-traffic areas to see where improvements could be made. These initiatives have decreased the number of slips, trips and falls by more than 77%.
Safety doesn’t just end with educational campaigns, however. Training sessions keep employees safer, especially in the area of safe patient handling, a major cause of injury among health care workers.
At Northwell, this is where “the bus” comes in. “The bus” is a mobile home that Northwell converted into a ‘mock’ hospital room, complete with a bed and lifting equipment, where employees can practice lifting, transferring and moving mock patients.
A team of ergonomists, occupational therapists and physical therapists assist in the training sessions to help provide guidance on the proper way to lift patients with minimal strain on the body and, since the unit is mobile, it can travel to each facility within the Northwell health care system.
“You don’t build a policy and a program for the tail wagging the dog. You build a policy and a program for everybody.” — Joseph F. Molloy, vice president, workforce safety, Northwell Health
The bus has even inspired events, such as the Safe Patient Handling Olympics, in which teams compete in different lifting scenarios. The events are judged by a nurse and an occupational therapist.
“It’s been very well received, and it’s been very successful and that has led to some pretty significant decreases in length of absence days from patient handling injuries,” Molloy said.
Results that Speak Volumes
The response at Northwell Health to the workforce safety department and the successes they’ve achieved thus far have been overwhelming.
They’ve decreased their average length of an absence after an injury from 90 to 77 days and cut their expected long term liability costs by nearly $10 million.
“Patient and employee safety is a top priority to Northwell. The creation of workforce safety and all of their programs really supports our mission and our vision while also demonstrating Northwell’s commitment to safety,” said Dorothy Feldman, Northwell’s chief risk officer.
“We’re pleased [to] have these resources that Joe and his team have built out to support our co-employees.”
Injured workers are taking notice as well. “Just reading testimonials and getting emails [from injured workers saying], ‘you really helped me through a difficult time,’ ‘your team did great,’ ‘this person was great’ — that really means we’re doing exactly what we set out to do,” Molloy said.
Part of why the program has been so well received is because of the inspiration Molloy took from one of his favorite films: Star Wars.
“Stay on target, stay on target, when all this other stuff is blowing up around you, that’s the key to success. You just stay on target, because things are going to happen, things are going to blow up,” he said. “You’ve got be committed.” &