Posts Tagged ‘safety’

Workers’ Compensation Performance Measurement: Keep The Bull’s Eye Simple

Wednesday, May 17th, 2017

For the last decade, injury frequency has been trending steadily lower. There are a number of reasons for this: automation, loss of manufacturing jobs, better safety engineering, etc. Injury severity, however, has not followed suit despite technological gains in claim administration and medical management and an ever so slow move to the use of predictive analytics.

This creates challenges for employers, especially of the small and middle market variety, and, to a certain degree, even for a few national, enterprise accounts who find themselves pretty much where they were ten years ago in terms of style and policy with respect to workers’ compensation. One reason for this is the deep rooted legacy mentality and resistance to change of many insurers and Third Party Administrators. In many ways, these organizations remind me of flies circling around a light in a lampshade, mistaking movement for progress.

However, employers still foot the bill and are still in command. Keeping in mind that the workplace is the best place to control workers’ compensation costs, employers still need to build and maintain solid programs to prevent and contain loss. Case in point is Bob Oberosler, Vice President of Loss Prevention for Rite Aid, a national pharmacy chain. At the New Jersey Self Insurers Association’s Annual Meeting a couple of weeks ago, he described his company’s work to craft a forward thinking loss prevention and workers’ compensation management program and communicate it to employees who are far and wide, indeed. But before that could happen, Mr. Oberosler said, he faced an even more daunting task – getting management’s commitment and buy-in to the effort. The good news is this happened and Rite Aid has been enjoying some spectacular results because of it.

This got me thinking. In order to sustain C-Suite commitment, a risk manager, or Loss Prevention VP, such as Bob Oberosler, needs to provide the Leadership team a steady, easily understandable Performance Measurement Results Dashboard. So, what should be the characteristics of such a Dashboard?

Performance measurement should have four characteristics: It should be simple, it should be meaningful, it should be consistent and it should be continuous.

By simple, I mean easily and quickly understood by senior management. Meaningful means that it should sit in senior management’s sweet spot; it should be something that is anticipated and valued by leaders. It should be consistent, because those leaders, once trained to view performance in one way, do not appreciate abrupt course changes. And to be effective over the long term, it has to be a continuous and routine process. The mantra should be: What is consistently well-measured is highly valued.

With this framework in mind, I usually recommend that monthly or quarterly reports to senior management measure two things religiously: Incurred losses per full time equivalent employee (and this should be done by department, division and company) and incurred losses per every hundred dollars of payroll (again, split out by department, division and company). Before any measurement occurs, however, management should settle on targets, which should be a bit of a stretch, but attainable. And target selections should be set against actual performance in the prior three or four years. For instance, if costs per FTE have been in the $200 to $300 range in the last few years, a good target would be a reduction of 30% to 40% in the current year.

Senior managers have finite attention spans. Therefore, workers’ compensation performance measurement should fit on one page, a Scorecard that senior management can assimilate in no more than a few minutes. If the information is pithy enough, that’s as long as it should take, but it should also lead to fruitful discussion about management actions to enhance performance, discussion that comes out of knowledge.

There are many other solid and valuable workers’ compensation metrics, but, in Lynch Ryan’s experience, these two are the ones that senior managers appreciate the most.

All of this assumes, of course, that, as at Rite Aid,  a serious and ongoing safety, workers’ compensation and injury management program is humming along and that all parts of the organization have been trained in how to keep it that way.

A 10 year anniversary Health Wonk Review & more noteworthy news

Thursday, September 22nd, 2016

It’s Health Wonk Review week! Louise and Jay Norris host a special edition at Colorado Health Insurance – not only is it a mere 46 days to the next election so that has the wonkers opining – it is also the 10th blogging anniversary for the hosting blog – The “We’re Ten!” Edition of the Health Wonk Review. There are great entries from both the usual subjects and some fresh faces. Louise is a great host, framing everything nicely. Congratulations on 10 years of blogging, Louise & Jay. *clinks champagne glass*

More news of note

Just by way of coincidence, September is our birthday month here at Work Comp Insider, too – we launched in 2003! That makes us a grizzled old timer in Internet time.

Oklahoma and opt out– in case you missed it, the Oklahoma Supreme Court Ruled Workers’ Comp Opt-Out Unconstitutional:

Justice Watt, in the Court’s highly anticipated written decision, said the OWCC previously found the Opt Out Act: “1) constituted an unconstitutional special law; 2) denied equal protection to Oklahoma’s injured workers; and 3) denied injured workers the constitutionally protected right of access to courts.”

And the high court agreed, finding that the core provision of the Act “creates impermissible, unequal disparate treatment of a select group of injured workers.”

The PCI and AIA were quick to applaud the decision. Joe Paduda hopes this is the end to what he sees as the pointless debate about Opt-Out (we hope so too). Bob Wilson looks at some of the loose ends in the wake of this decision.

Psych indicators – Most of us in the industry are pretty familiar with triggers or warning signs that would indicate an accident investigation or the need for early medical intervention — but perhapsare  less familiar with indicators that might signal the need for a psychological evaluation. Our friends at Work Comp Psych Net have posted a handy reference list of Predictive Psychosocial Triggers For Workers’ Compensation Claims.

Obesity’s toll on WC – A new study in the September Journal of Occupational and Environmental Medicine shows that obese and overweight workers are more likely to incur high costs related to workers’ compensation claims for major injuries;

But for workers with major injuries, high BMI was associated with higher workers’ compensation costs. In this group, costs averaged about $470,000 for obese and $270,000 for overweight workers, compared to $180,000 for normal-weight workers.

After adjustment for other factors—including high-cost spinal surgeries or injections—obese or overweight workers with major injuries were about twice as likely to incur costs of $100,000 or higher. Body mass index had no effect on costs for closed claims or for less-severe injuries.

Safety Culture Does Not Exist!  – This is a half-hour podcast interview with Dr. Edgar Schein, Professor at MIT Sloan School of Management. Well worth a listen. We weren’t aware of this podcast series and it looks great: The Pre Accident Podcast is an ongoing discussion of Human Performance, Systems Safety, & Safety Culture. The Dr. Schein interview is the #88th edition!

Speaking of safety …. It’s Farm Safety & Health Week from September 18-24.

More news of note

It’s North American Occupational Safety and Health (NAOSH) Week

Wednesday, May 7th, 2014

naosh
May 4 through 10 is North American Occupational Safety and Health (NAOSH) Week, a commemoration that has occurred since 1997 through an agreement between safety organizations in Canada, the United States and Mexico. The goal is to focus the attention of employers, employees, the general public, and all partners in occupational safety and health on the importance of preventing injury and illness in the workplace, at home and in the community. The slogan is Safety and Health: A Commitment for Life , and this year’s theme is How Safe Are You!
Here are participating partners / sponsors, where more information can be obtained:
American Society of Safety Engineers (ASSE)
Canadian Society of Safety Engineering (CSSE)
Canadian Centre for Occupational Health & Safety (CCOHS)
Labour Program of Human Resources and Social Development Canada (HRSDC)
Threads of life

Wearable technologies: the next frontier in workplace safety

Wednesday, April 9th, 2014

The use of health monitors and fitness trackers have exploded in recent years — but expect the next frontier in wearable technologies to be in the workplace. The implications for worker safety and productivity are promising. While Google first introduced its revolutionary Glass to consumers, the current marketing direction is aimed at custom work applications.
One example of this is Patrick Jackson, a firefighter in North Carolina’s Rocky Mountain fire department: This Firefighter Built His Own Google Glass App And It’s Saving Lives.
Jackson is also a member of the Google Glass Explorer program and has developed an app that displays incoming emergency dispatches, shows maps of where incidents are, nearest fire hydrants, and even building plans. You can see a brief demo of Glass at work in the short clip, below. In addition, “Jackson is also working on a CPR assist app for Glass, measuring the speed of compressions, and whether you need to speed up or slow down based on sensors that detect head movement. He’s teaming with a Michigan startup called team (evermed) during his days off from the department, where he spends 10 days per month working grueling 24-hour shifts.”

The article also suggest another work safety application in DriveSafe, a Google Glass app that uses infrared sensors to detect when you doze off and to issue alarms to wake you and direct you to the next rest area.
PC World takes a look at other potential workplace applications for smartglasses , noting that, “The future of smartglasses will be realized by a factory worker operating a 3000-pound stamp press, not a gamer stomping on virtual-reality bad guys. Face computers will be all about scanning bar codes on cardboard boxes, not scanning tourist attractions for augmented reality overlays.” They present a variety of work scenarios, from hands free scanning and troubleshooting to safety applications.
FierceCIO explores the topic further in Making wearables a good fit for workplace safety. They discuss potential safety applications and suggest that gaining optimal value from wearable devices will require IT departments to innovate with software applications, data management and administrative protocols and policies.
We’re really just at the threshold of wearables in the workplace. To see more of the opportunities, this excellent Deloitte University Press primer by Shehryar Khan and Evangeline Marzec on Wearables is helpful in exploring the potential of everything from productivity, training and worker safety:

“Wearables’ value comes from introducing technology into previously prohibitive environments–where safety, logistics, or even etiquette have constrained traditional technology solutions. Wearables can be the first seamless way to enable workers with digital information–especially where hands-free utility offers a clear advantage. For example, using wearables, workers in harsh environmental conditions can access data without removing gloves or create records without having to commit data to memory and then moving to a sheltered workstation.”

Wearables are not without their HR and IT challenges. Susan Kuchinskas explores some of these issues in Forbes: How To Prepare Your Business For Wearable Technology. Also see:The Wearable Technology Revolution: Is your workplace prepared?

April 28 is Workers Memorial Day

Friday, April 26th, 2013

WMD+poster
Each year, April 28 is designated as Workers Memorial Day. OSHA says that, “It is a day to honor those workers who have died on the job, to acknowledge the grievous suffering experienced by families and communities, and to recommit ourselves to the fight for safe and healthful workplaces for all workers.”
Here are some planning resources for marking the event.
The National Council for Occupational Safety and Health provides links to Workers Memorial Day Events, as well as a Workers Memorial Day Fact Sheet (PDF) and other resources.
AFL-CIO Workers Memorial Day has resources at their site, including a toolkit (PDF) to prepare for the event and a Collection of Worker Memorials.
USMWF Worker Memorial Day also has a list of planned events and a touching slide show tribute to workers who were killed on the job.
See 2012 Reports:
Death on the Job – AFL-CIO
Dying for Work in Massachusetts: The Loss of Life and Limb in Massachusetts Workplaces
California Dying at Work Report
North Carolina Workers Dying for a Job

Annals of Risk Management: Guns and Mental Illness in New York

Wednesday, January 16th, 2013

New York has just signed into law a new gun control measure [S. 2230] that comes as a direct response to the incomprehensible tragedy in Sandy Hook, CT. While the bill touts its “first in the nation” status, with respect to its approach to mental illness, it is by no means a model for other states to follow.
The bill addresses three distinct issues relating to mental illness: first, limiting access to gun licenses for those diagnosed as mentally ill and dangerous. Second, the bill requires gun owners who reside with a mentally ill and “dangerous” individual to keep guns under lock and key. Finally, and most disturbingly, the bill requires mental health professionals to report any patient who is “likely to engage in conduct that will cause serious harm to
him- or herself or others.” In other words, the bill assumes that any individual with suicidal tendencies is a potential mass murderer. Such stereotyping is not what is needed in the mental health community.
Double Bind
S.2230 places a formidable burden on mental health professions – who not only must treat their patients, they are held accountable for predicting future behavior:

A new Section 9.46 of the Mental Hygiene Law will require
mental health professionals, in the exercise of reasonable
professional judgment, to report if an individual they are treating
is likely to engage in conduct that will cause serious harm to
him- or herself or others. A good faith decision about whether to report
will not be a basis for any criminal or civil liability.

If we have learned anything in the all-too-frequent incidences of random slaughter, the “likelihood” of homicidal acts is usually only revealed retroactively, long after the fact.
The bill goes on to read:

When a Section 9.46 report is made, the Division of Criminal Justice
Services will determine whether the person possesses a firearms
license and, if so, will notify the appropriate local licensing
official, who must suspend the license. The person’s firearms will
then be removed.

After a therapist reports a potentially violent patient to the state – once again, this rather large population includes people who only threaten to hurt themselves – New York will run the names through the data base of licensed gun owners. All hits must result in license suspension. Of course, bureaucracies being what they are, it might take months for the suspension to take place. Hence, the individual who at one time exhibited psychotic symptoms or discussed violent feelings with a therapist might find him or herself months later confronted by cops on the doorstep. Such encounters will hardly be helpful for people trying to establish mental equilibrium.
Finally, the image of forcefully removing guns from the home surely presents enormous risk to gun owners and public safety officials alike. Who will do this and under what circumstances? My guess is that, given the profound implications of reporting patients to the state, most therapists will err on the side of non-reporting and rationalize their inaction, when necessary, under the heading of acting in “good faith.”
The Wrong Cohort
It is important to note that only individuals receiving treatment for mental illness will be subject to this onerous standard. Given the fractured and fragmented nature of mental health treatment in this country, the vast majority of mentally ill individuals have never received and are not about to receive any treatment. And among the violent individuals who might well contemplate an attack of homicidal proportions, few would bother to discuss it with a therapist or go through the formality of securing a gun license before buying an assault weapon.
The relatively small subset of people impacted by the New York bill – people diagnosed with mental illness who are licensed gun owners – is likely to prove statistically insignificant, as is the probability that a single mass murder can be prevented by this radical undermining of the doctor-patient relationship. Surely, there is a better way to manage what has become a remote but appalling risk of life in the 21st century.

Sugar: Bad for Consumers, Deadly for Workers?

Sunday, October 14th, 2012

It would be pretty hard to avoid the news about sugar: it’s bad for us. Diets high in sugar contribute mightily to the nation’s burgeoning problems of obesity and diabetes and may even be a factor in dementia. But sugar in its crop form is also proving to be deadly. The cause and effect, however, is as murky as a cloudy day in the rainforest.
Will Shorr has written a remarkable, hands-on article in the Guardian, examining the high rates of chronic kidney disease (CKD) among the workers who grow and harvest sugar cane in Central America. CKD is the second leading killer of men in El Salvador.
Why are sugar cane workers succumbing to kidney disease? Is it the working conditions? Is it the pesticides? Is it the diet of the workers? Fingers are pointing in a number of directions, and by the time the truth is sorted out, we may well find a toxic trail that includes of all three factors.
Dehydration
Nicaragua Sugar Estates, one of Central America’s largest plantations, has conducted its own internal studies, one of which identified one potential factor in the disease: “strenuous labour with exposure to high environmental temperatures without an adequate hydration program.” .Nonetheless, a company spokesman denies the connection: “We’re convinced that we have nothing to do with kidney disease. Our productive practices do not generate and are not causal factors for CKD.”
But researchers in the US have connected CKD to heat stress and dehydration. A standard day for an El Salvadorian sugar worker lasts between four and five hours, with double shifts during the summer planting season, when temperatures top out at 104 degrees.
Shorr quotes Héctor García, a 33 year old with stage-two kidney failure: “It’s very hot; we suffer. People sometimes collapse. More often they vomit, especially when the heat is worse. They do two shifts to earn more money.” Another worker, 40 years old and close to death with stage five CKD, reported the same symptoms, compounded by the limited resources in his home: “When I come home, I feel surrendered. Sick. Headache. I can’t shower because the water [from the roof-mounted tank] is too hot.” The image of the hand-rigged shower, full of very hot water, epitomizes the wretched living conditions of the workers.
Compounding the problem, most CKD sufferers do not even know they are ill: the disease is asymptomatic until its last, most deadly stages. Even when they feel unwell, many workers go into denial – they feel helpless, as they cannot afford the medication or the recommended diet of fresh vegetables and chicken breast. Dialysis – the last hope of the ill – is often avoided, because most of the workers who go on it end up dead anyway, so it appears to their co-workers that dialysis causes the death.
Chemicals
Researchers have found rates of CKD in cane cutters and seed cutters – the most strenuous jobs – to be higher than in pesticide applicators, who have greater exposure to agrochemicals. This seems to indicate that the pesticides are not a significant factor. But this conclusion may be premature.
Five chemicals are used in the cultivation of sugar cane: amine, terbutryn, pendimethalin, 2,4-D and atrazine. Shorr sent the chemical recipe for the yellow potion he observed being sprayed on the crops to Professor Andrew Watterson of the University of Stirling – an authority on agrochemicals and health. They were all herbicides, he noted. Watterson came up with a litany of potential problems:

Atrazine can cause kidney damage at high levels; acute exposure to 2.4-D can cause chronic kidney damage; pendimethalin is “harmful through skin contact and inhalation”; in lab tests, long-term feeding of terbutryn to rats caused kidney damage. None of them are acutely toxic, but this combination, plus the tropical climate, could worsen their effects.

On the prevention side, sprayers are supposed to avoid contact with skin; to wear face shields, respiratory protection, rubber boots and specialist coveralls. We can only surmise that such protective equipment, while technically useful, would be difficult to use in 100 degree weather. On the other hand, assuming the sprayers are protected, other workers do not wear protection and may thus experience greater exposures to the chemicals.
Sugar in the Diet?
Shorr concludes his article with a shocking new study that points in yet another direction. Richard Johnson, of the University of Colorado’s Division of Renal Diseases and Hypertension, thinks the problem might have its genesis in a mechanism that his team discovered in rats. Johnson speculates that if dehydrated workers with already sugary kidneys are rehydrating with soft drinks or fruit juice, they may experience a potentially explosive fructose load. He adds that “it’s not proven, so we don’t want to get ahead of the gun here [rather unfortunate metaphor].” The research has not as-yet been published. But Johnson goes on to say that the experimental data is quite compelling, and it “could explain what’s going on.”
It would truly be ironic if the cane field workers were dying from kidney failure in part because they use sugary soft drinks to rehydrate. “Buy the world a Coke” indeed!
Collateral Damage?
While it is too early to draw definitive conclusions, the Guardian article identifies at least three converging factors in the high CKD rates among field workers: extremely high heat compounded by hydration problems; a mix of potentially harmful pesticides; and an unhealthy diet too full of sweetened beverages. Add the impoverished living conditions of the workers – and marginal medical care – and you have all the makings of an abbreviated lifespan.
The US gets 23% of the its raw sugar from Central America; the European Union spends more than €4.7m on this import. Sugar is El Salvador’s second-biggest export. This is big business. With so much money at stake, the dying workers are little more than collateral damage. It appears that what they really need is an ample supply of clear, cool water, but such a simple remedy, alas, is nowhere in sight.

100 Years of Workers Comp

Tuesday, April 3rd, 2012

vintage photo of ambulance and injured worker
We’re happy to bring you this 12-minute, must-watch video commemorating the 100th Anniversary of Workers Comp. The video highlights progress in worker safety, treatment of injured workers and risk management in the past 100 years. In addition to telling the history of comp, it also features three visionary women who were instrumental in furthering health and safety of workers…one of whom witnessed the Triangle Shirtwaist fire. Until this clip, I did not realize the strong role that women played in this history.
Kudos go to Sedgwick as well as to our colleague and friend Peter Rousmaniere. who wrote the script.
Here’s some additional information about the women highlighted in the video clip:
Crystal Eastman
Frances Perkins
Alice Hamilton MD

A Window Into Fraud

Monday, February 13th, 2012

A couple of years ago we blogged the performance incentive program at Smurfit-Stone Container Corporation in California. The performance numbers were stellar, but not necessarily because the work was performed safely. Instead, the company conspired with local medical providers to secure limited treatment outside of the workers comp system. Two supervisors pled no contest in conspiring to deny comp benefits to injured workers.
With the recent conviction of chiropractor Robert Schreiner, we see into the black box of the conspiracy. Workers complaining of work-related problems were referred to doctors like Schreiner – giving rise, alas, to a new and ominous definition of provider network. In one instance a worker complained about a neck and shoulder injury. Schreiner denied that the problem was work related, saying that it was caused by carrying a back pack as a child. He provided a handful of treatments and then encouraged the worker to file the claim under his health plan to continue treatments. When the worker persisted and filed a comp claim, he was fired.
Schreiner is headed to jail to serve a mostly symbolic sentence of 30 days, to be followed by three years of probation. Perhaps he can provide some adjustments to his fellow inmates. Confined spaces sure can mess up the spine.
Faking Safety
Smurfit-Stone was bought out last year by RockTenn. You can still read about the company in Wikipedia. Here is the (unattributed) description of the company’s safety program:

Smurfit-Stone has been an industry leader in safety performance since 2001 [NOTE: the conspiracy to under-report claims began in 1999!]. In 2007, Smurfit-Stone’s U.S. operations had an OSHA recordable case rate of 1.05, the best in company and industry history. This represents an 84 percent improvement in the company’s recordable case rate since the implementation of Smurfit-Stone’s SAFE process in 1995.The SAFE process, which stands for Smurfit-Stone Accident-Free Environment, promotes five core beliefs:
1.All injuries are preventable
2.Safety is everyone’s responsibility
3.Working safely is a condition of employment
4.Training employees to work safely is essential
5.Safety is good business

As litigation has proven, Smurfit-Stone’s low OSHA case rate has less to do with safety than with a conspiracy to under-report claims. Perhaps the SAFE program stood for something else: Screw All Forsaken Employees. Aggressive safety goals are a good business practice; circumventing the workers comp system is not just a bad practice, it’s illegal. Just ask Robert Schreiber.

Highest injury rate POP quiz: construction, manufacturing, mining, or nursing homes?

Tuesday, November 1st, 2011

Pop quiz:
Match the Injury Incident Rate per 100 Full Time Equivalents (#1 through #4) with the industry (A, B, C, D)
1. 8.6
2. 5.6
3. 4.8
4. 3.5
A. building construction
B. coal mines, underground workers
C. nursing home workers
D. tire manufacturing workers
Answers: 1-C, 2-B, 3-D, 4-A
Yes, you read that right. Nursing home workers are at higher risk of injury than underground coal miners, construction workers, and tire manufacturers. And the picture is pretty much the same when you talk about serious injuries that result in lost time. “The lost-time/ restricted duty injury case rate for nursing home workers is 5.6 per 100 FTEs, compared to 3.7, 3.3 and 1.7 for these same sub-industries, respectively.”
At The Pump Handle, Celeste Monforton posts about new data that reveals that nursing home workers face an extraordinarily high rate of on-the-job injuries.
Of the 16 million US workers employed in health care and social assistance, more than 3 million are employed in US nursing and residential care facilities. In comparison, Monforton notes that about 17.1 million people were employed in manufacturing and construction. OSHA focused approximately 78% of its inspections on these two industries, and less than 2% on healthcare workers. She notes that there are different standards or triggers to prompt inspections in these industries. “Manufacturing plants on the targeting list, for example, aren’t selected for a possible inspection unless their DART rate* is 7.0 per 100 FTEs or greater. Nursing homes in contrast, have to have a DART rate of 16 per 100 FTEs or greater to “make the cut” for a possible inspection.
*DART: days away from work, restricted-duty or transfer to a different job
Related
NCCI study on safe lifting programs for long-term care facilities