Hospital saves $650,000 in workers’ comp costs
Hospital saves $650,000 in workers’ comp costs
Ergonomics is more than a buzzword
You hear enough about ergonomics these days that even Dilbert might be proud to know some attention is going toward improving the workplace. But ergonomic emphasis on wellness is more than a buzzword, and it can save you a bundle in workers’ comp costs.
That’s what officials at the 290-bed St. Camillus Health and Rehabilitation Center hospital in Syracuse, NY discovered. These were their hospital-based workers comp statistics three years ago:
• annual losses of $750,000;
• more than 20 of its 650 employees out of work at any given time.
"There was no light duty program and no one was managing the injuries," says Gina Emerson, OTR/L, risk manager for St. Camillus. "No one knew if anyone was out or back. No one was trying to prevent the injuries."
Faced with escalating annual insurance pre-miums and a possible loss of workers’ compen-sation insurance, St. Camillus decided to restructure its approach to workers’ compensation based largely on Occupational Safety and Health Administration’s (OSHA) ergonomic workplace proposals. The result has been a wholesale change in the way St. Camillus approaches workplace injuries and workers’ compensation. It also has helped the facility realize a $650,000 cost savings in its first three years, Emerson says.
St. Camillus’ program relies heavily on the education and training of its employees about how to keep the workplace safe and their own bodies injury free. Each new employee gets three hours of training on the subject, which includes information about anatomy, physiology, and pathophysiology of injuries, as well as job-specific training in body mechanics and the proper use of workstations. Wellness sessions and continuing safety education programs also are provided on a regular basis.
Emerson says the goal of this type of education is to make employees understand how the body can perform functions safely and, conversely, what motions cause injury. Supervisors also are trained to understand the job-specific considerations of injury prevention. This training enables supervisors to become more active participants in risk management.
A key component behind the program’s success was an initial worksite analysis throughout the facility based on ergonomic risks. (See story, p. 136, for a list of risk factors and ergonomic hazards in the workplace.) When the program began in 1993, Emerson and her team surveyed every department in St. Camillus to identify potential hazards and ways to prevent injuries.
For example, in the kitchen at St. Camillus, Emerson determined all the physical demands of working in that department. They included lifting containers of food weighing up to 25 pounds, reaching, bending, and squatting, all of which were potential sources of injury. Her solution was to move all of the heavy food containers to a mid-level storage shelf in the kitchen so that no one would have to bend, lift, or reach when moving those items.
In addition, Emerson found that the food preparation staff often spent long hours bent over tables, which was a potential source of a back injury. The solution was to raise the height of the tables to eliminate the need for bending.
St. Camillus also received the authorization to purchase one mechanical lift per month for patient transfers. Each nursing unit now has at least two lifts. Emerson used simple arithmetic to convince the hospital’s administration to fund the purchases. "If we were looking at $750,000 in losses and each lift costs $1,500 and each back injury cost us $30,000, getting the money for the lifts was no problem," she says.
Analysis depends on employee input
Workplace analysis for potential injuries is continuous. Emerson and her safety team rely on the employee input and injury tracking to identify other hazards in the facility and solutions. For example, if they notice that six employees were injured transferring a particular patient, the safety team will analyze the best way to transfer that patient.
If the team determines a mechanical lift is needed, Emerson will ensure the department where that patient is located has one for transfers. Once the need is established, she makes the use of a mechanical lift mandatory. Employees violating the rule can be subject to discipline.
She says that no complaint should be dismissed. Even complaints about headaches or allergies are investigated for potential causes.
"The key is responding to employees," she says. "Even if it is just one complaint, we respond. That is part of the key to success: We listened to what our employees had to say because we knew they knew what the unsafe jobs were."
Engineering changes reduce injuries
In addition to safety training and workplace hazard analysis, St. Camillus also instituted some engineering changes to try to prevent workplace injuries. In the name of safety, these changes prevent employees from circumventing extra steps.
Emerson cites meal carts as an example. St. Camillus serves 1,000 meals each day on stackable trays in carts. She noticed that some food service employees stacked the carts too high, creating a risk that the trays might fall on the employees or passersby or that someone might slip on food spills. Despite these identified risks, Emerson says, the employees did not respond to her warnings about overstacking.
As an alternate solution, the maintenance department created a bar across the top of each cart to prevent overstacking.
Once potential hazards and solutions were identified, St. Camillus also instituted rules requiring employees to follow ergonomically correct procedures. The rules cover a range of issues, from the transfer of specific patients to general procedures for all employees. Employees who do not follow the work practice controls are subject to discipline.
"If an employee goes into a resident’s room and knows that the resident is one who must be transferred with a mechanical lift and then does not do that, they have to be disciplined for not following policy," she says.
All injuries are investigated for corrective action. Emerson makes suggestions for discipline, but only supervisors have the authority to actually discipline employees.
In addition to the money saved through fewer workers’ compensation losses, Emerson says the program has helped improve employee morale and reduce employee turnover. "We feel that we are one of the safest facilities to work in in central New York. We think that attracts better staff and helps to keep people here longer."
Ergonomic hazards in the workplace
St. Camillus Rehabilitation Center in Syracuse, NY, has identified ergonomic workplace hazards based on back disorders and injuries caused by cumulative trauma disorders.
Back disorder risk factors include:
• bad body mechanics, including continued bending at the waist, continued lifting from the knuckle or from above the shoulders and twisting at the waist, especially while lifting;
• lifting or moving of objects of excessive weight or asymmetric size;
• prolonged sitting, especially with poor posture;
• lack of adjustable chairs, footrests, body supports, and work surfaces at workstations;
• poor grips on handles;
• slippery footing.
Cumulative trauma disorder risk factors include:
• repetitive and/or prolonged activities;
• forceful exertions, usually with hands (such as pinch grips);
• prolonged static postures;
• awkward upper body postures, including reaching above shoulders or behind the back and twisting the wrist to perform a task;
• continued physical contact with work surfaces;
• excessive vibrations from work tools;
• inappropriate or inadequate hand tools.
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