by Dr. Ann Hawkins
Whether your municipality, organization or corporation is large or small, has a phenomenal safety program, has new or tenured year employees, workplace injuries unfortunately occur.
A story from a municipality Risk Manager….
After a brief time on the job with a municipality, a risk manager was walloped with a hefty premium increase in work comp coverage. This was the primary impact of a spike in the municipalities’ Experience MOD. Specifically, the increase was a result of Worker’s Compensation frequency, as opposed to severity. Long story short, it was the replication of too many visits to occupational health care clinics and even the dreaded emergency room for incidents which could have been treated with first aid or home care.
Looking deeper into the issue and talking with several employees, the Risk Manager realized the policies were strong but, much of the burden to determine care was on supervisors, who are not medically trained professionals to make clinical care determinations. Policy directed injured workers to report injuries to their supervisor, who is tasked with both documenting and essentially triaging medical needs of the employees. This led to most supervisors erring on the side of caution and directing the employee to clinical care for a majority of reported injuries.
The municipality was averaging over 65% of reported incidents resulting in clinical care. More troublesome was late or absent notification to risk management of the injury. Little or no consideration was given to associated costs of clinical care (emergency room treatment versus clinic). Realizing this was not the recipe for a world-class workplace injury program, the municipality began its quest to change this culture.
The municipality partnered with a nurse triage provider to serve as a central contact for all injuries, except those needing immediate 911 care. The result has been approximately a 40% decrease in clinical care visits and most importantly, a landslide decrease in emergency room visits. In just 2 months of the previous year, the city experienced 9 ER visits as opposed to only one for the same period after the service was adopted. Additionally, Risk Management is notified of the incident within 10 minutes of the employee contacting the nurse triage line.
The employees were initially resistant to change; however, the program was quickly embraced by all. Employees are very pleased about the fact they have access to a registered nurse 24/7/365 for workplace injury assistance. Supervisors are very relieved that the program shifts liability from them in directing medical care. Additionally, the city worked with the nurse triage provider to customize employee calls to populate our Supervisor Report of Injury form which was previously required from the supervisor.
This program has assisted in changing our culture related to workplace injuries.
Industry trends have shifted toward less robust personal health care plans for employees. As personal benefits decrease, employees turn to other available resources to assist them in receiving medical treatment. This is an unfortunate, yet real, challenge which impacts the worker’s compensation program in the future.
Having a strong program in place for workplace injuries proves to be a tremendous resource to prevent erroneous claims. The implementation of a nurse triage program is a step in the right direction, and not using this resource to help manage Worker’s Compensation claims is fiscally irresponsible.
