WCRI’s 35th Annual Issues & Research Conference Part 2

WCRI Session 4:

Unions and Management: Creating A Successful Return-to-Work Program

Moderator: Andrew Kenneally, WCRI

Speaker: Dr. Cameron Mustard, Institute for Work & Health

Session 4 Speakers: Photo by Y. Guibert

Evaluation of the impact of a three year organization change initiative

aimed at reducing the burden of work-related injury and illness in one
of Ontario’s largest multi-site acute care community hospital systems (HCO)
employing over 4,300 staff.

Labor relations were frictional on many dimensions.Persistent conflicts

over adequacy of OHS practices and disability management practices.

3 year plan to address issues

7 principles for successful RTW (see slide for details)

1. Workplace has strong commitment to health and safety
2. Employer makes an offer of modified work to IW to enable early and safe RTW
3. Employer ensures that the RTW plan supports the IW without disadvantaging co-workers and supervisors
4. Supervisors trained in work disability prevention and included in RTW planning
5. Employer makes early contact with IWs
6. Someone has responsibility to coordinate RTW
7. Employers and health care providers communicate with each other about workplace demands, with workers consent

2 components of evaluation plan:

Process evaluation

Qualitative interviews with supervisors and mgrs focused on the implementation of RTW

Repeated cross-sectional surveys of samples of HCO staff returned
to work following disability episode

Outcome Evaluation

Quasi-experimental design, comparing workers compensation claim
incidence and duration in the HCO to a peer group of the 29 largest
hospitals in Ontario for a 3 year period prior to and following Jan 2012.

2 annual surveys of HCO staff who returned to work following a disability episode

14 questions about process using a 5-point scale

Approx 30% response rate; overwhelmingly positive

Dr. Mustard said you could palpably feel an improvement in how union

and labor leaders interacted with each other.

Conclusions

• Both process and outcome documented successful implementation of improved policy.
• Managers, supervisors and RTW coordinators broadly endorsed the improved policy.
• Employees who returned to work following a disability episode provided mostly positive assessments across all dimensions of the disability management process. 
• While the annual percent reduction in lost-time claims was similar to reductions observed in a peer group of 29 hospitals over a six year period, the implementation of the strengthened RTW policy was associated with greater improvements in disability durations than observed in the peer group.

WCRI Session 5:

Group Health Deductibles and Workers’ Compensation

Moderator: Ramona Tanabe, WCRI

Speaker: Dr. Olesya Fomenko,WCRI

Session 5 speakers photo by Y. Guibert

Dr. Olesya Fomenko, WCRI, presented WCRI study to determine whether

or not high deductibles in group health plans increase injured workers’ propensity
to file for workers’ compensation.

According to a Kaiser Family Foundation study, the average group health plan

deductible increased from $765 in 2008 to $1,505 in 2017. During the same
timeframe, the percentage of workers enrolled in high deductible group health
plans (deductibles over $1,000) increased from less than 20% to over 50%.

• Dramatic increase in cost-sharing over past decade
• % of workers enrolled in high-deductible plans almost triple

Major Findings of the WCRI study:

• Patients respond to cost-sharing at the time of the injury, when deciding to file injuries under WC
• Impact of high deductibles is much larger for claims involving soft tissue injuries than injuries by trauma
• Increase in WC filings due to high deductibles is concentrated in states where workers have control over their initial provider choice
• Due to growth in deductible from 2008 to 2017; WC volume increased by nearly 5%
• Increase of 10% in WC filing concentrated in states where workers choose their initial provide

WCRI Session 6:

Innovative Employer Ideas

Moderator: Laure Lamy, WCRI

Speakers:

Dawn Goree, The Home Depot

Marc Salm, Publix Supermarkets

Noreen Olsen, Starbucks Coffee Company

Session 6 speakers photo by Y. Guibert

This session was a lively, rapid fire discussion with a lot of dialogue amongst attendees.

Here are some highlights of the session, some captured by comments on Twitter. Noreen Olsen: “We have adopted an advocacy model at Starbucks.”

Tom Kerr @TomKerr11 on Twitter tweeted:

Olsen: the Starbucks advocacy approach to workers’ compensation includes:

1. Establish atmosphere of warmth and belonging
2. Offer best care but be transparent of what is available, recognize employee’s feelings and listen
3. Challenge the status quo

Tweet by @IAIABC

Abandon your dogma about workers’ compensation.
~ Noreen Olson, @Starbucks Risk Management.
Just take care of the injured partner (what they call employees). Yes!

Olsen: We rely on use of nurse case manager partners because people trust nurses

and they can set an expectancy of RTW and not a mindset of permanent disability.

Olsen: Though you watch our baristas work out front, you don’t see everything

they do behind the scenes. So we created a video of our baristas’ work day so
physicians can see the total job description so they get a true sense of their RTW plan.

Dawn Goree says that Home Depot adopted the advocacy model before it was
cool. We look at the employer as a first responder for the injured worker.  It’s
not just about workers’ compensation or whether or not the claim is compensable.
More about what has happened to this associate and what needs to happen to get
them on the right path to wellness.

Tom Kerr tweeted:

Home Depot’s Dawn Goree: when there is an injury we engage a nurse case
manager. We want to be sure to be there as quickly as we can for the employee
and family to wrap our arms around them and let them know we are there to
help them navigate the workers’ comp process.

Tom Kerr tweeted:

Marc Salm of Publix Supermarkets’ successful workers’ comp program:
“I’ve grown to appreciate the role of nurse case managers and I think everyone
should get them!”

Marc mentioned Judge David Langham, on Twitter @FLJCC, as a resource for

in depth observations on Florida claims and specific statistics. Judge Langham
is a frequent contributor to WorkCompCentral. Judge Langham’s blog is here if you’d
like to follow his workers’ compensation musings.