Managing Workers’ Compensation Risks in the Healthcare Sector

At the RIMS 2017 Annual Conference and Exhibition, this panel of healthcare risk professionals discussed the most-prominent workers’ compensation challenges and solutions facing the industry today.

Speakers included: 

• Rich Reynolds, Manager – Workers’ Compensation, Providence Health & Services
• Paul Posey, CEO, Ascension Care Management
• Martin King, Director, Corporate Risk Management, Kaiser Permanente
• Mark Walls, Vice President Communications & Strategic Analysis, Safety National
• Kimberly George, SVP, Corporate Development, M&A and Healthcare, Sedgwick

Violence against healthcare workers is getting a lot of attention these days. It’s a growing problem that is hard to manage. With OSHA’s new reporting guidelines, it is gaining visibility. Kaiser created a single point of entry for reporting called a “manager’s first report”. They utilized their TPA to determine which reports become workers’ compensation claims. And claims are rising. Situations you would not think would be an issue, like an employee being traumatized from being yelled at by a patient’s family member, are now becoming claims that require modified duty. 

Ascension says that their workplace violence reports are up 60% as a result of OSHA’s new reporting requirements. They consider their responsibility to not only capture and report the incidents, but also to concentrate on better training for their emergency department, for instance, to de-escalate certain situations. Security and training is always front of mind because there are no locks on their doors. If you have the right people trained to intervene, you have a better chance of de-escalating potential violent situations and avoid these workplace violence claims.

Providence is focusing on warning and training their caregivers about potential violent situations. The growing drug problem is also contributing to these violent situations. People become very violent if denied drugs. They now flag patient charts with violent history and have created standards to follow when treating these patients. Procedures include items like having two employees enter the room for flagged individuals with past violent behaviors.

Many employers are starting to have their employees report their own claims through online forms. TPAs have found that this helps make the injured employee feel more empowered in their claim and return-to-work process. It is also a great way to capture useful data with custom codes that can be created by the employer. Some employers prefer call centers for intake so that their employees can talk to someone in person. Different self-reporting options are available, and often customizable, to match different organizational, generational and industry-specific cultures.

Reporting everything early is critical so that your claims experts can get involved up front. You typically get into trouble when you have a lag in involving the claims professionals. They need to see understand the entire situation to best manage the claim and playing “catch up” hinders their ability to do that.

Safe patient handling is also a large area of focus. Patients are getting larger, therefore, handling them is becoming more dangerous for workers. Kaiser has multiple mobile patient lifting machines, but they are not always situated properly. It is a constant challenge

Ascension found that, on average, a nurse lifts 1.8 tons per shift. It is extraordinary what these workers have to deal with. They find that the staff needs simple, fast equipment and sometimes the equipment available does not meet those needs. These workers will immediately step in to help the patient, so if the equipment is not fast, they will not use it.

Providence found that often workers have to make a split-second decision to help a patient when falling and they get injured. You cannot really mitigate those situations. For their locations, they are trying to use analytics on utilization to try to determine what equipment is being used. They want to determine what works and what doesn’t so that they are purchasing the right equipment that will work in each individual facility.

Safety for external healthcare workers is also a challenge. There are several loss control measures that have to be taken for external healthcare workers, but the risks vary significantly.

Kaiser finds this issue to be challenging. They have on-call telehealth nurses who work from home. These are 24-hour workers who have ergonomic exposures. You can’t risk engineer everyone’s home.

Ascension has created policies and training on how to work at home. It’s challenging for them because it’s important, but this is not where the large losses are, so it doesn’t always get the attention it deserves.

Providence has found extreme difficulty in sending workers on employee-sponsored mission trips to needy countries. These workers are exposed to a lot of risks. There are global insurance providers, however, that are specialists in this type of exposure.

Home healthcare is also a huge exposure. Risks range from motor vehicle accidents to various risks that come with entering someone else’s home. Auto accidents seem to yield the most claims in this area and it is often the other driver’s fault, so it is hard to build controls around that