2. On-Site Industrial Health…
The “Sports Medicine” Model of Care
Traditional Onsite Industrial
Health
Athlete
Athletic Trainer Coach
Team
Physician
Employee
Expert
Clinician
Supervisor
Occupational
Medicine
M.D.
5. Our Mission
Divine Savior Healthcare’s On-Site Health
Team views your employee as an
“industrial athlete”, an integral asset to
your company’s overall success.
Our focus is on prevention and early
intervention of musculoskeletal disorders.
6. Goals for On-Site Care…
Endorsed by OSHA & WI Safety Council
Improve communication between the Employers / Employees & the
Medical Community
Improve efficiencies of healthcare decisions by Employers/Employees
Decrease healthcare costs for the Employer
– Direct and indirect healthcare costs
Pro-active vs. Reactive Medicine
7. Injury Management
Trained Industrial Rehab Clinicians
Injury Assessment
Manage Musculoskeletal Disorders
Job Site Analysis
Certified Ergonomic Assessment Specialists
Case-Management
Coordination of return to work
Promotion of workplace safety
8. Industry Concerns…
With MSD’s
OSHA Recordables
Lost Time
Lost days
Restricted days
Decreased Production
Work Comp Payouts
Insurance Utilization
Indirect costs
9. On-Site Industrial Health
Prevention
Ergonomic Intervention
Personal Ergonomics
Injury Assessment
ON-SITE Presence
10. Prevention
Taking care of the “Industrial Athlete”
through prevention and early
intervention
– Education / Orientation
Stretching & Conditioning
Proper Lifting
Posture
– Identifying Risks / Issues that can
lead to an MSD
Job Site Analysis
Body Mechanics
– Wellness
Fit for work – Fit for life
11. Mechanics of Movement &
Injury Causation
Personal Ergonomics
– Dynamic Posture &
Positioning
– Efficiency of movement
Job Engineering Strategies
– Cost effective measures
Easy to Implement
12. Assessment of the
Employee
Early intervention & recognition
Work & Non-Work Related
Management of the MSD
Home Exercises / Education
In-House Duty Modifications
Monitoring & Follow-Up
Referral
– When appropriate based on
condition / severity
Documentation
13. Our Approach….
Employee Interaction
– “On the Floor” – A Shift in Culture
Building Rapport
Assessing the Job
Brief & Efficient
Minimized Production “Down”
Time
– Private Consult When
Appropriate
Supervisor Interaction
HR / Safety Interaction
Compliments Company Safety
Programs
14. Early Intervention Impact…
Decrease Worker Compensation Payouts
– Lateral Epicondylitis (Tennis Elbow) Common $$’s Associated
Medical Appointments (Physician) $300
Prescription Medications $100
Physical Therapy Care (8-10 visits ) $2000
Diagnostics (MRI / X-Rays) $1500
Total = ~ $4000
On-site Early Intervention : Proactive Care
No Workers Compensation Payout
15. On-Site Industrial Health
Additional Benefits
Decreased Staff Turnover
– Decreased Training Costs
Decreased Absenteeism
Increased Employee Morale
Improved Work Conditions
Focus is on the Employee
16. Onsite Industrial Health
The “Sports Medicine” Model of Care
Early Recognition
– Building a Relationship with staff
– Onsite visibility
– Early identification & management of MSD’s
Efficient
– Onsite time used effectively and appropriately
– On the floor presence - private consults when necessary
– A Shift in Culture
Collaboration
– Physician Relationships
– Return to Work Restrictions
– Direct Communication
– Ambassador to the medical community
Cost Effective
– This model of care can save dollars in both work comp.
claims and indirect insurance costs
18. Employee
Injury
Report to
Supervisor
Employee
Receives
Medical
Attention
Follow Up
Appointment
Follow Up
Appointment
Start Physical
Therapy
Follow Up
Appointment
MRIReferral
6-8 Weeks
Return to
Work
Cost $$$$
Work
Assignments
Staffing Issues
Prescription
Recordable
Injury
Restrictions
Job
Accommodations
Communications
? Employee
? Supervisor
? Safety Coordinator
? Physician
? Clinician
Case Management
19. Employee
Injury
Report to
Supervisor
Employee
Receives
Education /
Home Exercises
Follow Up
2 - 4 days later
Not
Recordable
No Lost Time or
Work Restrictions
Cost
Frequent
Communications
PT is on floor or
notified
Short Term Duty
Modification
Communications
Employee
Supervisor
Safety Coordinator
Physician
Clinician
Follow Up
2 - 4 days later
Communication
with Supervisor &
Safety
Rapport with
Employee
20. COMMUNICATIONS
One of the biggest benefits of this program
Interaction and trust with staff
Connection with others on Case
Management
Keeping current with injury progress
Work related / non-work related
Proactive before injury becomes WC
21. Work Related Injury….
1) Employee Injury
2) Reported to Supervisor
3) Medical Attention (Available appointment or utilizing the Emergency
Department)
4) Report Filed
5) Get/Request Restrictions
6) Prescription Given (now Recordable Injury)
7) Accommodations
8) Follow up visit with Provider (1 week)
9) Follow up visit with Provider (1 week)
10) Continue Restrictions/Accommodations
11) Start Therapy (3 weeks after DOI)
12) Follow up visit with Provider (2 weeks)
13) Continue Therapy
14) MRI (6 weeks after DOI)
15) Determines no further treatment
** This case is Work Related, Recordable, Employee on Restricted Duty for 45+ days,
cost of injury = approximately $4,000
22. Sports Medicine Injury….
1) Employee Injury
2) PT on Site or notified of injury
3) Evaluates Injury
4) Home Exercises, Education, Ice/Heat
5) Checks back with Employee (2 – 4 days later)
6) Reviews Body Mechanics on Job
7) Consult with Supervisor
8) Weekly review with Safety Coordinator
9) Checks back with Employee (2 days later)
10)Revises exercises/instructions
11)Checks back with Employee (2 days later)
12)Employee is better (7 – 10 days after DOI)
** This is NOT a Worker’s Compensation Claim, Employee Does
Not Miss Any Work, Cost of “On-Site Industrial Health Program”
24. Managing the Claims
Although the number of Recordable
Injuries has remained relatively the same
This program has allowed us to “Manage”
the incidents
Restricted days from over 1,000 to less
than 100 days annually
Lost time days from over 300 to less than
25 days
Direct WC cost averaged $100,000 –
reduced to $30,000
25. We Are All Pieces of the
Puzzle in Case Management
On-Site
Industrial
Health
Physician
Supervisor
Safety
Coordinator
Employee
Wellness
Program
Communication
Light Duty
Ergonomics
26. “The Sports Medicine program has greatly
reduced our staff time away from work due
to injury – it has also freed up some of my
time as they follow-up on individuals with
work injuries and act as liaison between
administration, the physician, and injured
employee.”
Cindy – Director of Aging Services
27. “DSH has a really nice program for helping
employees who either have an injury from work or
best of all, not injured on the job. It helps the
employee with an injury to recover faster and
teaches employees strengthening exercises so
hopefully it won’t happen again.
Jim has always worked with me and each week he
not only checks up on me, but others to see how
each and everyone is doing. Jim has a very
positive and upbeat attitude.”
Thanks Jim and DSH
Joy - Employee
28. The program has been helpful for me
primarily because the ATs usually know the
case well prior to the pt coming to see me
and so they are able to often give me useful
information relating to both physical and
psychosocial factors.. If I learn that the AT
has already had the pt on restricted work,
then I would be inclined to order PT sooner,
and that may speed things along.
Dr. Oh - Occupational Health Physician
29. Early Intervention Impact…
Pro-active – on the floor presence
Assessment of the injury and the ergonomics
Communications with all parties involved
Relationship with staff
Managing the case
Following the progress of treatment
Education, exercises, start at a much earlier stage
Reduces WC claims, staffing issues, and COST
Before the implementation of this program, a typical strain or sprain injury went like this:
The employee would get hurt and report the injury to their supervisor. The supervisor would send the employee for medical attention OR the employee would go for medical without telling the supervisor of the injury. Typically the employee has to wait for an appointment or they will go to the Emergency Room for treatment. The ER normally treats serious injuries, get you stable and then have you follow up with your normal physician. Their focus is not on the treatment of strains or sprains. So typically a prescription is written for pain (even though over the counter pain medication may have been enough) and the employee is told to “take it easy or rest” until they get in to see the doctor. NOW we have a recordable injury to report to OSHA and a $500 injury instead of a $100 or less.
Once this occurs it becomes a “slippery slope” with job accommodations, staffing, doctor’s appointments, follow up, more restrictions and more follow up appointments.
There are times when this type of treatment and follow up care are absolutely necessary but not always, not for the typical strain or sprain.
Another part of the injury process is communications. IF the employee reports the injury to their supervisor right away; IF restrictions and paperwork are given to the employee or sent from the ER; IF the employee lets you or their supervisor know when the next appointment is and where the follow up paperwork is; etc, etc. Are things being lost in the translation?
OK, let’s look at the same type of strain or sprain injury utilizing the “Sports Medicine Program”. The employee has an injury and reports it to their supervisor OR directly to the clinician who is on the floor. “Hey Steve, as long you are here, my back is bothering me. I was helping Fred back into bed yesterday and I didn’t think much of it at the time but this morning it really hurts.” Can you guess where this one is going?
If the employee doesn’t make the direct contact with the clinician, then as soon as the supervisor or myself, the safety person, hear of an injury, we contact the clinician and ask them to check with the employee as soon as they can. Now you have “Hey Fred, how’s your back? I hear you strained it yesterday.” Fred, likes Steve, he sees him on the floor all the time. Steve has Fred show him where it hurts, what he was doing (ergonomic issues). He gives Fred a couple of stretching exercises to do at home, advises him to put ice on his back every couple of hours and to be more aware of how he is lifting or reaching. Steve checks back in a couple of days.
In the mean time, Steve has talked to Fred, has checked with the supervisor, has let me know how Fred is and if necessary refers or consults with the doctor. Everyone is in the loop, the employee gets better quickly and this is not a recordable injury. The communications part of this program has become a huge benefit as the clinician becomes the central communications of the case.
Therapy normally was started about 3 or 4 weeks into an injury. After it becoming a recordable claim, after restrictions.
Now therapy is there at the beginning
So what has this program done for us?
No under recording of claims but significant reduction in restricted and lost days which results in cost savings both direct and indirect. This has been a consistent trend, not just a blimp on the radar. Nearly 100 non-work related injuries were treated by the clinician and perhaps prevented from becoming a work related issue.
This is not a “stand alone” program but an important piece of the puzzle that helps the other pieces fit together better.
It is managing the cases, its making that contact with the injured employee at the beginning, early intervention, building a relationship, having a presence, interacting with the employee. This program has been very successful for us with positive feedback from employees. I has developed to the point where employees are directly contacting the clinician to find out when they will stop by again.
