MWCEA Conference

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MWCEA Conference Ocean City, Md September 23,
2003 Presented by Jayne Gribble, PT
PFS Jayne.F.Gribble_at_medstar.net
New Perspectives in Work Injury Management
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The single most powerful and sensible
strategy for decreasing the cost of doing
business and managing work injuries is PRIMARY
INTERVENTION

• The PROACTIVE Prevention of the Initiation of
  Injuries
• Injuries CAN be Prevented
• You Break It You Buy It

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Primary Intervention can Reduce Lost Time Days
60-70 - a Significant Return on Investment
A Kemper Insurance study revealed 68 savings
when direct therapy costs and lost time are
calculated
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The Cost of Breaking ItShow Me the Money

• Direct cost of workplace injuries increased by
  2.5 in 2002 (Liberty Mutual Work Place Safety
  Index)
• Between 1998 and 2000 the direct costs grew
  faster than the rate of inflation (Consumer Price
  Index)
• The frequency of disabling injuries fell by 1
  for the same period (Bureau of labor statistics)
• Indirect costs total between 3 and 5 for
  every 1 of direct cost.

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With costs rising the way they are, shouldnt
there be a renewed emphasis on services that
provide value above and beyond traditional
clinical services??
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Value Propositions

• Identifying risks on an ongoing basis
• Reduces the frequency and severity of injuries
• Lost time is reduced because injuries dont have
  the opportunity to progress to the point of
  significant tissue damage and inability to
  perform duties

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The current clinical model is like Pushing the
Rocks up the Hill
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A Relatively Small Number of Injuries Consume the
most Resources

• The top three injury categories accounted for
  51 of the direct costs in 2000up from 46 in
  1998.
• The top 10 categories accounted for 89 of the
  direct costs in 2000up from 86 in 1998.

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The Top Three Injury Categories Increased in 2000
17 increase in slips falls
12 increase in lifting injuries
13 increase in body position/use
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The Golden Rules for Supervisors
Learn to identify unsafe work practices and
workstations be a good role model
Improve new worker selection and hire smarter
Communicate with and support your human resources
Identify power struggles and adversarial
interactions early and learn to resolve conflicts
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Primary Intervention Strategies

• Wellness programs
• Job task analysis
• Pre-placement screen as Fit For Duty/Work

• Worker safety check
• Work risk analysis
• Education and empowerment

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Worker Safety Check

• Individualized
• Proactive prior to a report of injury
• Worker or supervisor initiated
• Looks both at work practice/behavior and the
  specific work flow/set up
• Specific recommendations and follow up

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Work Risk Analysis

• Comprehensive look at a job class or a specific
  group of workers
• Worker, supervisor or data initiated (i.e. injury
  trends)
• Specific recommendations regarding work flow, set
  up and risks by body part/region
• Worker education must be stressed

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Worker Selection

• Concept we all use our bodies to earn a living
• When being fit is a basic job requirement or is
  inferred by the description doesnt it make sense
  to establish a minimum standard for fitness and
  ability?
• Do we want workers who are capable of performing
  their duties without undue risk of injury or
  fatigue?

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Worker Selection

• We can relate fitness to the ability to perform
  essential job functions
• We can also educate individuals to relate fitness
  to work and know their
• health risks.
• Job tasks such as lifting/carrying and
  pushing/pulling require components of health such
  as strength (both absolute and dynamic),
  endurance and cardiac fitness.

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Fitness Trivia the Bad News ?

• Americans continue to deteriorate this
  effects general healthcare as well as workers
  compensation costs
• 64.5 are officially overweight/obese according
  to BMI (25-30 is overwgt., gt30 obese)
• (BMI wgt. x 703 / hgt. squared)
• 2. Type 2 diabetes has reached pandemic
  proportions
• 3. CVD remains 1 killer for both males and
  females

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Worker Selection

• A Job Task Analysis is CRITICAL to the selection
  process.
• Identify essential/core tasks
• Determine frequency and criticality
• Determine the fitness factor behind each task
• Screen MUST be job-related but does not have to
  be simulated

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Worker Selection

• Tests, standards and programs are meant to and
  can discriminate if job relatedness is
  established and documented.
• Are companies ethically responsible for hiring
  and retaining employees who are physically
  capable of performing essential functions?

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Worker Selection - Considerations

• Combine with education, wellness and empowerment
• Adverse impact may occur but is not illegal since
  the skills are job-related
• Implies emphasis on fitness post-hire as well
  change in company culture
• What are the consequences of being unfit for
  duty??

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The Process

• Informed consent -employment contingent
• Fitness assessment part of pre-employment
  physical
• Musculoskeletal factors such as flexibility and
  body mechanics cannot be used to discriminate but
  are useful for education and motivation
• Absolute, dynamic strength and aerobic fitness
  tests can discriminate

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The Results Options

• Reported to Human Resources
• Response based upon established company policy
• Hire without bias based upon results
• Hire with bias retest near end of probation
  period
• Offer placement in more appropriate position if
  available
• Reasonable accommodation may apply

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Fitness Trivia the Good News ?

• Exercising to increase your heart rate 30 minutes
  a day three days per week will reduce your risk
  of death from CVD and cancer by 50-58
• Increasing the intensity of your current workout
  by 50 will improve your fat loss by 53
• Source Cooper Aerobics Institute

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• If Your PRIORITY the creation and maintenance
• of a fit and healthy workforce you can
• Decrease costs associated with work injuries
• Decrease costs associated with general healthcare
  and disability BUT

If you keep doing what you have always done you
will keep getting what you have always got. Do
you like what you have been getting?
Thank You