By employing four key strategies, mills can better manage safety and workers' compensation issues, and in turn control costs

Once an Accident Happens, the Key Is To Manage the Process Effectively

This month, we look at the four post-incident strategies. Companies that perform all eight of these functions well and in a coordinated fashion can benefit from major direct cost reductions associated with safety and WC, as well as indirect cost reductions related to productivity, absenteeism, and turnover.

Incident Management. Incident management involves two steps. The first is to provide immediate treatment to the injured employee, with the level of treatment being dictated by the seriousness of the injury. It may only require first aid, or it may require ambulance service to a hospital emergency room.

The second step is to investigate the accident, identify the cause(s), and implement appropriate measures to prevent a recurrence. "Whenever an accident occurs, the supervisor must file

a written report within 24 hours," states Tom Churbock, workplace safety coordinator for Appleton Papers Inc., Roaring Springs, Pa. "This is a five-part form, and the employee receives one of the copies."

The employee must review the document and eventually sign off on the investigation. "The employee must be in agreement with what happened, but more importantly, what measures should be taken to prevent it from happening again." Appleton Papers, in fact, provides more space on the document for prevention information and how to communicate this information than it does for a description of what actually happened.

"During our accident investigations, we look for root causes," states Franklin Ikard, human resources manager for Pope & Talbot, Inc., Halsey, Ore. "We review these at our quarterly employee safety meetings and at our monthly central safety committee meetings to make sure that corrective action is taken." (Rather than schedule one-hour employee safety meetings each month, Pope & Talbot schedules half-day employee safety meetings each quarter.)

Jim Bergeron, director of safety, health and loss prevention for Consolidated Papers, Wisconsin Rapids, Wis. takes accident investigation a step further. "We investigate all OSHA-recordables, all first aids, and all near-misses.

"The purpose of the investigations is not to place blame, but to identify causes, then find what system within the organization failed." The "organization" consists of management, supervision and employees. "For an incident to have occurred, there must have been a system failure in at least one of these levels," he adds.

Physician Selection and FOLLOW-UP. Employers who allow their injured employees to visit their own family physicians for treatment and do nothing else are often robbing themselves of substantial cost savings. While some states require employers to allow injured employees to seek their own primary care physicians, all states allow employers at least some level of input into which physicians employees will see. Cost-conscious employers take care to iden-tify occupational physicians whenever possible–physicians who understand workplace injuries and understand the therapeutic (as well as cost) benefits of getting injured employees back to work in a timely fashion.

Such employers also try to arrange to have these physicians visit their worksites to see the nature of the work and communicate with physicians during treatment of injured employees. "We get to know the medical providers in our communities where we are located and bring them into our plants to see the types of potential hazards we have, the injuries we might expect, and the opportunities for restrictive duty when employees are recovering," states John Hayden, director of health and safety for International Paper Co., Memphis, Tenn.

Appleton Papers' Churbock notes that employees working in plants in small communities generally have permission to be treated by their family physicians, because occupational physicians and other specialists are often not available locally. However, this does not prevent the company from ensuring that its employees receive the best medical care possible if it is only available outside of their region. Recently, for example, the company arranged for an employee with a crushing injury to the foot to visit a world-renowned orthopedic surgeon in another state who specialized in treating such injuries.

Case Management. There are several elements to case management. Virtually all of them revolve around communication among the various "key players" in the process: the employer, the insurance carrier (or third-party administrator), the physician, and the employee. "We use technology to speed up our claims as much as possible," states Appleton Papers' Churbock. "Claims are in the process within one day of injuries being reported." Each plant also has a monthly conference call with risk management specialists at corporate headquarters (Appleton, Wis.), the corporate medical director, the insurance carrier and their claims people. "We discuss the progress of each case in detail," he states.

One of the most important elements of an effective case management program, and one of the most often overlooked, is the personal communication between the employer and the injured employee. Employees who fail to receive this communication often experience a range of negative emotions–confusion and alienation that no one has bothered to call or visit to see how they are doing, fear that they will no longer have jobs when they are ready to return, and even anger at being ignored. The latter can often lead to cases of malingering (remaining out of work longer than is medically necessary) and even the desire to bring an attorney into the picture. "We communicate on a frequent basis with our injured employees," reports Pope & Talbot's Ikard. "We send them copies of our daily newsletters. Supervisors and department heads also make frequent contact with them to see how they are doing." The company's HR department also maintains regular contact to discuss opportunities to return to light-duty work.

Return-to-Work Programs. While some companies simply wait until physicians give the "green light" for injured employees to return to full duty on a full-time basis, most companies that want to manage WC costs implement return-to-work programs. Such programs involve communicating with treating physicians to see how employees are progressing. Then, they make available a number of different, less strenuous jobs that employees can perform before they return to full capacity. Often, these jobs are in different departments and/or may be for fewer hours each day. Such programs are often called "transitional duty," in that they allow recovering employees to "transition" back into their regular jobs. While there is no question that return-to-work programs save money for employees, they also benefit the employees themselves. Not only do employees have the opportunity to return to work more quickly and thus receive full-time pay, but they can reestablish their social setting in the workplace–which most employees miss when they are not working.

"We have a very aggressive return-to-work program," states Pope & Talbot's Ikard. "As soon as a physician will allow an injured employee to perform some type of work at all, we will bring that employee back." Each employee signs a contract spelling out the terms and conditions of the work being provided to them, the estimated duration of that work, and the fact that the employee needs to work within the medical restrictions in order to prevent reinjury.

"We want to return employees to work as soon as possible in order to perform work that is mutually beneficial to the employee and the company, based on the medical restrictions outlined by the treating physician," states Consolidated Papers' Bergeron. "Once we know what an employee is capable of, we will determine if we have such work available within those restrictions. However, we will not create ‘sheltered employment' where an employee is brought back to sit in a corner for a day to say he was working."

"When we bring employees back to work, we monitor their progress," states Michael Sullivan, director of corporate communications for Potlatch Corp., Spokane, Wash. "As they are able to do more heavy duty work, we move them along, but always under appropriate medical supervision."

"We offer a return-to-work program," states Neal Leonhard, corporate manager-safety and workers' compensation, Miamisburg, Ohio. "We return employees to productive work as quickly as possible through return-to-work programs that bring them back to full productivity by providing them with work that will help them rehabilitate. This could involve a series of tasks from several different jobs."

"We find that the return-to-work program is mutually beneficial," adds International Paper's Hayden. "It not only reduces our WC costs, but helps to keep the employee productive."

Results. Employers that implement comprehensive safety and WC cost management initiatives reap significant savings in areas of safety, WC, productivity, absenteeism, and turnover. Below are some examples from successful implementation of safety/workers' compensation strategies :

• "We have seen some meaningful reduction in the number of accidents we have had over the years," reports Appleton Papers' Churbock.

   

• "Our WC rates are quite low, and we have been able to keep serious injuries to a minimum," reports Pope & Talbot's Ikard.

   

• "Over the past two years, we have seen some exciting initial progress in the reduction of the frequency and severity of injuries," notes Mead's Leonhard. "A secondary benefit has been a reduction in our WC costs. We still have a long way to go to be considered a leader in our industry, though, and we are working hard to achieve this."

   

• "In the last five years, we have seen a major improvement in our safety performance across the whole company," states Potlatch's Sullivan. "We have also seen a 4.5% reduction in overall health costs. Both of these have helped to provide significant reductions in our WC costs."

   

• "In the last ten years, we have improved our safety performance by 75%, resulting in 75% fewer injuries in 1998 than in 1988," states International Paper's Hayden. "In fact, some of our plants have worked for many years without any lost workday injuries. Two of our large facilities have worked over a year without even one OSHA-recordable. They are at 16 months and counting."

   

Mr. Atkinson has been a professional business writer since 1976, and resides in Carterville, Ill.