January 26, 2001
UPDATED APRIL 2002
Incident
Intervention-- A Powerful Resource in Loss
Control for Health and Safety Managers
Peter P. Greaney, MD
Board-Certified Occupational Physician
President, WorkCare
For most health and
safety managers, work responsibilities encompass
more than complying with OSHA standards and
overseeing tailgate meetings. Aside from
ensuring a safe and healthful workplace,
managers must keep a close eye on the costs of
their programs. They must identify and establish
best work practices that maximize company
resources and integrate cost-avoidance
strategies.
To help meet this
challenge, incident management services are
available from qualified doctors, nurses and
outsourcing firms. These services are designed
to support company safety goals and
targets--while reducing runaway-costs associated
with workplace injuries/illnesses.
This practice--also known
as Incident Intervention©--generates positive,
and measurable results that cut lost-time
accidents, reduce the number of OSHA recordables,
lower workers' compensation costs and return
recovered employees back to work in an expedient
manner.
Incident Intervention is
a two-phase process, involving pre-loss and
post-loss services. Pre-loss Incident
Intervention focuses upon using protocols to
minimize the escalation of the incident,
reducing the risk that it becomes a workers'
compensation claim, lost work day(s) or OSHA
recordable.
In this phase, the
supervisor notifies an occupational doctor or
nurse upon the occurrence of an accident. The
supervisor provides information on the type,
possible cause and scope of the incident. The
occupational physician provides responsive
evaluation of the incident, determines the most
appropriate course of action and consults with
the treating physician to design a quality care
treatment plan that meets the needs of the
employee and employer--in cases where the
incident is work related.
The physician used to
provide this service should be experienced in
incident management. The doctor should have the
expertise and training to serve as a
"medical advocate" for the employee,
recommending the "right" treatment
plan that ensures appropriate patient care,
while returning the employee to work as early as
possible.
How Incident
Intervention Works
This common back injury
case illustrates how Incident Intervention
works. A worker injured his back while lifting
an object at a job site. The supervisor
responded by sending the employee to a clinic.
The clinic's doctor determined that the worker
suffered a mild back strain and prescribed
prescription-strength Motrin for one week. The
doctor sent the employee back to work, but the
treatment he prescribed caused the incident to
be an OSHA recordable injury, as defined in
OSHA's revised recordkeeping rule (29 CFR 1904),
which went into effect on January 1, 2002 .
One of the key provisions
of OSHA's recordkeeping rule is the revised
definition of first aid. Understanding what
constitutes first aid is critical because "
any medical treatment that goes beyond first aid
meets the general recording criteria and is thus
recordable. "
The rule states:
"For medications available in both
prescription and non-prescription form, a
recommendation by a physician or other licensed
health care professional to use a
non-prescription medication at prescription
strength is considered medical treatment for
recordkeeping purposes ."
A doctor with expertise
in incident management could have
"intervened" to use their medical
expertise to look at the full range of treatment
options-some which may not be OSHA recordable.
The doctor's goal is to provide workers with
appropriate, effective care, while never losing
sight of how their medical decisions affect
employers.
And the key to successful
Incident Intervention is to establish contact
with an occupational physician as close to the
time of injury as possible. There is a real
window of opportunity to affect the outcome of a
case. The sooner an occupational physician gets
involved, the greater the impact that doctor can
have on the case.
The post-loss phase
(after incident) is aimed at returning a
recovered employee back to work as quickly as
possible. Employers should consider adopting
disability-management systems that use a
proactive approach to return employees back to
work. These systems are critical in reducing
workers' compensation and other disability
costs. Research indicates that most companies
experience a 25-30 percent reduction in
disability costs in the first year after
implementing a disability-management system that
includes return-to-work programs.
Such programs include
"transitional employment," a process
in which the employer and employee agree on a
scheduled plan with incremental steps (duration,
production speed, lift capacities and other job
functions) that are designed to encourage the
full productivity of a returning employee.
Transitional employment
is not light duty. It is a process in which the
employee has expressed the desire to return to
full capacity work or the treating physician
recommends a return to work. In transitional
employment, the employer and employee agree to a
working plan that allows the employee to work at
a level that is safe and tolerable. An
occupational physician can assist in setting up
this plan.
Incident
Intervention Versus Typical Patient Treatment
Typically, a physician
will rely exclusively on the employee 's
perspective to determine if the worker should
return to work. Without input from the employer,
doctors often prescribe time-off for
work-related injuries.
Through Incident
Intervention, corporate medical directors who
work on behalf of clients can consult with the
treating physician to establish alternative
patient treatments. The corporate medical
director will ask the treating physician what
type of work the employee can perform and
recommend a modified work plan-instead of time
off. These "doctor-to-doctor" calls
have proven to be effective in reducing workers'
compensation claims, preventing lost workdays
and getting the employee back into a productive
role.
The Disability
Mindset
Occupational doctors have
reported that it takes less than a few days for
a person to buy into the
"I-can't-work-syndrome."
"Getting employees
back to work as quickly as possible helps avoid
the disability mindset," said WorkCare
Physician Dr. Peter Wald.
Measurable
Results
Mike Luker ,
Industrial Hygiene Manager for US Filter,
discussed the benefits of Incident Intervention.
According to Luker, his company has avoided 8-10
lost-time accidents a year by using this
practice.
"In most cases,
employees are back to work on restricted or full
duty. This is a service our workers'
compensation carrier can not perform," he
said.
Insurance companies only
provide case management services after an
incident becomes a claim and they have been
informed, which is typically 6-10 days after the
incident.
Summary
Incident Intervention
provides critical resources that support health
and safety corporate goals-providing managers
with measurable results in cost avoidance.
If you would like further
information on Incident Intervention, please
contact www.workcare.com
or email info@workcare.com
.
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