THE JOURNEY TORETURN TO WORK
Angeli Mancuso, RN, COHN‐S/CMManager, Employee Health & SafetyCottage Health
About Cottage Health
3rd largest employer in town– 3,700 employees
3 hospitals– Santa Barbara Cottage Hospital
(450 licensed beds)– Goleta Valley Cottage Hospital
(52 licensed beds)– Santa Ynez Valley Cottage Hospital
(11 licensed beds)
1 laboratory– 25 locations between Fresno and
Westlake Village
Objectives
Costs behind absences for work‐related injuries Encouraging a rapid return — promising practices and approaches– Alternate positions– Reasonable accommodation– Other means of support
Manager/Employee engagement before an injury occurs
Definitions Lost time
– OSHA recordable days away from work
Modified duty– Not performing a piece of your job
Transitional alternate work (TAW)– Performing work that is completely different than your job
Reasonable accommodation– Performing your job differently
Interactive process– The dialogue necessary to coordinate return to work and may
involve all of the above
Why Early Return to Work?
Improved health care outcomes Improved employee/manager relationships Increased staff morale Decreased disability costs Decreased medical costs
Our Lost‐Time History
Lost Days
2017 560 (goal)
2016 622
2015 1298
2014 1953
2013 871
2012 1264
83 cases (average 7.5 days each) 5 outlying cases
– 101 (Corp)– 78 (PDL) – 71 (SB)– 63 (GV)– 46 (SB)
2016 Lost Days Employees Recordable Injuries
Lost Time Injuries
SB 312 3,036 155 42
GV 73 309 18 5
SY 27 100 11 3
PDL 97 328 22 4
Corp. 113 551 9 2
Comparing Multiple Factors
Injury Frequency
Claim Cost
Medical Cost
2012 164 $10,811 $6,710
2013 126 $9,743 $5,725
2014 138 $9,766 $4,839
2015 138 $6,345 $3,217
2016 152 $6,518 $3,017
Our Disability Costs
2016622 days lost x 8‐hour daysx $39.20 avg. hourly wage$195,059
2014 1,953 days lost x 8‐hour daysx $39.20 avg. hourly wage$612,460
$417,401
How Did We Get Here?
Culture
Communication
Persistence
How Did We Get Here? (cont.)
Early Case Management Open and clear dialogue Physician partnerships Diagnostic and imaging referrals without delay
How Did We Get Here? (cont.)
3 Tiers of Return to Work Tier 1 – TAW or modified duty assignment within the home department
Tier 2 – TAW assignment in a different department within the organization
Tier 3 – TAW assignment outside of the organization
How Did We Get Here? (cont.)
DepartmentOrganizationReEmployAbility
Where We Are Now Effectively managing absence after a work‐related injury
On the road to better non‐work‐related absence management– Initiating the interactive processes early– Employee Health & Safety and Employee Relations coordinate
communication– Encouraging manager support and communication
directly with employees
What’s Next?
Increased management training and support
Working throughremaining “lengthy” leaves —how long is too long?
TAW for disabilities not related to work injuries
Key Messages
Absence management is a complicated aspect of health care
The psychosocial aspect of being at work improves health outcomes
There are $$$ to be saved in this process
Education and support for managers will make this process easier
Messages need to be consistent throughout theorganization