WCB COMP INSTITUTE CYPRESS HEALTH REGION

Cypress Health Employee Staffing Strategies (CHESS)

RETURN TO WORK/ CHESS PRESENTATION

CYPRESS HEALTH REGION • Located in southwest Saskatchewan • 20 facilities • 5 integrated facilities • 8 long term care facilities (1 affiliate) • 4 acute care facilities • 4 x 8 hr. care facilities • 5 x Community Health Offices • 1700 employees (1,197 FTE’s)

THE NEED • In 2010/11 each Regional Health Authority (RHA) in

Saskatchewan was tasked with reducing the number of wage driven premium hours, including sick time and overtime, and Worker’s Compensation Board (WCB) claims

• In order to meet these targets delivered by the Saskatchewan Ministry of Health, the Cypress Health Employee Staffing Strategy (CHESS) was launched

• CHESS utilizes a variety of tools for reducing the quantity of sick time, overtime, and WCB claims brought forward by staff.

• The program has put the Cypress Health Region (CHR) on the map as a provincial leader in the reduction of sick time and has tasked all other RHA’s to meet similar targets.

GOALS & OBJECTIVES • The CHR was tasked with meeting provincial targets

in the reduction of wage driven premium hours and WCB claims. These targets were:

• 8% reduction of region overtime [hours per full time equivalent (FTE)]

• 3% reduction of region sick time (hours per FTE) • 10% reduction in workers’ compensation (claims &

days)

CYPRESS INTERNAL GOALS

When we started this journey in May 2010, these were our goals: • fewer than 72.00 sick time hours per FTE • fewer than 35.00 overtime hours per FTE • 0 WCB claims

THE PROCESS • In May 2010 we developed the CHESS program • CHESS stands for “Cypress Health Employment

Staffing Strategies” • There are 8 CHESS strategies • Each “CHESS piece” was developed as a vehicle to

highlight each of the 8 strategies with staff and was communicated through a variety of mediums including: posters in all facilities, the regional internal newsletter, CHESS presentations in the facilities as well as direct conversations with managers.

CHESS #1: Introduction • The introduction strategy focused on the supports,

processes, and safety requirements needed to ensure that CHESS would be seamlessly introduced across the entire region.

• The strategy included an introduction to various CHESS initiatives such as employee wellness, limiting the hiring of retiree’s, and the region’s attendance support plan.

CHESS #2: Sick Time Identify Modified Duties

• Modified duties were identified with each manager for every classification

CHESS #2: Sick Time Educating Managers

• Education provided for managers to clarify expectations in responding to employees that call in sick and what information is appropriate to discuss within Human Rights/Labour Standards

CHESS #2: Sick Time Calling in sick

• Employees may not leave a message on a schedulers’ answering machine

• When employees call in sick, they are coded as an unpaid/unverified sick code, and the scheduler emails the manager and copies the Ability Management Department to follow up with the employee.

• The employee remains coded as unverified sick until either the manager or Ability Management has a conversation with the employee to explore opportunities for modified duties or confirm to code as sick (contagious/infectious conditions)

CHESS #2: Sick Time The Dr’s Note

• The focus is not on the Dr.’s note, but rather encourages the manager to have a conversation with their employee about what the employee feels they can or can’t do and how we can accommodate them safely in the workplace

• The manager is expected to have these conversations with respect and compassion and use their discretion as to when to request medical verification.

• Medical verification is not requested for the contagious or infectious conditions unless a specific trend is observed such as calling in sick before or after a long weekend etc.

• The emphasis is on ability and what the employee can do, rather than the manager requesting a Dr.’s note.

• Physicians have voiced frustration with completing medical restrictions forms and appreciate knowing what the employer can offer with a return to work proposal.

CHESS #2: Sick Time 3 Step Approach

• The Cypress Health Region has developed a 3 step approach to safe and meaningful return to work:

1. Employee notifies scheduling/manager of illness or injury that is preventing them from their regular duties

2. Manager and/or Ability Management contact employee to discuss any opportunity for modified duties and develop a return to work proposal for the employee to take to their Medical Care Provider for approval prior to implementation

3. Employee signs the consent to release portion of the Return To Work Proposal and discusses with their Medical Care Provider for approval prior to implementation.

• Typically this approach is resulting in a one to two day turn around to safely return an ill or injured worker back to the workplace

CHESS #3: Limit Re-hire Retirees • Cypress only considers re-hiring of a retiree if from a

“hard to recruit” classification • In 2009 there was 40 staff that retired and 28 were

re-hired • Statistics showed that the sick time used in one year

from the re-hire retiree’s was enough to pay for one FTE in 2009

CHESS #3: Limit Re-hire Retirees - The Rationale

• Limiting the hiring of individuals post-retirement supports the Region’s Scheduling Processes Strategy to reach Ministry mandated targets.

• Securing our future success by maximizing our ability to hire people early in their careers and allowing a stronger succession plan

• Rehired retirees no longer contribute to SHEPP. Reducing the contribution to the plan.

• Allows the Region the ability to hire more employees who contribute to SHEPP which improves the financial stability of plan.

• Rehired retirees who worked full-time prior to retirement maintain full benefits for up to two years following their retirement date, potentially placing pressure on the viability of the plan benefits and costs.

• Those rehired retirees who work very few hours or none at all are providing limited service to the Region’s clients while they enjoy the benefit of coverage for group health and dental plans

CHESS #4: Attendance Support

• Attendance support meetings for staff that are above the peer group average and above our Region goals for sick time usage

• Very little need for attendance support meetings since the implementation of CHESS unless specific trending is observed

CHESS #5: Safe Work Values • WCB Mission Zero • We participated in the WCB audit • Cypress Health Region is on the WCB TOP 50 list

meaning that we are one of the top 50 employers in Saskatchewan that have high injuries rates at work

• Injuries in health care are 1.5 x higher than other industries despite TLR training, PART training etc

• 80% of employers in Sask have achieved MISSION ZERO – why can’t we!

CHESS #5: 10% less WCB Claims

• In 2010 The Ministry directed target was to file 10% less WCB claims

• In 2012 we filed 77 Time Loss & No Time Loss WCB Claims

• Our goal this year was to file 25% less WCB claims in 2014, with a long term goal of Mission Zero by March 2017.

TOTAL WCB CLAIMS April 1/13 To Feb 28/14:

TIME LOSS/NO TIME LOSS CLAIMS

CHESS #6: Employee Wellness • Cypress Health Region started doing employee

health assessments in 2008. • This is a voluntary assessment of one’s resting heart

rate/blood pressure, diabetes and cholesterol screening, height, weight, BMI, waist measurement, body fat %, strength, endurance, flexibility, aerobic fitness, and stress coping skills

• Staff receive a “report card” that compares them to other men/women their age and they set goals

• We conduct a follow up health assessment 3 mos. later

EMPLOYEE WELLNESS • The Cypress Health Region believes that the

health of its employees is crucial to reducing wage driven premium hours.

• The region’s employee wellness program has previously received a SAHO Green Ribbon Award Honourable Mention and has also been recognized by Accreditation Canada as a best practice

EMPLOYEE WELLNESS INDICATORS For the employees who attended the follow up

assessment the following improvements were found: – 17% of employees had a decrease in their waist

circumference. – 43% and an increase in their aerobic fitness. – 32% improved on the stress test – 30% improvement in blood pressure. In 2014 we are rolling out the Dr. Oz Real Age Health Assessments for staff

CHESS #7: Q and A

• A Question and Answer strategy was communicated to all staff and was designed to answer specific questions relating to CHESS, such as ‘How will CHESS affect me’ and ‘What will happen if I call in sick etc

CHESS #8: Safety in the Workplace

• Increasing the roles of the OHC • Expecting OHC investigation within a timely manner

(ideally 24 hrs) for any incident that results in time loss and/or medical attention

QUARTERLY MANAGER MEETINGS • The region implemented and continues to utilize quarterly meetings

with facility managers to discuss facility-specific data with the managerial group.

• These meetings allow managers the opportunity to explain variances and ask share questions/concerns.

• Teams are made up of the region’s Chief Executive Officer, Human Resources, Communications, Finance, Scheduling, Ability Management, and Payroll departments.

• At each quarterly meeting, facility managers set goals for the next quarter and brainstorm new concepts to aide in the further reduction of wage driven premium hours and WCB claims.

• At every meeting all parties sign an Accountability Document with set targets for the next quarterly meeting

SICK TIME RESULTS

2006 2007 2008 2009 2010Year 83,627 92,497 95,627 95,603 100,974

-

20,000

40,000

60,000

80,000

100,000

120,000

Sick Hours by Year

Year

Linear (Year)

Sick time had grown 20.74% from the fiscal year 2006 to the fiscal year 2010 which was an average of a 4% increase every year.

Savings from CHESS • As the above chart illustrates if we did nothing with our

sick time the sick time would have continued to grow at a 4% increase as the trend was showing.

• We replace 80% of the staff that call in sick • When we compare our projected sick time before

CHESS to actual sick time after the CHESS program we can see that our savings would be $4.2m (based on average 2014 salary

of $34.19/nr) • Using the formula that 50% of our sick is replaced at

overtime then the number increases from savings of $5.3m

PROVINCIAL HEALTH IMPLICATIONS

• If 13 health regions could all save $4.2m from managing sick time, this would mean a $55m savings for Saskatchewan Health Care, and we wouldn’t have to cut any jobs or closing any health care services

84.09 87.46

90.96 94.59

83.49

70.72 75.73 77.89 77.30

80.86

58.63 55.20 54.69

58.17

3.72 4.31 5.55 7.51

0

10

20

30

40

50

60

70

80

90

100

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014(projected)

Sick Hours per Paid FTE per Year

Trending - Sick Hrs/Paid FTE Actuals - Sick Hrs per Paid FTE Actuals - Unpaid Sick Hrs/Paid FTE

OBSTACLES • One of the obstacles CHESS faced was initial internal

resistance from facility managers who felt the quarterly CHESS meetings were a disciplinary meeting for those who were reporting above-target sick time/overtime/WCB claims.

• Managers soon realized, however, that the meetings were a collection of support systems in place who were prepared to stand behind, help, and support them in trying to reach our targets.

COLLABORATION • Significant collaboration was required to successfully

implement and sustain CHESS. • CHESS teams were made up of the region’s Chief

Executive Officer, Human Resources, Communications, Finance, Scheduling, Ability Management, and Payroll departments.

• Collaboratively, these teams created a support system for managers throughout the region and each facility manager was encouraged to communicate with colleagues to learn each others’ successes.

KEY TO SUCCESS • The success of the CHESS program is largely

attributed to a Top-Down supportive approach with attached accountabilities and targets set out by the Ministry that is inevitably changing the culture in the Cypress Health Region to a “CAN DO” culture

• THANK YOU • Q&A