By Danielle Ling
Much has changed in five years at Northwell Health, New York State’s largest healthcare provider and private employer.
In 2014, its total annual workers’ compensation cost hit $58.4 million — a nearly 300% increase from 2010’s total expense of $20.5 million. These increases were expected to double as the workers’ comp budget was projected to top $100 million in 2019.
Aside from the financials, a bigger issue surrounded the conversation at Northwell Health: workplace violence. The Occupational Safety and Health Administration (OSHA) reports that of the nearly 2 million U.S. workers who experience workplace violence each year, nearly 75% occur in healthcare.
As costs and liability risks rose, and the shortcomings of existing “old school” styled services became evident, in 2014, Northwell Health hired Joseph Molloy, vice president of Workforce Safety, to address both the employee safety concerns across the healthcare industry and the red flags.
Molloy set out to reverse the lack of transparency between departments and data that compromised Northwell Health’s workers’ compensation programs, and bring the healthcare company into a new era. In January 2015, Northwell Health created the Workforce Safety (WFS) department, which combined expertise from employee benefits, managed care, insurance, risk, employee health services and injury management to create a culture of safety and employee advocacy.
“By combining these professionals into one department, it has streamlined our ability to address short- and long-term strategies and day-to-day operations,” Molloy said. “We have generated exceptional results, and have grown the department to 37 members — a testament to how Northwell has embraced the advocacy model for safety and workers’ compensation.”
Since WFS was implemented, the total workers’ comp cost per $100 of payroll has remained flat, and thousands of employees have benefited from updated safety training and improved return-to-work programs.
Protecting Patients and Employees
The WFS workers’ compensation and safety training programs were designed with both patients and employees in mind, prioritizing the care and well-being of 2 million annual Northwell Health patients and its 69,000 employees. In creating the program, workplace violence was among the top workers’ comp concerns.
“Although the numbers confirm there is an issue, there is a belief that the numbers are still under-reported,” Molloy noted. “North well Health expanded our workplace violence definition to include patient aggression and incivility, along with more traditional workplace violence incidents.”
To address the issue, Northwell Health prioritized initiatives to protect its employees and in 2015, adopted “Preventing and Managing Crisis Situations” (PMCS), a de-escalation training program recommended by New York State’s Office of Mental Health.
Safe Patient Handling
Northwell Health also established the Safe Patient Handling (SPH) Program within WFS. An SPH Committee was formed at each Northwell Health location, and it meets monthly to share data and best practices related to safety and workers’ comp claims.
Sadly, nurses are among the most at-risk of experiencing workplace violence nationwide. Northwell Health’s WFS team works alongside the nursing team to provide customized, evidence-based training on safe patient handling practices.Training is provided annually and during new-hire orientation for all of the health system’s hospitals and skilled nursing facilities.
To better reach the 23 hospitals and 750 ambulatory locations, the WFS team designed its Safe Patient Handling Mobile Training Unit, equipped with both a classroom and a mock hospital room. Since its implementation, the program helped lower the average SPH-related cost by 45.5%, from $33,369 to $18,180.
Also within SPH, the Slips, Trips and Falls program for Snow and Ice Incidents has decreased the number of related incidents by 77.52% over 5 years through improved communications and storm preparation plans.
Getting Back to Work
The Return to Work Division within WFS ideally helps employees return to their original positions. But when physical limitations prolong recovery, the return-to-work (RTW) program places these workers on transitional assignments for up to 12 weeks. The Vocational Rehabilitation Return to Work program provides an opportunity for these injured workers to retrain and move into a different job that suits their physical limitations.
“We met with our third-party administrator, Broadspire, and explained the entire process would now focus on employee advocacy,” Molloy said. “We detailed that the employee should not have treatment interrupted because of an approval. The real key was to encourage immediate reporting, resulting in more immediate treatment. This has generated significant results.”
“We also work constantly with Broadspire on establishing appropriate reserves,” Molloy added. “This has led to us closing cases far above benchmarks. At the five-year mark, 98% of our cases are closed.”
Working with Unions
About one-third of Northwell Health is unionized. A partnership was established with 1199SEIU, the largest healthcare union representing about 16,000 employees. The organization works closely with both the delegates and 1199 leadership to drive specific initiatives and share safety programs.
“We have in place four metrics: length of absence, time to notification, participation on our transitional return-to-work program, and participation in our safe patient handling program that we’re using to measure our ability to include these employees across the board,” Molloy said.
Language is always an issue, Molloy says. “Fortunately, in healthcare, English is a predominant language, but we do have staff members who speak Spanish, Portuguese, Chinese and some Russian and Indian dialects.”
In addition, there are ongoing efforts to develop more materials in other languages.
After five years and nearly 1,400 employees served, Molloy says the future of WFS is ripe for expansion. “Having achieved many of our initial goals, mostly around building a program based entirely on employee advocacy,” Molloy said. “We are looking to raise the bar. We have already implemented a much more robust triage process, we’re ratcheting up our communications, and we’re implementing a new mobile-enabled platform.
Molloy says Northwell Health will continue to operate based on the guiding principal WFS was based on: transparency, sharing data and improving communications.
“Driving advocacy is still a relatively new approach to workers’ compensation,” Molloy concluded, “and we all have to work together to make the adversarial approach to workers’ comp obsolete.”
Credits:
Photography by Matt Furman