Successful Case Management

SUCCESSFUL SAFETY MANAGEMENT

Nursing homes and personal care facilities are among the nations fastest growing industries. Today nursing homes and personal care facilities employee approximately 1.7 million workers at 21,000 work sites. It is estimated that by 2005, the employment levels in this industry will rise 30% to 2.4 million workers.

In an effort to meet the needs of the society they serve, the nursing home and personal services industry will need to keep and attract qualified and healthy employees. This is and will continue to be a tremendous challenge and is only made more difficult by the frequency and severity at which employees suffer occupational injuries. Among U.S. industries, nursing homes have the fourth highest rate of nonfatal injury or illness. Only meat products processing, motor vehicle/equipment manufacturing industries, and air transportation industries rank higher.

Combining the estimated industry growth with the spiraling rate of occupational injury and illness, nursing homes and personal service facilities will need to place unprecedented importance on creating a work place committed to protecting employee health and safety if they expect to continue providing for the needs of our society while maintaining financial solvency.

DEVELOPING A SUCCESSFUL SAFETY PROGRAM

Numerous occupational health and safety hazards are potentially present in the jobs of nursing home and personal care employees. Among these hazards are constant stooping, standing, lifting, walking, pushing, pulling, twisting, and reaching. In addition, some jobs entail other hazards such as using dangerous equipment, handling hazardous chemicals, exposure to blood and other infectious material, and dealing with the behavior of confused and sometimes combative residents.

Developing a safety and health system that will effectively address current and continuously evolving workplace hazards requires the following elements:

Management Commitment and Employee Involvement: Visible management leadership provides an essential foundation for an effective safety and health program. Employee participation is also a vital part of an effective safety and health program.

Unconditional commitment to creating and maintaining a workplace that views employee safety as a value without compromise.
Establishes and actively supports company safety policy. (See Attachment A for sample Safety Policy)
Provides authority and assigns accountability for achieving safety and health goals.
Establishes safety goals and objectives and an action plan for meeting goals.
Endorses and supports program by providing adequate human and financial resources to support safety and health efforts.
Considers the safety of employees both a moral and legal responsibility.
Ensures performance evaluations for managers and supervisors include safety and health criteria.

Establishes, communicates, and enforces a disciplinary system.

Employee participation provides the means through which employees identify hazards, recommend and monitor hazard correction, and otherwise participate in their own protection. Participation in the decision-making process empowers and motivates employees to actively participate in achieving program goals.

Designate employees for assignments, based on employee interest and/or expertise.
Ensure that employees are involved in workplace inspections.
Establish written procedure requiring employees to promptly report injuries and unsafe work practices without fear of reprisal.
Provide follow up information to employees who have offered safety and health suggestions.

Worksite Analysis

An effective, proactive safety and health program will seek to identify and analyze all hazards.

Conduct baseline analysis of operational exposures to identify workplace hazards with potential to cause injury or illness.
Develop systematic methods for supervisors, managers, and employees to identify workplace hazards.
Periodically review accident and injury records (OSHA 300 Log and Accident Investigation reports) to identify specific problem jobs, departments, and/or tasks.
Encourage employee input on jobs or tasks that pose a hazard in their department or in general.

Hazard Prevention and Control

Exposure to all current and potential hazards should be prevented or controlled by using engineering controls, work practices and administrative controls, and personal protective equipment.

Use results of worksite analysis to establish and implement solutions to correct or control the identified hazards.
Implement systematic method of identifying and correcting workplace hazards (i.e, weekly, monthly, quarterly safety inspections)
Assign authority and accountability for correcting and controlling identified hazards.
Request suggestions from employees on how to eliminate or reduce hazards in their jobs.

Safety & Health Training

Safety and health training should cover the safety and health responsibilities of personnel who work in the nursing home. It is most effective when it is incorporated into other training about job performance and job practices. It should include all subjects and areas necessary to address nursing home hazards.

CONTROLLING WORKERS' COMPENSATION COSTS

NHRMA Members have the ability to take control of their workers' compensation costs by reducing the frequency and severity of injuries, and duration of disability claims. By making the following practices an integral part of the safety and health/workers' compensation program, NHRMA Members can maximize employee safety and minimize injury and illness and the consequential costs.

REQUIRE IMMEDIATE REPORTING: All employees should be made aware of the importance and requirements to report all injuries and illnesses -NO MATTER HOW MINOR- to their supervisor immediately. The company should develop written procedures to support this requirement.

INVESTIGATE ALL INCIDENTS: Identifying the root cause of each injury, illness, and near miss is vital to finding solutions to prevent recurrence of similar incidents and continually improving employee safety and health. Accident investigation forms should be completed to document circumstances and causation.

STAY IN TOUCH WITH EMPLOYEES: Supervisors should maintain communication with employees who are temporarily unable to return to work. Supervisors should communicate concern for employee's condition and interest in getting the employee back to work. Letting the employee know they are valuable and are missed can improve morale, decrease disability period, and reduce chances of litigation. Always keep Brentwood Services Claims Representative informed of changes in work status or medical condition.

REPORTING INFORMATION TO BRENTWOOD SERVICES: Submitting the required forms immediately and always within 24 hours of learning of the injury or illness. Reporting lag has a direct correlation with ultimate cost of claim. By receiving the report within 24 hours, Brentwood Services can quickly ascertain compensability, ensure injured employee receives professional care and begin applying medical cost control measures.

RETURN-TO-WORK PROGRAM: Providing for injured employees to return to work in alternative/transitional jobs while recovering is a proven method of controlling workers' compensation costs and maximizing employee morale.