Several years ago, Community Health Systems (CHS) Professional Service Corp. initiated a pilot program to improve employee safety at a hospital in Watsonville, Calif. The loss history at this facility was, to put it bluntly, not good.
“We knew if we could make our program work at this hospital, we would learn enough to make it work in other hospitals,” says Bruce Jones, insurance director in charge of employee safety and workers' compensation risks at CHS-affiliated hospitals.
As the project unfolded, Jones and his team identified a risk that was costly in its impact and which they believed they could improve upon: musculoskeletal injuries that were happening far too frequently—and usually as a result of staffers hurting themselves when having to move extremely obese patients.
“It was a trend we knew we could address and improve,” Jones said. “It's different than slip-and-fall claims. We can work to reduce those incidents, but they are still going to happen. But we saw these back injuries coming in, and we knew we could come up with a plan—and get the right equipment—to reduce the risk, costs and work time missed. This was where we could make the biggest difference.”
It took several years to perfect the Safe Patient Handling and Transfer Program (SPHTP) through the collection of data and assessment of the program's strong and weak points.
Patient-lifting equipment was purchased, procedures and policies were created and implemented, a training program was devised, and compliance was tracked. The initial pilot program was expanded to include a larger group of hospitals, then a second group.
Altogether, the hospitals implementing the SPHTP reduced losses by more than $11 million by the end of the third year.
MERGER MULTIPLIES THE BENEFITS
The timing of the SPHTP program could not have been better. After a merger with Triad Hospitals in 2007, CHS doubled in size. None of the newly acquired acute-care hospitals had loss-reduction and safety measures similar to the ones CHS had put in place.
“Hospitals are a complex work environment to begin with, and the merged facilities were not using our programs,” Jones says. “Each location is different, so we had to customize what we were doing in a slightly different way for each hospital. But we had the programs in place and results to go to them and say, 'We want to help you mitigate losses, and this will lead to a better and more productive workforce.'”
As CHS grew in number of facilities, its workers' compensation numbers actually shrank. Total incidents decreased 6.5 percent from 2008 to 2010, and the number of lost-time incidents was reduced by 16.7 percent.
The average cost per claim at CHS in 2010 was $1,017 compared to $1,602 at other healthcare clients of Gallagher Bassett, CHS's third-party administrator. CHS has reduced average lost work days per claim by 57.7 percent since the policy term ending in 2006.
MORALE BOOST
According to feedback from hospitals, the SPHTP improved morale among nurses, reduced employee turnover, improved patient safety by reducing falls and has become a recruitment advantage as hospitals hire new nurses.
All of this success is due not only to the SPHTP, but also to other workforce-safety initiatives that have been put in place.
Jones says he and his team are “constantly evolving” safety practices. They visit the facilities to assess how they are doing and what they need to do their jobs even better.
“This is a mindset,” he says. “We don't lay out some initiatives and walk away. We stay involved—we stay diligent. We're always learning, too.”
A real difference in costs, for example, can be made by simply emphasizing the importance of lag time in reporting an incident. CHS reduced the number of days from the date of loss to notice of its TPA by 42 percent since 2008.
“The faster we get into a claim, the lower the cost,” Jones says.
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