[MCOH-EH] info re: Fit for Duty related to WC costs

[Shea, Joann]

We do not perform any type of functional capacity examination on our hires at this time.  We have also looked at some of the FCEs available, but it was not feasible for our organization  at the time due to logistics of scheduling, staffing and cost.  We have done root cause analysis of our injuries and review our claims in detail.    When we look at our high cost and high frequency claims, most would have probably passed a functional capacity examination on hire.     You also risk opening a BIG can of worms with ADA by denying employment based on the results of one test.   An annual FCE would make more sense as many of our employees get injured as they get older and are here longer.

  This is only anecdotal information and I can’t provide a statistical analysis favoring a preplacement FCE one way or the other.  I don’t know how to quantify a reduction in WC costs without actually implementing the FCE.

We are also concerned about the aging population and increased acuity of patients as we are a Level 1 Trauma center that focuses on critical care.  Our hospital chooses to spend our resources on prevention of injuries through our Injury Prevention Program and we have been able to quantify a significant decrease in  back injuries (both frequency and severity) with this program.

Employee Health coordinates our  Injury Prevention Program with 22 FTEs on our Lift Team and an Injury Prevention Coordinator (PT) and an Ergonomic Specilaist (OT).  We also budget for all  lift/transfer equipment housewide in our cost center and our IPC trials and implements all equipment and provides training.  Our experience modification is 0.48 and we have a workers compensation case manager in EHS on site.

   Some of the actions we have taken:


·         3 hour mandatory safe patient handling and lifting class for ALL clinical staff (techs, RN, PT, OT, radiology techs, CVT techs, etc).  Reviews how to utilize the lift team and how to use equipment.

·         Ceiling tracks in 60% of rooms..working on increasing.

·         We have purchased Floor lifts, mini lifts, sit to stands, hover mats, slip sheets, gait belts, gantry lifts for rehab, pediatric mobility chairs, butterfly slings, repositioning slings.

·         L.I.F.T. Experts in each clinical area…We have over 150 certified.

·         Created four Lift Team supervisor positions (promoted four techs) and these staff are responsible for staff training and troubleshooting.

·         Just started “mobility techs” in our neuro and trauma ICUs.  Patient care techs hired just to assist with patient turning of lighter pts that the lift team cannot get to.   They train two weeks with the lift team on using equipment and also train with PT.

·         Automated work station assessment/ergonomic assessment request on our portal with ability to collect aggregate data.

·         Post rehab training in our new fitness center after PT is completed.  Fitness Center is under mgt of Employee Health and staff is being trained in injury management.

·         Fitness Center staff go to department staff meetings or education days and provide training by request  on back injuries, knee injuries, plantar fasciitis, stretching, etc.

·         We just opened the center in May, so don’t have all the plans in place yet.  We hope to use the employee Fitness center to rehab our employees with injuries and offer programs for our aging population.



Anyway…it’s a work in progess.   We probably won’t consider spending the money on FCEs preplacement in the near future.

[TGH_employee health serv-color]
JoAnn Shea, ARNP, MS, COHN-S
Director, Employee Health and Wellness
P.O. Box 1289, Tampa, FL 33601  Mobile: 813-789-3441   Work: 813-844-7692  FAX: 813-844-8144






From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Hudson, T. Warner
Sent: Tuesday, August 26, 2014 2:10 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] info re: Fit for Duty related to WC costs

Also interested in responses

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf Of Elizabeth.Moline at capellahealth.com<mailto:Elizabeth.Moline at capellahealth.com>
Sent: Tuesday, August 26, 2014 11:08 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] info re: Fit for Duty related to WC costs

Did you get any responses to this?  I would be interested in them.

Beth


Beth Colbert Moline, MSN, FNP-BC
Nurse Practitioner, Occupational Medicine
National Certified Medical Examiner
WIllamette Valley Medical Center
(503) 435 6586     FAX  (503) 435-6555
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Kim.Thompson at hcahealthcare.com<mailto:Kim.Thompson at hcahealthcare.com>
Sent: Friday, May 02, 2014 11:42 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] info re: Fit for Duty related to WC costs

Does anyone have any studies and/or anecdotes re: pre-employment Fit for Duty (the basic 15” kind where the employee picks up boxes, etc according to job desc, ensures they can squat, etc) and the potential for reducing WC injuries by doing these pre-employment? As most clinics/hospitals do, our employee population is aging and getting heavier. It seems that many of them can’t bend to empty a Foley never mind the risk of running to codes, getting down on floor to do CPR, lifting/transferring/repositioning patients all day long, etc. It also seems that once I begin treatment of the injuries, there have been more pre-existing issues to deal with than in the past. I am trying to justify a $40 Fit for Duty exam as part of our pre-employment process.

Any thoughts on the matter, studies, or personal experiences would be appreciated.

Kim Thompson RN, BSN
Employee Health Nurse Manager
Medical Center of McKinney
4500 Medical Center Drive - MOB, Suite 105
McKinney, TX     75069

972- 540- 4218 (phone)
469 - 713- 8660 (fax)

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