Rousmaniere: Three Ways of Looking at a Work Injury

Close to thirty years of comparative studies of nursing homes show how people can look at work injury risk in three ways. 

The choice of worksite should not be a surprise. Healthcare facilities are a good source of insight into what drives workers’ compensation costs. Their injury risk is high. Private hospital workers have higher injury rates than manufacturing. They face daily hazards of lifting and moving patients. Also, healthcare is one of the largest industries in the country, and is adding more workers than any other occupational group. 

Long term care facilities, a subset of healthcare facilities, are even the best of all worksites in the country to study workers’ comp. They are very many in number, and the similarity of them in size, injury risks and types of workers provides a great opportunity for comparison. In light of the prominence of patient mobility as the riskiest work in these facilities, over-exertion leads to slips and falls far more than in other kinds of work.

Prevent the injury

One of three ways of looking at injuries is to look at safety. The National Council on Compensation Insurance (NCCI) wrote in 2011 that increased emphasis on safe lift programs at long-term care facilities is associated with fewer workplace injuries and lower workers’ compensation costs. 

The University of Massachusetts at Lowell has been studying long term care facilities injuries for many years. It reported recently on what happened when a chain of facilities redoubled its safety program. Patient mobility claims rates, it reports, decreased in 82%. The researchers said, “reduction among these nursing home workers is plausibly attributable to the introduction of mechanical lifting equipment.”

Prevent plus recover

Employers long ago began to discover that good injury response can greatly reduce workers’ comp costs. The term “injury risk” can cover both prevention and response. In the late 1980s, a research team at the Upjohn Institute for Employment research began to compare the injury risks among Michigan employers, including nursing homes. The team coached employers on a common self-assessment scale. It found that 10% better self-rating on safety diligence translated into 17% fewer lost workdays. A 10% better self-rating on proactive return-to-work meant 7% fewer lost workdays.

Successful firms, it found, rigorously investigate injuries and communicate their commitment by immediately responding to risks when they are identified. They were most advanced in their safety efforts, very active in injury management, and had implemented at least some form of return-to-work.

Bolster the business model 

But safety alone, and integrating safety and injury response, do not tell the whole story. Two research studies close to thirty years apart show that injury risk varies by an employer’s business model. And, even within the same employer, the business model fluctuates among different worksites.

The Upjohn research team probed into the management styles of its population of employers.

In low-disability firms, managers viewed safety and disability management as components of quality, productivity and financial stability. 

An old aphorism applies here: “Inside every work injury a productivity improvement is struggling to get out.” I was told by Eric Race, who consults on patient mobility, that the quality of care for nursing home patients improves when workers feel safer from injuries. They are more inclined to transport patients for visits to common areas of the facility, for stimulating interaction with other patients and visitors.

The University of Lowell’s most recent of numerous articles about long term care facilities confirmed and expanded upon what the Upjohn people wrote many years ago. In a November 2017 article, researchers reported on their study of the interaction of quality of care, patient satisfaction, and patient safety. They compared 203 skilled nursing facilities, owned by one company. They found that better-performing facilities had better patient care outcomes and resident satisfaction; lower rates of workers’ comp claims; better patient mobility safety for patients; higher employee retention; and greater worker job satisfaction and engagement.

A worker safety problem may thus be twinned with a business practice problem. Impact one, impact the other. Bob Titus, an insurance advisor in Westborough, MA, with construction expertise, notes how construction defects risks rise with work injuries. Work injuries lead to recovering workers being on the job with physical limitations. He says that these workers, many of whom are performing job functions related to the project’s structural integrity, are more apt to make mistakes due to their injury-related physical limitations.

While on disability they are likely be replaced by workers with less experience and competency.  “These problems exacerbate the enormous general liability construction defect exposure of prime and sub-contractors,” he says. 

Thus, work safety is at the core of organizational life.  

ABOUT THE AUTHOR

Peter Rousmaniere is widely known throughout the workers’ compensation industry, both for his writing and consulting experience. Based in the picture perfect New England town of Woodstock, VT, he is a regular on the conference circuit, and is deeply in tune with trends and developments within the industry. His passion is writing and presenting on issues largely related to immigration, and he maintains a blog on the subject at www.workingimmigrants.com.

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