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Take on a bigger role in workers' compensation
Health managers should focus on business component
A newly hired occupational health nurse knew intuitively what she was saving her company, but lacked quantifiable numbers. To come up with hard data to show her worth, the nurse turned to her workers' compensation carrier.
"We put together a report for the nurse that illustrated the frequency and individual and aggregate costs of the company's claims," says Christine R. Zichello, RN, COHN-S, CSHM, ARM, FAAOHN, senior risk control specialist at PMA Insurance Group's Mount Laurel, NJ, office. "It was clear that lost time and injury claims, with the resulting loss of productivity, had been costing the company a considerable amount of money." The insurer was able to show that since the nurse came on board, the company had seen a 91% decrease in the frequency of claims.
Getting employees back to work more quickly, reducing the frequency of claims, and identifying high-risk areas: To get eye-catching results for any of these areas, you need a solid grasp of the workers' compensation process.
"As the economy continues to change, organizations are looking more and more at the bottom line," says Zichello. "You can actually save money for the company by becoming actively involved in the workers' comp process."
As insurance companies focus more on disability management and the medical aspect of workers' compensation, you need to diversify yourself, says Denise Zoe Gillen-Algire, RN, BSN, MBA, COHN-S/CM, FAAOHN, president of the Workers' Compensation Association of New Mexico and practice leader for Integrated Health and Productivity Management at Risk Navigation Group, both in Albuquerque, NM.
"If you are not involved in this realm of the business, you need to be," says Gillen-Algire. "Understand not just the clinical component, but also the business component and the employer's perspective."
Track claims by your company's top injury codes by frequency, and also top injuries by severity in terms of total claims dollars incurred. "The focus should be not only on the frequency and severity, but also on the potential for high-dollar claims," says Gillen-Algire.
You might find, for example, that you usually have more back claims in a particular department or shift. "You can turn that information back into your prevention efforts," says Gillen-Algire.
If you discover a high-risk area, perform an assessment of what the employees do and how hazards can be eliminated. "Go for the low-hanging fruit," says Gillen-Algire. For instance, slip-resistant mats can be added to a kitchen area to prevent fall injuries.
To increase involvement in case management of workers' compensation claims, Zichello advises obtaining certifications in case management from the American Board of Occupational Health Nurses or the American Nurses Credentialing Center. Armed with these skills, you'll be able to verify medical reasons for employee absences, follow up after absences from work, and assist employees with chronic illnesses. "Case management assists in the safe and timely return to work and results in cost savings," says Zichello.
New opportunities await
Your workers' compensation carrier can be your ally when it comes to coming up with hard data to show your worth.
Being well-versed in workers' compensation also could open up new job opportunities. Early in her career, Zichello was an in-house occupational health nurse for an insurance company. This led to her current position in the risk control department with an insurance carrier.
"We were writing a lot of health care accounts, and I saw the connection," says Zichello. "As a registered nurse, I know health care and realized that I could make an impact on the bottom line by combining by nursing knowledge and addressing safety issues."