Getting Physical in Return-to-Work Programs

Through the use of centralized information storage, deliberate processes and old-fashioned teamwork, organizations can drastically improve their return-to-work programs, decrease lost workdays and increase overall organizational performance.

On the surface, returning an employee to work is easy. You match what you know of the person's physical abilities to what you know of the job's physical demands, and you either get a positive or negative result. If the result is negative, you find the employee another job or he or she stays on disability leave.

The devil is in the details. Most companies only know what is required of an employee in terms of work output, but don't know how to create that output, especially with regards to physical demands. This fundamental lack of knowledge causes significant operational problems, unsafe work environments for employees and increased costs in many areas of the organization.

TODAY: STUMBLING AROUND IN THE DARK

Trying to accomplish return-to-work without the right processes and solutions is like asking people to function effectively together in a dark house they've never been in before: the lights are out and no one knows where the light switch is. Many companies work in this fashion because they don't know there's a better way. Most have learned to feel their way around and find enough of the important things to get by. But this is far from efficient.

For example, issues begin when human resources professionals can't hire the most capable person for a physically demanding job because they have little idea how physically demanding it is. The safety professional can't effectively prevent injuries because he or she doesn't know what activities or tasks pose the biggest risk to the work force. When injuries do occur — as they inevitably do — the doctors who are treating the injured employee don't know how to write a restriction because they don't know what they need to protect the employee from.

In this scenario, how can the return-to-work specialist possibly find a job for someone when he only has vague information from the doctor regarding the employee's capabilities and he doesn't know the physical demands that different jobs require? Additionally, it's difficult for the workers' compensation claims examiner to accurately reserve a claim when all involved parties lack critical information.

Let's look at some simple processes that can shed light on your return-to-work and placement efforts and help you improve them while keeping employees safe.

TOMORROW: ENLIGHTENED DATA GATHERING

It all starts with a process for understanding the physical demands that ensures consensus among all the stakeholders. This activity includes:

  • Measuring the physical demands objectively - your safety department knows how to do this already; they may even be doing it now.

  • Getting management involved - they'll know that you are measuring the full spectrum of job duties.

  • Checking your measurements with employees themselves - no one knows what it takes to do a job better than the people who do it.

  • Collaborating with each department - collective information will best identify the essential duties of the job.

This process seems simple enough, but gathering and agreeing on the physical demands and critical functions is just the beginning. It causes the lights to flicker on in one room but they risk going out quickly. To keep the lights on throughout the house, we must be able to retain this new knowledge in a central place that everyone easily can access. In addition, we'll need processes that:

  • Keep the data accurate and well managed through periodic (or as needed) audits.

  • Create simple “physical demand tests” that mimic the job requirements to be utilized in hiring, on-boarding and return-to-work.

Now that we have the lights brightly burning, let's look at how much better all our departments can function:

HR now has the knowledge and tools to create the right fit between the employees and the work they will be doing. They know exactly what is physically required to do the job for which the candidate is being hired. Using a physical demands test, the employee will see (and not have to imagine) what the work will feel like. Both parties can make an infinitely better and more informed decision about whether the work is a right fit. Though this will not completely eliminate the chance of a future injury, it greatly will reduce it.

The safety or risk management department can focus scarce prevention resources where there is the most risk, and therefore the most benefit. Just because a certain task hasn't hurt as many people as another task, it does not mean that it doesn't pose a bigger risk. With the new information they have, those responsible for prevention can eliminate the highest risks in the most important required tasks. In many cases, work-arounds can be established for non-essential tasks until a final fix can be determined. Over time, this efficient use of prevention resources leads to a dramatic reduction in both number and severity of injuries.

If you ask your doctor, he will tell you he prefers to work with the lights on. Doctors who know the physical demand requirements of their patients' work will be able to write very specific restrictions and specify more accurate absence durations. Without this objective information, doctors rely on what they are told by the patient. Objective physical demands data, in the hands of doctors writing restrictions, leads to more specific and accurate restrictions and removes a source of bias from the system. Now patients no longer can lead their doctors to write the restrictions they want.

The job of returning employees to safe and productive work also is easier with the lights on. The return-to-work specialist now has detailed knowledge of what each job physically requires, as well as very specific restrictions with an accurate time period from the doctor. Additionally, he or she no longer has to ask the management team if they can accommodate the employee. The return-to-work specialist simply refers to the consensus agreement, validates that the doctor-defined restrictions don't interfere with the essential functions of the job, and then places the employee in the job. When employees report to there new jobs, managers already know how they can put those employees safely back to work and how long the restrictions will last.

All the while, the claims adjuster is able to reserve the claim with greater accuracy and consistency.

If this is so simple, why don't all companies turn the lights on?

MAKE PHYSICAL DEMAND DATA MORE ACCESSIBLE

The fact is that it's difficult to achieve this using the conventional tools and mindset that exist today. It takes an integrated technology solution to make it simple. Few have found that technology and even fewer have been able to change the mindset.

The first step of gathering the data can be accomplished with minimal training and just a few tools. The team must gather the information in consistent and repeatable fashion so it can be turned into usable data. For example, knowing that an employee must lift 35 pounds at least 25 times a day is not informative, whereas understanding that the majority of employees will not be able to complete this task safely over time is usable data.

Simply gathering information is not particularly useful. It must be stored in a place that ensures only the appropriate people can modify it and that the right approvals are granted before an official revision can be made and a new version released. This configuration management ensures the information is always accurate and trustworthy. This will matter to your lawyers, especially if this information is being used for hiring.

The need for central storage of physical demands, control over (but distributed throughout the organization) access to data and a repeatable process for analyzing jobs is a task that begs for software.

Still, with the proliferation of technology in organizations, why have more companies not moved in this direction? In most cases, the reason is trust. Just because information exists in a central place does not mean that everyone who needs to use it trusts that it is accurate and up to date. Technology and business processes can help bridge that gap.

HOW TECHNOLOGY FACILITATES RETURN-TO-WORK

Today, technology can provide a solution that is more than a tool; it actually guides and controls the process. It tells those who have to gather the data what must be collected and what else can enhance the process. It enforces company policies on who can approve and release the data. It even reminds those individuals of the work that is pending and helps them resolve questions during their review. It provides structure and security by protecting multiple versions and only allowing the approved version to be viewed. In addition, it enforces business rules regarding audits and reviews. With this version-controlled, process-enhancing secure repository, everyone who uses the information (even the lawyers) can trust that the proper steps have been taken to ensure that it is accurate and up to date. Technology builds the trust in the information.

Once this trust is established, technology also can enhance how each department accomplishes their respective jobs in the company and the relationships these departments have with each other. Here's how:

HUMAN RESOURCES

When the lights were out, the best an HR manager could do when hiring was share a vague description of the work and the outcomes that were expected from it. He or she couldn't hope to relay any details of the physical requirements of the work. Potential employees usually fall into one of two categories — the ones who will say they can do anything to get the job, and those looking for a good excuse not to take the job. It is difficult, if not impossible, for the HR person to discern which group the candidate is in. Both pose significant risks for the organization.

Technology can offer tools and process guidance to help HR minimize these risks. Not only do HR professionals have access to the trusted physical requirements information and know the essential functions of the job, technology also can guide them through the use of specific tools to help ensure the right fit.

Very early in the process, HR professionals can show potential candidates video clips of the work that is required along with specific weights, forces and distances. This enables them to have more meaningful conversations with the candidates related to their physical capabilities and to introduce the physical demands testing as the next step in the process. Once both parties have decided to move to the next step, HR can schedule a physical demands test. This test, performed by a physical therapist, can accurately determine if the candidate can perform the essential functions of the job.

Technology guides HR professionals through the steps in this process and gives them immediate access to the tools needed to accomplish each. Once both parties decide to move forward, they both are more comfortable that the work is a right fit. In this way, a detailed conversation and physical demands testing significantly can reduce the risks that used to accompany hiring a candidate.

SAFETY AND RISK MANAGEMENT

Safety professionals and risk managers probably have been trying to turn the lights on the longest. In most companies, they are tasked with making sure the work is safe. This job has required them to understand the cause of risk. Surprisingly, many in this group commonly confuse injuries and risk.

For many years, the data with which this group worked was related to accidents and, at best, near misses. That data might include the body part that was injured and some gross-level classification. Some companies even have attempted to determine the “root cause” of injuries. Through this backward-looking data, they probably were able to determine that well over half of their past injuries were related to employees moving their bodies. They still didn't know where the risk was or where to focus their resources to prevent future injuries. Technology helps them look forward and focus.

Not only does it provide them with a process for gathering the data and a place to store and update it, technology automatically can interject science into the process. Ergonomists have done mountains of research on what different types of individuals reasonably can accomplish with their bodies — but technology is required to apply that science to the real world. Through the use of algorithms based on this science, the data that has been gathered can be turned into useful risk information.

Once the safety professionals and risk managers know where the risk to their specific employee population exists, they can focus prevention resources on eliminating the highest risk related to the most important tasks. They can eliminate, reduce or work around the most scientifically valid, highest risk related to the essential functions of the most important jobs. This focus on risk provides the most significant benefits to the organization and will lead to long-term improvements.

MEDICAL, CLAIMS MANAGEMENT AND RETURN-TO-WORK

For this entire group, the problems of the past always have been the same: they lacked effective tools and a process to communicate. As a result, they were doing their jobs in the dark without the most basic information necessary.

Each of these groups has been dependant on the information they were given by others who had some stake in the game and therefore a bias. As we explained earlier, employees could tell their medical practitioners what they wanted them to know of their job in order to get the work restriction written in their favor. Management also could change the description of the work restriction depending on whether they wanted a given individual back at work or not. There was no objectivity and therefore no light.

Now that technology has provided these departments with current, objective information regarding the employee's actual physical requirements and has predetermined the essential functions of the job, each now can apply their expertise to determine the best course of action for both the injured worker and the organization.

KEEPING THE LIGHTS ON FOR GOOD

Centrally located and easily accessible data about the physical requirements of a job are the foundation upon which more effective return-to-work, placement and safety programs should be built. It is the light switch that allows all groups involved to see new possibilities for improving their work processes and keeping employees safe. By implementing an integrated technology solution, they can keep that light burning brightly. Over time, this integrated solution will yield significant improvements in the way a company places employees, focuses its risk mitigation resources, interacts with its medical providers and returns employees to work. The outcomes of these improvements will allow for more efficient use of resources, create a safer work environment, improve employee retention and add funds back to the bottom line.


Bill Gonser is the principal of Paragon Consulting. Prior to starting Paragon, he served as director of safety and health at Disneyland Resort in Anaheim, Calif. Ben Archibald is the executive vice president of technology at Remedy Interactive Inc., an injury prevention software company based in the San Francisco Bay Area.

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