AIHce: Improving Return-to-Work Times

A dysfunctional safety culture, nonsensical company procedures, medical provider bias and the “medicalization” of employee work failures are among the top 10 factors that deter injured employees from quickly returning to work.

In a presentation at the 2007 American Industrial Hygiene Conference and Expo in Philadelphia, occupational health consultant Dr. Peter Greaney of California-based WorkCare Inc. and certified industrial hygienist Gary Beswick of Long Beach, Calif.-based Earth Tech Inc. explained that there are 10 common pitfalls that impede return-to-work times. Those pitfalls are:

  • Company culture – Long-time employees who believe their way of doing things is the best way can influence injured employees' lost-work times.
  • The “silo” effect – In many organizations, injured employees interface with a number of departments, including human resources, safety, a return-to-work coordinator, benefits and risk management. If these departments are disconnected (in “silos”), return-to-work times could be prolonged.
  • Misalignment of company goals – When other company programs and departments do not enhance EHS goals, it can lead to more injuries, increased workers' compensation costs and slower return-to-work times.
  • Employee perception – What employees really think is happening to them at the time of an injury drives the return-to-work process.
  • Fraud/abuse – Fraud can occur at the employee level, the corporate level and the medical provider level.
  • Lack of provider oversight – Medical provider practices can delay an injured employee's return to work.
  • Over-empathetic medical provider – Well-meaning doctors sometimes focus on the social needs of injured workers, impeding their return to work.
  • “Medicalization” of work failures – Disgruntled employees and employees with other work-related or personal issues tend to take longer to return to work after an injury.
  • Supervisor issues – When workplace injuries occur, some supervisors try to act as a treating physician, while others simply say, “Take it up with HR!” Either way, supervisors' inappropriate responses to injuries can negatively impact the return-to-work process.
  • Lack of communication/miscommunication – Another impediment to your return-to-work efforts.

"Legacy Culture"

When it comes to minimizing injured employees' days away from work, Beswick asserted that your company's safety culture is the most important issue to address.

A particularly lethal form of the dysfunctional safety culture is what Beswick called the “legacy culture.” In a legacy culture, long-time employees such as “Bob” – who are convinced that their way of doings things is the best way – impart their warped wisdom on new co-workers and even new supervisors or managers.

“There is a line of influence between the new employee [or] that new manager and the rest of your organization,” Beswick said. “That line of influence really is driven by Bob and people like Bob who've been at your company for a hundred years.”

Unfortunately, Beswick added, “that line of influence can have really, really far-reaching effects.”

For example, some companies have what Beswick called “a workers' comp mindset.” This mindset subscribes to the belief that “if somebody gets injured, that's what we have workers' comp for.” In their presentation, Greaney and Beswick urged safety and health professionals to take a much more active role in responding to workplace injuries and in managing return-to-work times. That type of approach begins with the safety culture.

“What we're trying to instill in an injury management culture, in a safety culture, is shared goals, employee accountability and trust among the medical provider, employer and employee,” Beswick said. “Because at the end of the day, what we really want to do is provide timely and appropriate health care – nothing more, nothing less. Timely and appropriate health care.”

Strengthening Your Safety Culture

As we all know, a strong safety culture not only encourages injured employees to return to work faster but also also reduces injuries, workers' compensation costs and absenteeism. A strong safety culture also boosts productivity, employee morale and employee retention. Before getting to that level, however, Beswick said that “we have to do the blocking and tackling first.”

At Earth Tech – a global provider of consulting, engineering and construction services – the blocking and tackling involved initiating a number of paradigm shifts, including moving from:

  • Top-down “command and control” to bottom-up ownership.
  • External enforcement to shared responsibility.
  • Safety as a priority to safety as a value.
  • A “workers' comp mindset” to management of employee health.
  • Failure-oriented to achievement-oriented.
  • Outcome-focused to process- (behavior) focused.

“We had to get away from safety as a priority – as if everything we do is not a priority – to safety as a value,” Beswick said, commenting on one of the paradigm shifts. “If we have senior managers walking around talking about safety all the time, to me that is safety as a priority. When safety is a value, it's almost unspoken. It's an expectation of everybody that walks through your door. You no longer have to wear it on your lapel. It's part of your DNA. That's what we need to get to.”

This is Part 1 in a three-part series detailing 10 company and medical practices that can undermine your return-to-work efforts.

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