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Risk managers have become finely attuned to the health and safety of patients, but what about the doctors, nurses, and other medical staff who care for them? More often than not, the safety of healthcare workers is overlooked because patients are the primary focus, some experts say.
As a result, more than 2 million reported lost work days due to on-the-job injuries are sustained annually by workers in the healthcare industry, says Scott Harris, PhD, MSPH, director of EHS Advisory Services for Underwriters Laboratories Workplace Health and Safety, a consulting group based in Franklin, TN. He says risk managers are beginning to pay more attention to the financial ramifications and bottom-line impact of neglecting the safety and health of hospital and other healthcare employees.
Harris studies the effects of worker injuries in the healthcare industry and says the costs are growing. For injuries sustained in 2011, the costs to healthcare employers totaled about $13 billion, but that number climbed to $13.9 billion for 2012. The worker population also went up in that timeframe, and the rate of injuries remained about the same.
"There seems to be a gentle shift toward a more serious injury," Harris says. "The leading type of injury by far is overexertion back injuries, which is double or triple anything else. That typically is associated with patient handling, tripping, and falling, often all at the same time."
The average injury cost also is rising, currently at about $79,000 per injury. When the cost of injuries is spread over the entire healthcare workforce, the cost comes to about $870 per worker, he says.
"You can look at that as a tax or a fee or whatever, but if you look at your entire workforce, you can expect to spend almost $900 a head for lost-time injuries this year," Harris says. "The numbers are huge. If I told you you had a $79,000 water leak, you'd probably go in there and fix that."
Hospitals account for half of the costs and close to half of the injuries, even though they don't employ half of the healthcare work force, Harris notes. (For information on how the Occupational Safety and Health Administration might become more involved with healthcare injuries, see the story on p. 18.)
Employee health also is a growing concern for Grena Porto, RN, MS, ARM, CPHRM, healthcare practice leader with ESIS Health, Safety and Environmental in Philadelphia and former president of the American Society for Healthcare Risk Management (ASHRM) in Chicago. Employee health and patient safety always have been closely intertwined, she says, but there also has been an effort to delineate the responsibility for the two.
"We've had employee health and risk management, and for a long time they were completely separate departments that just happened to have a lot of the same concerns," Porto says. "We were both concerned about falls and the cost of injuries that happened on the premises, but we in risk management always focused more on the patient."
Acknowledging the overlap does not necessarily mean that two departments should be merged or that the employee health duties should be heaped onto the already overflowing plate of the risk manager. Rather, risk managers should look for ways to work cooperatively with their counterparts in employee health and avoid duplicating efforts, she says.
Harris suggests that risk managers might play a role in investigating and preventing worker injuries because their field has concentrated so effectively on patient safety in recent years, whereas employee health professionals can get bogged down in the financial management of injuries after they happen. Risk managers also might have some expertise in exploring the true costs of an injury that are sometime not so obvious.
"A lot of times when we talk with employee health professionals, they will be able to cite the insurance costs and the time off work as expenses, but we normally see that their estimate of the cost of those 20 injuries last year was lower than it actually was," Harris says. "We try to focus on the real numbers, how that nurse being out for two weeks with a knee injury is going to cost you on average $79,000."
Hospital administrators typically do not treat patient injuries and worker injuries the same, Harris notes. They put much more emphasis on injuries occurring to patients, he says. (See the story below for more on the perceived difference.) That disparity is partly because patients are the focus in healthcare, and nurses often are tough people who are accustomed to working injured, he says.
"But at the end of the day safety is safety, and you can't say one group is more important than another when it comes to safety," Harris says. "The effort the healthcare industry has put into patient safety is admirable and there's no call to back away from it, but that only shows what could be done with the same effort in employee safety."