Employer rehabs its own workers back to health
Employer rehabs its own workers back to health
Back-to-work time down 80%
When an employee of the Coors Brewing Company in Golden, CO, suffers a heart attack, he or she usually goes back to work in just over a month. While most don’t return to full duty at that point, the cycle is still an 80% improvement over the pre-1982 cycle. That year, Coors created the country’s only workplace early post-hospitalization (Phase 2) cardiac rehab program. One of the company’s top managers, Bill Coors, established the program after an employee suffered an anxiety attack upon returning to work following a heart attack. Rehab activities take place in the Coors Wellness Center (CWC), a 36,000 square-foot facility housing exercise equipment, workout rooms, and classroom space. A number of full-time and contract health care providers staff the center.
The success of Phase 2 rehab depends partly on the quality of communication between CWC and community health care providers who take care of employees during the acute stage of a cardiac episode. For its part, Coors has designed communication links into its program, but the staff would like to see more reciprocity from the community providers.
The handoff between the attending physician or hospital and CWC’s consulting cardiologist takes place as soon as possible after a cardiac event such as angioplasty or cardiac surgery. "Our goal is to prevent further problems and help employees get back to work as quickly as possible," explains Joan Miller, MA, a wellness specialist. And who would quibble with this, given the Phase 2 rehab record? Current return-to-work rates average 1.4 months compared to pre-Phase 2 rates of 7.5 months. The company pays whether employees participate during sick leave or after they return to work.
To fulfill the handoff, CWC requests a referral from the attending cardiologist to the Phase 2 program. If the employee was treated in an ambulatory setting, CWC sends a letter and treadmill results to the personal physician along with a request for a referral and description of the Phase 2 rehab process.
A signed release by which the patient authorizes the community physician to send medical information to the CWC cardiologist allows further communication between the doctors. For patients who were hospitalized or treated through a hospital outpatient clinic, Miller says, "we need a communication channel with medical records departments so our staff can be informed of the prior surgery and tests the employee has received."
To lay the groundwork, the CWC staff meet each year with community cardiologists who take care of Coors employees. The point is to show physicians what Coors provides and to convey the company’s expectation that employees receive their rehab care through CWC. "We explain that after they refer our employees to the Phase 2 program, our rehab physician will facilitate the return-to-work process through communication with the rehab team, employee, and employee supervisor," Miller says.
But too often, effective communication is more a wish than a reality, observes Robert Gibson, MD, Coors’ director of occupational health services and a primary care physician. Gibson is also director of occupational health at Liberty Health Care, also in Golden, CO. "We can’t achieve optimal productivity for people in their life and work unless all the providers communicate. The biggest problem with hospitals is their communication with people outside of their system. Some are very good at it, and some are very bad at it."
Gibson describes Coors’ expectations as standard for any employer. "We don’t want to waste time getting our people back to work. On the other hand, we monitor to be sure they’re ready and that we’re not pushing them too far." The employer’s rehab staff and community clinicians have to talk to each other to make that happen, he notes. Spotty feedback "is like a doctor doing an MRI on a football player who injures his shoulder in the Sunday game and not reporting the results until Saturday afternoon!"
Throughout the 12-week program, participants are routinely monitored by the company’s consulting cardiologist. They attend three sessions a week for 90 minutes of exercise and receive one hour of stress training.
Phase 2 program components include:
1. check-in with Coors consulting cardiologist;
2. entry and exit treadmill tests, blood pressure readings, lipid levels and weight monitoring, as well as employee and family counseling by Coors’ employee counselor;
3. relaxation and stress management techniques such as yoga and meditation;
4. smoking cessation techniques;
5. nutrition education;
6. fitness exercise, including aerobic conditioning and strength training for job-specific activities;
7. phased return to full duty following a job-site analysis by the CWC rehab team.
Miller says most employees return to work within four to six weeks after the cardiac event. They often start with schedules of two to four hours a day for the first week. Most are back to full duty by the time they complete Phase 2 rehab, and 99% return to their original jobs.
Phase 3 rehab involves continued follow-up with services tailored to individual needs. Some employees work with the dietitians, and others require modified exercise prescriptions.
Generally, healthy lifestyle changes among Phase 2 and Phase 3 participants are permanent, Miller observes. Most continue to exercise at least three times a week and play volleyball with other Phase 2 participants. "They keep that group closeness," Miller says. "A cardiac event has an incredible impact on a person’s perspective because it’s life-threatening. People in this group do more sharing and develop a stronger support system than people in our orthopedic rehab group."
With a solid rehab record in place, Coors now addresses prevention. This month, CWC launches a cardiac risk factor screening. All employees are offered a comprehensive medical screening. Those who show a high potential for cardiac problems will be encouraged to participate in the Coors Health Intervention Program at the CWC.
Need More Information?
For further background on employee wellness programs, contact:
- Joan Miller, MA, Wellness Specialist, Coors Brewing Company, P.O. Box 4030, WC707, Golden, CO 80401-0030. Telephone: (303) 277-5351. E-mail: [email protected].
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