Rehab builds business with local industries
Rehab builds business with local industries
Site focuses on prevention in the workplace
Workplace injury prevention programs may not be as hard a sell as they once were, particularly as pressure mounts for corporations to reduce multiple injury claims that elicit higher insurance premiums and more scrutiny from the Occupational Safety and Health Administration (OSHA) in Washington, DC.
The key is to convince a major local company to try a prevention program and then to study the incidence of injuries after the intervention. That’s how Steps Rehabilitation Clinic of Arlington Heights, IL, a part of Schwab Rehab, has built a lucrative workplace injury prevention program.
"When I started in this business 14 years ago, we couldn’t give the prevention programs away," says Mary Ellen Modica, MHS, PT, director of Steps Rehabilitation Clinic, which also has a clinic in Chicago.
"Now we have done back injury education in 40 different industries, and back schools are one of the biggest programs we have," Modica adds.
The turning point came about 10 years ago when a local sanitation company hesitantly agreed to hold a back injury prevention program for its group of employees who had the greatest number of back injuries.
"We custom-made the program for them, and went out and looked at their injury record, took pictures of workers doing their job correctly and incorrectly, and put the pictures into a slide show," Modica explains.
The workers had the job of testing sewage water to make sure it didn’t contain illegally dumped materials. As part of their work, they had to carry around different pieces of equipment, so the rehab therapists showed them the correct ways and incorrect ways to carry the equipment.
"Then we set up a truck with equipment and showed them how to load it correctly and how to attach it to the sewer line," Modica adds.
Company saved $60,000 in injury costs
Months after the one-hour program, the sanitation company called the rehab facility to say it wanted more prevention training because that one program had saved $60,000 in injury costs, Modica recalls.
The next program was geared toward the company’s cleaning/paint/maintenance crews. Again, therapists custom-made the prevention program for this group, and the result was a 33% decrease in back injuries during the following year, Modica says.
"They were really happy," she adds. "When they looked at their stats, they saw that the majority of people who had back injuries had not gone through our classes, so now we have 1,200 of their workers in a class over a two-year period."
The sanitation company’s overall decrease in back injuries is 25% since the prevention program was started. Each worker attends the prevention class once every two years.
Even without such dramatic results, it’s well worth it for manufacturers and other heavy labor industries to contract for such prevention programs, Modica says. "If a company is having multiple injuries and is at high risk, the insurance company will drop them, and they may be changing insurance companies constantly."
She suggests rehab facility directors emphasize certain positive attributes of a rehab prevention program when they are making presentations to employers. Here are some of the selling points:
1. A rehab facility has trained staff who can quickly pinpoint problems that lead to injuries.
This is a crucial selling point for convincing companies to sign contracts with rehab facilities for preventive care. Often manufacturing executives and managers overlook key but simple solutions to workplace injuries, while a physical therapist can come onto the site for 30 minutes and immediately spot the problem and identify a solution.
While companies might be able to find some of these solutions on their own, a rehab facility manager can point out that trained therapists work with these issues every day and are better able to find long-term and inexpensive answers. (For examples of rehab solutions to workplace injury problems, see story, p. 96.)
2. Rehab therapists can help prevent carpal tunnel syndrome.
Rehab therapists also can help companies with office workers prevent ergonomic problems such as carpal tunnel syndrome. Steps Rehabilitation Clinic therapists photograph workers at their jobs then give the companies a printed analysis of what kind of ergonomic problems exist, based on the therapist’s observations and the photos. (See story on identifying ergonomic problems, p. 97.)
3. A rehab facility’s involvement in a prevention program will ensure the company meets OSHA standards.
OSHA requires companies to record workplace injuries, depending on the seriousness, in a log. If there is a substantial number of injuries in a certain area or job, the company must call OSHA, which may decide to visit the company to investigate the problem.
Preventing injuries and OSHA visitors
Steps Rehabilitation Clinic works with companies to prevent those major and repetitive injuries that may result in an OSHA visit. The rehab facility also helps companies meet all new OSHA regulations on ergonomics.
"We’re trying to deal with treatment of musculoskeletal disorders, and basically the new OSHA regulations are really focusing on materially handling jobs and manufacturing jobs," Modica says. "They’re basically instituting ergonomic programs when you have more than one injury in an area that requires medical care and is reportable."
Companies need ergonomic programs, and OSHA requires them to promptly care for injured workers and work on eliminating the injury hazard within 90 days. They have to keep records of what they’re doing and how it is making a difference in reducing injuries.
"OSHA wants to see that you’re monitoring these things and keeping records, and if they end up with more problems, then that’s a quick fix that didn’t work, and they’ll have to put a more in-depth program into place," Modica adds.
4. Rehab therapists can perform functional capacity evaluations (FCEs).
A major component of injury management by a rehab facility is performing an FCE, which is a baseline assessment of a worker’s functional ability to perform various work activities. The FCE typically is given to workers who have been off the job because of work injuries.
"It’s assessing the worker’s ability to lift, carry, push, pull, climb, and perform various other work-related tasks," Modica says.
Facility simulates airline baggage area
For example, Steps Rehabilitation Clinic has performed FCEs on airline workers who lift up to 100 pounds in luggage. The FCE showed a therapist exactly how much weight the injured workers could lift. "When we evaluated a couple of these clients, we found they maybe could lift only 30 pounds, and so they couldn’t go back to work with that," Modica says.
Therapists put the workers in a program that helped condition their bodies so they could improve their strength and endurance. The program provided simulated work activities. For instance, the rehab facility set up a mock luggage loading area and instructed the clients to stack luggage at different heights and move luggage in a kneeling position as if they were in the belly of a plane.
Clients also had to carry luggage of different weights and shapes up and down stairs. The rehab facility received some donations of materials and bought old luggage at thrift shops.
"Depending on how well they did, we started them on two hours and then four hours and then built them up to work a full day," Modica explains. "They would be here for eight hours when they finished, doing some simulation of their jobs."
The simulation program, which lasted about five weeks on average, was devised according to what the particular worker’s FCE showed. It told therapists what the client’s limitations were, identified restrictions, and enabled therapists to set goals that would enable them to return to their jobs.
In another FCE and work simulation program, the rehab facility set up a small house clinic for injured workers in the construction trade. Carpenters built the house, an electrician wired it; a plumber installed pipes, and a drywaller installed the interior walls and ceilings. Then, demolition workers tore the house apart. The tasks were part of a simulation program to build strength and endurance.
5. A rehab facility working with a company will be in a good position to help that company limit injury claims when workers are injured on the job.
Response to worker injury is immediate and comprehensive when the industry already has a working relationship with the rehab facility, but Steps Rehabilitation Clinic sometimes makes its first contact with an industry when a worker has been injured and needs rehab care. However the facility is working with injured workers, therapists follow a clear-cut plan of care that helps limit the costs of treatment and the time the worker is away from the job.
First, the physical therapist makes the initial contact. The PT looks at the injured worker’s posture, range of motion (ROM), strength, and neurological status. Therapists also visit the work site, and, if they are not already familiar with the various jobs, they become familiar with them.
"We are very functional and goal-oriented," Modica says. "We’re not going to just treat them with therapy as a Band-Aid."
Get them back to work
Goals are to work with the injured person on improving strength, ROM, and mechanics of a joint, all with the purpose of assisting the person back to his or her job.
For large companies, the rehab facility will have a clinic set up on the work site. "This works wonderfully because the worker can return to work and get time off for therapy, without losing [much] work time," Modica says. "The therapist knows what kind of work level the worker has to return to, and we make ergonomic changes at their job site."
For example, one injured worker had tennis elbow, caused by repetitive work in food preparation: cutting fruits and vegetables all day. A PT gave her treatment to help reduce the tendonitis, and when she returned to her job, the therapist gave her an ergonomic knife that changed the angle of her cutting, putting less force on the affected muscles.
"It worked great and made a big difference," Modica says. "So we did the same thing with other workers, too."
Therapists often adjust tools to fit a particular worker’s grip so the worker doesn’t have to work too hard to use the tool, she adds.
"If you don’t get to the root of the problem and instead just give them medication or put a hot pack on them, they’ll reinjure themselves," Modica explains. "So the best solution is to change the work site so it’s comfortable for that person."
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