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Some people are so sure you’re going to save money with ergonomics, they’re willing to guarantee it. Vendors of ergonomics equipment are offering money-back guarantees based on estimated cost-savings from reduced injuries. Some hospitals around the country are also receiving discounts on workers’ compensation premiums.
"It’s our way of creating an incentive for them to purchase equipment and to help fund the purchase," says Peggy Swirczek, CHSP, director of loss prevention services at the Michigan Health and Hospital Association (MHHA) in Lansing.
In most cases, the discounts are linked to an overall ergonomics program, which includes a risk assessment, employee training, and management commitment, in addition to equipment purchase. "The secret behind trying to get the ultimate results is by making a coordinated effort," says Don Maynes, president and chairman of Donald P. Maynes and Associates, a loss prevention consulting firm based in Altoona, IA, that offers an ergonomic risk management product that is endorsed by the American Hospital Association.
The incentives to implement ergonomics come in many forms. In Michigan, the MHHA offers discounts of up to 15% through its Model Loss Control Program in the group self-insurance fund, including a 10% discount off premiums for the purchase of mechanical lifts in the prior 12 months. Such incentives may make a difference at a time when hospitals are faced with so many cost pressures, says Swirczek. "They may not have been able to make [the purchase of lifting equipment] a priority," she says. "This gives them that added incentive to push them over the edge."
Swirczek recommends hospitals provide approximately one mechanical lift for every 15 to 20 patients, if at least half of them are partially dependent. The number of lifts would be higher in units with highly dependent patients, such as the intensive care unit. Hospitals concerned about the bottom line can keep this in mind: Mechanical lifts pay for themselves in reduced injuries, including fewer claims and lost workdays. And that’s guaranteed.
Maynes guarantees that workers’ compensation claims will be reduced by the total cost of the ergonomics program — including equipment, training, and other consulting fees — "or the facility is reimbursed dollar for dollar for every cent that the program costs them up to 100%, allowing them to keep the equipment and any and all services we have rendered. "It’s a no-cost type of scenario," he says.
The program usually spans a three-year period. For example, the Jim Thorpe Rehabilitation Hospital in Oklahoma City spent $140,000 on its ergonomic equipment and program. In the first year, claims dropped from $107,000 to $64,000, for a savings of $43,000. By the third year, claims had fallen to a mere $6,000. The three-year savings equaled $231,000.
After three years, the company usually passes on responsibilities to an in-house ergonomics coordinator — someone who maintains the commitment to the program and ensures that equipment is used properly. "You really are serving as a change agent," says Maynes. "In order to make sure that culture is appropriately adopted to the new ideas, you need to be there."
Equipment manufacturers also have taken the same approach of providing more than just machines and offering money-back guarantees. Arjo of Roselle, IL, has a back injury prevention program that guarantees a reduction in back injuries of 30% or more with the mechanical lift and repositioning equipment. Anyone who doesn’t receive that benefit or isn’t satisfied with the products can return them for a complete refund. "If you follow our program, we will guarantee a 30% reduction in the number of incidents," says Andrew Hepburn, vice president for Diligence Services at Arjo.
With the company’s new Diligence program, a clinical coordinator comes for monthly training and mentoring visits. The company guarantees a 60% reduction in incidents for a three-year period. "If you teach [employees] a better way to use the equipment, it becomes a valuable tool in the daily routine," says Hepburn, who notes that some employers have reduced injuries by 100%.
One benefit of these programs lies in the assessment and training. To implement a guarantee, the vendor has to supply more than just a collection of equipment.
Hill-Rom, a medical equipment company based in Batesville, IN, offers an evaluation, reviewing the needs for policy changes, training, and other aspects of a full ergonomics program. "It’s not enough to just put the equipment out there," says Rick Barker, CPE, manager of patient and caregiver safety. "It takes good policies and employees [who understand] not just how to use the equipment but why they should use the equipment."
The company views its guarantee as a "risk-sharing agreement." After an evaluation that includes the past injury records and existing ergonomics program, the company would outline how much the hospital can expect to save each year with the equipment and other ergonomics improvements. If the agreement states the hospital will save at least 30% in musculoskeletal disorder injury-related costs in a year, and the actual savings are 20%, the company refunds the difference, either through a direct payment or additional equipment, says Barker. The guarantee can’t exceed the purchase price of Hill-Rom products. "If they purchased $200,000 of equipment, that would be the top end of what we guaranteed," he says.
"Facilities closer to average or higher costs than average are going to see a much bigger opportunity to improve," he says. "With that bigger opportunity to improve, there’s going to be a greater [potential benefit]."
Of course, there are criteria. Participating hospitals must start out with "good historical injury cause data, so that they can track and understand the things that have caused injuries in the past," says Barker. After all, if you don’t have detailed information about your current and past injuries, you may not know how your future performance compares. Hill-Rom also expects "strong upper management support to the injury reduction process as a whole," says Barker.
"It’s also necessary that they fully implement the product recommendations and the program recommendations that we bring to the process," says Barker. "Those program elements would include things like developing an ergonomics plan, having specific policies and procedures in place, training for their safety committee, and training for their employees in ergonomics."
It’s up to the hospital to make sure employees use the equipment. "If people weren’t using the product properly at the time injuries occurred or they’re not consistently utilizing it, there’s language in the guarantee clause that allows excluding cases," Barker says.
[Editor’s note: For more information on ergonomics guarantees, contact Don Maynes at www.costsprogram.com or (888) 844-2678; Andrew Hepburn at www.arjo.com or (800) 323-1245, ext. 4875; or Rick Barker at (800) 445-2114, ext. 8793.]