Optimizing Supervisor Response to Work Injury



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Optimizing Supervisor Response to Work Injury Wayne S. Maynard, CSP, CPE Director-Ergonomics & Tribology Liberty Mutual Research Institute for safety International Telecommunications Safety Conference 9/21/06

Liberty Mutual Research Institute for Safety Center for Safety Research Center for Disability Research Quantitative Analysis Unit to advance scientific knowledge in the areas of workplace and highway injury prevention and mitigation, and return to work.

LMRIS Research Strategic Focus on areas of greatest societal burden Business-relevant (loss prevention) Multi-disciplinary Non proprietary Publish in peer-reviewed scientific journals International collaborations Harvard, Tsinghua, others National institutes for health and safety

Session Agenda Overall research: supervisor and response to work injuries Liberty Mutual research: Training to improve response and get results (Shaw et al.) Developing a training program: Training modules from Optimizing Supervisor Response To Work Injury

The Safety Management Process Ergonomic Job Accommodations Pre - Injury Prevention Management Leadership Transitional Duty Worker Health Care Liaison Plan Rehabilitation Services Targeting Primary Cost Drivers Job Hazard Analysis Hazard Reduction & Control Education and Training Employee Participation Disability Management Programs Job Placement Medical Evaluations Post - Injury Return to Work

Training: Measuring Success Safety Approach Organizational readiness assessment Needs analysis Skills and knowledge assessment Development plans Training implementation Training Evaluation Results! Research Organizational readiness assessment Supervisor needs assmt organizational response survey EE survey Training design Training implementation Training Evaluation Pre an post session survey

Supporting Research Work and organizational factors have been shown to influence frequency and disability duration of workplace injuries (NRC, 2001) Many workers report indifference or hostility from supervisors after reporting MSD pain and discomfort (Strunin & Boden, 2000) Workers with disabling conditions list responsiveness of their supervisors as a major determinant in their decision to return to work (Akabus & Gates, 1991) Training alone to improve injury response has never been studied

Overall Conclusions From Research 1. Supervisors have a critical role in disability prevention 2. Immediate response by supervisor to workers reporting work-related injury significantly influences length of disability 3. Supervisor attitudes and practices can impede return to work and rehabilitation for injured workers 4. Improving response of supervisors to reports of work-related MSD discomfort can have significant and independent effects on disability outcomes

Why MSDs? Very costly (Liberty Mutual Workplace Safety Index) Lengths of disability nearly twice as all other WC claims Nonspecific or unknown causes Frustration with prevention Frustration with return to work Bad experiences both employee and supervisor

Disability for Musculoskeletal Injuries and Illnesses 0 1 2 3 4 5 6 7 8 9 10 11 12 Time loss duration (months) Percent 100 90 80 70 60 50 40 30 20 10 0 % out of work Cheadle et al., 1994

Employee Surveys: Common Themes Employee perceptions that supervisors: Blame worker for the injury Never contacted the worker after the injury Didn t speak with the worker privately Discouraged the worker from filing a claim Didn t believe the symptoms were real Were angry with the worker for being injured Didn t try to work out solutions with the worker

Discomfort level 10 9 8 7 6 5 4 3 Provided self-care at home Tried to adjust my work Notified supervisor 2 1 0 Talked with a co-worker 1 2 3 months GRADUAL ONSET OF MUSCULOSKELETAL PAIN

Shaw, W.S., Robertson, M.M., McLellan, R.K., Verma, S., and Pransky, G., A Controlled Case Study of Supervisor Training To Optimize Response To Injury in the Food Processing Industry, Work, Vol. 26, pp. 107-114 (2006)

Training Research Results Two training groups: staggered training N=23 (400 EEs each group) Group 2 trained seven months after Group 1 Three time periods; claims 1-7 month pre-intervention 8-14 and 9-21 months post-intervention Overall results 47% reduction new claims,18% reduction active lost-time claims (Group 1) 27% reduction new claims, 7% reduction active lost-time claims control (Group 2)

Optimizing Supervisor Response to Work Injury

Session Objectives Improve your role in controlling disability associated with work-related musculoskeletal disorders (WMSDs) Communicate effectively with injured workers Increase options for accommodation and reintegration of injured workers Reduce conflicts arising from disability Increase productivity and improve bottom line Improve retention of employees

Introduction What are MSDs? WC incident, claims and claims cost discussion (customize if possible) WMSDs and Disability Loss Rate/$100 Payroll $1.40 $1.20 $1.00 $0.80 $0.60 $0.40 $0.20 $0.00 $1.21 $0.48 $0.37 Materials Handling Accident Type Loss Rate per $100 of Payroll $0.98 $0.63 $0.27 $0.17 $0.24 $0.14 $0.13 $0.19$0.18 Struck by/against Repeated Trauma Slips and Falls - same level $0.56 $0.62 $0.51 All Other Evans Industries SIC 3089, 3364, 3369 and 3429 Nonferrous die-cast and foundries Business Market Benchmark - CA, IN and MI

Module 1 Rationale For Supervisor Involvement Safety management process and supervisor role Brainstorm barriers and enablers to managing work injuries MSD descriptions and types of disorders MSD disability

Module 2 Responding To Musculoskeletal Discomfort Safety management process MSD discomfort and early reporting Active listening techniques Video workshop (1 and 2) 1 2

Module 3 Understanding Musculoskeletal Discomfort and Disorders Medical evaluation and treatment First aid and self care techniques Medical red flags for upper extremity disorders and low back pain

Module 4 Ergonomic Work Modifications and Problem Solving What is ergonomics? Upper extremity and low back pain occupational risk factors Ergonomic strategies for workplace accommodation Reducing risk factors and examples (customize) Collaborative problem solving

Module 5 Maintaining Communication After Injury Supervisor role Maintaining contact with employee Assessing functional limitations Video workshop (3 and 4) 3 4

Module 6 Reintegration and Return To Work First day back Problem solving Make a plan Follow-up Video workshop (5 and 6) 5 6

Summary The supervisor s role is critical in controlling disability costs Timely & appropriate communication with workers is essential Use ergonomic principles to accommodate disabled employees and facilitate return to work A training program for supervisors can significantly reduce length and cost of lost time