Hospital offers free case management for workers
Program generates new industrial clients
Providing free, around-the-clock case management for injured workers who come to its emergency department (ED) has paid dividends for the industrial rehab program at Southern Ohio Medical Center in Portsmouth.
The case management program is conducted by members of the hospital's industrial rehab team and includes full-time employees from all disciplines. They are available 24 hours a day, seven days a week for any type of injury or illness that occurs at work, ranging from poison ivy and eye injuries to broken bones and muscle sprains. About 25% to 35% of the patients who are case-managed under the hospital's Workwell program are referred for therapy at the hospital.
"It provides a good continuity of care. They can see whomever they like for rehab, but they get to know us, and many choose us for their rehab," says Emily Carson, OTR/L, coordinator of the program.
In addition, the hospital offers drug and alcohol screens and other industrial rehab services, and the Workwell case management services give the program a foot in the door, says Ron McCain, MSSW, vocational counselor. And because the Workwell program concentrates on making sure patients are referred to rehab evaluated and treated within 24 hours, the number of therapy sessions has decreased.
For instance, Workwell patients with low back and muscular skeletal problems make an average of seven visits. Other patients with similar diagnoses come in for an average of 10 therapy treatments. "It fits in with the hospital's vision of promoting health and wellness of its clients," McCain says.
Building communication lines
Currently, 41 companies have signed up for the Workwell services, which are available only for work-related injuries. "We think of this as a customer service program. In the past, employers have been frustrated with lack of knowledge. A lot of times they may not be aware that an employee has been injured. It has really opened the lines of communication," Carson says.
When injured workers come to the ED, they see either the triage nurse or the registrar who have been trained to identify Workwell patients. If the employer works for a Workwell company, the ED staff mark the patient record with a red stamp that says "Workwell" and alerts the Workwell department.
During normal working hours, 8 a.m. to 4 p.m. Monday through Friday, Greg Nartker, ATC, the center's transitional work specialist, primarily covers the emergency cases. But if he isn't able to see a patient, another staff member covers it.
All staff, including physical therapists, occupational therapists, certified occupational therapy assistants, physical therapy assistants, nurses, and social workers rotate being on call. The rotation changes daily and is coordinated by Nartker. Staff answer an average of about 15 calls a week, McCain says. "Sometimes, we've gotten three calls at one time. Other times, we'll go for days without a call," he adds.
When injured workers come to the ED, Workwell staff assess them and begin to work with the ED physician, the injured workers, and the employer to manage the cases. Two physiatrists are available for referral. Workwell staff look at the employees' job duties and consult with the ED physician to decide if the employees can return to their old jobs or if they need modified duty.
"We're not making medical decisions. We're making sure all the issues are addressed. Our goal is to get the patient back to work as soon as possible," Carson says.
Among the services Workwell staff provide are these:
o Answering the workers' questions about their medical coverage or workers' compensation in general.
o Alerting the company officials that a worker is injured.
o Working with the ED staff to determine if the employee can go back to work.
o Reporting to the company about a return-to-work plan.
o Suggesting limited-duty options if the employee can't return immediately to his or her regular job. For instance, in the case of a maintenance worker treated for poison ivy, the case worker was able to help the employee find a job that didn't entail groundskeeping until the infection healed.
o Following the injured worker through any subsequent care. In the past, injured workers sometimes got lost in the shuffle, McCain says. For instance, if they didn't have a family physician, they may have returned to the ED for follow-up care and been seen by different physicians.
The Workwell process decreases workers' comp costs and gets the workers back on the job sooner, he says. "The injured workers are being seen in a timely fashion. They don't return over and over to the emergency department, and the employee knows what is going on."
In addition, by getting injured employees back to work quicker, the program decreases the chances of malingering, depression, and anxiety that sometimes accompany workers' comp cases.
The industrial medicine program began marketing its Workwell program by word of mouth two years ago, then advertised in the newspaper. The center has an industrial rehab advisory board with representatives from local business. Many of them were interested in the service for their companies.
"Now we're at the point that we don't have to do any marketing. The companies come to us," Carson says.
[Editor's note: For more information on Workwell, call Emily Carson at (740) 354-7670.]
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