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Article of the week: Ergonomics can have you sitting pretty

Rehab Regs, February 15, 2008

Add an injury prevention program to your facility's offerings

In addition to their current therapy, many of your patients may also need treatment for on-the-job injuries, repetitive motion problems, or shoulder and neck strain. Instead of having them come to you, why not go to them?

Contracting with businesses is a great way to create a niche market for your rehab agency and earn new patients to boot.

Because the need for injury prevention programs is not geographically specific, any place is the right place to start a program.

Most patients come to you after they experience pain or discomfort or after a workers' compensation incident has occurred. Consequently, therapists are used to being reactive in their treatment rather than proactive.

But you can help business owners improve their bottom line by catching problems before they start, according to Sandi Sorum, OTR/L, an OT with the Sioux Valley Clinic's occupational medicine department in Sioux Falls, SD.

Here are a few of the benefits an ergonomics program can offer an employer:

An increase in employee morale
An increase in employee physical well-being
Increased efficiency at work
Decreased injuries, illnesses, and workers' compensation costs
Decreased absenteeism and turnover

"Unfortunately, most employers are too busy taking care of other things and only focus on injury prevention when they have a huge number of workers' compensation claims that force up their insurance," says Michael Weinper, MPH, PT, chief executive officer of PTPN, a network of rehabilitation professionals in private practice in Calabasas, CA. "[Injury prevention] is a market that has great opportunity."

With workers' compensation insurance rates gaining more publicity recently, it's becoming easier to convince employers that ergonomics education is the way to go.

"The biggest challenge is to get businesses to be proactive," says Kathy Wellbery, PT, CIE, ergonomic program coordinator at the Health and Fitness Institute in Concord, CA. "But in the past year, it's been easier for me to go into a company proactively because workers' compensation is so much in the news."

Therapists can use ergonomic principles to improve the fit between the worker and the workplace, says Sorum. One of her program's first clients were staff in the employee health department associated with her department's hospital.

Recently, she learned that a group of employees were being relocated. As the employees adjusted to their new workspace, Sorum held a half-hour inservice and provided them with information on proper office setup, demonstrated various stretching techniques, and stressed their importance.

After the training session, Sorum went to each workstation and talked with employees about any aches and pains and made helpful adjustments to chair height, computer location, etc.

"If I go around to each employee in an entire department, I can catch some problems early," says Sorum. "From factory workers to food production [employees] to dried flower arrangers, any type of industry can benefit from ergonomic evaluations."

Wellbery holds similar hourlong educational sessions during which she discusses proper positioning for each body part that a patient may use in his or her job. But she also suggests doing a bit of prior research to determine the needs of the employees with whom you'll be speaking.

"Go through ahead of time and take some digital pictures," says Wellbery. "Show a picture of a worker positioned incorrectly and then another picture of [him or her] doing it right."

William Beaumont Hospital's WorkAbility Program in Royal Oak, MI, began in 1986 and includes every thing from a loading dock to bouncing truck seats and simulated scaffolding. By creating a work-hardening environment that is as close to an actual work site as possible, patients can make improvements before returning to work.

"It takes a good week for patients to let their guard down about getting reinjured," says Daun Klein, OTR, program supervisor. "If you can treat them while they are simulating the job they actually do, [patients] relate to it better."

In this 4,000 sq. ft. outpatient facility, four OTs and a certified OT assistant initially see patients covered by workers' compensation and auto insurance for four hours a day, five days a week. Therapists scale back the frequency as patients recover from their injuries and go back to work.

In addition to work hardening in their state-of-the-art clinic, the therapists at WorkAbility also go into the community to do work site evaluations.

Unlike other niche markets that require an initial investment in capital equipment, the items you need for proactive injury prevention are minimal. Consider the following tools:

Tape measure-for measuring heights and distances in a workstation
Force gauge-to measure the push and pull force of any tools in an industrial setting
Scale-to weigh items an employer expects an employee to lift, and then make sure they match that individual's job description
Digital camera-to take before and after photos of a workstation

Most likely, you already have these items at your facility. But something you should invest in is education and training for the staff members who will conduct these inservices and evaluations.

Most patients whom you see in your facility after they begin suffering from ergonomic-related injuries will either be covered through workers' compensation or automobile insurance. If you contract with companies that want to take the initiative and have you hold an inservice or evaluate their workstations, they will pay you directly.

"The beauty of injury prevention programs is that they are cash-based, and you can work [evaluations and trainings] into your schedule during nonpeak treatment times," says Weinper.

Keep in mind these other important nuggets of information from the experts:

Cultivate referral sources. Most referrals will come from physicians, workers' compensation case workers, or word of mouth. If you do work-site evalua tions, employees to whom you present may also con tact you when they need treatment outside of work.

Job descriptions are helpful, but not always available. Know exactly what an employee does at his or her job. If you can't obtain a job description, conduct a thorough interview to determine his or her goals, or perform a job analysis.

Research the market. Before you set prices for your services, study the prices of similar services in your area and also track regional workers' compensation and auto insurance rates.