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Colorado's Repetitive-Motion Injury Cost Reduction Program

An outline of the State of Colorado's plan for reducing repetitive-motion injuries.

September 18, 2003
Here’s the Repetitive-Motion Injury Cost Reduction Program, as outlined bythe State of Colorado Department of Personnel and Administration at a conferencein August of 2002.

BACKGROUND 

  • In the early 1990s, the reported occurrences of upper body repetitivemotion injuries such as carpal tunnel syndrome, tendonitis, thoracic outletsyndrome, golfers’ or tennis elbow, chronic back pain and neck strain, beganto show a growth trend of alarming rates at a time when ergonomic solutions werein their infancy.

  • Since 1991, repetitive motion injuries have accounted for approximately 25percent of the State of Colorado’s reported work-related injuries.

  • The workers’ compensation claims and medical costs, and the costsassociated with lost work hours and reduced productivity due to these injuries,presented a difficult human resources management challenge for the State ofColorado’s Safety and Loss Control Team.

  • The Safety and Loss Control Team recognized that traditional medicaltreatment for these injuries did not help curtail the number of claims.

  • Instead, the injury response method of such treatment dealt primarily withthe symptoms, and this approach became increasingly costly.

  • The traditional medical approach also returned employees to the samepostural work habits that caused or exacerbated these injuries.

  • In 1991 when ergonomic solutions were still in their infancy, thethree-member Safety and Loss Control Team began traveling the state performingergonomic evaluations.

  • These evaluations analyzed, identified, and corrected workers’ behaviorsand environments that contributed to, caused, or exacerbated repetitive motioninjuries.

  •  Positive results soon followed, but Safety and Loss Control Team wanted tobring ergonomic evaluations and training to a wider number of employees.

INNOVATIVE SOLUTION

With the initial success of the ergonomic evaluations, Safety and LossControl Team began to develop a more comprehensive program--The RepetitiveMotion Injury Cost Reduction Program (RMICRP)--with the following goals:

  • Improve workforce awareness about repetitive motion injuries;

  •  Increase repetitive motion injury prevention training for employees;

  •  Multiply the number of ergonomic evaluations being performed;

  •  Decrease the occurrence of these injuries and the subsequent claims; and,

  •  Reduce the cost of treating these injuries when they do occur.

  •  RIMCRP provides on-site, holistic, and comprehensive treatment for theinjury and its causes, rather than merely addressing the symptoms of the injury.

  •  RMICRP incorporates three distinct yet complimentary components to achieveits goals:

  1. an "Ergonomic, Train-the Evaluator" training course;
  2. a Web-based "On-line Repetitive Motion Injury Prevention" course; and,
  3. the "Trauma Release Techniques TM"--abbreviated TRT TM--analternative and highly effective, on-site, hands-on, treatment derived fromRolfing, which is a deep tissue manipulation system.
  • The on-premises treatment includes an evaluation by a certified Level IIoccupational medicine physician who determines treatment eligibility and followsthe claim through to closure.

  • Prior to this course offering, each Safety and Loss Control Team membercould perform between 50-300 evaluations each year. The training course allowsus to reach many more employees.

  • The increased training makes it easier for departments to incorporate anergonomic evaluation as a part of the state’s new-hire orientation.

  • The training increases the ability to proactively evaluate employeeworkstations either before injury occurs or becomes permanently damaging.

  •  Employees who begin to exhibit symptoms of repetitive motion injuries havetheir workstations adjusted earlier in the course of an injury becauseevaluators are trained to recognize the early visual signs of these injuries.

  • By incorporating the use of the Web and adding the on-line trainingcomponent, Safety and Loss Control Team has significantly increased thereachable audience.

  • The on-line training has helped us raise awareness in the workforce aboutrepetitive motion injuries.

  • Educating employees facilitates positive change in postural work habits.

  • TRTTM is an alternative and highly effective, on-site, hands-on,treatment derived from Rolfing, a deep tissue manipulations system.

  • A TRTTM session takes approximately 30 minutes as opposed to the one totwo hours per visit usually needed by traditional treatment methods.

  •  Every employee who participates in the TRTTM treatment method must alsohave a workstation evaluation done as part of the treatment process. Thismitigates more serious injury, further pain, loss of productivity and cost.

RESULTS

  • Results from our one department pilot program showed a significantdecrease in cost per case. Using matured data, 69 cases in FY 2000 had anaverage cost per case treated by traditional medicine of $2,622.15 while theaverage case treated by TRTTM was $409.50.

  • We are extremely optimistic that within three years we can reduce ourtotal repetitive motion injury costs by 80 percent.

  • Pilot program data also shows a drastic decrease in lost work time due totreatment.

  • Participants also felt more comfortable these being treated on-site. Thisrelieved some of the fear associated with treatment.

  • Claims close much faster and "Maximum Medical Improvement" is reachedfar earlier than traditional medical treatment.

  • Participants in TRTTM have overwhelmingly positive things to say aboutthe treatment.

  • Our third party administrator also recognizes the positive results.

  • While we cannot quantify the improvement in morale, comments about theprogram from employees and supervisors clearly depict this change.

  • Increased productivity correlates to the limited time away from work fortreatment.

  • Supervisor and employees have noticed an improvement in work habits asemployees return to work feeling better.

  • Every department now participating is seeing similar results.

  • Through continued employee education and proactive ergonomic evaluationsfor all each employees, we feel as though we can dramatically curtail theincidents of repetitive motion injuries.

LESSONS LEARNED

  • One of the most attractive aspects of the program is that it requires fewresources to begin, so you can get started.

  • The Ergonomic Train-the-Evaluator Course requires only a training video,qualified facilitator and TV/VCR.

  • The online Training Course is on the Internet and is immediately availableto the workforce.

  • Interested trainers and employees to introduce the program and itsbenefits should be easy to find.

  • One of the more difficult challenges has been finding the number oftherapists trained in TRT™ to accommodate our large workforce.

  • Educate your risk managers. Determine where your repetitive motion claimsare occurring; don’t limit it to upper extremities only--lower backrepetitive motion injuries should be included.

  • Begin educating the workforce about repetitive motion injuries andergonomic solutions.

  • Try to incorporate education into new employee orientations.

  • Introduce the concepts to management; having a trained therapist toactually demonstrate TRT™ helps but is not necessary.

  • Request and select volunteers to participate in ergonomic evaluations,training and alternative treatment.

  • As employees became more aware of what repetitive motion injuries are andthe availability of a program, we experienced an initial rise in claims. We haveattributed this to the discovery that many serious claims had previously goneunreported until the advent of the program.

Reprinted with permission of the HR Center at the International PersonnelManagement Association (IPMA), 1617 Duke St., Alexandria, VA 22314; (703) 549-7100.

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