Volume 18 |

Contents

HOTCOMP STILL NEEDS your help! Take the Self – Assessment Today

The ED and other units can identify strategies to keep patients and staff safe

The three-minute videos helping your employees receive better medical care

HOTComp’s Hurricane Harvey Affected Hospitals Receive $30,000 in Texas Mutual Grants

Stepping up for family after a workplace accident

HOTCOMP STILL Needs Your Help!
Take the Self – Assessment Today

The HOTCOMP Safety Committee is asking our hospitals to complete the free online Self – Assessment. This Self – Assessment was developed as an analysis tool that incorporates the guidelines and benchmarks of the ANA Interprofessional Standards. You have received an email with your facility registration token. This token can be given to others at the facility interested in taking the Self – Assessment. The results of the Self – Assessment will not be used by Texas Mutual or have any negative impact your premium. The results will be used by Atlas in partnership with HOTCOMP to create a safety program for our hospitals. As we have seen with dividends, a safer hospital saves you money.

The HOTCOMP Safety Committee’s main focus is to help our member hospitals create a safer work environment for their employees. Historically, strain injuries have been the top cause of the HOTCOMP Safety Group’s claims. Patient handling is one of the highest risk activities for hospital employees to sustain a strain injury. The committee has focused on finding a solution to help our hospitals with safe patient handling (SPH). This problem is not unique to our hospitals. In recent years, the US annual Workers’ Compensation claims for SPH has exceeded 7 billion dollars. Like everyone in the healthcare industry, our hospitals must develop solutions to Safe Patient Handling and Mobility (SPHM). The HOTCOMP Safety Committee is excited to announce a collaboration with Atlas Lift Tech to help our member hospitals develop the best safe patient handling solutions.

ATLAS Lift Tech is the partner of choice for SPHM programs in health facilities nationwide. Founded in 2009, Atlas Lift Tech is transforming the way care delivery organizations nationwide deploy and manage safe patient handling and mobility programs. Atlas provides proven and effective practices that reduce caregiver injury, promote patient safety, and produce a thriving and sustainable culture of safety. Atlas Lift Tech’s clients include some of the largest healthcare systems in the country including: Stanford University Medical Center, Memorial Herman, Tenant Health, and Cedars-Sinai. Working together with a facility’s interdisciplinary team, Atlas identifies opportunities for the integration of an SPHM program customized to the unique requirements of each facility.

This collaboration will allow our hospitals the opportunity to take advantage of the same knowledge and tools usually accessible to only the larger healthcare systems. Atlas offers a fresh perspective on what our hospitals can do to reduce injuries among staff members involved in patient handling. No hospital is immune to the challenges of employee injuries due to strain. The program will benefit both hospitals with a proven track record of having a successful employee safety program and those hospitals who struggle with the challenge of employee safety.

The safety committee is striving to have 100% of our safety group member hospitals complete the Self – Assessment. We are asking for as many employees of the hospital take the assessment as possible. Please take the time to have your hospital complete the Self – Assessment.

If you did not receive your facility’s token please email safety@hotcomp.net.
If you have any questions please contact the Program Administrator, Barry Couch.

The ED and other units can identify strategies to keep patients and staff safe
by Sallie Jimenez NURSE.com

Lisa Wolf, PhD, RN, CEN, was working in the emergency department at Cooley Dickinson Hospital in Northampton, Mass., when she experienced a painful reminder that workplace violence is a reality for nurses. She was caring for a psychiatric patient in his 80s, and as she attempted to move him in his bed, the patient kicked her in the face. The blow to her temple left her momentarily confused and in considerable pain. If the patient had been wearing shoes, Wolf suspects she would have been knocked unconscious.

“People are often stunned when they hear about the frequency of workplace violence in nursing,” said Wolf, director of the Institute for Emergency Nursing Research at the Emergency Nurses Association. “Other patients and staff are often not aware that it’s happening because these incidents occur behind curtains or closed doors.”

According to a survey of more than 7,000 emergency nurses nationwide, more than 54% of participants reported experiences of physical violence or verbal abuse within the past seven days. The leading forms of physical violence were being grabbed/pulled, hit, spit on and pushed/shoved/thrown, while the most common types of verbal abuse were being yelled at, sworn at, called names or threated with legal action. The full study was published in 2011 by the ENA.

For Wolf, one of the disturbing discoveries was that 33% of nurses in the study said they considered leaving the profession due to the violence. “This is a huge problem because this could be a significant loss of expertise and experience, which would have implications for patient care,” Wolf said.

Findings from a different study of 5,000 nurses at Inova Health System in Virginia suggest that violence is also prevalent in other hospital units. Forty-four percent of nurses in inpatient units reported incidents of workplace violence in the last year — higher than the EDs or psychiatric units at Inova, according to the 2014 study in the Journal of Emergency Nursing. Also, male nurses experienced fewer incidents of violence, but they were more likely to formally report these incidents.

Interventions that reduce risk

At Inova, the violence research study prompted hospital-wide changes to create a safer environment, said Tammy Fitch, RN, CCRN, a nursing supervisor at Inova Loudoun Hospital in Leesburg, Va. In the past, only psychiatric unit staff were required to complete a yearly crisis prevention and intervention class, and now the EDs are doing the same.

In the training, Fitch learned how to watch for signs that a patient may be escalating emotionally, such as posturing behavior like pacing or verbal cues like rapid speech or a higher tone of voice. She used these skills recently when a patient in his 20s started pacing in front of the door in his room. Fitch started talking to the patient’s mother to ease the tension, and she was careful not to turn her back on the patient as she moved herself closer to the door to unblock her exit pathway.

Wolf also encourages nurses to download the ENA’s Workplace Violence Toolkit, which allows departments to customize a violence prevention plan after assessing which situations most commonly lead to violence. “There is no one-size-fits-all intervention,” Wolf said. “Nurses should consider what types of patients are higher risk in their unit, where it is happening, such as triage or in the hallway, and if there are certain times of the day or night it is more likely. Then they can direct the intervention to address those issues.”

he American Psychiatric Nurses Association also has developed online toolkits to help nurses enhance skills that decrease the chances of workplace violence, such as patient engagement techniques. Establishing a human connection with the patient is perhaps one of the most important skills nurses can acquire to keep themselves safe, said Diane Allen, MN, RN-BC, NEA-BC, chair of the Council of Safe Environments for APNA.
“Sometimes this may seem counterintuitive when we are feeling afraid of a patient, but it’s critical to make that connection and explain to a patient that I’m on his or her side,” said Allen, who is acting director of nursing at New Hampshire Hospital in Concord, an acute, inpatient psychiatric hospital.

The majority of the patients at her hospital have been admitted involuntarily because they have been deemed dangerous due to mental illness, and many of them do not recognize that they have an illness. She’s treated patients who tell her they need to leave, and rather than becoming controlling, Allen offers to help them understand why they were admitted and what they can do to get discharged.

“When I focus my attention on trying to understand their biggest concerns, whether it be getting a glass of water or making a phone call, I have built an alliance that can carry over as I continue working with the patient,” she said.

Although organizations like the APNA are promoting practices that increase safety for nurses, research suggests that nurses need even more support. According to a study published in Research in Nursing & Health, assault rates in psychiatric units have not changed significantly over time. In the study, researchers collected data from 345 hospitals nationwide between 2007 and 2013, and they found that nursing staff members were the most severely injured victims in assaults in 65% of cases during those six years. When nurses are assaulted, it’s important for organizations to provide support, such as employee assistance programs and assaulted staff action programs, Allen said.

“Nurses shouldn’t expect violence to be a part of providing care,” she said. “As demand for services continues to increase with the aging baby boomers and more nurses retiring, it’s more important than ever for nurses to take steps to protect themselves and their units.”

How to protect yourself

Communicate frequently and thoroughly with colleagues to identify potentially violent patients early
Don’t let a patient get between you and the only exit
If you are feeling threatened, turn your body sideways with one foot in front of the other. This helps you to keep balanced and presents a smaller target to the aggressor
Don’t point your finger at people. Fold your arms or put your hands on your hips when talking
If a patient is escalating, call for help early from colleagues or security
Do not wear dangling earrings or necklaces
Do not wear a stethoscope around your neck
When possible, do not block a patient who wants to leave

Freelance writer Heather Stringer contributed to the writing and research of this article.

The three-minute videos helping your employees receive better medical care

The health care industry is evolving every day with rapid growth particularly in digital health technologies like smart watches, calorie counter apps and pedometers. Patients can benefit from this transition when there is a united front between quality care and digital innovation.

Knowing how to diagnose a workplace injury like trigger finger requires training and experience in occupational medicine. That’s why Texas Mutual is addressing the need for innovation in the treatment of workplace injuries. Texas Mutual’s medical director, Dr. Nicholas Tsourmas, is helping to lead this effort, and one of the ways he is doing so is through Workplace Diagnosis. The tool is the first online, real-time patient diagnosis video tool for physicians treating workers’ comp patients.

By visiting texasmutual.com or using our mobile app, physicians can select an area of the body to watch a video and learn about specific injuries. Each video averages three minutes and features Dr. Tsourmas with a patient discussing a common workplace injury and offering tips on how to diagnose it.

Dr. Tsourmas was recently recognized for his achievements in the workers’ compensation health care field when he received the Medical Professional of the year award at Work Comp Central’s Comp Laude Awards. His work is helping ensure that Texans with occupational injuries are accurately diagnosed and treated, and have options for modified job duties during recovery.

Dr. Tsourmas has been with Texas Mutual since 1993. Since then, he has traveled throughout the state to give onsite training to our network providers and educate the medical community on workers’ comp and musculoskeletal ailments. The same training he shares with providers throughout the state is shared with Texas Mutual’s team of adjusters to improve the claim process for injured workers and give our team the tools to understand doctors’ recommendations.

Texas Mutual puts a lot of effort into preventing workplace injuries, but when they do occur, we are dedicated to making sure that the injured workers we cover receive the quality care they need. Innovative resources like Workplace Diagnosis are a part of that collective effort. Dr. Tsourmas’ recognition is reflective of his leadership in these areas and speaks to our ongoing commitment to creating a stronger, safer Texas.

HOTComp’s Hurricane Harvey Affected Hospitals Receive $30,000 in Texas Mutual Grants

Texas Mutual offered a $10 million grant program for policyholders whose businesses have been affected by Hurricane Harvey. Three HOTComp Hospitals received grants totaling $30,000. Each hospital received $10,000 to use for payroll, building rehabilitation or repair, machinery and equipment repair or purchase, replacement of lost inventory, and other expenses associated with rebuilding. Each hospital was affected in a different way, but what they all had in common was the drive to rebuild and continue to serve their communities.

Stepping up for family after a workplace accident

More than 500 Texas families lost loved ones to workplace accidents in 2015. This is what drives Texas Mutual to promote safety, so that workplace deaths can be prevented. But if the unthinkable happens and a worker is involved in a catastrophic accident, our commitment extends to their family. It’s one of our most important responsibilities.

One of the ways Texas Mutual support surviving family members is through our scholarship program, which offers scholarships to qualified surviving family members of employees who die from an on-the-job accident.

On April 15, 2013, Morgan Carmichael became one of those whom Texas Mutual supports when her father died in a traffic accident on the job. Watch her story below.

It’s impossible to go back to normal after losing a family member, but it’s our mission to set children and spouses up for success. With a scholarship from Texas Mutual, Morgan is able to go to college without worrying how to pay for her tuition.

Texas Mutual’s scholarship program is one of the ways we put our commitment to creating a stronger, safer Texas into action. The Texas Mutual Scholarship Program has distributed $600,390 in college funds to the dependents of catastrophically injured workers since 2001, with more than $85,000 awarded in 2017.

Learn more about the scholarship program on Texas Mutual’s website and see how to apply. To learn more about how we are making a difference in our great state, visit TXM for Texas.

Safety Tips: Slips, Trips and Falls

An employee was walking into the building when she tripped on a twig and fell forward onto her knee. In another incident, an employee was walking outdoors, slipped on a rock and fell. Slips, trips and falls are often underestimated, but both of these incidents lead to serious injuries and no industry or employee is immune.

Safety Tips:

Put down the phone; always pay attention to where you’re walking.
Practice good housekeeping and alert a supervisor if there are any spills or other materials that need to be cleared.
Do not carry significantly heavy loads or loads that are too tall to see over.
Don’t rush when walking and use the handrail when going up or down stairs.

e-Learning course suggestions:

Floor & Walkway Safety & Auditing
Slips, Trips and Falls

Your Safety Committee

The HOTCOMP Safety Committee meets twice a year to discuss the issues of safety in our member hospitals and what we can do to do to help make them safer workplaces.The majority of the Committee members are administrators and safety specialists in your fellow member hospitals. We understand that issues come up through the year. If you would like to post a question to the safety committee members as a group or individuals, please email us at safety@hotcomp.net. We will pass your questions on to the appropriate member(s).

Barry Couch, CEO Program Administrator	Linda Rasor, CEO Castro County Hospital
John Henderson, CEO Childress Hospital	Gayle Cannon, Director of HR Childress Hospital
Christina Hertel, Director of HR Hamilton General Hospital	Marcy Murrell, Co-Safety Director/Infection Control Nurse Sweeney Hospital
Carol Villareal, HR Manager Gonzales Healthcare

About Safety Matters:

It is our hope that this publication, in addition to Texas Mutual’s Safety Resource Center, proves a useful tool to promote safety in our members’ hospitals. The newsletter will focus on safety issues that specifically trend to our membership hospitals.

We hope to hear from you on safety issues your hospital is facing and on successful safety procedures you have implemented. It is the safety committee’s goal to create a collaborative exchange of ideas that contributes to making all of our hospitals safer which, in turn, will increase our safety group’s benefits.

Please send your ideas, questions and comments to safety@hotcomp.net.

Why Your Safety Matters:

You’re receiving this email as a member of the HOTComp safety group. The group is a joint effort between HealthSure and Texas Mutual Insurance Company.

Group members receive exclusive benefits like targeted safety resources, a discount on their workers’ compensation insurance and potential dividends based upon the safe performance of the group. HOTComp group participants have shared in over $1 million in group dividends since 2008 in addition to individual dividends from Texas Mutual.