Industry: Insurance Carriers - SIC Code: 63

Employees: 2,017 (as of October 2002)

Success Brief:

CTD-related repetitive strain injury claims and costs have fallen from 103 and $526,000 in 1991, to 52 and $137,000 in 2001.

The Problem:

In 1991, CTD-related injuries among employees performing data input tasks on computers were rising. Blue Cross Blue Shield of Kansas (BCBSKS) reported 103 CTD-related claims costing over $500,000.

The Solution:

Since 1991, the company's focus has shifted from "managing RSI claims" to "facilitating work safety and overall employee health," thus educating and accommodating employees to be as comfortable and pain-free as possible both at work and at home. The BCBSKS ergonomics program has continued to change over the years to meet the needs of an ever-changing organization. Measures implemented by the company include the following:

• Purchasing 900 "ergonomically correct" chairs at the end of 1990 in an attempt to ease low back pain and carpal tunnel syndrome.
• Using accessories such as glare screens, articulating and split keyboards, document holders, mouse rests, and different mouse varieties.
• Initiating and maintaining educational ergonomic programs and training for all BCBSKS employees.
• Since 1993, providing ergonomically designed workstations and indirect lighting in the company's new buildings.
• Remodeling older buildings with ergonomically correct office equipment.
• Increasing from one part-time to two full-time corporate registered nurses. In 1993, the nurses helped create an on-site electronic job-site questionnaire that educates and requests information on employee workstation comfort.
• Nurse availability for employees experiencing work-related (or non-work-related) pain or illness. The nurses follow their workers compensation physician's standing orders for assessment, evaluation and implementation of conservative measures during initial exam.
• Since 1998, body composition analysis (body fat %) via Tanita machine has been available for employees. A Corporate Nursing staff member assists with the analysis and the printed results are immediately available for the employee.
• In 2000, BCBSKS installed three Health Stations for use by the company's employees. The machines are available for use "24/7." They monitor blood pressure, pulse and weight.
• Since 2000, free flu shots are available to all interested employees, provided by the Corporate Nurses.
• Cholesterol testing has been offered free to employees. In 2002, the Cholestech finger stick cholesterol testing was provided by the Corporate Nursing department staff. With the Cholestech testing, immediate printout results are available for the tested employee.
• Each year we also invite local dermatologists (skin specialist physicians) to come on-site for free employee skin checks. This has been a life-saving program.
• In 2001, five Li'l Medic machines were installed at BCBSKS. The machines offer employees various over-the-counter medications for only $.25 each.
• New employees are educated during their first day of employment with BCBSKS in their orientation session regarding ergonomics and proper alignment techniques with their workstations.
• All new employees receive a job site evaluation typically within 10 business days of employment with the company. The employee and their management receive copies of the job site form for future reference.
• The company follows up with all employees who receive job site evaluations within 30 days of their evaluation.
• BCBSKS has designed and builds equipment necessary for workstation comfort when specific equipment cannot be found. For example, the pro-vu spacemizer podium was developed in 1996. It has since been modified and is utilized by most employees. The podium, which sets in front of the PC, behind or above the keyboard, is utilized for holding papers, books, and literature viewed for pc input or analysis; thus, neck, back and eye strain are reduced. The company has also designed and fabricated workstation extension bars, chair arm writing support mechanisms, terminal risers and more.
• In 1996 a "loaner pool" of new, fully adjustable chairs was established. If an employee needs a different chair and no other available chair will suit their needs (all available chairs are perused), with management approval they consult with the Corporate Nursing department where a new, fully adjustable chair is fitted to the employee by a Corporate Nurse (several styles of chairs to choose from, all cost-effective with solid warranties). The employee is allowed to sit in the chair for one week. If after that period the employee and their management decide to keep the chair, it is then transferred to their cost center. If the employee does not like the fit of the chair, the process begins with another new chair.
• The company has issued new, larger, 21-inch monitors for the majority of employees.
• The Corporate Nursing department continually researches ergonomic information/literature/equipment and implements additional measures as needed.
• We work closely with our workers compensation TPA.
• We also work closely with our workers compensation medical provider.
• Together with our TPA and workers compensation medical provider, we have developed and utilize a preferred provider network for our employee work-related medical care.
• Began company-wide stretch program in 1999. A member of the Corporate Nursing department staff travels to individual units approximately 2 times/month to lead and facilitate various stretching exercises. Focus leaders from within the units keep the stretches going twice per day throughout the rest of the month. Incentives such as handouts, music, bright colors and fun encourage participation in the stretch program.
• The company strives to accommodate any return to work status, including alternative duty.
• Club Blue exercise facility was established in 1995. All employees are able to utilize the exercise facility (open "24/7") upon completion of a brief equipment orientation. The facility features cardio machines, stationary exercise equipment, and exercise floor area for the daily exercise classes offered to employees. A TV, VCR, and exercise tape library is available for employee use as well.
• The company also holds an annual employee health fair celebrating National Employee Health and Fitness month in May. In 2002, the health fair featured an employee on-site Olympics and also an employee Health Risk Factor game (similar to the Fear Factor TV program).
• Future services may include on-site physical therapy under physician direction.
• The company teams and partners with the following departments to get the job done:
  • Corporate Nursing
  • Facilities
  • Maintenance
  • Purchasing
  • Corporate
  • Education
  • Accounting
  • Personnel
  • Management
  • Info Center

The Impact:

CTD-related repetitive strain injury claims and costs have fallen from 103 and $526,000 in 1991, to 52 and $137,000 in 2001.

Source:

• Terri Janda, RN BSN, Corporate Nursing Department, Blue Cross Blue Shield of Kansas (November 2002).