By Tammy Bradly, Sr. Director Clinical Product Marketing at Enlyte
How confident are you in driving to a new destination without a navigation system? What roadblocks might you encounter and how would you know if you’re following the safest and quickest route? Would you remember directions someone had given you at a time when you didn’t need them?
Many of us would feel apprehensive about partaking in a journey without guidance, and that’s how most employees feel after sustaining a workplace injury. They’re navigating without a compass, unsure how to report it, who to notify, whether they need treatment and, if they do, where to go to receive it.
The best workers’ comp programs offer employers the ability to provide a professional guide to employees at the time of injury. Much like a navigation system helps drivers, nurse triage programs are designed to guide employees to choose the right level of care for their specific injury.
The Workers Compensation Research Institute identified trust in the work relationship as a critical variable in predicting return-to-work outcomes. When a workplace injury occurs, employees need to trust their employer will do right by them. That trust extends to those assigned to manage these injuries, including treating providers, insurance companies and third-party administrators. If trust isn’t established at the onset, the injured employee’s recovery can easily veer off course.
One way employers can demonstrate trust at the time of injury is providing employee access to an expert in managing health — a nurse. Year after year, nurses have topped Gallup’s honesty and ethics list for most-trusted professions. This makes nurses the ideal point of contact when an injury occurs.
Without access to this trusted resource, injured employees often must rely on a frontline supervisor to determine how to proceed with treatment. Oftentimes, they’ll be instructed to go to an emergency room or an urgent care clinic. In some cases, the injured employee might see his or her own personal physician. The consequences of such scenarios can result in over- or under-treatment and unnecessary costs.
Alternatively, ClinicalCare24 offered by Genex, ensures the injured employee receives timely, clinically sound treatment recommendations. After an injury occurs, a call is made to a toll-free number staffed around the clock by registered nurses who can assess the employee’s injury. Depending on employee demographics access to bilingual nurses and/or interpreters for non-English-speaking callers, as well as relay services for employees with hearing impairments, are offered as part of the standard ClinicalCare24 service.
Armed with clinical knowledge and evidence-based triage guidelines, the nurse helps the injured employee make an informed decision about the most appropriate setting or level of care.
Depending on the nature of the injury, options might range from simple first aid or self-care instructions to having the injury seen by a health care provider. In a surprising number of cases, self-care is often the most appropriate choice made by the impacted employee. According to the Wellness Council of America, 70 percent of all doctor’s office visits are unnecessary, and 66 percent of all ER visits are non-emergencies. The total cost of unnecessary emergency room visits is just under $14 billion annually. Nurse triage programs used in workers’ comp have demonstrated that nearly half of all callers are likely to opt for self-care rather than their original plan of seeking out medical care in an emergency room, urgent care or with a physician.
When the employee chooses self-care, the nurse provides specific instructions and a follow-up call or text to confirm the condition is improving. Or, if treatment is indicated, the injured employee can be referred (if jurisdictionally allowed), to a preferred provider in the employer’s workers’ comp network. This ensures the employee will be seen by a credentialed provider experienced in the treatment of work-related injuries.
Engaging a Case Manager
Nurse triage at the time of injury can go a long way toward building trust and positioning care in a positive direction, often preventing the incident from becoming an actual claim. Employers who want to further nurture trust, when medical attention is obtained, may choose to extend care beyond nurse triage and engage a case manager, who can coordinate with the treating provider and follow up on return-to-work plans.
Employer Results Matter
Employers who have implemented nurse triage programs have seen significant decreases in the number of medical and indemnity claims and in workers’ comp-related medical costs. In fact, one employer cited remarkable results including: injury reporting timelines dropping to an average of one day, medical only claims dropping by 1/3 and a return on investment of $19 for every dollar spent. These results demonstrate that giving employees a clear roadmap helps drive improved outcomes for all involved.
If you are ready to take the next step in establishing trust, simplifying the route for your injured employees and improving overall outcomes, contact us and we can get you on the right path.
This is a sponsored post from WorkCompWire marketing partner Enlyte.