Sharing strategies to battle the opioid epidemic

By Brian Wilson, DC, BWC Medical Projects Director

How do we make headway in combating the opioid epidemic? The fact is there are many answers to that question. We’ve learned here in Ohio that tackling this issue must be a collaborative effort, and we can all learn from each other.

I know from my work with the International Association of Industrial Accident Boards and Commissions (IAIABC) that my counterparts in other states feel the same.

The IAIABC is an international association of workers’ comp agencies and industry stakeholders. BWC regularly engages IAIABC and its members, leaders at similar agencies across the country, to discuss policy and regulatory issues that affect the workers’ comp industry. One of those leading issues is the opioid epidemic.

I have the honor of working closely with IAIABC and its executive director, Jennifer Wolf-Horejsh, as a member of its Medical Issues Committee. The committee gathers information on how local and state agencies are managing important issues like the use of formularies, drug educational materials and prescription drug monitoring programs.

In June 2018, Ms. Wolf-Horejsh and I had the privilege of speaking at Ohio’s 2018 Opiate Conference in Columbus, Ohio. Here, we gave a glimpse into preliminary findings of the report to-date and compared Ohio to other states for those who attended.

Most recently, I sat on the Opioid Task Force, a multi-state collaborative effort that recently released the Opioid Policy Inventory a compilation of survey data from 33 states and their responses to the opioid epidemic. The report is a summary of major strategies, including which states are using them, along with links to national resources.

Understanding the incredible reach of this issue, and that everyone with a stake in this crisis can learn from each other, the report provides not just a workers’ compensation perspective, but a collective look at what a variety of local and state agencies are doing. Our goal is to create a dynamic and collaborative conversation starter piece for policy-makers across the country.

This report is important because it allows states to review strategies that are working elsewhere and they may be able to replicate. It could also stimulate fresh ideas. Thanks to all the outstanding committee members whom I served alongside during the development of this document.

I hope you’ll take the time to review the report* and use it as a reference, especially if you’re involved in efforts to ease the impact of this epidemic in your community.

*This is a living report and it will be updated as states report new strategies to the IAIABC.

 

Celebrate National Nurses Week, Day: May 6 – 12

Nurses: Inspire, Innovate, Influence

By Mary Charney, BWC Director of Nursing

Inspire, Innovate, Influence. That’s the theme for National Nurses Week, which runs from Sunday, May 6, to Saturday, May 12 (National Nurses Day celebrating Florence Nightingale’s birthday).

This year’s theme also reflects the important role nurses have in holistically caring for Ohio’s injured workers at work and home.

Better You, Better Ohio!,BWC’s health and wellness program for employers (including health care clinics, offices, practices and centers) of 50 or less employees, emphasizes the importance of employee and injured worker wellness for lifelong health.

BWC nurses lead the way

Our 58 nurses work in a variety of areas, from medical policy and employee health to rehabilitation, claims management and clinical advisement. They inspire, innovate and influence Ohio’s injured workers and our employees to manage their health and they promote the highest quality of life and well-being for all of us.

We, along with the rest of the nation, devote this week to highlighting the diverse ways registered nurses work to improve health care.

In honor of National Nurses Week, we thank our nursing professionals for what he or she does every day at work and within our communities. Nurses make a difference by inspiring, innovating and influencing all of us throughout our lives.

Largest, most trusted health-care profession

Nursing is the largest of all health-care professions, according to the American Nurses Association (ANA). For the 16th consecutive year, the American public ranks nurses as the professionals with the highest honesty and ethical standards, based on a Gallup poll.  The ANA believes advocacy is a pillar of nursing.  Accordingly, the ANA calls on nurses, as one of the most trusted professions, to be healthy role models.

In its Healthy Nurse, Healthy Nation Grand Challenge, a nationwide movement, the ANA states, “If all four million nurses increased their personal wellness and then their families, coworkers and patients followed suit, what a healthier nation we would live in! That’s the goal of the grand challenge an initiative to connect and engage nurses, employers and organizations around improving health in five areas: physical activity, nutrition, rest, quality of life and safety.”

Health, safety and wellness risks for nurses

The Executive Summary of the ANA Health Risk Appraisal (HRA) findings reports,

“Nurses and nursing students face unique hazards in the workplace and multiple health, safety and wellness risks.” The findings suggest that “nurses are less healthy than the average American. Research shows they experience 2.8 times more stress, have a 30 percent less nutritious diet, five percent higher body mass index (BMI), and get 10 percent less sleep. The HRA results show there is room for improvement in nurses’ health, particularly with physical activity, nutrition, rest, safety and quality of life.

“As seen by the fact that 68 percent of the nurses reported putting the health, safety and wellness of their patients before their own, now is the time to educate nurses and employers on the importance of nurse self-care.”

To help lessen safety risks for nurses related to patient lifting, needle sticks and/or infection control, BWC’s Division of Safety & Hygiene, offers safety grants for health-care employers to improve patient and staff safety. If a nurse is injured, our transitional work grants program helps transition injured nurses back to work safely and quickly.

In summary, “nurses are critical to our nation’s (and our state’s) health. Healthy nurses are great role models for their patients, colleagues, families and neighbors.”

Promoting health and a balanced lifestyle is just one nursing role. Every day, BWC’s nurses strive to serve as the best resource and provide excellent service for Ohio’s injured workers and our employees.

Return to Work – Yes You Can!

Brain Injury Association of Ohio’s TBI Summit Panel Discussion

By Jeff Buffer, MA, CRC, BWC Vocational Rehabilitation Supervisor

I had the opportunity to participate in the Brain Injury Association of Ohio’s TBI Summit held at OSU’s Fawcett Center last month.  The conference’s goal was to help persons with traumatic brain injury (TBI), their families, and providers learn strategies that can help with community and work re-entry during recovery from a brain injury. The summit included information about brain injury treatment, services and therapies that can assist with those goals.

Brain injury survivor panel member

BWC’s Nurse Director Mary Charney, BSN, RN, and I co-presented in a panel titled, Return to Work-Yes You Can! Kara Moore, an Ohio Health speech and language pathologist, also joined us. Kara shared tips for working with employers of persons with a brain injury and she shared her perspective as a brain injury survivor after a motor vehicle accident and the challenges she experienced during her return to work.

Some tips she shared included following advice from doctors and therapists as to how much a person can do when they first attempt to go back to work after a brain injury, and letting the employer know about issues the worker with a brain injury is having and how they might be addressed. This could include being assigned a lighter work load initially or having a coworker help with more complex tasks.

Kara also talked about going back to work gradually and taking frequent rest breaks as needed. She mentioned types of job site modification that can be done to help with symptoms of a brain injury, such as changing the type of overhead or desk lighting in a work setting.

Preventing injuries, case management

Mary, who has extensive health-care experience in occupational medicine, presented on the importance of BWC’s injury prevention programs as they relate to reducing the number of brain injuries. BWC’s Division of Safety and Hygiene offers statewide safety awareness campaigns for slips, trips and falls, safety education and training programs, and safety grants that assist employers to purchase equipment designed to reduce workplace hazards.

She also discussed the importance of medical case management and care coordination, especially during the acute phase of care and rehabilitation. Patients with catastrophic injuries see multiple specialists and are faced with many complex decisions.  It’s the catastrophic case manager’s role to help the patient navigate confusing and complex health instructions and appointments and ensure the lines of communication remain open between the patient, family, providers and others involved in the case.

Medical management’s goal is to return every injured worker back to his or her optimal level of function, maximum quality of life and return him or her to work when possible.

Vocational rehabilitation in workers’ compensation

My presentation, drawing from over 30 years of vocational rehabilitation experience, included eligibility for services, when a person with a TBI might be ready to participate, and which services are considered the most effective when working with persons with brain injuries and employers. We discussed Information about being ready for vocational rehabilitation services for persons with brain injuries, plus the challenges they face, including a lack of understanding by employers and coworkers about brain injuries and accommodating the TBI employee’s needs.

Services that make a difference

Other challenges include identifying providers who have a knowledge of working with persons who have a brain injury. Some positives included vocational rehabilitation can develop specialized plan services to meet the TBI worker’s unique needs, and these services can focus on the whole person.

Services that help persons with a TBI include vocational case management and employment services such as a work trial, situational assessment, employer-based work adjustment or job coaching services.  Return-to-work (RTW) incentive services such as a gradual RTW plan or employer incentives for when a person’s productivity might be limited initially can be helpful. Other employment-based services such as on-the-job training, job modification, ergonomics and tools/equipment may also assist the worker.

In addition, supportive services such as adjustment to disability counseling and living maintenance can make a big difference when a person with a TBI is attempting to RTW in a vocational rehabilitation plan. It’s rewarding when all parties work together for one common goal to return a worker with a TBI back to the job.

Jackie Stanton, Ph.D., CRC, a case manager for Metro Health Rehabilitation Institute of Ohio’s Work Matters Program, facilitated the panel. The audience asked good questions about the information presented, and the current director of the BIAO, Stephanie Ramsey, (former BWC medical services director), commented that the presentation was well received and included needed information.  The attendees were persons with brain injuries, their families and providers – including psychologists, therapists and nurses, as well as case managers.

Focus on survivor’s strengths

Overall, the panel emphasized the importance of everyone working together as a team, including the person with a TBI, their family or support system(s), their employer and coworkers, doctors, psychologists, case managers, vocational providers and therapists.  It’s also important to focus on a patient’s strengths, and what they can do after a TBI, as this keeps the person engaged in the overall medical and vocational recovery process.

The more a person with a TBI learns about their new level of functioning after a brain injury, the more prepared they are to get back to activities of everyday life including employment.

Note: Here is a short video about an injured worker describing his experiences with a TBI who is back to life.

2018 Ohio Workers’ Compensation Medical & Health Symposium third year of success; adds provider staff forum track

We did it again with the help of Ohio’s providers!

Based on accolades from our 2018 Ohio Workers’ Compensation Medical & Health Symposium participants, the symposium’s third year was a smashing success.

Despite dealing with a snow storm, nearly 600 health-care professionals attended this unique, multi-disciplinary event held March 8 – 9 at the Greater Columbus Convention Center.

Thank you!
Together, symposium participants share our joint passion for the comprehensive care of Ohio’s injured workers.

We centered the program around injured workers’ total care.

To assist with this process, we offered up to 12.75 continuing education credits for 10 health-care professions this year.

A special thanks to the symposium’s outstanding presenters, exhibitors and participants as well as our Medical & Health Division for leading this event that we offer participants at no cost. We continue to offer state, national and international experts for our provider clinical education sessions.

The Medical and Health Symposium​ featured two outstanding speakers who shared their inspiring stories of overcoming obstacles and adversity while recovering from injuries. They offered tips for injured workers, providers and family members on how to deal with sudden change following a catastrophic injury. Now they are giving back to others from their life experiences.

Brad Hurtig lost both hands in a workplace accident while in high school, and Dale Hull, M.D. became a tetraplegic following a trampoline accident.

Here is an earlier BWC story about Hurtig’s injury and recovery. He has come full circle in his recovery.

What was new this year?
This year our annual symposium included a full-day provider staff forum track (March 9) designed specifically for office support staff.

BWC and managed care organization experts led lively sessions that included panel discussions and questions and answers.

           

Again, the exhibitor area was a big success with 21 exhibitors who help care for Ohio’s injured workers.

               

Ohio State Chiropractic Association (OSCA): OSCA representatives reach out to symposium participants about the latest trends and advantages in chiropractic care for Ohio’s injured workers to help them get back to work, back to life.

We couldn’t be more pleased with the symposium’s success. Thank you for joining us and for helping us in taking care of Ohio’s workers – at home and at work.

Remember to log in to the Attendee Service Center no later than April 11 to evaluate your sessions and print attendance certificates.

Here’s a look back in photos and tweets!

We’re off and running! Registration was in full swing at our 2018 Ohio Workers’ Compensation Medical & Health Symposium.

Comprehensive Care: BWC’s Chief Medical Officer Dr. Terry Welsh kicks off the symposium emphasizing continuing education’s value for providers at all stages of their careers.

When Change Chooses You:  Dr. Dale Hull of Utah shares his story of dealing with tetraplegic paralysis following a spinal cord injury. He reviewed what he learned as a patient that he would have ignored as a physician.

Return to function: Dr. Ranavaya, who is also an attorney, reviewed stay/return to work strategies for injured workers. He also discussed how to help methodically determine disease causation in another session.

Speakers who kicked off the symposium: They are from l. to r. Dr. Hull who had a life-changing accident that lead to paralysis; Dr. Mohammed Ranavaya of Marshall University School of Medicine who reviewed how providers can help injured workers stay/return to their jobs and our Dr. Welsh, a physical medicine and rehabilitation specialist.

Moving Toward a Targeted Approach to Concussion:  Dr. Alicia Sufrinko of the University of Pittsburgh Medical Center Sports Medicine Concussion Program, discusses the framework for looking at an injury and how assessments lead to certain clinical profiles for concussions.

 

Shoulder Injuries – Treatment, Referral, Surgery and Return to Work: Dr. Matthew Levy, orthopedic surgeon of St. Vincent Charity Hospital, Cleveland, answers questions about different surgical techniques for repairing shoulder injuries.

 

Wellness and Total Worker Health: Dr. Otto Schmidt discusses warning signs or red flags to look for when taking care of an injured worker’s total health with a fellow chiropractor.

 

 

Diversity – Cultural Competencies lead to better Outcomes: Dr. Alejandro Diez, Ohio State University, explains how demographic changes in Ohio’s population form the current diversity of our patient population.

He discussed cultural issues that impact patients’ health and well-being.

 

Pharmacy trends: Dr. Amanda Waltemath, Healthesystems of Florida, discussed current and emerging pharmacy trends and their impact on workers’ compensation.

 

Neurobiology of Addiction – Science Meets Recovery: Dr. Susan Blank, chief medical officer and founder, Atlanta Healing Center, says the American Society of Addiction Medicine defines addiction as a primary chronic disease of the brain. It influences the mind, body and soul.
  
Pharmacy blogger: Mark Pew, senior vice president of PRIUM (right) discusses the genesis and scope of the opioid epidemic with symposium participants and with our Pharmacy Director Nick Trego (left).

 

 

 


Health and Behavioral Intervention:
Dr. Michael Sullivan of McGill University, Canada, reviewed a behavioral/health program to assist injured workers in getting back to work, back to life.

BWC Initiatives and Strategies: From a medical perspective, Administrator/CEO Sarah Morrison reviewed BWC’s new initiatives that impact providers and their patients.

Find A Way: BWC Administrator/CEO Sarah Morrison stands with motivational speaker and injured worker Brad Hurtig before Hurtig’s presentation that closes out our symposium with a standing ovation. 

Hurtig was tragically injured in high school at a local manufacturer and lost both his hands. But, he turned obstacles into opportunities by continuing to play football and leading his team to victory.

See you in 2019! Thank you for helping injured workers get back to work, back to life.

OSC18 – The postgame wrap-up

Thanks for joining the team!

By Erik Harden, BWC Public Information Officer

At Ohio Safety Congress & Expo (OSC18) last week, we made the most important addition to our safety team: You!

For three days, more than 8,000 employers, workers, safety and medical professionals found their winning safety and health game plan at OSC18 and our Medical and Health Symposium.

We were thrilled to see so many of you tweeting and sharing your #OSC18 experience on Twitter! Check out our Twitter recap and scroll back through our blog coverage from last week while you’re here on the site.

Remember, to visit the OSC18 website’s Attendee Service Center if you need to print course attendance certificates or access presentation materials from many of the classes.

Now let’s go for a repeat! We’ll hold #OSC19 March 6-8, 2019, at the Greater Columbus Convention Center. We can’t wait to team up with you again next year!


The crowd arrives for registration and badge pick-up.

Record numbers fill the convention center.


BWC Administrator Sarah Morrison tips off OSC18. If you missed her opening remarks, which included a sneak peek of our safety campaign commercial, you can watch it on YouTube.

Attendees put the full-court press on the Expo Marketplace!

Innovative all-stars: We announced the 2018 Safety Innovations Award winners March 8. Navistar took first place!


Fan favorites: MPW Industrial Services took home second place and the People’s Choice award.


In third place, Terracon Consultants, Inc.

Ramco Electric Motors received the honorable mention award and $1,500. Congratulations to all!

Finding a way: Injured worker triumphs through tragedy

Brad Hurtig, a double amputee, inspires audience at BWC medical symposium

By Tony Gottschlich, BWC Public Information Officer

The workplace accident that took Brad Hurtig’s hands in 2002 could have taken so much more from the high school student-athlete — his place as a star linebacker on the football team, his hopes, dreams and career goals.

But Hurtig, who gave the final lecture Friday at the 2018 Ohio Workers’ Compensation Medical & Health Symposium, wouldn’t let that happen, thanks to a coach who wanted him back on the team and a water bottle on the practice field.

“He invited me to practice when I got out of the hospital,” Hurtig recalled to hundreds of health care providers gathered at the Greater Columbus Convention Center. “It was in late July, super hot and muggy. There was a water bottle on the ground, and I asked my coach for a drink. Well, he paused for a moment, looked at the water bottle, then up at me and said something that would ultimately change my life: ‘If you’re thirsty enough, you’ll find a way.’”

Hurtig found a way, along with a new motto that propels him to this day as a motivational speaker and youth minister.

A three-sport jock, Hurtig had broken a school record for tackles as a middle linebacker his sophomore year. After his accident and a failed stint as a placekicker (“I was terrible”), he returned to his old position his senior year, broke more records (111 tackles) and made all-state honors in his division.

Now 33, the northwest Ohio resident travels the country talking to high schoolers, the media and others about perseverance through adversity. He calls his lecture, Find a Way: Turning Obstacles into Opportunities.

BWC Administrator Sarah Morrison stands with motivational speaker Brad Hurtig before Hurtig’s lecture Friday afternoon at the Ohio Workers’ Compensation Medical & Health Symposium.

Speaking for about an hour to the symposium audience, Hurtig recalled the June day of his accident 16 years ago, shortly after finishing his sophomore year, and the journey that followed.

He was working in a friend’s family business, a metal shop, placing sheet metal in a 500-ton power press that stamped metal into automotive parts. One sheet was misaligned. He attempted to straighten it, but his friend at the control switch didn’t notice. The press came down, severing Hurtig’s right arm below the elbow and crushing his left hand.

“The first thing I remember wasn’t really the pain or even the physical sensation, it was hearing someone scream when they looked at me,” he said.

Hurtig spent 11 days in a Toledo hospital and endured multiple surgeries. In the weeks and months that followed, he worked closely with his medical team and BWC to adapt to his new life and make life adapt to him. BWC provided equipment so he could drive, open doors, turn the shower on and operate a computer. Key to his recovery were myoelectric prosthetic arms.

He removed his prosthetics and explained to the audience how they work. He spoke of the family, friends and health care providers who supported him throughout his ordeal, the empathy of doctors and others who seemed genuinely caring and dedicated to his recovery. “BWC was huge,” he said.

He also shared a couple of workplace safety tips:

  • Stop and think. Impulsive, snap decisions get us into trouble.
  • “If I just communicated with my friend, I would still have my hands.”

“The reality is we all have challenges in life, we all have setbacks, and I can tell you that how we handle those setbacks will in many ways define our lives,” he said. “Excuses will only get you so far. If you’re truly thirsty enough, you will find a way.”

For more on Hurtig, visit bradhurtigsafety.com.

Report: Ohio in poor health

‘We need to step up our game,’ chiropractor says

By Tony Gottschlich, BWC Public Information Officer

When it comes to health and wellness, Ohio is in pretty shabby shape, a Cleveland chiropractor told hundreds of health care providers Thursday afternoon at the Ohio Workers’ Compensation Medical & Health Symposium.

Dr. Otto Schmidt, referring to America’s Health Rankings for 2017 by the United Health Foundation, said Ohio ranks 39th in overall health and wellness compared to the rest of the country.

“I saw where Ohio is ranked, and it kind of took me back,” Schmidt told an audience at the Greater Columbus Convention Center. “I find that a little disconcerting as a health care provider. We have to ask ourselves, can we do better?”

Schmidt pointed to several health indicators where Ohio ranks near the bottom: cancer deaths (40th), heart attacks (39th), smoking (45th) and drug deaths per 100,000 people (46th). But Ohio ranks highly in the number of primary care physicians (13th) and number of hospitals (5th).

“We need to step up our game,” Schmidt said.“In workers’ compensation, we need to focus not just on the trauma of the injury but on the wellness of the injured worker.”

That means looking at the total person and recognizing “red flags,” he said.These includes physical and behavioral barriers that complicate an injured worker’s recovery, co-morbidities such as obesity, diabetes and smoking, anxiety, poor attitude and other self-defeating behaviors.

He said getting injured workers back to work takes a team effort from all stakeholders involved,including physicians and other health care providers, injured workers and their support network, and even employers.

Schmidt, who also serves on BWC’s HealthCare Provider QualityAssurance Advisory Committee, noted two BWC programs that incorporate those elements, physician-driven models that stress coordinated care. They include the Enhanced Care Program, a pilot program focused on knee injuries, and the Health and Behavior Assessment and Intervention rule, which offers coaching and counseling sessions to help patients overcome negative thinking, poor coping skills and other behavioral barriers to recovery.

BWC also is addressing worker health and wellness with a free program it launched Feb. 1. The agency’s Better You, Better Ohio! program offers health risk assessments, biometric screenings, personalized health plans, coaching and more to Ohioans who work for companies with 50 or fewer employees in certain high-risk job classifications, such as construction, manufacturing, agricultural, and others.

“We all have to be on the same page,” Schmidt stressed. “I don’t see any reason why we can’t go from 39th to the top 10. We just need to step up our game.”

The health symposium, which runs in conjunction with BWC’s Ohio Safety Congress & Expo, continues through Friday.