BWC nurses help provide quality, holistic care for Ohio’s injured workers

By Mary Charney, BWC Director of Nursing

Nursing: The Balance of Mind, Body and Spirit. That’s the theme for National Nurses Week that runs this week until Friday, May 12. This year’s holistic theme also reflects BWC’s approach to caring for Ohio’s injured workers.

BWC’s 58 nurses work in a variety of areas, from medical policy and employee health to rehabilitation, claims management and clinical advisement.

They help Ohio’s injured workers and each of us remember to balance our lives — our mind, body and spirit — for total wellness.

National Nurses Week is a good time for all of us to appreciate nurses and thank them for what they do. Take time to remember the last time you talked with a nurse and how that nurse helped you. Nurses make a difference in our health care journey throughout life.

Nursing is the largest of all health care professions, according to the American Nurses Association (ANA), which declared 2017 to be the Year of the Healthy Nurse. Accordingly, the association is encouraging nurses to be healthy role models for the rest of us.

In its Healthy Nurse, Healthy Nation™ Grand Challenge, the ANA states thatNurses, at 3.6 million strong and the most trusted profession, have the power to make a difference! By choosing nutritious foods and an active lifestyle, managing stress, living tobacco-free, getting preventive immunizations and screenings, and choosing protective measures such as wearing sunscreen and bicycle helmets, nurses can set an example on how to BE healthy.”

For more information on National Nurses Week, visit the American Nursing Association’s National Nurses’ Week website. Again, thank you to our nurses!

Provider perspective: Ohio Workers’ Compensation Medical & Health Symposium in photos

We did not think it was possible – the second year was better than the first for the Ohio Workers’ Compensation Medical & Health Symposium. We increased participation with a capacity crowd of more than 400+ health-care providers.

Thank you!

We appreciate everyone who joined us for our two-day event held last week in conjunction with the Ohio Safety Congress & Expo at the Hyatt Columbus. You share our joint passion for the comprehensive care of Ohio’s injured workers.

A special thanks to the symposium’s exceptional speakers, exhibitors and participants as well as our Medical & Health Division for leading this unique, multi-disciplinary event at no cost to participants.

For ongoing learning, Ohio’s providers took advantage of continuing education opportunities designed for chiropractors, nurses, occupational and physical therapists, pharmacists, physicians, psychologists, rehabilitation counselors and case managers.

What was new this year?

In 2017 our annual symposium featured an exhibit area with 13 exhibitors who help care for Ohio’s injured workers. The exhibitors ranged from prosthetic suppliers and health-care associations to inpatient and outpatient rehabilitation facilities. In addition, we added continuing education for occupational and physical therapists, pharmacists and psychologists.

We continue to include state, national and international experts for our symposium sessions detailing best practices in caring for Ohio’s injured workers. And, we are overwhelmed by the positive comments we are receiving from symposium participants.

Now as we look forward to 2018, experience the symposium by reviewing highlights from 2017.

#BWCmhs exhibitors ready to see providers at med & health symposium!

Between sessions exhibitors visited with #BWCmhs providers.

An association exhibitor was available to answer questions about a safe medicine and responsible treatment program for providers’ patients.

Dr. Matthew Levy (center), orthopedic surgeon at Cleveland’s St. Vincent Charity Hospital answers questions after presenting Periarticular Injuries of the Lower Extremity.

Providers waiting in line to ask Dr. Atchison questions after the first session. He is a medical director for the Rehabilitation Institute of Chicago who presented on managing pain and return to work early.

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Dr. Ali Rezai, Director of the Neurological Institute at OSU Wexner Medical Center (center) talking with attendees after his session on Neuromodulation Advances for the Management of Chronic Disease.

Dr. William Marras, Director of OSU Spine Research Institute (left) pictured below with BWC’s Dr. Stephen Woods. Dr. Marras presented study results on the clinical lumbar motion monitor.

Dr. Nicholas U. Ahn, orthopaedic surgeon, University Hospitals of Cleveland, reviewed a recent discography study in the last session. He presented another study that examines workers’ comp patients with nonorganic pain.

Attendees on break between sessions.

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Kevin T. Glennon, vice president of clinical services for One Call Care Management in Jacksonville, Florida. Glennon spoke about the work comp challenges of the aging workforce. Read a detailed blog about his presentation here.

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Dr. Susan K. Blank, co-founder and chief medical officer for The Atlanta Healing Center, an outpatient treatment recovery program. Dr. Blank spoke about addiction and misuse of controlled substances. Read more in our blog Wired for addiction.

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Dr. Richard W. Rosenquist, M.D., chair of the pain management department at the Cleveland Clinic, addressing the transition from acute to chronic pain.

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BWC’s Dr. Brian Wilson, DC, introduces Dr. Robin A. Hunter, DC., who presented on approaches to non-opioid treatment options.

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Phil LeFevre, senior vice president of business development for the Work Loss Data Institute LLC in Austin, Texas greets a seminar participant. He presented on using the Official Disability Guidelines for evidence-based care management.

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Gerald Steiman, M.D., a practicing physician at Steiman Neurology Group in Columbus.He delivered a presentation on concussions.

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Attendees also heard from Dr. Michael Coupland, a registered psychologist who spoke about pain in his presentation, The Psycho Neurobiology of Pain: Up Pain, Down Pain, Good Brain, Bad Brain. Check out the BWC Blog here for a review of his presentation.

See you next year!

Comprehensive Care of an Injured Worker

By Stephen T. Woods, M.D., BWC Chief Medical Officer

When any group of individuals comes together with one common purpose, they can achieve what others believe is not possible. I got to see such a group at our recent Medical & Health Symposium, held in conjunction with BWC’s annual Safety Congress and Expo. In this case it was hundreds of providers with a shared passion for taking care of Ohio’s injured workers. Those of us at BWC share that passion and are dedicated to providing world-class care and coverage from Portsmouth to Ashtabula.

The Medical & Health Symposium was an excellent opportunity for providers to learn the latest best practices for the comprehensive care of an injured worker.

I was pleased that more than 400 providers attended. Our system often deals with people who are in their most vulnerable state – emotionally, medically and financially – after work-related injuries. The providers in attendance represented a broad range of disciplines, but all had the unique skills and the passion to pursue a virtuous cycle of continued improvement on behalf of their patients.

Those of us who serve injured workers do so knowing that we are choosing to be their advocates and understanding the complexities of their conditions and of our system.

That commitment is something we’re really focusing on at BWC. That includes being committed to holistic, comprehensive care that is patient-centered, minimizes the burden of injuries and avoids preventable disabilities. That focus on the customer also means that we have to understand the diverse needs of our customers and operate in a way that lets us quickly adapt to both their unique needs and the rapidly changing world around us.

Specifically, in BWC’s Medical & Health Division, we are continuing to push efforts to reduce the amount of bureaucracy our providers endure so they can spend more time managing the overall needs of the injured worker. Pharmacy management, better-designed fee schedules and treatment guidelines, access to non-medication options, and health behavior assessments are all areas we are exploring to make sure injured workers are better able to return to work and return to life.

Of course, no amount of effort on our part will make a difference without the partnership of our providers and other stakeholders. So, thanks to all of you for your commitment in providing comprehensive care for Ohio’s injured workers. You are all part of our world-class team.

Coping with pain

‘Visualize your way out of it,’ psychologist tells work comp audience

By Tony Gottschlich, BWC Public Information Officer

There’s another way to deal with chronic pain that doesn’t involve medications or surgery, a psychologist told an audience Friday at the 2017 Ohio Workers’ Compensation Medical & Health Symposium.

It’s called Cognitive Behavioral Therapy, and it’s not as complicated as it sounds. In fact, the techniques are rather simple, said Michael Coupland, medical director for Integrated Medical Case Solutions in West Palm Beach, Florida.

Cognitive Behavioral Therapy (CBT) is a widely accepted form of psychotherapy that is based on the cognitive model: the way that individuals perceive a situation is more closely connected to their reaction than the situation itself.

Coupland explained that we can condition our brains to control pain or banish it from our consciousness. But it takes practice, a daily repetition of mantras, deep breathing techniques, meditation and other mindfulness methods for it to take root and stick.

Thanks to neuroplasticity, the brain can reorganize or rewire itself, both physically and functionally, throughout your life in response to your environment, behavior, thinking and emotions.

“Exercise your neurons, visualize your way out of this,” he said. “I tell my patients, ‘Whether you believe in this or not, just humor me and do this every day for eight weeks.’ These techniques help stand down the body’s stress-arousal system.”

Coupland admitted it’s tough for most patients to accept this approach. Mindfulness, a state of active, open awareness of the present moment, and meditation are about “letting go,” but the American educational system teaches us to “hold on” to everything we learn.

Coupland shared with the audience a book he authored in the style of Dr. Seuss that illustrates the simplicity and effectiveness of CBT. It’s titled, “Up Pain, Down Pain, Good Brain, Bad Brain,” and can be found for free here.

For more on Coupland and his work, visit www.icms.us or www.cope-with-pain.com.

‘Wired for addiction’

Addiction specialist addresses work comp health symposium

By Tony Gottschlich, BWC Public Information Officer

Many believe drug addicts are weak-willed people of diminished moral character who choose drugs, getting high and even criminal behavior over a proper, law-abiding life.

And they would be wrong, a longtime psychiatrist and addiction specialist said Friday morning at the 2017 Ohio Workers’ Compensation Medical & Health Symposium.

“Addiction is not about the drugs or the behavior, it’s all about the brain,” said Dr. Susan K. Blank, co-founder and chief medical officer for The Atlanta Healing Center, an outpatient treatment recovery program. “This is a genetically inherited brain disease.”

Blank, speaking to a capacity audience at the Greater Columbus Convention Center, spoke for an hour on the topic, “The Perfect Storm: Pathophysiology of Controlled Substance Misuse and Addiction.” Her presentation was the first continuing education session on the final day of the two-day symposium for health care professionals.

Blank explained there are three key forces behind addiction, and choice has little, if anything, to do with it. They include:

  • Genetics. Our brains are hardwired for addiction because of our genes. Some of us inherit malfunctioning “dopamine feedback loops.” When we experience pleasure, whether from food, drugs or sex, it’s because our brains are releasing the feel-good neurotransmitter dopamine. In addicts, that feedback mechanism doesn’t shut down and they just want more and more, regardless of the consequences. “It’s never enough,” Blank said. This is particularly hard to overcome if the addiction started in one’s youth. That’s because drug and alcohol abuse can damage the prefrontal cortex, our brain’s impulse-control center, which is still developing into our mid 20s.

Worried your children might be future addicts? Look for the thrill-seeking child who thrives on adrenaline, the child who’s the first to take a dare. These are behaviors that demonstrate he or she is seeking a dopamine release, Blank said.

  • Exposure. Growing up around addicts increases the likelihood of addiction.
  • Environment. There must be an environmental trigger or stressor – loss of a job or loved one, for instance – that keeps the addiction cycle going.

“You have to have all three legs of that stool for addiction to manifest itself in your life,” said Blank, who is also president of the Georgia Society of Addiction Medicine. Genes alone won’t doom you.

Addictions often start through prescription drugs, she said, and can’t stop without outside help. They lead to brain changes that can’t be undone. “Our rational brain is gone.”

Drug overdose is the leading cause of accidental death in the United States in recent years, fueled by powerful opioids, heroin especially. Ohio is the nation’s overdose death capital, with 3,050 OD deaths in 2015, or more than eight per day, according to state-by-state statistics compiled by the Henry J. Kaiser Family Foundation.

Blank noted that addictions aren’t limited to painkillers and street drugs, of course. People can be addicted to sugar, sex, tobacco and other dopamine triggers, too. It’s all about the dopamine. (Surprising fact to nonsmokers: “Nicotine is better than food, sex and morphine,” Blank said.)

Blank provided a number of sobering facts and statistics, including this one: “This is a chronic disease and there is no cure.”

But there is hope, she said. Addictions can be managed, and many addicts go on to live long, productive and healthy lives. Nationwide, opioid prescriptions are falling and there’s a growing awareness and understanding that addiction is a disease.

She concluded her remarks with a warning: “If you can’t escape addiction, choose yours carefully.”

The health symposium concluded Friday. It was held in conjunction with the 2017 Ohio Safety Congress & Expo, the Ohio Bureau of Workers’ Compensation’s annual safety, health and workers’ compensation conference.

Comprehensive care for injured workers, innovative employers highlight busy day 2 at #OSC17 and #BWCmhs, much more to come

Welcome back to the Columbus Convention Center, home of the Ohio Safety Congress & Expo and the Ohio Workers’ Compensation Medical & Health Symposium!

We have a lot in store before we bid farewell this afternoon but first, here’s a rundown of yesterday’s activities.

The second day of OSC17 was the first day of the Medical & Health Symposium. This is the second year of the symposium, which filled to capacity weeks ago. BWC sponsors this conference for health-care professionals who treat Ohio injured workers to hear from leading national and state experts. This year, our theme is “Comprehensive care for the injured worker.”

BWC Medical Director Dr. Stephen Woods welcomed participants and kicked off the event. The day featured several intriguing sessions on various topics related to the care of injured workers. One session covered how the aging workforce challenges the workers’ comp industry. Read a detailed blog on that topic here.

Over at OSC17, we got the day started with the Safety Innovation Awards. ICP Adhesives from the Akron area took first place, and Holloway, Henderson & Martin LLC of Pickerington snagged the People’s Choice Award.

All of the finalists were impressive!  Here’s the final list of award winners along with links to videos highlighting their innovations:

  • 1st place ($6,000 award): ICP Adhesives and Sealants, Norton (Video )
  • 2nd place ($4,000 award): C&K Industrial Services Inc., Cleveland (Video)
  • 3rd place ($3,000 award): Holloway, Henderson & Martin LLC, Pickerington (Video)
  • Honorable Mention ($1,500 award): Suburban Steel Supply Company, Gahanna (Video)
  • Honorable Mention ($1,500 award): Ames Arboreal Group, Columbus (Video)

And our very own Dr. Abe Tarawneh, superintendent of the BWC Division of Safety and Hygiene delivered a presentation on the role of safety leaders in building and executing strategic direction for occupational safety and health programs. Abe advised attendees that the mission of a safety leader is simple: elevate safety as a core value for the organization. If it is not a core value, make it one.

We’re not done yet! Our final day will feature more informative sessions at OSC and the symposium.

See OSC17 and symposium schedules here, in the event guide or on the mobile app. Follow @OhioBWC on Twitter and keep an eye on hashtags #OSC17 and
#BWCmhs for coverage.

Stay tuned for a wrap of the day as we bring the curtain down on another successful OSC17 and M&HS.

Aging workforce challenges work comp industry

By Tony Gottschlich, BWC Public Information Officer

Americans are living longer and they’re working longer, which presents a particular set of health care challenges for the injured worker, as well as economic challenges for the workers’ compensation industry, a longtime nurse and work comp veteran said Thursday morning at the 2017 Ohio Workers’ Compensation Medical & Health Symposium.

“Many of us don’t want to retire or we can’t retire, and that’s changing how we look at individuals in the workforce before they have an injury and how we manage their care after an injury,” said Kevin T. Glennon, vice president of clinical services for One Call Care Management in Jacksonville, Florida.

Glennon, speaking to a capacity audience at the Greater Columbus Convention Center, spoke for roughly 50 minutes on the topic, “Managing the Changing Needs of the Aging Injured Worker.” The session was one of 13 continuing education classes offered at the two-day symposium for health care professionals. The symposium continues Friday in conjunction with the 2017 Ohio Safety Congress & Expo, the Ohio Bureau of Workers’ Compensation annual safety, health and workers’ compensation conference.

Glennon pointed to U.S. Bureau of Labor Statistics indicating that older workers are less likely to get injured on the job, but when they do, it’s almost always worse than when a younger person is injured.

“When a 25-year-old worker falls on the job, she might get a bruise, but for a 75-year-old worker, it’s a broken hip,” he said.

While applauding people who want to work past the typical retirement age, Glennon noted the risks for doing so. Older workers typically have decreasing strength, endurance and reflexes, as well as diminished vision, hearing and mental acuity. And when injured, their recovery might be compromised by other existing health problems, such as diabetes, as well as medications that are contraindicated and an increasing susceptibility to infectious diseases.

The list goes on. All of which becomes even more complicated and costly if injured, aging workers have no family at home to help with their recovery.

Glennon told the audience to be proactive in managing work comp cases involving the elderly, even for cases where the worker was injured decades ago.

“I have one patient who is 80 who was injured at 22,” he said. “I’m a firm believer that when you have these older injuries, check up on these patients at least once a year.”

In any case involving the elderly, Glennon said to make sure the patient’s needs are being met, that they’re receiving proper vaccinations and routine medical checkups. Look for red flags —untreated wounds, recent ER visits — that could lead to a downward spiral of health problems. “And whatever we can do to keep the respiratory system healthy is money well spent,” he said.

Glennon added that technology, while expensive, can be more cost effective in the long run for the aging patient. Self-operated lifts to help the patient get out of bed, for example, or a wheelchair that helps a patient stand upright is likely cheaper than the costs of a home health aide over months and years.

As he wrapped up his presentation, Glennon said the aging workforce has caused employers to adjust their approach to risk management and workplace health and safety. Today the focus is on wellness and prevention — smoking cessation and weight management, for example — as well as modifying job tasks to better suit the worker.