RETURN TO WORK/ CHESS PRESENTATION - WCB COMP INSTITUTE CYPRESS HEALTH REGION Cypress Health Employee Staffing Strategies (CHESS) - Saskatchewan WCB

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RETURN TO WORK/ CHESS PRESENTATION - WCB COMP INSTITUTE CYPRESS HEALTH REGION Cypress Health Employee Staffing Strategies (CHESS) - Saskatchewan WCB
WCB COMP INSTITUTE
CYPRESS HEALTH REGION
 RETURN TO WORK/
CHESS PRESENTATION
  Cypress Health Employee
  Staffing Strategies (CHESS)
RETURN TO WORK/ CHESS PRESENTATION - WCB COMP INSTITUTE CYPRESS HEALTH REGION Cypress Health Employee Staffing Strategies (CHESS) - Saskatchewan WCB
CYPRESS HEALTH REGION
•   Located in southwest Saskatchewan
•   20 facilities
•   5 integrated facilities
•   8 long term care facilities (1 affiliate)
•   4 acute care facilities
•   4 x 8 hr. care facilities
•   5 x Community Health Offices
•   1700 employees (1,197 FTE’s)
RETURN TO WORK/ CHESS PRESENTATION - WCB COMP INSTITUTE CYPRESS HEALTH REGION Cypress Health Employee Staffing Strategies (CHESS) - Saskatchewan WCB
THE NEED
• In 2010/11 each Regional Health Authority (RHA) in
  Saskatchewan was tasked with reducing the number of
  wage driven premium hours, including sick time and
  overtime, and Worker’s Compensation Board (WCB) claims
• In order to meet these targets delivered by the
  Saskatchewan Ministry of Health, the Cypress Health
  Employee Staffing Strategy (CHESS) was launched
• CHESS utilizes a variety of tools for reducing the quantity of
  sick time, overtime, and WCB claims brought forward by
  staff.
• The program has put the Cypress Health Region (CHR) on
  the map as a provincial leader in the reduction of sick time
  and has tasked all other RHA’s to meet similar targets.
RETURN TO WORK/ CHESS PRESENTATION - WCB COMP INSTITUTE CYPRESS HEALTH REGION Cypress Health Employee Staffing Strategies (CHESS) - Saskatchewan WCB
GOALS & OBJECTIVES
• The CHR was tasked with meeting provincial targets
  in the reduction of wage driven premium hours and
  WCB claims. These targets were:
• 8% reduction of region overtime [hours per full time
  equivalent (FTE)]
• 3% reduction of region sick time (hours per FTE)
• 10% reduction in workers’ compensation (claims &
  days)
RETURN TO WORK/ CHESS PRESENTATION - WCB COMP INSTITUTE CYPRESS HEALTH REGION Cypress Health Employee Staffing Strategies (CHESS) - Saskatchewan WCB
CYPRESS INTERNAL GOALS
When we started this journey in May 2010, these were
our goals:
• fewer than 72.00 sick time hours per FTE
• fewer than 35.00 overtime hours per FTE
• 0 WCB claims
RETURN TO WORK/ CHESS PRESENTATION - WCB COMP INSTITUTE CYPRESS HEALTH REGION Cypress Health Employee Staffing Strategies (CHESS) - Saskatchewan WCB
THE PROCESS
• In May 2010 we developed the CHESS program
• CHESS stands for “Cypress Health Employment
  Staffing Strategies”
• There are 8 CHESS strategies
• Each “CHESS piece” was developed as a vehicle to
  highlight each of the 8 strategies with staff and was
  communicated through a variety of mediums
  including: posters in all facilities, the regional internal
  newsletter, CHESS presentations in the facilities as
  well as direct conversations with managers.
RETURN TO WORK/ CHESS PRESENTATION - WCB COMP INSTITUTE CYPRESS HEALTH REGION Cypress Health Employee Staffing Strategies (CHESS) - Saskatchewan WCB
CHESS #1: Introduction
• The introduction strategy focused on the supports,
  processes, and safety requirements needed to
  ensure that CHESS would be seamlessly introduced
  across the entire region.
• The strategy included an introduction to various
  CHESS initiatives such as employee wellness, limiting
  the hiring of retiree’s, and the region’s attendance
  support plan.
CHESS #2:  Sick Time
 Identify Modified Duties
• Modified duties were identified with each
  manager for every classification
CHESS #2:  Sick Time
      Educating Managers
• Education provided for managers to clarify
  expectations in responding to employees that
  call in sick and what information is appropriate
  to discuss within Human Rights/Labour
  Standards
CHESS #2:  Sick Time
         Calling in sick
• Employees may not leave a message on a schedulers’
  answering machine
• When employees call in sick, they are coded as an
  unpaid/unverified sick code, and the scheduler emails the
  manager and copies the Ability Management Department
  to follow up with the employee.
• The employee remains coded as unverified sick until
  either the manager or Ability Management has a
  conversation with the employee to explore opportunities
  for modified duties or confirm to code as sick
  (contagious/infectious conditions)
CHESS #2:  Sick Time
         The Dr’s Note
• The focus is not on the Dr.’s note, but rather encourages the
  manager to have a conversation with their employee about what
  the employee feels they can or can’t do and how we can
  accommodate them safely in the workplace
• The manager is expected to have these conversations with respect
  and compassion and use their discretion as to when to request
  medical verification.
• Medical verification is not requested for the contagious or
  infectious conditions unless a specific trend is observed such as
  calling in sick before or after a long weekend etc.
• The emphasis is on ability and what the employee can do, rather
  than the manager requesting a Dr.’s note.
• Physicians have voiced frustration with completing medical
  restrictions forms and appreciate knowing what the employer can
  offer with a return to work proposal.
CHESS #2:  Sick Time
       3 Step Approach
• The Cypress Health Region has developed a 3 step
  approach to safe and meaningful return to work:
    1.   Employee notifies scheduling/manager of illness or injury that
         is preventing them from their regular duties
    2. Manager and/or Ability Management contact employee to
         discuss any opportunity for modified duties and develop a
         return to work proposal for the employee to take to their
         Medical Care Provider for approval prior to implementation
    3. Employee signs the consent to release portion of the Return To
         Work Proposal and discusses with their Medical Care Provider
         for approval prior to implementation.
• Typically this approach is resulting in a one to two day turn around to
  safely return an ill or injured worker back to the workplace
CHESS #3: Limit Re-hire Retirees
• Cypress only considers re-hiring of a retiree if from a
  “hard to recruit” classification
• In 2009 there was 40 staff that retired and 28 were
  re-hired
• Statistics showed that the sick time used in one year
  from the re-hire retiree’s was enough to pay for one
  FTE in 2009
CHESS #3:
 Limit Re-hire Retirees - The Rationale
• Limiting the hiring of individuals post-retirement supports the Region’s
  Scheduling Processes Strategy to reach Ministry mandated targets.
• Securing our future success by maximizing our ability to hire people early
  in their careers and allowing a stronger succession plan
• Rehired retirees no longer contribute to SHEPP. Reducing the contribution
  to the plan.
• Allows the Region the ability to hire more employees who contribute to
  SHEPP which improves the financial stability of plan.
• Rehired retirees who worked full-time prior to retirement maintain full
  benefits for up to two years following their retirement date, potentially
  placing pressure on the viability of the plan benefits and costs.
• Those rehired retirees who work very few hours or none at all are
  providing limited service to the Region’s clients while they enjoy the
  benefit of coverage for group health and dental plans
CHESS #4: Attendance Support
• Attendance support meetings for staff that are above
  the peer group average and above our Region goals
  for sick time usage
• Very little need for attendance support meetings
  since the implementation of CHESS unless specific
  trending is observed
CHESS #5: Safe Work Values
• WCB Mission Zero
• We participated in the WCB audit
• Cypress Health Region is on the WCB TOP 50 list
  meaning that we are one of the top 50 employers in
  Saskatchewan that have high injuries rates at work
• Injuries in health care are 1.5 x higher than other
  industries despite TLR training, PART training etc
• 80% of employers in Sask have achieved MISSION
  ZERO – why can’t we!
CHESS #5: 10% less WCB Claims
• In 2010 The Ministry directed target was to
  file 10% less WCB claims
• In 2012 we filed 77 Time Loss & No Time Loss
  WCB Claims
• Our goal this year was to file 25% less WCB
  claims in 2014, with a long term goal of
  Mission Zero by March 2017.
TOTAL WCB CLAIMS
April 1/13 To Feb 28/14:
TIME LOSS/NO TIME LOSS CLAIMS
CHESS #6: Employee Wellness
• Cypress Health Region started doing employee
  health assessments in 2008.
• This is a voluntary assessment of one’s resting heart
  rate/blood pressure, diabetes and cholesterol
  screening, height, weight, BMI, waist measurement,
  body fat %, strength, endurance, flexibility, aerobic
  fitness, and stress coping skills
• Staff receive a “report card” that compares them to
  other men/women their age and they set goals
• We conduct a follow up health assessment 3 mos.
  later
EMPLOYEE WELLNESS
• The Cypress Health Region believes that the
  health of its employees is crucial to reducing
  wage driven premium hours.
• The region’s employee wellness program has
  previously received a SAHO Green Ribbon
  Award Honourable Mention and has also been
  recognized by Accreditation Canada as a best
  practice
EMPLOYEE WELLNESS INDICATORS
 For the employees who attended the follow up
 assessment the following improvements were found:
  – 17% of employees had a decrease in their waist
    circumference.
  – 43% and an increase in their aerobic fitness.
  – 32% improved on the stress test
  – 30% improvement in blood pressure.
  In 2014 we are rolling out the Dr. Oz Real Age Health
  Assessments for staff
CHESS #7: Q and A
• A Question and Answer strategy was communicated
  to all staff and was designed to answer specific
  questions relating to CHESS, such as ‘How will CHESS
  affect me’ and ‘What will happen if I call in sick etc
CHESS #8:
         Safety in the Workplace
• Increasing the roles of the OHC
• Expecting OHC investigation within a timely manner
  (ideally 24 hrs) for any incident that results in time
  loss and/or medical attention
QUARTERLY MANAGER MEETINGS
• The region implemented and continues to utilize quarterly meetings
  with facility managers to discuss facility-specific data with the
  managerial group.
• These meetings allow managers the opportunity to explain
  variances and ask share questions/concerns.
• Teams are made up of the region’s Chief Executive Officer, Human
  Resources, Communications, Finance, Scheduling, Ability
  Management, and Payroll departments.
• At each quarterly meeting, facility managers set goals for the next
  quarter and brainstorm new concepts to aide in the further
  reduction of wage driven premium hours and WCB claims.
• At every meeting all parties sign an Accountability Document with
  set targets for the next quarterly meeting
SICK TIME RESULTS
                                   Sick Hours by Year
  120,000

  100,000

   80,000

   60,000                                                   Year
                                                            Linear (Year)
   40,000

   20,000

       -
              2006     2007     2008     2009      2010
       Year   83,627   92,497   95,627   95,603   100,974

Sick time had grown 20.74% from the fiscal year 2006
to the fiscal year 2010 which was an average of a 4%
increase every year.
Savings from CHESS
• As the above chart illustrates if we did nothing with our
  sick time the sick time would have continued to grow
  at a 4% increase as the trend was showing.
• We replace 80% of the staff that call in sick
• When we compare our projected sick time before
  CHESS to actual sick time after the CHESS program we
  can see that our savings would be $4.2m (based on average 2014 salary
   of $34.19/nr)

• Using the formula that 50% of our sick is replaced at
  overtime then the number increases from savings of
  $5.3m
PROVINCIAL HEALTH IMPLICATIONS
 • If 13 health regions could all save
   $4.2m from managing sick time,
   this would mean a $55m savings for
   Saskatchewan Health Care, and we
   wouldn’t have to cut any jobs or
   closing any health care services
Sick Hours per Paid FTE per Year
100
                                                                                                                              94.59
                                                                                                                    90.96
90                                                                                                   87.46
                                                                                       84.09

80    83.49
                                                                            80.86
                                             77.89           77.30
                             75.73
70
              70.72

60
                                                                                       58.63                                  58.17
50                                                                                                   55.20          54.69

40

30

20

10                                                                                                                  5.55       7.51
                                                                                       3.72           4.31

 0
      2005     2006          2007            2008             2009           2010      2011           2012          2013       2014
                                                                                                                            (projected)

              Trending - Sick Hrs/Paid FTE           Actuals - Sick Hrs per Paid FTE   Actuals - Unpaid Sick Hrs/Paid FTE
OBSTACLES
• One of the obstacles CHESS faced was initial internal
  resistance from facility managers who felt the
  quarterly CHESS meetings were a disciplinary
  meeting for those who were reporting above-target
  sick time/overtime/WCB claims.
• Managers soon realized, however, that the meetings
  were a collection of support systems in place who
  were prepared to stand behind, help, and support
  them in trying to reach our targets.
COLLABORATION
• Significant collaboration was required to successfully
  implement and sustain CHESS.
• CHESS teams were made up of the region’s Chief
  Executive Officer, Human Resources,
  Communications, Finance, Scheduling, Ability
  Management, and Payroll departments.
• Collaboratively, these teams created a support
  system for managers throughout the region and each
  facility manager was encouraged to communicate
  with colleagues to learn each others’ successes.
KEY TO SUCCESS
• The success of the CHESS program is largely
  attributed to a Top-Down supportive approach
  with attached accountabilities and targets set
  out by the Ministry that is inevitably changing
  the culture in the Cypress Health Region to a
  “CAN DO” culture
• THANK YOU
• Q&A
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