Carolinas Occupational Health Center
Keeping Our Workforce Healthy
This article was first published in Health View, June 2001.
Kathy Lewis is a registered nurse, but she's got a pretty good handle on what it's like to work at a lumber company and a soft drink bottling plant. While Dr. Kenneth Johnson is more likely to be found suturing a hand or dressing a burn, it wouldn't be an unusual sight to find him observing assembly line workers at a steel factory or watching how a crew unloads a shipment at a grocery store. That's because it's their job to understand other people's jobs and how those jobs impact employee health and wellness.
Providing a link between medicine and the business community, the Occupational Health Center at Carolinas Hospital System offers a range of services to help employers maintain a healthier workforce. Lewis serves as Director of Occupational and Behavioral Services; Dr. Johnson is the Center's Medical Director. Together with a staff of 12, they work hand-in-hand with over 300 employers in Florence and surrounding counties. These partnerships mean that the staff gets to know the corporate clients, whether they are retail stores or factories or dental offices. They learn about the product or service that each provides, and what's involved in the day-to-day routine. They determine the most effective ways to keep healthy employees at work and to restore injured employees to a productive status as quickly as possible.
At the Occupational Health Center, Dr. Johnson checks a laceration for Todd Philips, a Department Manager at Lowe's Home Improvement Warehouse.
"We're very hands-on with the companies. We really look at our services to make sure we're meeting the needs they have," Lewis said. In the four years that she has been with the Center, Lewis has seen their number of clients triple. "Industry in the area is really growing. And today companies are looking at any cost-effective way to serve their employees, especially in workers' compensation situations," she said.
One of the services that area employers have found to be particularly beneficial is the urgent care clinic for employees injured on-the-job. Not only is the clinic on the hospital campus open from 8:30 a.m. to 5:00 p.m. Monday through Friday, but after-hours and weekend coverage is provided through Carolinas' Emergency Department. "You're going to get the same delivery of care 24 hours a day," said Lewis. Regardless of when an injury occurs, a profile of every company served by the Occupational Health Center can be accessed on the hospital's computer system. The profile outlines particular procedures that must be followed, forms to be completed and the unique needs of each employer when an employee is hurt at work. "If we have a major trauma come into the Emergency Department at 2:00 a.m., we have all the information that's needed at the drop of a hat," Lewis said.
The Center also prides itself on the efficiency with which patients are treated. "The beauty of the clinic is that you can get in and out fast because occupational health is our entire focus. Most times, patients can be seen by a physician in 30 minutes," said Lewis. On-site lab and x-ray services also help eliminate waiting time and delays in treatment.
Dr. Johnson and the Center's other physician, Dr. William Ward, are both family practitioners that are also board certified in Emergency Medicine. On any given day, the Center serves as many as 60 people, providing x-rays, drug screens, lab work and workers' compensation injury treatment. With the likes of cuts, fractures and back strains occupying the exam rooms, Dr. Johnson contended that, "Today's companies have implemented good safety procedures and safeguards, but sometimes things just happen. People get in a hurry... something falls... a piece of metal just goes astray or a spark burns you... no matter how well protected you are."
In addition to treating injuries and work-related illnesses in an expedient manner, the objective of the Occupational Health Center is to return workers to the job as soon as they are medically able to do so. Sometimes this means doing alternate tasks or "light duty" until the employee is physically ready to resume his or her normal responsibilities.
Kay Howard, Personnel/Training Coordinator at Lowe's Home Improvement Warehouse in Florence, has found that the use of light duty cuts down considerably on the amount of lost work time from employee injuries. "The staff at the Occupational Health Center stays on a continuous communication process with me." By informing Howard of the injured employee's status and any further treatment that may be required, the Center's staff helps her determine what that employee is capable of doing once he or she comes back to work. "If they release the employee back to light duty, then we can work on that. We'll find something for that employee to do, whether it's answering the phones or being a door greeter or doing filing. It just depends on the injury," she said.
Howard has also been impressed with the follow-up that is done on every employee who receives care at the Center. "They don't just treat them one time and let them go. Our employees know that someone will be calling them back and that they'll have to show up for any additional appointments that are necessary." The Center's case manager is particularly helpful in instances in which an employee requires extended treatment and a number of healthcare visits over a period of time. "Our case manager is the contact for these employees, handling a lot of the details, making sure the patient gets to the right doctor and that the insurance company gets the right paperwork," Lewis said.
On-site at Lowe's, Dr. Johnson and Juanice Floyd observe employee Thomas Papeo to make sure that he is using the proper body mechanics.
The Occupational Health Center's record-keeping system allows them to track the types of injuries that are coming in and to make companies aware of any trends that may be occurring. Sometimes it's necessary for staff members to visit a worksite to observe employees on-the-job and determine why certain injuries keep happening. "They [the employers] don't see things from a physiological standpoint. That's our job. Their job is to see that the widgets are made," Lewis said. Sometimes the solution is as simple as advising employees to move their bodies a different way when performing a particular task. Implementing such a change can avoid future injuries and save employers money and lost work time.
Employee physicals serve as another preventive measure by identifying health problems that could lead to extended illness or injury down the line. The Center offers pre-employment physicals, as well as annual exams that are mandated for particular types of jobs.
The Occupational Health Center also provides drug testing for employers with pre-employment screens, random drug testing and assessment of employees who are suspected of having a chemical dependency problem. Guidelines and documentation requirements vary extensively from one company to another, and the Center's staff members pride themselves on performing a professional, accurate service that gets the job done right. In fact, a staff person is on call 24 hours a day to perform drug screens, which are required by many employers when an employee is hurt on the job.
When an employee is having problems at work that may indicate an alcohol or drug problem, Lewis encourages the employer to let her staff step in. "We want to take that responsibility out of their hands and have them let us handle it," said Lewis, who is also the director of Bruce Hall, Carolinas' 24-bed addiction treatment facility. After a thorough assessment, a determination is made whether detox, inpatient treatment or an outpatient day program is the best option for the employee's recovery.
The Center's staff also refers employees to Carolinas Hospital System's Rehabilitation Services when necessary. When an injury has caused a loss of function, the hospital's specialized team of rehabilitation professionals helps the employee to restore as much independence as possible. This is done through an individualized treatment plan that can be carried out in Carolinas' acute rehabilitation unit or outpatient rehabilitation facility. The hospital's Home Health Services can also play a role in providing therapy and home health visits, along with oxygen and other medical supply needs.
"I think the people at Carolinas are wonderful. They're concerned and caring, and I know that they're looking out for my company."
- Kay Howard, Personnel/Training Coordinator for Lowe's Home Improvement Warehouse.
The extent of Occupational Health's scope isn't limited by the four walls of the Center. In addition to making onsite visits to study injury trends, staff regularly conduct a variety of wellness programs at the workplace, including health fairs, cholesterol screenings and classes on back injury prevention. "I may get a call from a manager saying that he employs a lot of men in their forties and wants them to know what we can do to keep them healthy. Some companies call after they've changed their smoking policy and employees are no longer allowed to smoke inside the building. They want some education on quitting smoking," Lewis said. She added, "If we can take a service on-site, then we'll do that for the convenience of the employer and the employees. Sometimes the Center's staff fills the particular request; in other instances, Lewis involves the expertise of another hospital department. Using the vast array of resources available at Carolinas Hospital System, the Occupational Health Center serves as the hub that coordinates all the needs of its corporate clients.
The Occupational Health Center also provides x-ray and lab services for physician offices in the Medical Office Building they occupy adjacent to the hospital. In addition, the staff handles all pre-employment physicals and drug screens for Carolinas Hospital System employees and any injuries hospital employees sustain at work.
When an injury does occur - whether it's a respiratory therapist or a waitress or delivery truck driver - the focus at the Occupational Health Center remains the same. The goal is to treat patients in an expedient manner and get them back to work as soon as possible. "They're working people with families who are dependent upon them and their livelihood is on the line. We want them to get back to where they were before they were hurt," said Dr. Johnson. He added, "We feel for them and want them to get well. And first and foremost, our job is to treat the employees, not the insurance company or the employer, but to treat each patient with compassion and empathy." For Howard, this approach is working quite well for her and the Lowe's employees. "I think the people at Carolinas are wonderful. They're concerned and caring, and I know they're looking out for my company," she said.
By Diane J. Epperly, Contributing Writer
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