This blog post is based on a presentation given by Dean Frieders at AIHce EXP 2022. An expanded version was published in AIHA's 2022 ebook, The Essentials of OEHS Communication.

Work Health Solutions is an occupational health service provider, but the company was founded by people who first experienced OEHS outside the profession, as clients working within many different fields and industries. For instance, WHS Chief Solutions Officer Dean Frieders, JD, previously worked as a private attorney, city attorney, risk manager, city manager, and firefighter emergency medical technician. According to Frieders, backgrounds outside the OEHS field give WHS leadership a unique understanding of their clients' needs. In his AIHce EXP 2022 presentation, "Reevaluating Occupational Health and Safety in a Post-Pandemic World," Frieders described how WHS worked with clients to build strong, effective occupational health programs after the COVID-19 pandemic changed the world in 2020.

How COVID-19 Changed OEHS

In January 2020, Frieders was working as a city manager, having not yet joined WHS. His team held weekly meetings during which team members talked about topics they saw on the news and how they needed to prepare to face them. When they began hearing reports of a new disease, the team decided to prepare for the oncoming pandemic by purchasing a year's supply of rubber gloves and sanitizer wipes. Although they were trying to be proactive regarding occupational health and safety, they didn't have access to global or regional health data and didn't know how other cities and organizations were preparing. "So, we couldn't follow best practices," Frieders said. "We were guessing based on what we heard on the news."

Frieders added that, in 2019, most OEHS professionals didn't think that an occupational health issue could shut down governments and businesses around the world. Corporate executives weren't very aware of their OEHS staff and their roles. Neither was corporate decision-making particularly driven by occupational health or employee safety concerns. This changed dramatically in the early months of 2020: after Frieders' team bought gloves and sanitizers in January, the city's board of directors asked them why they had spent so much money on supplies they didn't believe would be necessary—but two months later, the board asked why they weren't spending more money on face masks, gloves, and other control measures. Likewise, Frieders' team had believed they were cautious in their estimation of the risk posed by COVID-19, but they weren't prepared for the challenges before them.

This shift means that organizations will now find funding for OEHS programs intended to address COVID-19. But they are still largely unaware of the significance of other occupational health and safety issues, even those that affect employees more significantly than COVID-19. "We've captured the imagination of senior leadership," said Frieders. "They understand now that an occupational health issue cannot just impact profitability. It can close a company; it can close a country. Take that awareness and pivot that to whatever your occupational health needs are," he continued.

The Necessity of Being Proactive

When Frieders had started the job he held before becoming a city manager, his employer had shown him the workplace's first aid cabinet and told him what paperwork he would fill out when, not if, he became injured. The employer's message focused on what employees would do after being injured, not on taking proactive measures to prevent injury.

WHS' Healthy Worker Pyramid shows this type of "reactive care" at its very top (see Figure 1). Reactive care aims to heal an injured person and restore them to work, typically requiring a lot of money and resources to be spent on only this individual. But as clients shift focus to subsequent layers of the pyramid, they engage with more of their workforce at a lower cost.

Proactive care aims to prevent injuries and address emerging conditions before they become reportable injuries. In the next step, employers collect biometric data, track injury trends, and perform OEHS screening. Some forms of surveillance, such as audiometric and respirator fit testing, are required by OSHA, but employers should track this data to know if changes occur in workplace health. Education aims to interest and engage employees in OEHS issues; "lunch and learn" sessions that provide free lunches may be an effective, low-cost way of teaching workers about health and safety. At the bottom of the pyramid, tracking health issues across their region and the world helps organizations stay on top of health issues that might affect their workforces and allows them to act early enough to engage in preventative care.

Most workplaces will still experience some health emergencies, so it's necessary to invest in reactive responses. But Frieders advised organizations to focus more on preventive, proactive, predictive, and protective actions and on activities that reduce injuries and make employees happier.

"Stopping the Bleed"

When WHS starts working with a client, they focus on "stopping the bleed" by immediately addressing the company's most urgent need as quickly as possible. In medical terms, they perform triage.

Unlike in medical emergencies, however, WHS can assess the client's “most urgent need" in two ways. First, "stopping the bleed" might mean addressing urgent problems affecting large numbers of workers. But in situations where the most severe problem affecting a workplace might take years to completely fix, OEHS professionals and service providers may have more immediate success by responding to another significant problem quickly and effectively. OEHS professionals can collect data from this early win that they can use as evidence for their programs' value.

These two approaches aren't mutually exclusive; resolving a problem that seems to have a relatively straightforward fix may still have a noticeable positive impact on people's lives. According to Frieders, one WHS client employed cooks who reported high rates of soft tissue injuries from flipping omelets. Purchasing a device that flipped omelets for the cooks eliminated these injuries.

In the wake of the pandemic, "stopping the bleed," Frieders explained, isn't necessarily about addressing COVID-19. It's about identifying urgent needs and investing in the future of your client or employer's OEHS problems. Although COVID-19 response is likely to be part of airborne transmissible disease programs for the foreseeable future, there may be other major occupational health "pandemics” occurring in your workplace. Identify smaller or shorter-term OEHS projects that allow you to gather data, where you may effectively address problems through pilot programs that are narrow in scope. Show executives the impact of other OEHS issues and your solutions. In this respect, Frieders agreed with Margretta Murphy's recommendation (covered in a previous blog post) to identify programs that will be successful early on, which will help you win your leadership over.

Case Study: OEHS at an Athletics Company

In fact, COVID-19 was the most urgent OEHS issue affecting a global athletics company when WHS began working with it in May 2021. The company wanted to get its employees back to work but had concerns about vaccine availability and COVID-19 testing. Right away, WHS started work on a program that involved clinicians performing on-site COVID-19 vaccinations to employees and their families, with the understanding that exposure to family members was a crucial factor in COVID-19 transmission. WHS also started a pilot program testing people whose return to work had the highest priority.

Once progress was made on these projects, WHS began considering the company's other possible needs. In what other areas could WHS achieve early wins as they worked toward re-envisioning how the company provided occupational health services to its employees?

To address repetitive movement and soft tissue injuries among workers at the company's manufacturing facilities, WHS implemented a program that brought personal athletic trainers on site who provided basic interventions for workers experiencing soreness. The athletic trainers treated all complaints, regardless of whether the injury was attributable to work. The injuries weren't OSHA-reportable, but the interventions helped the company avoid reportable injuries before they occurred. Pilot programs began at two manufacturing facilities in October and November 2021.

Because health issues often arose outside of work, the athletic company was also interested in providing 24/7 healthcare support to employees. In December 2021, WHS helped the company launch a telemedicine program that connected employees with clinicians who could perform diagnoses and could make informed decisions about the level of care needed.

With COVID-19 infection rates falling among the employees who were already back on site, the company began planning for a general return to work. This required addressing the needs of people who would arrive on campus but weren't the company’s employees, including contractors, vendors, and visitors. Starting in January 2022, WHS deployed the Safe Campus Program, which provided COVID-19 testing and vaccination for vendors, instituted vaccine card verification for visitors, and offered on-site testing for athletes arriving on campus to test products.

In April 2022, WHS started a program to address injuries within the company's facilities in areas without well-developed emergency medical services. As of May 2022, WHS and its client had begun the planning stages of a project intended to train employees in basic first aid. The athletic company was also interested in programs such as providing primary care through on-site clinics and expanded concierge services that visited executives or important clients in their homes or hotels. But the relationship between WHS and this athletic company began with a discussion of the client's short-term needs, then progressed to long-term projects.

One Program Doesn't Fit All

In the pandemic's aftermath, increasing numbers of employees are working remotely. WHS assisted another client in building a three-step ergonomic program. It included virtual training sessions that taught employees how to set up safe workplaces at home, telemedicine appointments with OEHS professionals who gave employees feedback on improving their setups, and complete virtual ergonomic assessments for employees with serious problems.

Sometimes WHS' approach to helping clients involves deploying programs it has already created, and sometimes WHS invents new programs. In these cases, WHS starts by assessing its clients' existing needs and how to meet them.

Different types of workplaces require different solutions. Many small sites don't need on-site clinicians and would be better served by telemedicine or mobile medical services. Likewise, there are many ways to do COVID-19 testing and OSHA surveillance. Frieders advised that occupational health service providers resist the temptation to rely on a single solution in every circumstance.

Finally, Frieders cautioned against becoming complacent once you've addressed one problem in your workplace. What's the next problem you can tackle?

Resource:

Frieders, Dean. “Reevaluating Occupational Health and Safety in a Post-Pandemic World.” AIHce EXP, AIHA, May 25, 2022, virtual. Conference Presentation.