The development & evolutionThe development & evolution
ofof a successful riska successful risk basedbased
injury managemen...
Are there any Questions?
In ClosingIn Closing
Actuarial Assessment of
Estimated Outstanding Liability
Copper - 47%
Coal - 64%
Reductions In Outstanding LiabilityReducti...
Our Company has developed an
employer based injury management system
that incorporates risk management principles
to promo...
The primary goal
of returning injured workers
to pre-injury duties is critical
and any significant risks
to achieving this...
Web BasedWeb Based ––Injury Management SystemInjury Management System
On LineOn Line -- Risk Assessment ProcessRisk Assessment Process
The development & evolution of a
successful risk based injury
management system for employers.
 Initial principals, philo...
Payment Profile in QLD
Claims PaymentsClaims Payments
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Paid to Date
Payment & Stat Est. Profile in QLD
Claims Payments & Stat EstimatesClaims Payments & Stat Estimates
2005 2006 2007 2008 20...
Payment & Stat & C/Law Est. Profile in QLD
Payments + Stat & C/Law EstimatesPayments + Stat & C/Law Estimates
2005 2006 20...
104
75
58 58
98
70
40
60
80
100
120
Overview of Stat Claims &
Common Law Claims Lodged
Statutory & C/Law ClaimsStatutory &...
104
75
58 58
98
70
60
80
100
120
Overview of Stat Claims,High Risk
& Common Law Claims Lodged
Introducing High Risk CasesI...
20
40
60
80
100
120
21 15 13 15 22
12
83
60
45 43
76
58
Claims by Current Risk Assessment
Operations 2008 to 2013
Total In...
Strategy - A plan designed to achieve a particular long term aim.
Are we Naturally Strategic?Are we Naturally Strategic?
O...
Planning to achieve a particular long term aim ?
Where do you sit?Where do you sit?
Or are you following the process to se...
Successful EmployersSuccessful Employers –– The EvidenceThe Evidence
Christine Randall presentation 2008
What are the principals and philosophy
that provides the best strategy
for your business?
We chose risk based principals a...
A risk based approach is an integral part of many safety
systems that are heavily promoted by employers and
enforced throu...
Injury Management Review
AIM - To develop a system that provides a method for assessing and
managing risks associated with...
Injury
Consequence
Incapacity Type
Max Period of
IncapacityMedical Treatment
Injury (MTI)
Restricted Work Injury
(RTI)
Los...
Injury
Consequence
Incapacity Type Max Period of
Incapacity
Medical Treatment
Injury (MTI)
Restricted Work
Injury (RTI)
Lo...
20
30
40
50
60
70
5 7
11
9 16 13
15
9
14
17
11 12
19 13
16 13
14 18
14
22
29
38
17
27
25
17
20
25
23 26
22
34
27
11
25
15
...
Injury Management & Resource Matrix
Injury
Consequence
Treatment Provider
Workers'
Compensation Cert
Required?
Work Capaci...
Injury Management & Resource Matrix
Injury
Consequence
Treatment Provider
Workers'
Compensation Cert
Required?
Rehab File
...
The Injury Consequence & Resource and
Management Matrix should be discussed and
developed with Employees, Management,
Reha...
Injury Management Review
AIM - To develop a system that provides a method for assessing and
managing risks associated with...
First Aid Minor Moderate Major Serious
Injury Management Matrix
IMM
A
B 247 12 17 21
L
I
K
E
L
CONSEQUENCE
20 23 2511 16
S...
The risk assessment process should be
designed to assess:-
the risk of a worker not returning to
normal pre-injury duties
...
The next step is to determine:-
1. the likelihood of the worker returning
to pre-injury duties &
2. other factors that may...
On LineOn Line -- Risk Assessment ProcessRisk Assessment Process
2
2
3
3
4
4
5
5
0
1
0
1
1
0 0
20
0 0
1
Single Site Injury Management cases opened since 01/01/2013 by Risk Assessment
Sing...
2
3
4
5
6
7
8
33
3
2
1
2
1
2
2
2
2
1
1
1
1
0
0
0
1
1
0
0 0
0
Multi Site Injury Management cases opened
since 01/01/2013 by...
Flow ChartFlow Chart
Model PresentationsModel Presentations
Continuous ImprovementContinuous Improvement
 Create a list words, terms and phrases
that:-
◦ are consistent with the language used in your
company
◦ provide a positi...
 Employer based injury management
 Striving for better outcomes
 Early intervention – early resolution
 Resource alloc...
 XtraCare review conducted in 2007 in the face of rising costs
and outstanding liabilities.
 In QLD 90% of costs came fr...
 Created a language that was consistent with the
company’s strategic objectives and business
terminology. (Sustainability...
Vision Holistic - All encompassing EMPLOYER view
based on the knowledge of the nature, functions,
and properties of the co...
How relevant is the term Injury Management to the
CEO, the Board or Shareholders
People waiting on top down approach toPeo...
Bill Nevin - XtraCare, A Self-Insurance Unit for Queensland Employees of Glencore - The development & evolution of a succe...
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Bill Nevin - XtraCare, A Self-Insurance Unit for Queensland Employees of Glencore - The development & evolution of a successful risk based injury management

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Bill Nevin delivered the presentation at the 2014 Return to Work Forum.

The 2014 Return to Work Forum brought together speakers from multiple sectors to share best practice in return to work, injury management and rehabilitation.

For more information about the event, please visit: http://bit.ly/returntowork14

Published in: Recruiting & HR
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Bill Nevin - XtraCare, A Self-Insurance Unit for Queensland Employees of Glencore - The development & evolution of a successful risk based injury management

  1. 1. The development & evolutionThe development & evolution ofof a successful riska successful risk basedbased injury management systeminjury management system for employers.for employers. Informa – Return to work forum Melbourne 29-30 July 2014 Presented by Bill Nevin Manager XtraCare
  2. 2. Are there any Questions? In ClosingIn Closing
  3. 3. Actuarial Assessment of Estimated Outstanding Liability Copper - 47% Coal - 64% Reductions In Outstanding LiabilityReductions In Outstanding Liability 2007 2008 2009 2010 2011 2012 2013 Coal - 64%
  4. 4. Our Company has developed an employer based injury management system that incorporates risk management principles to promote early assessment and consistent allocation of injury management resources Documented IntentDocumented Intent consistent allocation of injury management resources to assist injured workers achieve early and sustainable return to work outcomes.
  5. 5. The primary goal of returning injured workers to pre-injury duties is critical and any significant risks to achieving this goal are escalated for management intervention Clarified IntentClarified Intent escalated for management intervention and development of strategies to resolve issues and achieve sustainable outcomes.
  6. 6. Web BasedWeb Based ––Injury Management SystemInjury Management System
  7. 7. On LineOn Line -- Risk Assessment ProcessRisk Assessment Process
  8. 8. The development & evolution of a successful risk based injury management system for employers.  Initial principals, philosophies and beliefs  Simple agreements to get you started  Developing a model with the future in mind Topic on the BrochureTopic on the Brochure  Developing a model with the future in mind  Adopting a new paradigm to achieve better outcomes
  9. 9. Payment Profile in QLD Claims PaymentsClaims Payments 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Paid to Date
  10. 10. Payment & Stat Est. Profile in QLD Claims Payments & Stat EstimatesClaims Payments & Stat Estimates 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Paid to Date Stat Est.
  11. 11. Payment & Stat & C/Law Est. Profile in QLD Payments + Stat & C/Law EstimatesPayments + Stat & C/Law Estimates 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Paid to Date Stat Est. C/Law Est.
  12. 12. 104 75 58 58 98 70 40 60 80 100 120 Overview of Stat Claims & Common Law Claims Lodged Statutory & C/Law ClaimsStatutory & C/Law Claims 15 6 6 5 2 0 0 20 40 2008 2009 2010 2011 2012 2013 Stat Claims C/Law Claims
  13. 13. 104 75 58 58 98 70 60 80 100 120 Overview of Stat Claims,High Risk & Common Law Claims Lodged Introducing High Risk CasesIntroducing High Risk Cases 21 15 13 15 22 12 15 6 6 5 2 0 0 20 40 2008 2009 2010 2011 2012 2013 Stat Claims High Risk C/Law Claims
  14. 14. 20 40 60 80 100 120 21 15 13 15 22 12 83 60 45 43 76 58 Claims by Current Risk Assessment Operations 2008 to 2013 Total Incurred Cost by Risk Assessment Operations 2008 to 2013 TotalTotal IncurredIncurred –– BasedBased on Riskon Risk 0 2008 2009 2010 2011 2012 2013 15 13 15 12 High Risk Low/Medim Risk 2008 2009 2010 2011 2012 2013 High Risk Low/Medium
  15. 15. Strategy - A plan designed to achieve a particular long term aim. Are we Naturally Strategic?Are we Naturally Strategic? Or are we more like the frog in slow boiling pot of water ?
  16. 16. Planning to achieve a particular long term aim ? Where do you sit?Where do you sit? Or are you following the process to see where it leads ?
  17. 17. Successful EmployersSuccessful Employers –– The EvidenceThe Evidence Christine Randall presentation 2008
  18. 18. What are the principals and philosophy that provides the best strategy for your business? We chose risk based principals and adopted an employer based Principals & PhilosophyPrincipals & Philosophy adopted an employer based injury management philosophy.
  19. 19. A risk based approach is an integral part of many safety systems that are heavily promoted by employers and enforced through legislation. First Aid Minor Moderate Major Serious Injury Management Matrix IMM A B 247 12 17 21 L I K E L CONSEQUENCE 20 23 2511 16 Why a Risk a based approach?Why a Risk a based approach? D E C 1 3 6 10 15 9 14 19 4 8 13 18L I H O O D 2 5 22 The aim was to create an Injury Management/Rehabilitation process that mirrored what was already operationally accepted
  20. 20. Injury Management Review AIM - To develop a system that provides a method for assessing and managing risks associated with workplace injuries. The system should provide:-  A method for rating various levels of incapacity;  Appropriate control measures for each level of incapacity; Appropriate control measures for each level of incapacity;  A mechanism to assess potential escalation factors;  A rating process consistent with current risk management practices. The Original PresentationThe Original Presentation
  21. 21. Injury Consequence Incapacity Type Max Period of IncapacityMedical Treatment Injury (MTI) Restricted Work Injury (RTI) Loss Time Injury (LTI) First Aid As Per TARP Minor Moderate Up to 14 Days Up to 14 Days on Normal Shift, no reduced hours Building an Injury Consequence TableBuilding an Injury Consequence Table * Major # Serious * To include all stress related conditions regardless of time frames # To include all injuries requiring hospitalisation and immediate surgery following injury
  22. 22. Injury Consequence Incapacity Type Max Period of Incapacity Medical Treatment Injury (MTI) Restricted Work Injury (RTI) Loss Time Injury (LTI) First Aid As Per TARP _ _ _ Minor Up to 14 Days Up to 14 Days on Normal Shift, no reduced hours _ 14 Days Moderate > 14 Days - < 8 Weeks > 14 Days - < 8 Weeks 1 to 14 days 8 Weeks Injury Consequence TableInjury Consequence Table * Major > 8 Weeks - < 20 Weeks > 8 Weeks - < 20Weeks > 2 Weeks - < 4 Weeks 20 Weeks # Serious > 20 Weeks > 20 Weeks > 4 Weeks Unlimited * To include all stress related conditions regardless of time frames # To include all injuries requiring hospitalisation and immediate surgery following injury
  23. 23. 20 30 40 50 60 70 5 7 11 9 16 13 15 9 14 17 11 12 19 13 16 13 14 18 14 22 29 38 17 27 25 17 20 25 23 26 22 34 27 11 25 15 21 22 5 4 4 3 2 6 3 2 1 3 2 1 2 2 2 4 3 3 2 Injury Management cases opened since 01/01/2012 by Consequence Does this graph assist Management?Does this graph assist Management? 0 10 7 2 2 6 7 5 5 1 1 1 1 3 2 6 1 4 2 1 2 5 6 2 1 7 6 1 1 6 4 3 6 0 4 4 4 2 0 3 9 16 13 14 8 11 12 11 16 14 18 14 Serious Major Moderate Minor Other
  24. 24. Injury Management & Resource Matrix Injury Consequence Treatment Provider Workers' Compensation Cert Required? Work Capacity Assessment Required Appoint a RRTWC Meetings with Manager Referral Required to External Provider? First Aid Occup. F/Aider, Nurse or Doctor Minor Doctor Moderate Doctor Major Doctor # Serious Doctor Management & Resource MatrixManagement & Resource Matrix # Serious Doctor Responsible Party AS Per TARP Injured Employee Work Capacity Assessment Required Appoint a RRTWC Meetings with Manager
  25. 25. Injury Management & Resource Matrix Injury Consequence Treatment Provider Workers' Compensation Cert Required? Rehab File Required? Registration in Injury Management System Risk Assessment Required? Referral Required to External Provider? Workers' Compensation Claim Required? Line Management Notification First Aid Occup. F/Aider, Nurse or Doctor No No No No Not Required No Supervisor Minor Doctor Yes Short File Only Registered as Short File No Not Required Only if Worker Requests Superintendent Moderate Doctor Yes Yes Yes Yes To be reviewed at 15 Days Claim Must be Lodged Manager Major Doctor Yes Yes Yes Yes Immediate Claim Must be Operations Here’s one completed earlierHere’s one completed earlier Major Doctor Yes Yes Yes Yes Immediate Referral Claim Must be Lodged Operations Manager # Serious Doctor Yes Yes Yes Yes Immediate Referral Claim Must be Lodged Senior Site Executive Responsible Party AS Per TARP Injured Employee RRTWC RRTWC RRTWC RRTWC Injured Employee RRTWC to Advise
  26. 26. The Injury Consequence & Resource and Management Matrix should be discussed and developed with Employees, Management, Rehab professionals and the Insurer. By obtaining approval by Management and the Insurer to the Matrix; -RRTWCs are now empowered to:- • take action • incur costs Seek & Obtain ApprovalSeek & Obtain Approval • incur costs • engage providers and • engage management It is important to ensure every early intervention strategy that might be required is listed in the matrix.
  27. 27. Injury Management Review AIM - To develop a system that provides a method for assessing and managing risks associated with workplace injuries. The system should provide:-  A method for rating various levels of incapacity;  Appropriate control measures for each level of incapacity; Appropriate control measures for each level of incapacity;  A mechanism to assess potential escalation factors;  A rating process consistent with current risk management practices. Back to the Original PresentationBack to the Original Presentation
  28. 28. First Aid Minor Moderate Major Serious Injury Management Matrix IMM A B 247 12 17 21 L I K E L CONSEQUENCE 20 23 2511 16 Step 1: Step 2: Risk Assessment ComponentsRisk Assessment Components D E C 1 3 6 10 15 9 14 19 4 8 13 18L I H O O D 2 5 22 Low Mediu m High
  29. 29. The risk assessment process should be designed to assess:- the risk of a worker not returning to normal pre-injury duties following a work related injury. Determine the Risk to be assessed.Determine the Risk to be assessed. Note :- The primary rehabilitation goal of returning the worker to pre-injury duties does not change because of the risk assessment.
  30. 30. The next step is to determine:- 1. the likelihood of the worker returning to pre-injury duties & 2. other factors that may cause escalation in the risk of the worker not returning to pre-injury duties. Likelihood & Escalation FactorsLikelihood & Escalation Factors returning to pre-injury duties. Note - whilst 2 workers may sustain the same injury and receive the same level of rehabilitation and treatment the likelihood of them returning to work may be vastly different.
  31. 31. On LineOn Line -- Risk Assessment ProcessRisk Assessment Process
  32. 32. 2 2 3 3 4 4 5 5 0 1 0 1 1 0 0 20 0 0 1 Single Site Injury Management cases opened since 01/01/2013 by Risk Assessment Single SiteSingle Site 0 1 1 2 1 0 0 2 0 1 0 0 0 1 2 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 High Medium Low No Assess
  33. 33. 2 3 4 5 6 7 8 33 3 2 1 2 1 2 2 2 2 1 1 1 1 0 0 0 1 1 0 0 0 0 Multi Site Injury Management cases opened since 01/01/2013 by Risk Assessment Multiple SitesMultiple Sites 33 0 1 0 0 0 3 1 1 0 0 0 0 0 0 0 0 0 0 0 11 3 1 1 2 0 0 1 0 1 0 2 0 1 0 02 1 1 0 0 1 1 0 1 00 0 0 0 0 0 0 0 High Medium Low No Assess
  34. 34. Flow ChartFlow Chart
  35. 35. Model PresentationsModel Presentations
  36. 36. Continuous ImprovementContinuous Improvement
  37. 37.  Create a list words, terms and phrases that:- ◦ are consistent with the language used in your company ◦ provide a positive message ◦ reinforce the desired behaviours ◦ are business orientated Choose a LanguageChoose a Language ◦ are business orientated ◦ limit expectations ◦ avoid insurance or medical terminology ◦ SIMPLIFY the message
  38. 38.  Employer based injury management  Striving for better outcomes  Early intervention – early resolution  Resource allocation  Risk management  Injury consequence  Activity based rehabilitation Some SuggestionsSome Suggestions  Activity based rehabilitation  Sustainable return to work  Information gathering  Stage management
  39. 39.  XtraCare review conducted in 2007 in the face of rising costs and outstanding liabilities.  In QLD 90% of costs came from common law claims where the claim centred on no employment or that current employment was not sustainable.  Workers’ Compensation was a problem for the company in each state in Australia.  Solution had to be Employer based as being compliant in each state meant different things in different states. (Outside the QLD Insurance Silo Thinking.) The XtraCare EvolutionThe XtraCare Evolution the QLD Insurance Silo Thinking.)  The holistic view became to develop a consistent employer based injury management system based on risk principals that could operate any where in the world.  Focus on “Sustainable return to work Outcomes” and early resolution as these save costs in any Workers’ Compensation System.
  40. 40.  Created a language that was consistent with the company’s strategic objectives and business terminology. (Sustainability & Risk)  Developed flow charts and diagrams that reflected the message, developed & promoted the system and demonstrated the thought process through new injury management models.  Defined management’s time as a valuable resource used for strategic decisions, created forums to engage management and health and The XtraCare EvolutionThe XtraCare Evolution –– cont.cont. forums to engage management and health and safety.  Most importantly moved the responsibility for Injury Management to the Employer through the promotion of employer based injury management.
  41. 41. Vision Holistic - All encompassing EMPLOYER view based on the knowledge of the nature, functions, and properties of the components, their interactions, and their relationship to the whole. Philosophy - can refer to "the most basic beliefs, concepts, and attitudes of an individual or group” Do you want an Employer or Insurer philosophy Intent - A readily grasped declaration of the course that the company needs to take into the future to Vision, Philosophy & Documented intentVision, Philosophy & Documented intent that the company needs to take into the future to deliver better outcomes. The intent needs to be easily understood by every member of the company and be consistent with current strategic goals
  42. 42. How relevant is the term Injury Management to the CEO, the Board or Shareholders People waiting on top down approach toPeople waiting on top down approach to Injury ManagementInjury Management

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