When Monica Manske does rounds
at Rochester Regional Health’s five
hospitals and six long-term care
facilities, she looks at shoes, among
Her interest is safety — not fashion.
However, offering employees more
fashionable options helped increase the
compliance rate in RRH’s mandatory
safety shoe program from 35 percent
a few years ago to 85 percent in 2016,
said Manske, RRH’s senior manager of
workers’ compensation and employee
Safety shoes are an important factor
in preventing slips and falls, which
are a major loss driver for health care
facilities, especially for employees
in food service, environmental and
housekeeping and direct patient care.
In the five years since its inception,
the safety shoe program contributed
to a 42 percent reduction in lost-time
claims and a 46 percent reduction in
That change came only with
deliberate and concerted use of one-on-one communications, surveys,
budget adjustments and historical
claims data, Manske said.
By virtue of mergers and
acquisitions, RRH grew during
the past decade from about 10,000
employees to almost 17,000. As it grew,
the workers’ comp and safety team —
three employees dedicated to workers’
compensation, two for ergonomics,
plus physical therapy and clinical
education staff partners and 150
safety champions — educated waves
of new employees in safety protocols,
including the shoe program.
The team is strategic in its approach
to shoe compliance. Rather than
punish non-compliant employees, it
launched a survey asking workers to
disclose why they chose not to wear
the safety shoes. The responses helped
facilitate program refinements.
As a result of the feedback, the shoe
subsidy grew substantially, as did the
quality and variety, including more-
fashionable Sketchers and Reeboks.
Compliance now approaches 90
percent, Manske said.
When she does rounds and sees a
non-compliant employee, “I introduce
myself in a friendly way and ask about
the shoes.” Maybe they don’t fit right.
Maybe the employee is new and hasn’t
been fitted yet.
The same process applies to other
programs, she said, such as direct
patient care where soft tissue and
musculoskeletal disorders are common
and largely avoidable. Housekeeping is
a key focus as well due to its potential
factor in infections such as MRSA.
Frequent, direct employee contact
is essential to spreading the safety
gospel, said Laurie Muratore, injury
don’t just train
at first hire
and then cut
It takes daily
she puts on
spends a few
days on a unit to immerse herself in
the staff’s struggles and challenges. “If
you’re not out there in the mix, it’s hard
to teach and preach and be accepted.”
The safety team works hard to
cultivate its image as “good cops”
rather than “bad cops.” It encourages
individuals to report mistakes so the
precursors to errors can be better
understood to fix system issues.
“I like to be the carrot. Not the stick,”
said Manske. “We don’t punish mistakes.
This is fact finding, not fault finding.”
“When they see me coming, they say,
‘Here’s the back lady!’ ” said Muratore,
who has a background in physical
therapy. Back injuries are the scourge
of nurses, who lift, pull, push and shift
patients, often in 12-hour shifts.
Sometimes Muratore shows up with
new safety devices, such as slings and
straps that RRH is thinking of buying.
“They say, ‘Got any new toys for us?’ ”
WHAT GETS MEASURED
A measure of a good workers’
compensation safety program is
how quickly claims are reported,
said Charles Bolesh, senior account
At Rochester Regional Health, the workers’ comp and safety team champion employee engagement and
executive, PMA Management
Corporation, the health system’s TPA.
Delays, he said, are understandable
since each hospital’s first priority is to
care for patients. But delays are often
Carrots: Not Sticks
positive reinforcement. By Susannah Levine
“I like to be the carrot.
Not the stick. We don’t
punish mistakes. This
is fact finding, not
— Monica Manske, senior
manager, workers’ compensation
and employee safety, Rochester
Regional Health System
• Safety shoe compliance shot
from 35 percent to 85 percent
thanks to employee engagement.
• Workers’ comp and safety
personnel work shoulder-to-shoulder with hospital employees.
• Strategic deployment ensures
effective use of limited resources.
symptoms of stretched resources and
lack of leadership focus. They’re a
red flag for weak injury prevention.
“Delays can lead to bad outcomes.”
For example, he said, injured
workers facing a long reporting delay
may not have a return-to-work plan,
let alone testing, medical care and
therapies. They may retain an attorney.
“There’s a direct correlation
between reporting delays and higher-
cost claims,” he said.
When PMA first partnered with
RRH in 2000, claims reporting could
take a full month. Bolesh offered some
advice: Report faster. “They ran with
it,” he said. Now, reporting to PMA
takes place within a few days, and
injured workers get treatment and a
return-to-work plan in short order.
Incident reports are detailed,
A culture of positive reinforcement is one of the keys to Rochester Regional Health System’s success. PHOTO COURTES Y OF RRH