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LABOR SHORTAGES AND WORKPLACE INJURIES

12/08/2021
 * 
 * 
 * 

This webinar covers a number of topics related to worker shortages and workplace
injuries, including:

 * Pandemic-induced labor shortages
 * Injury volume data by industry
 * Mitigating work injuries amid labor shortages

Speaker: John Anderson, DO FACOEM, FAIHQ, Chief Medical Officer, Concentra


WELCOME AND INTRODUCTION OF SPEAKER

1:00-1:06

Hello, everyone, and welcome to the Concentra webinar, “Labor Shortages and
Workplace Injuries.” Today's webinar will be presented by Dr. John Anderson,
chief medical officer at Concentra.

Dr. Anderson oversees delivery of care by more than 2000 medical clinicians
nationwide. He also oversees quality assurance of Concentra medical practice
based on high quality, value-based care for shorter case duration, Concentra,
early intervention model for rapid sustainable recovery. Dr. Anderson has more
than 40 years with medical experience, is board-certified in occupational
medicine, and has been with Concentra since 1993.

At the conclusion of the presentation, we will have a Q&A session with Dr.
Anderson. You can submit your questions throughout the presentation to be
answered during the Q&A. Dr. Anderson will answer as many questions as possible
within the time allowed. After the webinar, a recording of the webinar and a
copy of the slides will be emailed to you so you can view them again at your
convenience.

Dr. Anderson, we're ready to begin.


OPENING

1:08-2:54

Thank you. And welcome and thanks to everybody for being here. I know your time
is valuable, and our intention is to give you some information that will be
helpful to you and in managing through the labor shortages at this time that I
think we're all experiencing.

We'll go over some of Concentra’s data on the subject, and then try to make
sense of how you, as an employer, can meet some of the challenges that you're
experiencing and maybe mitigate some of the risks associated with this current
labor market, which seems to be affecting every industry.

I know at Concentra, we're facing the same challenges as many of you with
workers who had that time during the pandemic to consider their current
employment.

To consider other employment options—to consider work-life balance as well.

We're even seeing physicians retiring early or reducing their work schedule
sometimes dramatically—sometimes going into telemedicine.

So, they don't have to experience workplace exposures to the virus.

Demand for higher wages seems to be pretty universal. And in a shrinking pool of
qualified candidates, we're needing to meet that demand in order to remain
staffed with qualified medical assistance.

Rad techs, advanced practice clinicians, our nurse practitioners, and PAs…

Even front desk, staff, coding, billing specialists, and all the support. So, it
seems like we're all in this together, considering the attendance today. So,
I'll try and make this relevant for you.

There are, however, no magic bullets—warn you in advance of that. We can advance
to the next slide.


AGENDA

3:00-4:06

Let's take a look at the agenda and beginning with a look back.

At the work shortages, which started even before Covid reared its ugly head—how
these ingredients for a labor pinch were brewing before the pandemic.

We'll explore some of the pandemic-induced labor shortages and some pain points
that currently exist for employers.

Take a look at some of the current trends in workforce behavior and how these
affect your business, your current workforce, and even prospective employees.

Then we'll take a look at some of Concentra's data on common work injuries that
occurred both before and during the pandemic, and the injury volume data that
Concentra is currently experiencing, and then some of the national injury volume
data.

Take a look at Covid’s influence on workers' comp claims during the pandemic and
wrap up with how business leaders are facing very challenging circumstances,
implementing occupational health best practices in the face of labor shortages
and the impact of all that on workplace injuries.

So, then we'll close, as she said, with a brief Q&A session, and then I'll
answer as many of your questions as time might allow.


LABOR SHORTAGES: PRE-COVID

4:15-4:59

But before looking into some of the possible factors related to our current
state, it's really important to recognize that labor shortages existed before
the pandemic, especially for blue-collar industries. Eighty-five percent of the
companies in industries with a high volume of blue-collar workers reported labor
shortages and recruiting difficulties in 2019—before Covid was even heard of.
Then, as the pandemic hit very rapidly, layoffs and furloughs followed in 2020.

Employers figured out how their employees could work remotely, and some of them
got very accustomed to that and began to like it very, very quickly.

So, let's talk about how pandemic has influenced labor shortages.


PANDEMIC-INDUCED LABOR SHORTAGES

5:03-7:41

Earlier this year, the U.S. Chamber of Commerce declared the country's labor
shortage a national economic emergency. That's a pretty big deal, and it's an
emergency that's getting worse by the day.

Chamber also released a survey revealing that 88 percent of U.S. businesses have
found it difficult to fill job vacancies since the start of the pandemic.

So, what are some of the factors that have been credited for causing an
exacerbation and the labor shortages related to this pandemic? Well, before
vaccines, and even therapeutics—which are soon to arrive—became available. Some
employees would stay away from the workplace, out of fear of infection, or
exposure. You might recall some of the televised images early on as different
industries where employees were working shoulder to shoulder in very cramped
quarters. Those were pretty alarming. And it makes it understandable why people
would not want to go back into those workplaces.

So, when companies reopened after the initial lockdowns and after
government-imposed measures, fewer employees wanted to return are a variety of
reasons but mostly led by fear of contagiousness and infection. And this fall,
as the labor crunch was becoming even more evident, many, blamed the problem on
the Enhanced unemployment benefits program provided through the Cares Act. Those
benefits, however, expired in September and many, in most places, and yet, we're
still dealing with labor shortages, so it wasn't just that. On top of
virus-related issues, many employees have been re-assessing their career choices
or haven't been acquiring new skills and advancing their education. This caused
some employees to explore new job opportunities or demand higher pay—part of the
trend called “The Great Resignation.”

Moreover, national and state vaccine mandates have also forced the hand of some
employers, resulting in resignations and terminations over noncompliance issues.
And despite wide vaccine availability and overwhelming data that support the
safety and efficacy of the available vaccines, many workers still have lingering
concerns over the vaccine. And even many who are fully vaccinated are concerned
about exposure to those unvaccinated in the workplace, especially in jobs with
high levels of person-to-person interaction.

Overall, it's really impossible to pinpoint any single factor that's causing
these workforce shortages, which makes a simple solution even more elusive.
Maybe impossible, but let's talk about employer pain points that are influenced
by some labor shortages. So, what's causing supervisors, and safety and risk
managers alike to lose sleep because of these labor shortages?


EMPLOYER PAIN POINTS

7:58-9:23

Let’s start with an understanding that many, many, many, many loyal and
hard-working employees that you have, and we have, may have to now work longer
shifts with fewer breaks to meet deadlines or production quotas because of the
shortage. These time constraints may tempt employees to overlook safety
regulations or cut corners. With fewer workers doing more, there's also the risk
of less oversight, subpar work performance, which translates into more errors
and inferior quality. Longer hours with higher work volume can cause fatigue and
frustration, impacting employee retention and workplace morale.

Burnout is always a risk in some industries, including medicine, in health care,
resulting in higher than usual turnover rates. We know from our own physician
group that those nearing retirement have retired early as a result of the
coronavirus pandemic. And while fatigue, longer shifts, and overtime affect
retention, it's predictive of increased injury rates as well. Adding and
training new hires puts a strain on tenured employees and also predicts the
likelihood of increased injury rates in the new hire group.


PATTERNS IN WORKFORCE BEHAVIOR

9:24-10:30

Some of you may notice some trends in workforce behavior, as well, that can be
influenced by the understaffing issue. Employees may feel overwhelmed by
constant work demands caused by depleted, workforces. Overworked and frustrated,
these employees may schedule time off more often.

You may also see an increase in the number of employees calling in sick or
abruptly requesting time off. More often now, new hires may reject a job offer
after accepting it or simply not show up for work on their start date. That's
known as ghosting.

These behaviors have a direct impact on productivity and morale, creating a
vicious cycle, stressed-out employees who are spread thin. This cycle will
expose employees to more injuries as well. When employers need to hire more
workers to stay ahead of these work demands, they can't afford to lose their
existing workforce to occupational injuries or illnesses.

So, let's talk about some common work injuries that have been occurring both
before and since the start of the pandemic.


MOST COMMON WORK INJURIES (PRE-PANDEMIC AND PANDEMIC)

10:38-11:45

Understanding the nature and frequency of common injuries may help to prevent
them. So, Concentra Clinical Analytics and Quality Department has compiled
injury volume and mixed data based on work injuries that our clinicians have
treated before and during the pandemic. To add some context, our centers treat
one out of every five reported occupational injuries in the United States. So,
our database is quite large.

The highlighted groups on the left—five different groups—are also represented in
the bar graph to the right and represent the top five injury types based on
percent distribution. You can see that there is an exceptional amount of
consistency before and during the pandemic for these injury types.

Interesting or maybe incredibly there's no diagnostic group experiencing more
than a 0.7 percent change in distribution during the pandemic. So, injury types
have remained by and large the same. On the other hand, the pandemic impacted
industries in industries—singular industries—in considerably different ways.


CONCENTRA INJURY VOLUME DATA BY INDUSTRY

11:55-13:55

You can see at the bottom of the table the total number of new injuries treated
in our centers with an overall decrease in 2020 of about 18.5 percent. Some
months in the early stages of the pandemic actually hovered in the 50 percent
range in spring and early summer. While there's been an increase in injuries in
2022 and 2021, volumes still not returned to 2019 level, which is a good thing.
And each industry sector has had a different experience.

If you look at the hotel industry about midway down that table there, you'll see
that there was a 59 percent drop in new injury volume in 2020. That's only a
moderate recovery in 2021. This is perhaps not surprising with staff reductions,
and some hotel services may rebound very slowly or not at all. For instance,
room service and daily maid services have been discontinued or curtailed. Some
restaurants and hotels have closed entirely. Bar service at night has been
discontinued in many hotels.

On the other hand, if you look at the top industry—the airline industry at the
top—you’ll see that in 2020, compared to 2019, the percent variance was -52.1
percent. That rebounded pretty considerably in 2021. And if you look at 2021
versus 2020—quite a remarkable improvement, to 2000, to 70.5 percent rather.

So, each industry has had a different experience. The only ones that really had
a positive experience were the delivery industries and the retail industries,
and also to a certain extent, the warehousing industry.


NATIONAL INJURY VOLUME DATA

13:57-17:13

So, moving onto the next slide…from a more national perspective, Bureau of Labor
Statistics and the NCCI have issued some data as recently as last month.
According to BLS data that was released for nonfatal private industry employers,
injury and illness cases decreased by 5.7 percent. And that was due mostly to a
decline in the injury rate from 2.6 to 2.2 per hundred FTE workers. That's a
pretty big drop for one year. However, at the same time, occupational illnesses
quadrupled, largely due to an incredible 4000 percent increase in respiratory
cases. The culprit, of course, being coronavirus infections.

In all private sectors, the total injury and illness cases decreased or remained
the same except for health care and social assistance. In those sectors, there
was an increase from 3.8 to 5.5 cases per 100 FTE workers, and…the healthcare
industry accounted for 74 percent of the pandemic-related respiratory cases.
There was a 32.4 percent increase in last time cases. This is really important.
About a third of those were categorized as Covid-19 related illnesses. More
worrisome, however, than the increase in lost time cases is the median number of
days away from work for all occupations increased from eight days to 12 days
between 2019 and 2020. So, that's an increase of four days for about one point
two million lost-time cases, which means an additional loss of about 4.8 or five
million productive workdays in 2020 in private industry alone.

Some interesting stats nursing assistants had the highest number of days away
from work cases; that makes sense, given the nature of the patient population
that they were handling. Heavy and tractor-trailer truck drivers had a 9.4
percent decrease in the cases—probably, largely because of a decrease in
transportation. And there was also a decrease in their rate, but they had an
increase in days away from work from 19 to 23 days. So, four days, again—pretty
significant.

In private leisure, entertainment, and hospitality, there was a drop in overall
case rate, largely driven by a decline in injuries.

Days a week from work cases for a woman increased 68 percent, likely related to
the number of women, health care workers. And days away from work cases for men
increased only by 7.8 percent.


PANDEMIC-INDUCED WORKERS’ COMPENSATION CLAIMS

17:14-18:41

Not unexpectedly, 75 percent of Covid-19 cases are lost-time claims. So, in all
of the reported cases with lost time, one in three was categorized as quote,
“other diseases due to viruses not elsewhere classified (including reported
COVID pandemic-related illnesses).” In other words, coronavirus. Company leaders
need to investigate workplace exposures to Covid- 19 in the same manner that
they would any other type of claim that might be eligible for workers'
compensation. Both payers and TPAs have generally been at the forefront of
establishing criteria and eligibility to qualify for compensation in the face of
an exposure. So, if you have any possible work comp, Covid-type claims, lean on
those resources—perhaps the local health department for guidance. And remember
that these claims, once validated, are recordable as an occupational illness.

Unfortunately, your shorthanded workforce could be diminished even further when
an employee has been diagnosed with or exposed to Covid in the workplace. These
claims for Covid can be confusing and frustrating for both the affected employee
and company, and only add to the list of worries for supervisors, safety and
risk managers, and other company leaders.


THE BURDEN OF LEADERSHIP

18:43-19:52

So, as employers continue to pick up activity at the workplace, we shouldn't
overlook the increased demands placed on those company managers and leaders who
are tasked with overcoming production losses, meeting ongoing demands, managing
expectations in the face of employee attrition, fear, mistrust, loss of morale.
These same leaders are often working under the same constraints as their
employees; they’re overworked, and they're frustrated.

So, how does an employer overcome these challenges? Ultimately, there's no
overnight fix for the complex problem of labor shortages. But there are steps
that employers can take today to mitigate the costly risks associated with
preventable occupational illnesses and injuries. While you're each the expert
within your own company, Concentra or other occupational health provider groups
can help employers to focus on retaining and preserving their current workforce
by actively addressing injury risks.


MITIGATING WORK INJURIES/ILLNESSES AMID LABOR SHORTAGES

19:54-23:28

Here we can offer some occupational health best practices and measures. First,
being mindful of work hours.L onger shifts and overtime can cause fatigue, and
fatigue results in injuries and loss of productivity. Encourage employees to
take breaks during their shifts. This is important. And don't just consider the
length of their shifts. Also, consider the scope of their work. Is it difficult?
Physically demanding? Tedious? If job rotations are possible, consider that in
order to reduce the possibility of overuse syndromes and boredom. Do something
unexpected to make the day or the week more interesting. A little bit of fun can
go a long way in preserving employee relationships.

Stretching programs and conditioning—especially with new employees, or those
returning from layoff or leave of absence—can reduce their risk of injury.
Rebalancing work duties among your employees to keep them interested and
engaging can be helpful.

Finally, while we're all experiencing pandemic fatigue, it's still important for
most employers to apply indoor masking policies, hygiene protocols, and
social-distancing standards for infection control. Enforcement of your safety
programs may depend on your local community’s transmission rate and other
factors.

Many of your employees will view this positively as a message that you do care
enough to promote safety in the workplace, and there is no better way to end the
pandemic than vaccination. We're currently in a pandemic of the unvaccinated.
There's more variants undoubtedly in our future and a very long road ahead. So,
let's use and promote all of the tools we have available today to shorten and
end the pandemic without further loss of life. You have more power of persuasion
with your employees than you might think. Some of your employees [who] have been
resistant or hesitant to get vaccinated, are starting to reconsider their
decisions. You might just tip the balance for them, So, do what you can. And
keep in mind that enabling risky behavior in the workforce balance places your
workforce balance in much deeper jeopardy. We remind our clinicians regularly to
promote vaccination during each of their office visits.

So, while no vaccine can offer total protection, vaccination remains the single
most effective way to reduce workplace exposure risks, relieve anxiety about
working on site, and reduce the number of covered-related workers' compensation
claims.This results in improving workforce productivity, worker availability,
and ultimately, your company's competitive value.

One last thought…remember that employee recognition and showing gratitude toward
your employees—especially during the pandemic—can mean the difference between
their staying or leaving for a better workplace. A sincere “thank you” sometimes
simply for showing up to work can make a huge difference.

That concludes our presentation for today, and we will be opening it up for
questions.




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