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Injury Management Database “IMdb”

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					Injury Management Database “IMdb”
Company BMA Blackwater & IMC Pty Ltd
Entered in the 2007 Queensland Mining Industry Health & Safety Innovation awards
For more information Contact (07) 49805829

The Problem or Initiative
Rehabilitation improves functional outcomes; however, there was previously scant data
on the profiles and outcomes of workers undergoing rehabilitation in BMA Blackwater.
Further, there was a requirement for us to have a tool, to capture and implement the
normal functions of a best practice rehabilitation operation.

A number of group meeting with the following participants (Tony Lord HSEC Manager
BMA , Mark Desira BMA, Russell Nelson IMC GM, Denise Lord BMA), were held and
it was determined that the data base needed to address the following issues:

The implementation objectives of this Injury Management Database (IMdb) were;

1.     Provide a tool for the site rehabilitation and return to work coordinator to ensure
       an efficient system exists for immediate reporting of injuries to enable early
       worker contact regarding rehabilitation, to comply with employer’s duty to report
       injury to the insurer.

2.     Develop, coordinate and monitor workplace rehabilitation strategies for injured
       workers, including developing suitable duties plans and case management plans.

3.     Keep accurate and objective case notes of all communications, actions and
       decisions, and reasons for actions and decisions.

4.     Indicate the status on every worker on Rehabilitation and the status of their
       Medical certification and currency of the Suitable Plan.

5.      Project against a national data set the average return to work durations for
       specific injury types and work activities.

6.     Provide Management by department a suite of reports on the current position of
       their workers on rehabilitation.

7.     Provide Payroll with an accurate list of workers on rehabilitation as required.

8.     Indicate the reporting line for Rehabilitation cases to facilitate contact with
       supervisors and or managers.

9.     Provide a digital file system to reduce the Paper generation and facilitate the
       emailing of data and documents to other parties.
10.    Document the clinical characteristics and functional outcomes and costs using the
       Functional Independence Measure (FIM), of all workers entering as clients of
       rehabilitation unit at BMA Blackwater Mine, and to identify and analyse factors
       significantly associated with better discharge functional scores and higher
       functional gains.

11.    Have the ability to integrate data from various other sources e.g. HR systems and
       First Priority as well as all Microsoft Office Suite programs.

12.    To ensure that the database maintained the information in highly confidential and
       stable manner.

The Solution

BMA Blackwater’s Injury Management database system is the cornerstone of our case
management framework. Best Practice rehabilitation is focused on a set of clearly-
defined practices, underpinned by quality assurance and continuous improvement
methodology. It ensures effective management of a rehabilitation cases from notification
through to finalisation, supported by sound decision-making made available thru the
assistance of the (Imdb).

It focuses on cost-effective service delivery and aims to ensure the achievement of timely
and sustainable return to work outcomes and maximum functional capacity. The goal of
rehabilitation case management is a timely, safe and durable return to work for injured
workers and contractors, both domestic and work related.

Our framework incorporates seven case management principles of which the Imdb is an
integral component:

1. Managing daily case Coordination
2. Triage and screening
3. Clearly-defined practices
4. Records management
5. Sound decision-making
6. Cost-effective service
7. Quality assurance and continuous improvement.

PRINCIPLE 1 – MANAGING DAILY CASE COORDINATION

IMdb provides the Rehabilitation Coordinator with the systems and real-time information
to:

•Approach managing injuries, claims and return to work in a holistic and systematic
manner
•Maximise return to work and health outcomes for injured workers, while minimising
risk of re-injury

•Establishes an effective rehabilitation management infrastructure with open
communication channels

•Deliver cost-effective rehabilitation management with a strong focus on outcomes.

• Provides information immediately for influencing key parties including the injured
worker, employee representatives, General Practitioners and other service providers to
achieve agreed goals.

• Simplifies maintaining regular and appropriate contact with all parties to determine the
injured worker’s progress and possible barriers to progress or any risks of delayed return
to work, recovery and finalisation.

• Provides data to the self insurance unit to accurately determine provisional and ongoing
liability.

• Assists in the coordinate’s services and manages providers to achieve identified
outcomes through a collaborative approach, to medical treatment, return to work, dispute
management, legal matters and other rehabilitation decisions.

• Maintains up-to-date knowledge base of services and providers, which will meet the
needs of the injured worker and achieve goals.

• Provides information to regularly review all aspects of the claim, including service
provision, service levels and appropriateness of treatment, service providers’ adherence
to protocols and guidelines.

Relevant, accurate and timely data ensures consistent and up-to-date management of
rehabilitation cases.

Our Injury Management Database facilitates decision-making and assists the
Rehabilitation coordinator to:

• Identify factors as early as possible that place recovery or return to work at risk
• Record all case management activities and actions
• Identifies, diaries and monitor milestones, including capacity to prompt review dates
• Review activities
• Retrieve accurate rehabilitation details immediately
• Identifies exceptions and timeframe failures.

A risk management approach to the provision of best-practice rehabilitation case
management identifies the likelihood of strategic and operational risks that could
adversely affect delivery of case management. It identifies where systems and practices
fail, and allows rapid remedial action to be taken.

IMdb allows for the early and accurate identification of the needs, risks and potential
barriers to achieving health and return to work outcomes ensures the focus of
management is upon risk factors indicative of poor outcomes.

Categorising cases according to the risk of delayed return to work, long-term disability
and delayed finalisation allows us to quantify, track and priorities case activity.
IMdb assists with timely re-screening throughout the life of the rehabilitation case and
facilitates periodic review of risk factors and barriers to ensure that intervention is
effective in mitigating the risk and reducing the impact, and continues to be relevant to
the worker and key parties. These IMdb database provides evidence to support or refine
the screening system.


PRINCIPLE 2 – TRIAGE AND SCREENING

IMdb Triage facilitates sorting the cases into broad categories and making an early
assessment about the extent to which an injured worker’s return to work and recovery are
potentially at risk. This evidence-based system and practice for gathering accurate and
relevant information is essential to effective triage.
Screening and re-screening is an assessment of risk factors, psychosocial indicators and
return to work barriers. An effective screening tool must be consistent, replicable,
research based and captures data.


PRINCIPLE 3 – CLEARLY-DEFINED PRACTICES

Clearly-defined practices reflect case management that proactively moves the claim
towards finalization and manages the expectations of key parties. These practices support
appropriate interaction with key parties that ensure injured workers and employers
receive services in a supportive, efficient and
cost-effective manner. IMdb underpins the delivery of proactive case management that is
aligned with the legislation.

PRINCIPLE 4 – RECORDS MANAGEMENT

The scope of records management includes all communication in relation to a claim. The
IMdb system delivers complete, accurate, timely, secure and accessible information that
contributes to an injured worker’s rehabilitation.

Any records management system irrespective of jurisdiction, must comply with
legislative requirements for record-keeping. It includes:
• Case record identification
• Archive, storage and retrieval procedures
• A record of events, including communication with key parties
• Worker’s rights to give the authority to release and obtain information,
• Application of confidentiality and privacy principles to the collection, maintenance and
storage of Information.

PRINCIPLE 5 – SOUND DECISION-MAKING

Sound decision-making is free of preference and prejudice. It considers outcomes for the
injured worker, the employer, and if applicable the workers compensation system. Sound
decision-making means considering options, and then acting. Our decision-making model
is clearly understood and consistently adopted by the rehabilitation coordinator, this is
achieved by IMdb providing the coordinator informed, outcomes-focused, cost effective,
evidence-based information.

PRINCIPLE 6 – COST-EFFECTIVE SERVICE

Outcome-focused management of the injured worker and their case includes the need to
effectively manage the overall costs associated with the worker’s recovery, and
determination of the vocational and return to work goals. Our Injury management
database provides an effective system for:
• Evaluating costs
• Managing expenditure
• Assessing outcomes against costs.

PRINCIPLE 7 – QUALITY ASSURANCE AND CONTINUOUS
IMPROVEMENT

Ongoing review, analysis and evaluation of systems and work practices, tools and
resources are essential for effective and efficient case management. Using the data allows
the BMA Blackwater mine to identify areas of strengths and opportunities to implement
improvement strategies to enhance performance and achievement of outcomes.

Benefits/Effects

The benefits of the system to date have been numerous:
   1.  Significant reduction in processing times for day to day operations of the
       rehabilitation function.
   2.  Reporting functions to management have been improved.
   3.  Turn around times for acceptance and or other notifications from our Self
       Insurance Unit have been reduced to the point that one recent claim was accepted
       with 1:15 minutes of transmission to them.
   4.  Sustainable reductions in paper consumption have been achieved.
   5.  Turn around times with Medical Practitioners and Allied Health professionals
       have reduced significantly.
   6.  Comprehensive reductions in LTI duration rates against the national indices have
       been achieved.
   7.    Management of Alternate Duties/Suitable Duties programmes are now easier.
   8.    Significant improvements in Alternate Duties/Suitable Duties hours are occurring.
   9.    Documentation of case notes is now more effective.
   10.   All other aspects of Rehabilitation Case management have benefited from the
         implementation of the system.
   11.   Tangible results in case turn around time have been extensively recorded however
         due to privacy constraints this information is not available.


Transferability across Industry
Considerable thought was also given to making the system transferable to other
Australian Worker compensation jurisdictions with minimal intervention. During its
inception and at a number of points along its trial, various BMA Blackwater mine
contractors have viewed, the system and it has been very well received with a number of
requests to have the system installed in their operations. The system is applicable in any
industry where injuries and the necessity to manage them occur.

Innovation
Research was undertaken and it was determined that no Injury
Management/Rehabilitation specific data base applications were available for purchase
which met our requirements. To the best of our knowledge no other program is available
which can provide the day to day operational support required, by a site rehabilitation
coordinator.


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