Offering prevention services directly to employers is a great opportunity to provide a valuable service and expand your practice. The menu of services can include: job analysis, post-offer/pre-hire functional screening, ergonomic assessment and recommendations, employee education and early reporting/first aide at the worksite. 

The selection of services will vary according to each employer's issues. Employers who will be receptive to discussions regarding prevention are typically self-insured, have high workers compensation costs and physically demanding jobs. The individuals within each organization who are responsible for hiring new employees and creating a safe work environment are usually the primary stakeholders for these projects.  Depending on the organization's structure, you will likely need to speak to the VP/manager of human resources, VP of risk management, VP of safety or a team comprised of these individuals. Physical and occupational therapists have the unique skill set to offer these services based on their expertise in function and body mechanics.

Preparing to Work With the Employer
To create opportunities with employers, many clinics begin by determining their previous patients' employers. If there are some "frequent flyer" organizations, these clinics take the opportunity to contact the employer to express an interest in helping with prevention. 

Working successfully with employers involves understanding their industry as well as their individual company. The internet makes researching the company and industry easy. Visiting the company's website is a natural starting point. In addition, you may want to investigate any internet sources that speak to the incidence and cost of injuries in the relevant industry.   

Understanding industry turn-over rates and costs is also helpful. To become familiar with the terminology associated with the industry in question, the Dictionary of Occupational Titles and the O*Net will be helpful. Peruse the websites and newsletters of any trade associations relevant to that industry. Through this type of research you'll gain an understanding of the industry's terminology, the equipment used, the issues facing the industry and the types of work processes typically executed by this organization.   

Interfacing with the Employer
When you meet or talk with the company representative, it's important to ask questions and do much more listening than talking. Trust is developed by asking quality questions and people do business with people they trust. You'll want to know if high worker compensation and turn-over costs are a problem.  You'll also want to know the types of injuries that are the most prevalent. Is it strains and sprains, slips, trips and falls, lacerations and/or repetitive motion injuries? 

Some companies will share their OSHA 300 logs and or other injury data. If their injuries are occurring primarily in new hires, then post-offer/pre-hire functional screening may help. If injuries occur on a particular shift, in a particular department, or with a particular group of jobs, that may be the area on which to focus prevention efforts. Focusing the project allows the employer to realize the biggest return on investment which will develop long-term employer relationships for your clinic.

Some employers will allow you to do a "walk through" to see the work. The walk through will give you a better idea of how the work is performed, allow you to see the equipment and will likely generate some ideas for prevention. During the walk through, you will likely see improper lifting, awkward postures, and poor work practices. These observations create an opportunity to demonstrate your knowledge and skill and to find out what, if anything, has been done in the past to address the issues. The challenge is to introduce your comments at the right moment and with the right tonality so that the employer does not become defensive.    

After you have developed the appropriate level of trust, asking to see any existing job descriptions will allow you to see the scope and complexity of each job. Most job descriptions do not provide enough specifics about the physical demands of the job upon which to base hiring or return-to-work decisions.  Pointing this out to an employer at the right moment can create an opportunity to help with expanding or updating job descriptions. 

You'll also need to understand if there is a union presence. If unions are present, including union representatives in the discussions regarding prevention is essential. However, the timing of these discussions is typically critical and it's important to follow the employer's lead regarding union discussions.

Future Columns
Future Industrial Insight columns will provide insight specific to industries that have benefited from prevention. Some of the future topics will address the trucking industry, utilities, oil and gas, warehousing and distribution, and meat processing. Each column will discuss the common processes found in that industry, unique terminology, frequently encountered equipment, common ergonomic issues, common injuries and case examples of successful interventions. Our goal is to provide useful information that will help you and your clinic as you step out into the world of prevention and partnering with employers for a safer, healthier work place.       

Deborah Lechner is president of ErgoScience, Inc.