THE LEADER in Work Injury Management & Prevention Systems

Improving Industrial Rehabilitation
Vol. 26 • Issue 7 • Page 17 

Industrial Rehabilitation

Safety can be an overused buzzword these days in industry. As physical therapists, we have an excellent opportunity to help companies make a transition from focus on safety to results in safety. As with most aspects of our individual lives, the first step we take when we discover something that needs to change is discussing how we need to focus on the task or idea.

Unfortunately, this is often where it ends. This same trap exists with companies attempting to improve their safety record and decrease their number of injuries. Companies realize that safety is important, but it is just one of many things that demand attention.

The challenge management faces is that safety is not their sole focus. Business requires attention to deadlines, profit, customer satisfaction, and current trends. It is essential that management keeps this focus to ensure the company remains profitable and sustains employment for its workers. Assisting with or assuming this safety role is where onsite therapists can make their largest impact.

Advanced Injuries

When I started as a therapist in an outpatient practice, it was always frustrating to see workers come into the clinic with injuries so far advanced that our ability to help them was diminished. I would often wonder how I could get to patients sooner, to prevent injuries from progressing to the point where my ability to make positive changes was so challenged. Working onsite lets me put the majority of my effort into prevention, and limit the number of repetitive strain injuries (RSIs) that result from on-the-job injuries.

For the past five years, I've been working with Work Injury Solutions & PT and the faculty at DSI Work Solutions, using onsite job function matching (JFM) programs with local companies. This system helps companies move from focus on safety to results based on the commitment and perseverance needed to work through the required changes.

Most companies come to us because their focus is on safety, but they need assistance to achieve their safety goals. Through DSI's JFM and work-injury management programs, we can help them reach these results.

One example is American Packaging Corporation (APC), where I've been working with Finishing Manager Terry Wilkin to help decrease injuries and make sure employees are safe. When I started working at APC, they already had a good safety program in place. They had achieved many ergonomic modifications to decrease stressors on their workers, but our goal was to help them expand on their commitment to safety.industrial rehabilitation

We first created a system of injury prevention by offering first aid to employees through education and worksite modification if they were beginning to have minor symptoms. Employees could either approach me while I was onsite, or ask their supervisor whether I could stop to talk with them.

I could then have discussions with them, observe the task being completed, and if needed, make a recommendation for changes to the task, tool or technique they were having difficulty with. Our goal was to keep small problems small and prevent them from developing into RSIs.

Ergonomic Concerns

Our next step was to perform a job function analysis (JFA) for each job to develop a list of ergonomic concerns and potential solutions, as well as a job function description (JFD). The JFD defines the essential functions of the job title, the actual amount of forces, and the movements and positions required to perform the tasks. This is an extremely useful tool for both the safety team as well as human resources.

The JFD provides a framework for human resources and the management team to describe job requirements to new candidates, as well as determine job tasks that can be performed when an individual is returning to work on restrictions.

For example, when an injured employee comes back with a 20-pound lifting restriction, the management team can look at the JFD to identify tasks or essential functions the employee can safely perform.

The list of ergonomic concerns and the JFD are then used to develop an action list for the safety team to address. A task that required an awkward reach and a pull in excess of 60 pounds was identified. Working directly with Wilkin and members of APC's safety team, we identified a mechanized way to reduce the push force and decrease unnecessary stress on the individual worker. We worked together to justify the cost of this new equipment based on savings obtained through decreases in injury, and increased efficiency of the workers through eliminating the reach and pull force.

Often this is where the commitment of management and employees is truly tested. Any time there are changes in the way things are done, there will be resistance. Having a physical therapist onsite can help make these transitions smoother for all parties. We assist the employees to understand how the new way helps keep them safe, and educate them on proper technique.

Employee Input

While we are onsite, we communicate with employees and management. When employees do not embrace change, it's typically because they feel they aren't part of the process, and that people who don't understand the job are changing it. We're consistently working with them to receive their feedback and input.

One thing I quickly learned when I started working onsite is that although I'm an expert in kinesiology, body mechanics and injury prevention, I'm not an expert in the specific processes that employees are completing on a daily basis. The truth is they are the experts. I can develop a solution that makes the most sense for their bodies and injury prevention, but if those changes are forced upon them without their input, the whole process breaks down.

The majority of successful changes I've helped implement have been proposed by an employee while in discussion about modifications I feel must be made. When finding the proper solution, it would be a pivotal error to exclude the workers who perform the job.

The final piece of the puzzle to help companies minimize their injury risk is the implementation of job function tests (JFTs). The JFT is created from the JFA/JFD and can be used during hiring as well as with the RTW process.

With post-offer pre-employment, this test will help the employer ensure the candidate it plans to hire meets the demands of the work he will do. In return-to-work testing, the worker is tested against the demands of the essential functions of his job, which is fully compliant with the ADAAA.

The employee can see what he's able to perform through actual activity, the medical provider gets objective information to make return-to-work decisions, and the employer receives useful guidance for safe return to duty or needed accommodation.

When PTs graduate, our goal is to help people; to decrease their pain, improve their function and get them back to the activities they desire. Working onsite can be extremely rewarding in helping people remain at work and be productive members of the workforce.

APC has moved from a focus on safety to results in safety. After averaging approximately two RSIs per year, APC has had zero recordable repetitive injuries over the past two years. We have helped their employees avoid the work injury cycle by collaborating to understand their work, improve safety, and prevent injuries.

Brian Briggs is a physical therapist with Work Injury Solutions & PT in Rochester, N.Y., specializing in onsite provision of injury prevention and management services. He is also an adjunct faculty member in the orthopedics clinic at Nazareth College, Rochester, N.Y., and can be reached at Curt DeWeese, PT, president of Work Injury Solutions & PT, and COO of DSI Work Solutions in Bowling Green, Ky., contributed to this article. He works with many employers using job function matching for workplace injury prevention and management, and can be reached at

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