By John Sallade, Managing Director 

Rosemary Orner, Executive Assistant, Management, for the SEDA-COG Council of Governments, has been appointed to the PComp Board of Directors. She replaces Ryan Unger, who recently left SEDA-COG for other employment. Rose is one of two county-related entity representatives on the board, positions which are appointed by the remaining members of the board. The appointment was made at the June PComp Board Meeting, after a notice was sent to all PComp members seeking nominations.

Rose handles HR responsibilities for Lewisburg based SEDA-COG, including workers' compensation and medical benefits, among other duties.

By Bob Lauzonis, Loss Control Specialist

INTRODUCTION
 

Success is measured by results. One of the best ways to prevent tomorrow's accidents is to investigate the causes of the accidents that occur today. In some ways, a good accident investigation is like a crime scene investigation. Imagine the TV show CSI, to solve the mystery and find the culprit (in this case, the cause of the accident, not an individual), you have to get in and thoroughly check the scene for clues. You have to assemble all the available evidence before anything is moved or changed. You also need to interview witnesses while the experience is still fresh in their minds. And then you have to piece all this information together to try to understand why the accident happened.

SUCCESSSFUL ACCIDENT INVESTIGATION
 

A successful accident investigation takes place immediately after the accident.
 

• Determines the facts-What happened
• Determines the causes-Why did this happen
• Recommends corrective action to prevent future accidents

BEFORE AN ACCIDENT INVESTIGATION CAN BE PERFORMED
 

Before an accident investigation can be performed, your initial responsibility is to provide injured personnel (or guest/visitor) with prompt medical care. You should have a defined plan for prompt implementation of:
 

• First aid
• Treatment by a physician
• Ambulance service
• Emergency hospital

ACCIDENT OCCURRENCES
 

Yes, accidents resulting in injuries certainly deserve priority. However, an accident investigation is even more effective, as a loss control mechanism, when accidents that damage equipment, materials, vehicles or property are investigated as well.

SEVEN KEY QUESTIONS
 

Accident investigations must answer these seven key questions:
 

• What happened? Exactly what happened moment by moment during the accident?
• When did it happen? What time of day did it happen? On which shift?
• Where did it happen? In what part of the facility did it happen? In which work area?
• Who was involved? Who was injured? Who was working in the area? Who saw what happened?
• How did it happen? What led up to the accident? What task or operation was involved? Which materials, equipment, or substances were being used at the time?
• Why did it happen? What were the possible causes? Was there more than one cause? Were unsafe acts, unsafe conditions, or both, involved?
• How can you keep it from happening again? What conditions need to be corrected? What procedures need to be changed? What additional training is needed?

GET YOUR EMPLOYEES INVOLVED
 

Get your employees to help. Why It Matters...Over four million workplace accidents a year in the United States result in injuries or illness. Some 5,000 of those incidents result in an employee death. Successful investigations uncover the cause of an accident so that you can correct safety problems and prevent future accidents. Employees who understand the investigation process and their role in it will be more likely to correct the problems that cause accidents in your workplace. No accident investigation can succeed without the assistance and cooperation of employees.

Explain that they can assist investigations by:
 

• Reporting all accidents and near misses right away. Even if nobody was hurt, management needs to know what happened so steps can be taken to prevent future problems.
• Trying to remember what happened, if they witness the accident. Tell employees to write down what they saw as soon after the accident as possible-what, where, when, who, and why.
• Not disturbing the scene of the accident. Emphasize that they could destroy valuable evidence that could help investigators figure out exactly how the accident happened.
• Providing any information they have about an accident. Anyone who knows anything about an accident should come forward right away and tell what they know. Their cooperation is essential to the success of the investigation.
• Lending their expertise to the investigation. If they have special knowledge about the equipment or procedures involved, the circumstances surrounding the accident, etc., they should tell what they know and offer suggestions.
• Encouraging their co-workers to cooperate in accident investigations. Remind them that the purpose of an accident investigation is to prevent future accidents-accidents that could involve any one of them.
• Joining with co-workers and management to implement corrective measures and making sure to follow any new safety rules that result from an accident investigation.

POSSIBLE CAUSES
 

Obvious accident causes are most probably symptoms of a "root cause" problem. Some examples of unsafe acts and unsafe conditions which may lead to accidents are:

Unsafe Acts

Unauthorized operation of equipment

Running - horseplay, not following procedures, bypassing safety devices

Not using protective equipment

Under influence of drugs or alcohol

Unsafe Conditions

Ergonomic hazards

Environmental hazards

Inadequate housekeeping

Blocked walkways

Improper or damaged personal protective equipment

Inadequate machine guarding

REVIEW THE FINDINGS OF THE ACCIDENT INVESTIGATION
 

As a result of the findings, is there a need to make changes to:
 

• Employee training
• Work Stations Design
• Policies, procedures or operations
   

Remember to make your recommendations.

JOB HAZARD ANALYSIS
 

Job hazard analysis (JHA) is part of many existing accident prevention programs. In general, JHA breaks a job into basic steps, and identifies the hazards associated with each step. The JHA also prescribes controls for each hazard. A JHA is a chart (or a table) listing these steps, hazards, and controls. Review the JHA during the investigation if a JHA has been conducted for the job involved in an accident. Perform a JHA if one is not available. Perform a JHA as a part of the investigation to determine the events and conditions that led to the accident.

SUMMARY AND CONCLUSION
 

The purpose of an accident investigation is to identify hazards and prevent workplace accidents from occurring. It is a fact-finding process to determine the underlying or root cause(s) and implement corrective action. Remember, prevention of future accidents is the key and main focus of any investigation. If you have any questions, or need professional assistance with accident investigations, call your CCAP Loss Control Specialist.

By Linda Rosito, Insurance Training Director
 

With September comes the beginning of the fall workshop season sponsored by the County Commissioners Associations of Pennsylvania Insurance Programs. We have a total of 22 workshop opportunities this fall.

We hope you will take advantage of these excellent workshop opportunities. Please remember if your county is a member of the sponsoring insurance program the workshop is FREE to attend. And lunch is included!

UPCOMING WORKSHOP OPPORTUNITIES:

• Thursday September 8 - Excellent Supervisor Seminar, Regional Learning Alliance, Cranberry Twp.
• Thursday, September 8 - Defensive Driving Course, Best Western/Country Cupboard, Lewisburg
• Tuesday, September 13 - Four Generations in the Workplace: A Survival Guide, CCAP North Office, Harrisburg
• Tuesday, September 13 - Defensive Driving Course, Scranton Hilton, Scranton
• Wednesday, September 14 - Excellent Supervisor Seminar, Scranton Hilton
• Tuesday, September 20 - Navigating Through the Act 195 Maze, Regional Learning Alliance, Cranberry Twp.
• Wednesday, September 21 - Excellent Supervisor Seminar, The Penn Stater Conference Center Hotel, State College
• Thursday, September 29 - Time Management in the New Economy, The Penn Stater Conference Center Hotel, State College
• Thursday, September 29 - Defensive Driving Course, The Penn Stater Conference Center Hotel, State College
• Tuesday, October 4 - Four Generations in the Workplace: A Survival Guide, Scranton Hilton, Scranton
• Wednesday, October 6 - Time Management in the New Economy, CCAP North Office, Harrisburg
• Wednesday, October 12 - Safety Workshop, The Penn Stater Conference Center Hotel, State College

For more information on these workshops and the rest of the fall workshop season, please refer to Glimpse Online.

You should have already received your copy of the fall Glimpse. If you have not received a copy and would like one or would like additional copies let us know!!

As always, if you have any questions, please feel free to contact Linda Rosito or

Jenn James at (800) 895-9039.

We hope to see you this fall!

By Dave Harman, Claims Manager 

The Prison Inmate Medical Cost Containment program (PIMCC) is pleased to announce another great service for PIMCC members. Diamond Pharmaceuticals, a PIMCC service provider, has agreed to provide, free of charge, their SAPPHIRE eMAR system. Here are the benefits of the SAPPHIRE system:

SAPPHIRE eMAR: Use in the Correctional Setting
 

While many correctional facilities are still using paper-based charts and processes, Diamond's correctional customers are beginning the transition to the electronic world of ordering, administering and managing their medications. Diamond's internally developed web-based Sapphire eMAR is helping facilities deliver medical care more efficiently and accurately. Automating many of their traditionally manual processes has allowed facilities to save time, reduce errors and maintain more complete records.

While very easy to navigate, the system provides a sophisticated and comprehensive collection of features, alerts and reports. Sapphire eMAR is fully HIPPA compliant, and data is secured with clustered-server architecture. The Sapphire team provides training and support throughout the transition, and an online Help Desk is available 24 hours a day. From order entry to Med Pass to managing inventory, Sapphire eMAR can ease the transformation to a paperless pharmacy process between correctional facilities and Diamond. Diamond is offering the Sapphire pharmacy setup, software, training and support at no charge to PIMCC Members.  
 

ORDER ENTRY
 

Moving away from the traditional fax-and-fill process, Sapphire makes order entry more efficient, accurate and thorough. Drop-down menus allow the user to select medications, prescribers, delivery types, etc. Diamond's complete inventory is available to the user, and searching for the exact medication is simplified with an auto-complete function, brand/generic searches and indicators for medications most commonly prescribed at your facility or for a specific patient. All medications are clearly marked as to their formulary status at each particular site. Sapphire also makes it easy to process more complicated orders such as tapers or those orders linked to vitals or labs. To ensure patient safety, Sapphire will issue duplicate-therapy warnings immediately upon generating an order.  

MED PASS
 

The efficiency of Sapphire can reduce Med-Pass times by as much as 50% and totally eliminate the time-consuming, end-of-month MAR change over. Beginning with the Med-Pass Prep List, Med Passes can be organized to the user's exact specifications. This list can be sorted by name, location or time.

During administration, there are several features in place to ensure that each patient is receiving the correct medications at the correct time. When using a barcode scanner, simply scan the patient's badge (or look up manually), and the proper medications will appear. If a patient's medication and administrations do not match, the user is notified and cannot proceed until it is addressed. Sapphire has detailed patient profiles with photos and aliases to facilitate identifying patients. Medications to be administered are clearly labeled in both brand and generic names and images of the medications are displayed on the screen.

Sapphire records the administration date and time as well as the individual who administered it. Refusals are also recorded, and all non-administered medications are indicated in the Med-Pass Status Bar. The user has the ability to add notes to the patient's chart during Med Pass to document any information that may be needed at a later date.

INVENTORY
 

Managing inventory has never been easier or more accurate. As orders arrive, they are reconciled by scanning them in as opposed to a manual process. Inventory will then automatically be updated within the system. Sapphire will use actual Med-Pass administrations to count the depletions to inventory. Using specifications on maximum and minimum quantities for each medication, Sapphire will alert the user when it is time to place stock and patient-specific orders, prompting one-click refills or order renewals. Sapphire also has a module for returning medications and performing controlled medication counts during shift changes.

REPORTS
 

Recognizing the need for all of the above functions to be recorded and measured and the results to be presented in usable formats, Sapphire has incorporated a variety of reports commonly requested in correctional facilities. The existing collection of reports can measure patient compliance and refusals, user activity and medication usage such as KOPs, non-formularies, therapeutic classes, etc. Sapphire also provides several variations of patient MAR reports that can be pulled for inclusion in patients' charts. All reports can be customized by setting filters, and settings can be saved by each individual user. The Sapphire team will work with each new facility to select and format the appropriate reports to match their unique requirements.

If you are a current PIMCC member and haven't set up your implementation yet, or if you are not a PIMCC member but wish to become one to take advantage of this new program, and other great cost saving opportunities offered by PIMCC, please contact Ruth Morowski Keller at Cost Management Plus, Inc. 2319 Walnut Street, Harrisburg, PA 17103; Phone # (800)552-2752 or costmanagementplus@comcast.net.

By John Sallade, Managing Director 

Here are some updates on the CCAP staff:

Dianne Carman joined the insurance staff on May 31, as a Claims Representative 1. Dianne is handling PComp claims and was hired to replace Nancy Witaconis, who retired at the end of June. Dianne brings to CCAP strong experience in medical billing, workers' compensation experience with Kemper Insurance and claims experience with Great American Insurance. She can be reached at (800)895-9039, extension 3382.

Maureen McMahon  Loss Control Specialist, joined the staff on July 11. Maureen has extensive loss control and insurance experience, having worked for Liberty Mutual, Great American Insurance and as an independent consultant. She is a graduate of IUP and has attained the CSP (certified safety professional) and ARM (associate in risk management) certifications. Maureen is based in the CCAP North office, and can be reached at (800)-895-9039, extension 3306. She will be assuming primary loss control contact responsibility for the PCoRP, PComp and PELICAN members in parts of western and central Pennsylvania which were the responsibility of Greg Cunningham.