NAOHP Certifies St. John’s Occupational Medicine

St. John’s Occupational Medicine, Springfield, is the first occupational health program in Missouri to receive a three-year Quality Certification award from the National Association of Occupational Health Professionals (NAOHP). The program obtained a score of 97.6 out of a possible 100 percent compliance with the standard during a November site visit. The program is affiliated with the St. John’s Health System, which promotes itself as “The Nation’s #1 Integrated Health System,” and part of the larger Sisters of Mercy Health System.

St. John’s occupational medicine and workers’ compensation clinical services are closely aligned with the system’s Corporate Health and Wellness program and other relevant specialty areas. St. John’s comprehensive range of products and services are delivered at worksites, via two dedicated clinics in Springfield and at affiliated outlying hospital campuses.

Site Surveyor Donna Lee Gardner, a nurse and consultant who was instrumental in developing the NAOHP standards that are applied during the certification process, said she was impressed by the program’s emphasis on well-qualified staff, service integration, and employer relations.

For example, for the first time during a site visit, she was invited to have lunch with an employer advisory group, which provided useful insights into St. John’s performance from the client’s perspective. She noted that another one of the program’s key attributes is the use of a dedicated care manager who works closely with employers and patients throughout the course of treatment.

Certification Value

Jeff Tucker, program director, said NAOHP certification confirms that staff competencies and training efforts are appropriate for the range of services provided by St. John’s and that its performance metrics are in line with national benchmarks. “The certification shows that we uphold a certain standard as we serve our customers,” he said. “We feel if we are going to go to the next level with occupational medicine and workers’ compensation, we have to demonstrate that we are a center of excellence for these types of services. We have many companies that look to us to provide the best possible service. And, as we reach out to new clients, we can tell them we are the only certified program in Missouri.” While it is gratifying to receive a high score, Mr. Tucker said it is more satisfying to be able to identify and correct deficiencies that become apparent while going through the certification process. “The end result of certification is great, but even more importantly, we definitely have been able to improve our program,” particularly in the area of data collection and outcome reporting to employers, he said. “Certification isn’t just about achieving the piece of paper, it’s about growing as a result of working through the process. I highly recommend not putting it off just because you don’t think your program is ready for it.”
Marilyn Hill, administrative director, of Corporate Health and Wellness, believes the integration of a broad spectrum of services is what sets St. John’s apart from its competitors.

“We have a very integrated working relationship that just makes it easy,” she said. “We know, ‘This is the path we are going to take,’ and everybody is on board with it.” Ms. Hill is particularly pleased with St. John’s ability to successfully integrate external workplace-based safety programs with wellness offerings.

“That is one of my primary areas of focus – to truly integrate safety, wellness and prevention,” she explained. “Health care costs are driving employers to explore other avenues and wellness now has a front-row seat in a lot of organizations. It just makes sense that healthier employees have fewer injuries. Whenever there is an injury, we try to educate the patient and the employer on preventive aspects. From the standpoint of overall prevention, we provide health risk assessments and other evaluation tools and related interventions at the workplace.”

Site Visit Preparation

The occupational health team agrees that certification was facilitated by the groundwork laid nearly a decade ago under the leadership of James Jordan, M.D., medical director, of Corporate Health Services.
Cyndi Baker, return-to-work coordinator, said a session on NAOHP certification at RYAN Associates’ 2008 national conference on Providing Health Care Services to Employers served as a catalyst for the late 2009 site visit. The concept also was supported by the health system’s internal workers’ compensation task force, which concentrates on the health and well-being of St. John’s 9,000-plus employees. Task force members felt NAOHP certification was necessary to validate the delivery model and elevate the program to the next tier of effectiveness.

NAOHP Certifies St. John’s Occupational Medicine

The task force has recently focused its efforts on coordinated service delivery, in part by tracking workers’ compensation cases as they progress from initial treatment to closure within the health system. The task force, which meets monthly, includes representatives from practice management; specialists including spine and neurology; orthopedic, trauma, general and plastic surgery; physical therapy; occupational medicine and corporate health. “We have a lot of integrity,” Ms. Baker said. “Our team really cares about what happens to patients and clients. The entire staff knows the company contacts by their first names. That takes a lot of time; it takes a lot of attention.” Ms. Baker said she started preparing for the NAOHP site visit about eight months in advance by asking staff at various service locations to begin collecting and cataloging the documents required to demonstrate compliance. “When I asked for the data, I would tell the staff why I needed it, and whenever I asked for something more, I used that opportunity to reinforce the importance of certification,” she said. “It was a cooperative effort.”

One of the more significant challenges for the program is associated with the use of St. John’s management information system, EPIC, which is not specifically designed to support occupational health operations. Staff has been working with EPIC experts to collect relevant data, generate appropriate documents and forms, and make the shift to electronic health records. “I would like to try installing software to interface with EPIC from an occupational medicine standpoint,” Ms. Baker said. With regard to data collection, the program is working to routinely capture diagnosis codes, lost workdays, modified duty and full-duty days, and return-to-work recommendations. The program uses the Official Disability Guidelines as a benchmarking resource as part of this effort. “We are comparing each case to make sure we are within benchmarks,” Mr. Tucker said. “We intend to share this information with larger companies to demonstrate how we are getting their patients back to work in a timely manner. “It’s all about working together as a team to develop and build relationships with the companies we serve.”

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