When PG&E introduced the 24/7 Nurse Report Line four years ago, the goal was to do what many other companies across the United States have been working to do: improve access to timely, quality care and reduce the cost of injury care. The concept of the 24/7 Nurse Report Line is to address an injury early, in the hopes that with proper care a minor injury will not become something more serious down the road.
When a work-related injury or discomfort happens, the employee is supposed to report the injury to the Nurse Report Line within 24 hours. The employee may receive advice from the nurse for self-care, or be referred to a health care professional for further action. Additionally, the employee’s supervisor and safety professional are notified of the call-in report, so that they can monitor the progress of the care and support the health of the employee.
PG&E’s data reveals that the 24/7 Nurse Report Line has experienced varying degrees of growth across identified lines of business. In 2015, PG&E employees reported discomfort or injury anywhere from 75% of the time in Nuclear Generation to a low of 46% in Information Technologies. The Electric and Gas lines of business reported at 64% and 63% respectively, with Corporate Services at 57%. The total reporting average ended the year at 61% of employees reporting within 24 hours. Employees in some lines of business tended to wait longer than a day to use the report line. For example, the Electric line of business had 656 reported injuries during the year, however, 30% — almost 200 injuries — were reported more than one day after the injury occurred. According to the statistics, lines of business that tended to report later were more likely to have higher rates of extended or long-term injuries.
By comparison, other companies of comparable size and industry find employees reporting discomfort or injury to a nurse line within 24 hours on average 76% of the time, with top performers receiving reports within one day more than 86% of the time.
It is not uncommon for a new program to have an initial slow start until education and employee utilization bring it fully on line, but when they compare the PG&E statistics to other companies with similar programs, report line program managers are questioning why progress with PG&E’s program seems to have stalled.
Employees Surveyed on Program Performance
To determine why greater numbers of employees chose not to report injuries early, Nurse Report Line managers surveyed a group of 155 randomly selected employees who used the report line in the past. The majority of those responding indicated that they simply believed their injury was minor and would go away in time, and care was not needed. It was only when the injury did not go away or returned that they felt the need to report it.
Some also expressed concerns that reporting an injury may cause them to be viewed as complainers or disruptive to their operation by supervision. Most employees acknowledged that they knew they were supposed to report, but perceived that supervision would not approve.
One aspect of the call-in process that made employees shy to report was the distribution of their medical reports to supervision. Employees shared that they were told who would be notified of their report, but often times did not know who the person was or why they were receiving what was considered by some to be a private report. Based on this feedback, Nurse Line managers have reportedly changed the notification process so only the direct supervisor and a safety professional receive these notifications.
Once the call had been made, some employees described the process as awkward, with medical questions asked repeatedly in a formulaic, uniform manner. However, other employees reported the person helping them was doing a good job at identifying needs and suggesting care.
The survey also revealed that continued work needs to be done to get the word out on the report line, so that employees fully understand what the report line is intended to do, and the benefits of reporting early. According to the survey results, 91% of employees had heard of the program but wanted more education and information on a regular basis.
Results showed that in some areas, supervision was very supportive and informative, even suggesting to employees to report, while in other areas, employees heard of the program only by word-of-mouth from a co-worker, but saw no supportive action from supervision. In all, many employees expressed a desire for an increased level of participation in the information stream by supervision and for supervisors to be well-informed.
Nurse Report Line program managers have been open in describing the various hurdles they have encountered to the major line of business safety councils, and have asked for advice on how to smooth bumps in the report line road. Educating employees on the availability and use of the report line is an ongoing effort that has received increased focus and resources. Managers have seen an upward trend of reporting by employees since embarking on the education effort.
Nurse-to-employee interaction is also being reviewed to make sure that program specifics are clearly identified and care is consistent with employee needs and wishes. Effective first-time experience has influenced the way employees view the program going forward. Anecdotal accounts from those who have used the report line can potentially influence the perception of those who may use it in the future.
What may be most challenging is demonstrating the benefits behind reporting early and the perception of risk when a person does report. Muscular skeletal disorders (MSDs) and soft tissue injuries account for the majority of workplace injuries reported at other companies nationally, and PG&E is no exception. An annual review of PG&E OSHA 300 injury logs by the IBEW Local 1245 Health and Safety committee indicated that MSDs account for over half of total lost-time injuries and the majority of lost-time work days.
For employees, lost-time injuries affect earning potential, but when discomfort and injuries are acted upon and treated early, most potential long-term injuries can be prevented, providing a good reason to be pro-active. As for the risk of being discriminated against or targeted by supervision for reporting an injury, California Labor Code 11(c) prohibits such activity and any violation would be counter to the effectiveness of the report line program.
Clearly the 24/7 Nurse Report Line program needs some adjustment to address employee reluctance and lack of awareness of services available, and program managers appear to be poised to make those adjustments. Care programs such as the nurse line become settled and institutional over time when employees experience the benefits and grow to view it as a positive tool that helps them to remain healthy and productive.
–Rich Lane, IBEW 1245 Business Representative