When Heather Hall joined Intel in 1988, after completing her master's degree in COEH's Occupational Health Nursing Program at UC San Francisco, the company was just beginning to notice an increase in the incidence of cumulative trauma disorders (CTDs) like tendonitis and carpal tunnel syndrome among employees.
"We started to focus on what was potentially causing it, how we could decrease the incidence, and how we were responding in the clinic," Hall says.
The challenge was to find a consistent methodology that would address both sides of the CTD picturehow to prevent it and how to treat it.
Intel's CTD rate was higher than the national rate, and both rates were trending up. Hall and her colleagueswho included COEH graduate Michael Fischman, MD, MPH, corporate medical director, and COEH nursing intern Melinda Fike Vertinwanted to reverse that trend, reduce time lost from work, and make employees happy and healthy more quickly.
They started gathering data aggressively, increasing employee awareness, and instituting training programs. By 1993, "the increased awareness spiked up our numbers tremendously, as we anticipated it would, but, then, it wasn't more than a year and a half later that things started to trend downward and have dramatically decreased ever since," she says.
"At first, the nurses were trying to do everything, as we always do," Hall recalls, but the company heeded their advice to hire ergonomists, who could do expert assessments and in-depth analyses.
Meanwhile, Hall and other case managers developed a medical management protocol for dealing with CTDs, covering care from the moment an employee walks in the clinic doorexamination, assessment, testing, in-house treatment, referral, instructions to the employeethrough follow-up, including an ergonomic evaluation of the employee's workplace, additional training, furniture changes, whatever might be necessary to bring about improvement.
"Right now, we feel our reactive program in other words, our response when employees walk through the door of health servicesis very solid," Hall says. "What we're focusing on now is what we're doing for people before they need to come in. We drive the training very hard."
Employee training used to concentrate on body mechanics and types of injuries. Now, employees learn to do their own practical ergonomic assessment to avoid discomfort and possible injuries. Ergonomics training, tailored to specific kinds of work, is mandatory for all new employees. Intel nurses receive training to ensure that their approach to occupational health is consistent company-wide, and the medical staff boosts its instructional capacity by churning out information on Intel's interactive website and training trainers throughout the company.
The focus on prevention has become so strong that furniture is custom fit for employees, and furniture movers, trained in ergonomics, are known to discourage employees from setting up an office in a way that doesn't pass ergonomic muster.
The drive to prevent injuries, report problems early, and manage cases effectively has paid off: In 1994, the number of lost days from CTD problems was 1,860. By 1996, this number had decreased to 230 days, and the number is still going down, Hall reports. In 1994, Intel estimated that its cost for lost time due to CTD was about $4.3 million. By 1996, this cost had decreased to $552,000for a savings of $3.7 million. These figures are all the more impressive considering that Intel's employee population has nearly doubled in the last five years, to more than 50,000 people worldwide.
Hall attributes the success of the CTD program to "a lot of people paying attention over time and trying to do the right thing," with strong support from senior management.