8/9/2018 Employment Issues in Healthcare Settings Teresa Goddard, - PDF document

8/9/2018 Employment Issues in Healthcare Settings Teresa Goddard, M. S. Lead Consultant, Sensory Team Matthew McCord, M.S., CRC Consultant, Motor Team JAN is funded by a contract with the Office of Disability Employment Policy, U.S. Department of Labor. 1 Accommodations - Healthcare Objectives  JAN Overview  Interactive Process  Typical Issues  Situations and Solutions  Questions 2 Job Accommodation Network Consultation  Job Accommodations  All industries, job categories, and impairments  Employment Legislation  Americans with Disabilities Act  Rehabilitation Act 3 1

8/9/2018 Job Accommodation Network Technical Assistance  Free  Confidential  National  Easy to Use  Audience Focused  Employers  Individuals  Service Providers  Others 4 Accommodations - Healthcare JAN’s Interactive Process 5 Accommodations - Healthcare Step 1: Recognizing an Accommodation Request Starting the Interactive Process 6 2

8/9/2018 Accommodations - Healthcare What is a reasonable accommodation request?  An applicant or employee asks for something that is needed because of a medical condition. 7 Accommodations - Healthcare An employee is disciplined for poor performance. In response, she says, “It’s because I have ADD and I can’t concentrate with all these distractions.” Is this an accommodation request? 8 Accommodations - Healthcare Is this an accommodation request? Yes.  Quieter work environment is needed  Because of a medical condition 9 3

8/9/2018 Accommodations - Healthcare Step 2: Gathering Information Getting What You Need To Process the Request 10 Accommodations - Healthcare What is allowed?  Limitations, work-related problem, accommodation ideas  Medical documentation  Employee has a disability  Employee needs an accommodation 11 Accommodations - Healthcare In response to a poor performance evaluation, a nurse practitioner provided a doctor’s note claiming her multiple sclerosis is contributing to her performance problems and says she may benefit from an accommodation. Is this enough information? 12 4

8/9/2018 Accommodations - Healthcare Did we provide all the information? No.  Did not provide limitations  Did not provide problem 13 Accommodations - Healthcare What is prohibited:  Irrelevant information  Information that is known or obvious 14 Accommodations - Healthcare Step 3: Exploring Accommodation Options Figuring Out What Accommodations Might Work 15 5

8/9/2018 Accommodations - Healthcare What should you do?  Brainstorm  Think outside the box  Talk with the employee  Use available resources 16 Accommodations - Healthcare A child therapist wanted to continue working while undergoing treatment for cancer. Because of her treatment she had a suppressed immune system and her doctor recommended she wear a mask while working. She found a mask that did not interfere with her speech, but found out that it frightened some of the young children she worked with. It looked like she might have to take leave time until finished with treatment. What might she or her employer do? 17 Accommodations - Healthcare What might she or her employer do? Call JAN!  Mask with cartoons  Met employee’s needs and allowed her to perform her job 18 6

8/9/2018 Accommodations - Healthcare Step 4: Choosing an Accommodation Exercising Your Prerogative 19 Accommodations - Healthcare Consider:  Employee’s preference  Business needs 20 Accommodations - Healthcare A medical transcriptionist could not tolerate personal fragrances worn by coworkers. No private workspace was available. His employer was considering putting up cubicle walls and an air purifier in his work area. His job could be done from home, but the employer was concerned about isolating the employee. How can we help the employer decide which accommodation to choose? 21 7

8/9/2018 Accommodations - Healthcare How can the employer decide which accommodation to choose? Talk with the employee!  Employee preferred to work at home so not forced isolation  Employee was more concerned about the cubicle/air purifier drawing attention  Employee expressed his preference and concerns to employer 22 Accommodations - Healthcare Do not consider:  Co-worker morale  Customer preference  Power struggles 23 Accommodations - Healthcare Step 5: Implementing the Accommodation Taking Steps Necessary to Make Accommodation Work 24 8

8/9/2018 Accommodations - Healthcare May involve:  Purchasing and installing equipment  Ordering a service  Training  Notifying those who need to know 25 Accommodations - Healthcare An employee was given permission to park in a accessible (“handicap”) customer parking space. The employer decided not to tell the parking office because of ADA confidentiality rules. Is this the right approach? 26 Accommodations - Healthcare Is this the right approach? No.  Parking office needs to know  Limit details 27 9

8/9/2018 Accommodations - Healthcare Step 6: Monitoring the Accommodation Making Sure the Accommodation Continues To Be Effective 28 Accommodations - Healthcare Do:  Establish open lines of communication  Check with the employee periodically  Take responsibility for maintenance and updates 29 Accommodations - Healthcare A nurse had allergies to substances used in one type of diagnostic test. The test was done infrequently, so she had been informally allowed to trade duties with other nurses when the test had to be administered. A new supervisor wasn’t notified about the situation and when the nurse refused to help with the test, the new supervisor reprimanded her and then placed her on leave, stating that the nurse was not qualified for her job. How could this have been better handled? 30 10

8/9/2018 Accommodations - Healthcare How could this have been better handled?  Even informal accommodations should be documented  New supervisors and managers need to be trained  Inform new supervisors and managers as needed 31 Accommodations - Healthcare A social worker with vision impairment requested a reader/scribe aid to do all her keyboarding for case notes. How can we figure out what else might work? 32 Accommodations - Healthcare How can we figure out what else might work? Call JAN!  Seek an individualized assessment  Use state AT project’s services  Consider assistive software and training  Consider hardware needs  Check to see if software needs to be updated or modified with scripting  Seek help from HR and IT 33 11

8/9/2018 Accommodations - Healthcare Situations & Solutions 34 Accommodations - Healthcare JAN Study Example A pediatric resident with short stature used a power chair to maneuver. They were having trouble accessing the facilities, specifically employee entrances and office doorways. The school administrator called JAN to discuss accessibility standards. 35 Accommodations - Healthcare Accommodation: The accommodation solution included modifying the worksite via door accessibility and help getting around. The employer stated they are not done with the accommodation, so they expect it will need improvements. 36 12

8/9/2018 Accommodations - Healthcare Cost: No cost reported. Benefit: Allows the employee the ability to do their position without extra needs and going the extra mile. 37 Accommodations - Healthcare JAN Study Example A pharmacist was having difficulties standing for eight hours a day on a tile floor. 38 Accommodations - Healthcare Accommodation: The work area was carpeted using extra padding, which assisted in reducing fatigue, and a sit/stand stool was purchased to assist the employee when standing. Employee was also permitted to take frequent rest breaks throughout the day, so another pharmacist was available to cover his breaks. 39 13

8/9/2018 Accommodations - Healthcare Cost: Approximate cost $2,500. Benefit: The pharmacist could continue working without exacerbating his medical condition. 40 Accommodations - Healthcare JAN Study Example A nursing student with essential tremors wore a wrist brace to help to steady her hand. After she entered her clinicals, the nursing faculty became concerned about the brace and transmission of bacteria/infections from the brace to her glove and to the patients. The student covered the brace with a hospital gown but they did not think this offered adequate protection. The school called JAN looking for alternatives. 41 Accommodations - Healthcare Accommodation: A JAN consultant discussed the use of a disposable sleeve protector and provided information on a variety of options ranging from basic plastic covers to sterile surgical sleeve protectors. Noted that the hospital may already have some in stock that could be tried. JAN also referred to exceptionalnurse.com as a resource for the student as she progresses in the program . 42 14