Abstract

Purpose: The personal, physical, and financial toll of workplace injuries on workers is enormous, with many experiencing isolation and depressive symptoms.

Objective: This quality improvement project aimed to improve the Workers' Compensation (WC) program to enhance workforce retention, productivity, team member well-being and reduce liability.

Approach: The project implemented a structured, iterative process grounded in baseline data to inform and refine process improvement and outcomes. Strategies for improvement included: (1) foster professional well-being through an accommodation model that emphasized belonging and meaningful contributions during recovery; (2) creative and flexible solutions leveraging team members' abilities rather than limitations that aligned with operational needs and supported recovery; (3) increase productivity and workforce optimization through coordination between nursing leadership and the Workers' Compensation program, supported communication tools, accurate timekeeping; and (4) reduce organizational liability by standardizing the return to work process, improving paid time off allocation accuracy, and tracking systems that supported regulatory compliance and data-informed decision making.

Results: Productivity rose from 14% to 87% of available work hours. Enrollment rates improved from 6.98% to 12.89%, with the average duration of participation increasing slightly, indicating sustained engagement. Role-specific outcomes were equally compelling. RNs and LPNs, alternate duty assignments rose from 30% to 79% of available hours, eliminating 1,574 hours of unproductive time and converting 941 unit-based hours into productive alternate duty. This translated into a 1.2 FTE gain. Nursing Assistants and Interns eliminated 3,672 hours of ‘no work’ and converted 1,589 hours, resulting in a 2.5 FTE gain. Team members experienced a sense of purpose and inclusion during recovery periods.

Conclusion: Reimaging Workers' Compensation through the lens of workforce optimization and team member well-being demonstrates how a human-values approach can transform a traditionally reactive process into a proactive strategy for retention, efficiency belonging and purpose. This quality improvement project is scalable across departments and adaptable to allied health and support services. It also opens the door to accommodating team members outside of WC, such as those with American with Disabilities (ADA) requests or temporary restrictions.

Notes

Presenter notes available in attached slide deck.

References: American Nurses Association. (2022). Nursing workforce resilience and well-being. ANA Enterprise.

Buerhaus, P. I., Auerbach, D. I., & Staiger, D. O. (2020). The impact of the COVID-19 pandemic on the nursing workforce. JAMA Health Forum, 1(5), e200618.

Carnide N, Franche RL, Hogg-Johnson S, Côté P, Breslin FC, Severin CN, Bültmann U, Krause N. Course of Depressive Symptoms Following a Workplace Injury: A 12-Month Follow-Up Update. J Occup Rehabil. 2016 Jun;26(2):204-15. doi: 10.1007/s10926-015-9604-3. PMID: 26324252.

Courtney, N. (2025, March 28). Breaking the negative cycles in the workers’ compensation process. HR Executive. https://hrexecutive.com/breaking-the-negative-cycles-in-the-workers-compensation-process/

Granger, S., & Turner, N. (2025). Work injuries and mental health challenges: A meta analysis of the bidirectional relationship. Personnel Psychology, 78(1), 11–57. https://doi.org/10.1111/peps.12649

Description

Examine how a regional medical center transformed it’s Workers' Compensation program into a strategic workforce optimization tool, increasing productivity, reducing liability and enhancing team member experience through innovative alternate duty accommodations.

Author Details

Tina M. Santos, MBA, MSN, RN, NEA-BC, CPXP - Chief Nursing Officer, Orlando Regional Medical Center & Arnold Palmer Hospital for Children, Assistant Vice President of Patient Care Services, Orlando Health

Kathleen Jancek, BSN

Sigma Membership

Theta Epsilon

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Other

Keywords:

Implementation Science, Workforce, Acute Care, Workers' Compensation, Personnel Retention, Well-Being, Productivity

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-04-27

Click above link to access the slide deck.

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Transforming Workers' Compensation into a Workforce Optimization Strategy

Washington, DC, USA

Purpose: The personal, physical, and financial toll of workplace injuries on workers is enormous, with many experiencing isolation and depressive symptoms.

Objective: This quality improvement project aimed to improve the Workers' Compensation (WC) program to enhance workforce retention, productivity, team member well-being and reduce liability.

Approach: The project implemented a structured, iterative process grounded in baseline data to inform and refine process improvement and outcomes. Strategies for improvement included: (1) foster professional well-being through an accommodation model that emphasized belonging and meaningful contributions during recovery; (2) creative and flexible solutions leveraging team members' abilities rather than limitations that aligned with operational needs and supported recovery; (3) increase productivity and workforce optimization through coordination between nursing leadership and the Workers' Compensation program, supported communication tools, accurate timekeeping; and (4) reduce organizational liability by standardizing the return to work process, improving paid time off allocation accuracy, and tracking systems that supported regulatory compliance and data-informed decision making.

Results: Productivity rose from 14% to 87% of available work hours. Enrollment rates improved from 6.98% to 12.89%, with the average duration of participation increasing slightly, indicating sustained engagement. Role-specific outcomes were equally compelling. RNs and LPNs, alternate duty assignments rose from 30% to 79% of available hours, eliminating 1,574 hours of unproductive time and converting 941 unit-based hours into productive alternate duty. This translated into a 1.2 FTE gain. Nursing Assistants and Interns eliminated 3,672 hours of ‘no work’ and converted 1,589 hours, resulting in a 2.5 FTE gain. Team members experienced a sense of purpose and inclusion during recovery periods.

Conclusion: Reimaging Workers' Compensation through the lens of workforce optimization and team member well-being demonstrates how a human-values approach can transform a traditionally reactive process into a proactive strategy for retention, efficiency belonging and purpose. This quality improvement project is scalable across departments and adaptable to allied health and support services. It also opens the door to accommodating team members outside of WC, such as those with American with Disabilities (ADA) requests or temporary restrictions.