Article | March 31, 2020
Almost all conversations about healthcare disruption focused on new entrants into the industry transforming parts of the traditional service model and taking market share. Politically, most of the conversation centered around whether we would dismantle the ACA, build it back up or move to Medicare for All. Despite all the noise about disruptors, politics and consumerism, I felt like incremental change was the most likely scenario. Although the industry had been changing – digital experiences and telehealth for instance – a revolutionary, wholesale change to our industry seemed far off to me. The odds of the system being truly disrupted – something like Medicare for All happening within the next decade – felt highly unlikely. And where are we know? It truly feels like there are forces brewing that could result in radical transformation and a complete, ground up rethinking of our entire system. As the COVID-19 crisis has unfolded, it has raised many serious questions that we’ll need to grapple with over the next 12 to 18 months. Where we land on these issues will have a profound effect on what healthcare in this country becomes for the rest of our lives.
Article | September 9, 2020
© 2019 American Cranes & Transport Magazine.
Moving over-sized, over-dimensional loads during the day is no easy task. Adding darkness and poor visibility to your trip adds numerous hazards that must be thoroughly identified and mitigated.
When planning a specialized transportation project, there are three primary objectives:
Ensure the safety of the transport crew and the general public.
Protect the integrity of the cargo and transport equipment.
Protection of Infrastructure – roads, bridges, traffic control devices, utilities and the like.
For the most part, specialized carriers perform night transports to reduce the impact on day-time commuter traffic. Route challenges – construction, road closures, lane crossovers, bridges and other obstacles – are often better solved at night. Police and utility support are often more readily available at night.
Night transport hazards include employee fatigue, slowed reaction time and poor visibility for both the transport crew and motorists. Decreased visibility increases potential for trips, falls, runovers, back overs and equipment strikes.
It can’t be emphasized enough how critically important it is to ensure that all transport crew members have had adequate rest for these projects. Workers need complete rest before the transport takes place. A fatigued worker is a danger to himself as well as his fellow crew members. And while impaired drivers can be out on the streets during the day, there is often an increased number of these drivers on roadways at night.
Limited visibility is a given when it comes to night-time transports. Limited visibility increases the chance of going off route and striking objects, and the transport driver’s maneuverability and reaction time maybe be reduced. Road conditions can abruptly change during a night-time transport. Therefore, it is critically important to know the route and to have drivers run it in advance. Statistically speaking, accident frequency increases when the transporter goes off route and attempts to correct itself. While providing the necessary lighting to make night transport is important, artificial lighting can pose visibility hazards, especially to the drivers. Other hazards may include bright work lighting that produces glare.
OSHA has identified the “Focus Four” accident events that make up the most serious injuries and fatalities in the construction business. They are also known as the “Fatal Four.” Many carriers have had employees injured in the past as a result of one of these four incidents.
Caught-in-between hazards are injuries resulting from a person being squeezed, caught, crushed, pinched or compressed between two or more objects or between parts of an object. This is also referred to as “pinch points or entrapment.” As the transporter navigates its designated route the landscape is continuously changing. It is imperative that all ground crew members maintain situational awareness and not place themselves between the moving transporter and fixed objects such as guardrails, parked vehicles, buildings, etc.
Struck-by hazards are injuries produced by forcible contact or impact between the injured person and an object or piece of equipment. There are many potential struck-by hazards. Guide wires that must be raised can snap and strike workers on the ground. Tag lines should be used to control loads. The primary purpose of using tag lines is to control the load but more importantly give the worker a safe buffer distance away from suspended and the uncontrolled movement of these loads.
Fall hazards are anything that could cause an unintended loss of balance or bodily support and result in a fall. To prevent fall hazards all workers should have either fall prevention or a means of fall protection in place. As a rule, 100 percent tie off is required when using a fall arrest system (FAS). FAS’s should be thoroughly inspected before each use.
Electrocution hazards result when a person is exposed to a lethal amount of electrical energy. Maintaining minimum approach distances (MAD) is a critical safety practice. As everyone knows, equipment does not have to physically make contact with energized equipment or lines to cause serious injuries and even death. Electrical energy can “jump” from lines into equipment that has encroached the Minimum Approach Distance based on its voltage.
As noted above, it is critically important to ensure that crew members have had adequate rest and are not fatigued. Night transports are difficult enough, and the last thing you want to introduce are tired and fatigued workers. Being fatigued creates a risk for anyone who undertakes an activity that requires concentration and a quick response.
All companies should have an “Hours Worked Policy” that clearly spells out the number of hours allowed to work before a mandatory rest period. This policy should ensure that the transport crew has had adequate rest during day, that a fatigue assessment is conducted on all team members, that crews are never allowed to work double shifts and that employees are prohibited from driving long distances to return home.
Dealing with darkness
Visibility and slowed reaction times should be a part of the project planning. A limited amount of ambient light that only projects upward and outward impedes vision and increases blind spots for drivers. Lights cast shadows, increasing the potential for slips, trips and falls.
All transport moves should establish pre-planned Emergency Action Plans. When an emergency occurs, time is of the essence and can mean the difference between life and death. If it is a long-distance move the emergency numbers and first responder information can change. Crews should know when it’s time to seek emergency “safe harbor.”
When approaching overhead obstructions such as guide wires, electrical lines, communication lines and overpasses, travel speed is of utmost importance. Again, pre-route surveys provide advance knowledge of obstructions. At night, visual identification of roadway obstructions is reduced and delayed and last second reactions to oncoming hazards can lead to accidents. Support personnel in bucket trucks also have the challenge of reduced visibility.
In darkness, overhead hazards often require more utility support for height clearances, which means the need for raising energized lines, lifting traffic control devices, trimming tree limbs, releasing tension on guide wires, removing highway signs, repositioning street lights and raising railroad crossing arms.
Traffic control can also create hazards. The general public may ignore pilot car lights at night, so it’s often advisable to also use police escorts. All support vehicles and trucks should be properly marked and equipped with strobe lights.
The configuration of the transport system can also be a hazard. Navigating sharp turns or crossovers is greatly reduced based on the length of transporter. Snake-like maneuvers of trailers pose an increased risk.
It’s important to never allow personnel to take shortcuts by walking through or under transporter while it’s in motion. Stop or have the worker go around.
The transport crew must always maintain “situational awareness” to prevent being in line of fire or entrapped between moving and fixed objects.
All the equipment used in the transport must be deemed safe. You should have procedures to conduct thorough assessment of all new equipment.
Ensure machine guard devices are in place especially around moving components.
Provide secured areas using catwalks/railing system.
All steps should be designed with slip resistant material.
Ensure that all deck openings are properly protected and covered.
Components that hydraulically extend and retract should be clearly posted with DANGER signs.
Roadway conditions are always a bigger concern at night. Assess weather conditions prior to start of the project and don’t take chances. A “Go – No Go” criteria should be developed for each project. Once the decision is made to transport the load there is no turning back. Changing weather can cause the transporter to lose traction. Underpasses that are shaded during the day will likely freeze up more quickly. If the temperatures drop significantly during the move, equipment performance may be affected – especially those with hydraulics.
Because the reaction time of the transport crew is reduced, speeds are often reduced, causing potential for curfew violations. Boarding and deboarding the transporter increases risk for slips and falls. Other potential road condition hazards include grade of road, width of road, shoulder surfaces, railroad crossing clearances and bottoming out, overpasses, tight and narrow turning lanes, parked vehicles and frequent grade changes.
Crew prep is essential and should be a part of the job plan and job training. The team should be briefed each day to identify the responsibilities of all crew members. The crew should know it is empowered; everyone has the authority to stop the transport if something looks unsafe or when someone is unsure. In the event of a complication, crews should be informed of how to regroup and formulata mitigation plan. There should be an established means of communication that is limited only to transport issues. Most importantly, crew should embrace these words: When in doubt, call time out!
A Task Hazard Analysis (THA) should address all scope of work activities, identify hazards and have a mitigation plan for each, clear channels of communication, the traffic control plan and an “Emergency Preparedness Plan.” And finally: Know the route; ride the route and expect the unexpected.
Edwards Moving performs a night move using it’s Goldhofer Faktor-5 transport system.
Keys to a successful night transport
Early planning and attention to detail. Anticipate roadway hazards such as guardrails, poles & hydrants that pose obstruction with travel path or turning radius.
Preparing a detailed traffic control plan.
Thorough due diligence throughout scope of work.
Established contingency plan for equipment.
Article | December 8, 2020
Let’s face it. It’s been one tough year with too many of us sitting idle and indulging in calorie-laden foods for way too long as the coronavirus pandemic continues to sweep the globe. For all too many, sheltering in place has prompted unwelcome weight gain—a troublesome truth as we head into the holiday season where gluttony oft reigns supreme.
That said, many individuals did have foresight and motivation back in March and the months that followed, wisely leveraging that extreme downtime to “diet for dollars” with HealthyWage—a pioneer of money-driven weight loss contests and challenges for individuals, teams and business groups. In fact, those who started a 6-month HealthyWager challenge during the pandemic (late March through May) broke company records, spurring a dramatic increase in pound shedding success rates—and in-kind cash payouts—against the norm. So motivated became America to drop, or avoid, the so-called ‘quarantine 15’ and score some cold hard cash in the process, HealthyWage reports that this past May it logged a substantial year-over-year increase in challenge participants at large. This is not surprising given Google search trends indicates the portion of people searching for weight loss hit a 5-year high in May of 2020—a level even exceeding the quintessential New Year’s diet resolution season.
Beyond the fact that people who started weight loss wagers during the pandemic achieved much greater success as compared to participant results the prior year, and earning hundreds and even thousands of dollars for their efforts, it is women and individuals under 30 years of age primarily accounting for the sustained increases. For example, among the litany of pandemic era success stories, Lisa S. won over $1,900 for losing 50 pounds in 6 months while Hayden T. won over $1,200 for losing over 62 pounds in 6 months—both during the COVID-19 pandemic.
As the coronavirus rages on well into the fourth quarter, we collectively find ourselves again having to shelter-in-place. Those trying to reconcile how they will survive this next round of being home bound, and the holiday season at large, with mitigated waistline and budgetary wreckage—and who are even planning their New Year resolution approach just beyond—would be wise to consider the gamified dieting approach. “Loss Aversion is a powerful dynamic and the reality of having ‘skin in the game’ can propel the results of a gamified weight loss initiative,” notes HealthyWage co-founder David Roddenberry.
The efficacy of diet gamification is well-proven. For one, according to study findings published by JAMA Internal Medicine, behavioral economics-based gamification led to “significantly” increased physical activity among overweight and obese Americans. In this particular study, pairing a step tracking device with social incentives led to sustained, long-term behavior change—prompting participants to take more steps then with a step tracking device, alone. While the report explains that “gamification interventions significantly increased physical activity during the 24-week intervention,” with competition being the “most effective.”
That’s something HealthyWage has seen play out since launching its weight-loss gamification platform in 2009. HealthyWage is, in fact, founded on earlier substantive research and "double-incentivization" methodology that proves competition and rewards—especially the cash variety—can as much as triple the effectiveness of weight loss programs.
“A key element for the success of a gamification program is giving participants something to lose if they fail to meet their goal—whether tangible or intangible,” notes Roddenberry. “In this particular study, it was just points at stake but even this effected behavior change. There are actually throngs of studies demonstrated that the threat of losing something of value is much more effective than the opportunity to win something of equal value. That’s precisely why we advocate that program participants ‘pay to play’ and make an investment out of their own pocket in order to win rewards—in our case large cash prizes—for losing weight and getting more active in the program.”
A few other notable HealthyWager success stories (both female and male) are case-in-point. These include Jean N. who lost 71 lbs. and won $3,357.99 for her efforts, and Jeremy M. who also lost 71 lbs. and won $1,886.32 for his own slimdown success. From its website, HealthyWage.com shares yet more inspirational success stories of both women and men who gained financially for their pound-shedding achievements using the company’s unique gamification approach. This includes Kristin W. who lost a staggering 114 pounds and won $4,000 for her efforts, Anastasia W. who lost 41 pounds and won a whopping $10,000 in kind, and Blake S. who lost an impressive 151 pounds and won $4,670 for his own slimdown success. Figures that are tasty, indeed.
These and other such HealthyWage payouts are proof positive. For their weight-loss achievements that collectively exceeds an astounding 1,050,000 pounds for this year, alone—269 of which losing in excess of 100 pounds (and nearly 7.5 million pounds lost since the company’s launch), HealthyWage has reportedly paid more than xx30,000 dieters over $13 million cash in 2020, specifically, and over $55 million cash since its inception in 2009.
HealthyWage programs apply these principles:
HealthyWager Challenge: participants commit to a weight loss goal and an upfront financial payment and get their money back plus a financial return if they accomplish their weight loss goal. The average participant loses 40.7 pounds and gets paid $1,245.
HealthyWage Step Challenge: participants commit money and agree to increase their steps by 25% over 60-days. If they achieve their goal they get their money back plus the money from those who don't hit their goal.
Upholding the new findings while also further validating HealthyWage’s well-honed approach, an additional study published in the journal Social Science and Medicine continue to prove that money is an effective motivator to “increase both the magnitude and duration of weight loss.” The same hold true in business for staff wellness initiatives. Results from one study published in the Annals of Internal Medicine indicated that “Loss Incentive’ Motivates Employees to Take More Steps ,” finding that financial incentives framed as a loss were most effective for achieving physical activity goals.
As a prolific corporate and group wellness purveyor, since 2009 HealthyWage has worked with an array of hi-caliber participants on workplace and staff wellness initiatives, including Halliburton, ConocoPhillips and more than 25% of the largest school districts in the country. HealthyWage has, in fact, formally created competitive, money-motivated programs for more than 1000 Fortune 500 and other public and private companies, hospitals, health systems, insurers, school systems, municipal governments and other organizations throughout the U.S., and their program has been more informally run at more than 7,000 companies and organizations seeking to bolster staff health and well-being, and boost bottom lines in kind.
“Throngs of studies reiterate the importance of the 'stick' in the design of a wellness incentive program, whether for individuals at home or for employee groups,” Roddenberry says. “Many studies have demonstrated that the threat of losing something of value is much more effective than the opportunity to win something of equal value. That’s precisely why we advocate that program participants ‘pay to play’ and make an investment out of their own pocket in order to win rewards—in our case large cash prizes—for losing weight and getting more active in the program.”
Studies do consistently show that monetary incentives serve to enhance the effectiveness of, and duly complement, weight-loss programs of any and all sorts, especially when paid out quickly like HealthyWage’s various programs. For its part, HealthyWage reports that the average participant more than doubles their investment if they are successful at achieving their goal. The financial upside potential is impressive.
So, if this is the season when you would like to not only resolve to lose those extra lbs. but also actually achieve that worthy goal, consider a cash-fueled approach. It just might give you that extra dose of motivation that’ll truly help you stay the course, shed weight and make some extra money in the process. There’s no better time than right now to bank on yourself.
Article | April 20, 2020
Across the spectrum of healthcare delivery – payor, provider, vendor, consumer, there is a land rush underway to embrace consumer-centric care. With tools like value-based care, chronic disease management, retail services, analytics, and remote patient monitoring, healthcare organizations are pivoting towards capabilities that provide a deeper understanding of patient behaviors and address the whole patient and not just the condition.