Early Intervention as a Framework for Managing Psychological Injury in the Workplace

Presented by:

Ms Laura Eyles, Senior Rehabilitation Consultant/Psychologist

27 February 2014

Session Objectives

Early Intervention: Research and Trend Analysis

Implications of a Traditional Approach to Early Intervention

Injury Treatment Pilot project results

Design and Application of an Early Intervention System

Outcomes of Psychological Early Intervention Frameworks

Incident occurs or illness reported

Notification to the Agent if

compensatory

Assessment of the claim Application of

appropriate clinical intervention

Commencement of treatment and

occupational rehab

Momentum w RTW and

Treatment

Injury Resolved

RTW on full hours and Duties

Worker completes

documentation

Supervisor forwards

documentation to Mgt

Management contacts HR

Research and Trend Analysis

Industry Performance Statistics – 2011 / 2012 (HWCA 2012)

• 67% of injured workers agreed management would help injured workers’ RTW (decreased from 71% in 2009/2010)

• 66% of injured workers agreed their employer had clear policies and procedures about returning injured workers to work

• 62% agreed that management would spend time and money on making the workplace safe (decreased from 66% in 2010/2011)

2010/2011 2011/2012

Durable RTW 86% 75%

Pre-injury duties 73% 67%

Non-durable or non-RTW 14% 25%

Mean length of time of durable RTW (NB: 2003/2004: 159

days – IW’s are taking longer to RTW than a decade ago

145 days 149 days

Mean length of time of non-durable RTW 68 days 76 days

Early Intervention Psychological Injury Context

Psychological Injury

Circumstance where one’s normal cognitive, behavioural or emotional functioning is

overwhelmed by demands. Normative and effective strategies for self regulation

become overwhelmed and prove less effective.

Early Intervention Psychological Injury Context

• Psychological injuries account for approximately 1/3 of the total cost of all claims. Largest rate of claim declinature – what happens next?

• Most psychological injury claims do not result from a significant traumatic event or critical injury. Research shows injuries develop over a 6-month period or more, often in response to a variety of workplace and personal factors.

• The longer an employee is off work the less likely they are to return.

• Recent increases in claims related to ‘work pressure’ now account for 50% of the total psychological injury claims.

The EI Context

• Reduce overwhelming demands;

• Increase access to normative and effective strategies for self regulation;

• Remain focused on a Vocational and Employment context

Traditional vs Best Practice Approach

Traditional Cost Best Practice Interventions

delivered

Focus on speed of

notification

Fears around a

reporting culture

Slow/multi-layered

decision making

Dependency on

people

Operational KPI’s are

not linked to EI or

claims durations

Lack of clinical

relationships /

stakeholders unclear

of expectations and

responsibilities

Extended periods of

unfit certification

Reduced

productivity =

financial loss

Delays in claims

notifications

Workplace strategy

not implemented /

not progressive

Extended periods of

claim durations

Lack of diagnosis

/objective medical

information

Delays in obtaining

clinical opinions &

EBT

Interventions delivered and

measured

Focus on speed of intervention

Clear expectation and

responsibility

Systemic approach

Effective risk categorisation

Evidence based resources &

intervention

Barrier mitigation &

management

Systemic employee engagement

Effectively informed teams

Prepared & empowered leaders

An organisational culture open to

EI

Early Intervention Context and Benefits

Pilot Study

Early Intervention Injury Treatment Pilot Study

Multi-national organisation employing over 30,000 staff nationally

200 claims registered per month

Staff work across a range of industries

Partnered with Injury Treatment for their NSW business in January 2011 with rollout occurring in June 2011

Pilot Study – 2011/12

2010/2011 2011 / 2012

Total no of claims in NSW 162 174

Average days incident – notification 26.8 days 17.1 days

Average days unfit to SD’s (lost time) 19.2 days 5.19 days

Average days from notification – PID’s certification

138.67 days 45 days

Average weekly benefits $1025.54 $942.17

Average total claims costs $5836.18 $2790.55

Application

Design and Implementation

Gap Analysis

Clear expectations & responsibilities of employees and management

Documented early intervention psychological injury & illness management policy and procedures

Efficient psychological injury notification / case screening processes

Expert clinical suppliers

Communication & marketing

Prevention / Continuous Improvement

Responsibilities and Psychological Injuries

How does this model work on the ground?

What is the skill level of my managers?

How do I measure success?

Are KPI’s linked to injury management?

What communication needs to occur and when?

What training needs to occur to up-skill my leaders?

What is our process for identifying those at risk of psychological injury?

What is the skill level of supervisors to identify and raise a psychological concern?

What do we consider to be a psychological case risk?

What is our process when somebody sustains a psychological injury?

What are our timeframes that this should occur within?

Application of the right resource

Who makes this decision?

Is our decision evidence based?

What timeframe have we set?

Do we use psychological early intervention assessments?

Do our suppliers (medical/rehab/treatment) understand our business and model?

Outcomes

Early Intervention Expected Outcomes

Diagnosis and medical intervention = RTW success

Early psychosocial screening may identify those at risk of long term disability

Subsequent early psychological intervention may curb long term disability

Systematic identification of workers at risk of developing biological, psychological and social barriers to return to work

Targeted / consistent referral for appropriate services

Early Intervention Expected Outcomes

Minimisation of treatment and rehab costs associated with inappropriate or more intensive services than required;

Removes subjectivity of individual Case Managers = uniform system & consistency in barrier assessment and mitigation.

Reduced suitable duties durations = reduced operational costs

Reduced claims durations, durable RTW rates

Maintaining / increasing productivity

Summary Best Practice EI from a Psychological Framework

• Interventions delivered and measured

• Focus on speed of intervention

• Clear expectation and responsibility

• Systemic approach

• Effective risk categorisation

• Evidence based resources & intervention

• Barrier mitigation & management

• Systemic employee engagement

• Effectively informed teams

• Prepared & empowered leaders

• An organisational culture open to EI

Questions?