RTW Plans and How Effective RTW Plans and How Effective Rehabilitation is Managed

Nikki Brouwers

Managing Director

The Interact Group

Nikki@interactgroup.com.au

0419618868

Principles underpinning RTW plan

• Diagnosis is not a predictor to RTW

(OECD, 2007)

• Early intervention

• Focus on function, not dysfunction• Focus on function, not dysfunction

• RTW related to the personal, social and psychological ( bio psychosocial model)

Steps toward achieving RTW

• Assessing capacity of worker• Negotiating with the NTD• Use of suitable duties registers and

worksite assessments• Understanding/addressing the • Understanding/addressing the

motivators of the worker• Early intervention• Worlds best practice: The role of the

supervisor

Assessing capacity of the worker

• Focus on capacity not incapacity

• Use of positive messaging

• Activities of Daily Living

• The power of observation

• Functional Capacity Evaluation

• Treating parties observations

Negotiating upgrades with the NTD

• Evidence based decision making

• Health Benefits of Work • www.healthbenefitsofwork.com.au

• The role of the secretary• The role of the secretary

• The benefits of face to face conferencing

Use of suitable duties registers/worksite assessments

• Matching of capacity to requirements of the task

• A graded RTW plan shows the clear pathway to upgrade to pre injury dutiespathway to upgrade to pre injury duties

• Needs to be time specific and agreed by all parties

• Use of volunteering and worktrials

• The power of purposeful work

Worker motivation to RTW

Predictors to RTW

1. Job satisfaction

2. Co morbidity

3. Family history3. Family history

4. Personality

5. Expectations

6. Fear of re injury: workplace modifications

Vulnerable workers: Canadian research

• Education level: the postcode effect

• Failure to complete HSC resulted in 3 times injury rate

• Fear of re injury http://www.youtube.com/watch?v=3jLGkmOVtnI

Early intervention: Stay at WorkWork absence tends to perpetuate itself: that is, the longer someone is off work, the less likely they become ever to return.

If the person is off work for:

• 20 days the chance of ever getting back to work is 70%;

• 5 days the chance of ever getting back to work is 50%; and

• 70 days the chance of ever getting back to

work is 35%.

International best practice includes:

• Building supervisor capability

• Early intervention/strong assessments

• Integration of OHS/Injury management. • Integration of OHS/Injury management. Involve IW in safety improvements

• Language that “work is good for you”

Early intervention

• Dame Carol Black recommends referrals at 4 weeks to assess barriers to RTW and to develop a RTW

• The Dutch triage at 6 weeks• The Dutch triage at 6 weeks

• The Germans triage at 2 weeks

New employer

• Retraining occurs outside the workplace in contrast to Germany where all retraining occurs “on the job”

• Philosophically believe that training outside of work, the worker remains outside of work, the worker remains stigmatised and therefore never return to work.

• UK( Black) recommends early intervention for seeking new employer before termination.

Integration of OHS and injury management = Positive

workplace culture

• Consistency of language: stay at work

• Consistency of suitable duties• Consistency of suitable duties

• Alignment from HR: health benefits of work

References

• Thönnes, F, http://www.bmas.de/SharedDocs/Downloads/DE/PDF-Publikationen/f372-forschungsbericht-eibe.pdf?__blob=publicationFile

• Dame Black, C, Frost, D, November 2011, Health at work – an independent review of sickness absence, The Stationary Office Limited, United Kingdom.

• Dame Black, C, September 2012, 6th International Forum on Disability Management, 10 September 2012, Disability Management and work. Are we making progress? London, United Kingdom.

• Dr M Mohammed, September 2012, International Forum on disability Management, SOCSO’s RTW Programme, proceedings from conference, London, United Kingdom.proceedings from conference, London, United Kingdom.

• Breslin FC, Institute for Work and Health, Young workers out of school, with no diploma, more likely to be injured, Canadian Journal of Public Health, 2008: vol. 99, no. 2, pp. 121-124, http://www.iwh.on.ca/highlights/young-workers-out-of-school-with-no-diploma-more-likely-to-be-injured

• Institute for Work and Health, Return-to-work practices, http://www.iwh.on.ca/return-to-work-practices

• Australasian Faculty of Occupational and Environmental Medicine -http://www.racp.edu.au/index.cfm?objectid=57063EA7-0A13-1AB6-E0CA75D0CB353BA8

• Johnson D, Fry T. Factors Affecting Return to Work after Injury: A study for the Victorian WorkCover Authority. Melbourne: Melbourne Institute of Applied Economic and Social Research;2002.

Thank you

Nikki BrouwersManaging DirectorThe Interact Group

Nikki@interactgroup.com.au0419618868