Background: Medical treatment under workers’ compensation represents just a miniscule portion (about 1 percent) of total medical costs in the U.S. Furthermore, legislation and rules are determined autonomously by each state. Objective: To study Workers’ Comp systems in each state and determine what, if any, impact states adopting the use of evidence-based treatment guidelines has had to outcomes within the respective states. Hypothesis: Worker’ comp medical care, and the outcomes of that care in each state, can theoretically represent a microcosm of what could be achieved in an entire country. Methods: A trend began in 2003, starting with California, for states to consider adopting Evidence-Based Treatment Guidelines EBTGs) as a mechanism to insure timely and quality care for injured workers by following the least invasive, most-effective treatments today's science has to offer. Bi-products to the effective implementation of EBTGs, include earlier return to work, better outcomes resulting in reduced indemnity costs, less friction in the system (providers know what treatments are authorized and will be paid for), fewer episodes of over-utilization of services, and decreased medical costs, benefiting employers, insurers, providers and business. Findings: Outcomes where true EBTG have been implemented: Ohio adopted EBTGs in 2003. A Pilot conducted in 2005 showed a decrease in medical costs by 64%, lost days by 69% and treatment delays by 77%. Texas adopted EBTG in 2006; Total costs have declined by 50%, patients are recovering more quickly, more providers are willing to treat these patients, opioid abuses have declined and many states are looking to adopt this model. Discussion: Other state outcomes and essential elements needed in an EBTG will be discussed, time permitting. Conclusion: Outcomes realized through the adoption/implementation of evidence-based treatment guidelines by selected states, need not be isolated to the US or to the “microcosm” of workplace injuries and illnesses. Countries adopting evidence-based treatments guidelines within their healthcare systems can benefit from the same results: more timely and quality care, better outcomes, reduced costs, less disputes, reduced utilization of unnecessary procedures and services.
{"title":"Evidence-based treatment guidelines: at work in a microcosm","authors":"P. Whelan","doi":"10.1017/idm.2014.18","DOIUrl":"https://doi.org/10.1017/idm.2014.18","url":null,"abstract":"Background: Medical treatment under workers’ compensation represents just a miniscule portion (about 1 percent) of total medical costs in the U.S. Furthermore, legislation and rules are determined autonomously by each state. Objective: To study Workers’ Comp systems in each state and determine what, if any, impact states adopting the use of evidence-based treatment guidelines has had to outcomes within the respective states. Hypothesis: Worker’ comp medical care, and the outcomes of that care in each state, can theoretically represent a microcosm of what could be achieved in an entire country. Methods: A trend began in 2003, starting with California, for states to consider adopting Evidence-Based Treatment Guidelines EBTGs) as a mechanism to insure timely and quality care for injured workers by following the least invasive, most-effective treatments today's science has to offer. Bi-products to the effective implementation of EBTGs, include earlier return to work, better outcomes resulting in reduced indemnity costs, less friction in the system (providers know what treatments are authorized and will be paid for), fewer episodes of over-utilization of services, and decreased medical costs, benefiting employers, insurers, providers and business. Findings: Outcomes where true EBTG have been implemented: Ohio adopted EBTGs in 2003. A Pilot conducted in 2005 showed a decrease in medical costs by 64%, lost days by 69% and treatment delays by 77%. Texas adopted EBTG in 2006; Total costs have declined by 50%, patients are recovering more quickly, more providers are willing to treat these patients, opioid abuses have declined and many states are looking to adopt this model. Discussion: Other state outcomes and essential elements needed in an EBTG will be discussed, time permitting. Conclusion: Outcomes realized through the adoption/implementation of evidence-based treatment guidelines by selected states, need not be isolated to the US or to the “microcosm” of workplace injuries and illnesses. Countries adopting evidence-based treatments guidelines within their healthcare systems can benefit from the same results: more timely and quality care, better outcomes, reduced costs, less disputes, reduced utilization of unnecessary procedures and services.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79082112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The Healthcare Sector in British Columbia, Canada is comprised of over 110,000 employees covered by four union collective agreements. The overall disability burden for this industry is close to $300M annually. The EDMP was negotiated and developed through employer-union partnership. It is a province-wide program that is a component of the four healthcare collective agreements. Implemented in 2012, EDMP supports employees that are absent from work/struggling at work due to occupational or non-occupational illness/injury. Objectives: To showcase a leading DM best practice, highlighting effective joint union/employer stewardship of a comprehensive DM program for a major industry in British Columbia, Canada. Methods: Participation in EDMP is required for regular employees who meet one of the following criteria: • shift due to illness or injury resulting from a work-related event• consecutive shifts due to a non work-related illness or injury. Comprehensive policy and process documents developed collaboratively guide the program, with provincial steering joint committee over-site. Union representatives with DM-specific training support the program, working in collaboration with employer's DM professionals to administer a pro-active, comprehensive case management plan with an overarching principle of early intervention and recovery at work. DM-related issues are removed from the labor-relations realm, with a separate dispute resolution process to address disagreements with case management plans. Findings: The collaborative partnership between EDMP union reps and employer DM professionals facilitates engagement of injured/ill employee and improves the ability to identify and address return to work barriers: medical, workplace, vocational, personal. The mandatory component of the CA language improves engagement from both union and employer, with reductions in both WCB and LTD claim durations as a positive result. Fewer conflicts regarding DM related issues are an additional benefit. Conclusion: The EDMP should be used a model of effective union-employer partnership in the management of employee illness/injury and should be replicated in other industries/jurisdictions.
{"title":"Enhanced DM program in British Columbia's healthcare sector","authors":"T. Morrison, Lani deHek","doi":"10.1017/IDM.2014.51","DOIUrl":"https://doi.org/10.1017/IDM.2014.51","url":null,"abstract":"Background: The Healthcare Sector in British Columbia, Canada is comprised of over 110,000 employees covered by four union collective agreements. The overall disability burden for this industry is close to $300M annually. The EDMP was negotiated and developed through employer-union partnership. It is a province-wide program that is a component of the four healthcare collective agreements. Implemented in 2012, EDMP supports employees that are absent from work/struggling at work due to occupational or non-occupational illness/injury. Objectives: To showcase a leading DM best practice, highlighting effective joint union/employer stewardship of a comprehensive DM program for a major industry in British Columbia, Canada. Methods: Participation in EDMP is required for regular employees who meet one of the following criteria: • shift due to illness or injury resulting from a work-related event• consecutive shifts due to a non work-related illness or injury. Comprehensive policy and process documents developed collaboratively guide the program, with provincial steering joint committee over-site. Union representatives with DM-specific training support the program, working in collaboration with employer's DM professionals to administer a pro-active, comprehensive case management plan with an overarching principle of early intervention and recovery at work. DM-related issues are removed from the labor-relations realm, with a separate dispute resolution process to address disagreements with case management plans. Findings: The collaborative partnership between EDMP union reps and employer DM professionals facilitates engagement of injured/ill employee and improves the ability to identify and address return to work barriers: medical, workplace, vocational, personal. The mandatory component of the CA language improves engagement from both union and employer, with reductions in both WCB and LTD claim durations as a positive result. Fewer conflicts regarding DM related issues are an additional benefit. Conclusion: The EDMP should be used a model of effective union-employer partnership in the management of employee illness/injury and should be replicated in other industries/jurisdictions.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88586657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Improving client outcomes whilst maintaining scheme sustainability In 2010 the Transport Accident Commission commenced its journey in placing Client Outcomes as a corporate objective alongside those of Scheme Viability and Client Experience. It was widely agreed to be the right thing to do but also took a leap of faith in that the impact of this focus on the more established scheme measures was at that time unknown. Through the use of both quantitative and qualitative data analysis, this presentation aims to review the hypothesis that including Client Outcomes as a corporate objective would strengthen the management of scheme viability and client experience.
{"title":"Improving client outcomes whilst maintaining scheme sustainability","authors":"Kate Kerr, David Gifford, S. Fleming","doi":"10.1017/IDM.2014.25","DOIUrl":"https://doi.org/10.1017/IDM.2014.25","url":null,"abstract":"Improving client outcomes whilst maintaining scheme sustainability In 2010 the Transport Accident Commission commenced its journey in placing Client Outcomes as a corporate objective alongside those of Scheme Viability and Client Experience. It was widely agreed to be the right thing to do but also took a leap of faith in that the impact of this focus on the more established scheme measures was at that time unknown. Through the use of both quantitative and qualitative data analysis, this presentation aims to review the hypothesis that including Client Outcomes as a corporate objective would strengthen the management of scheme viability and client experience.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89308315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In order to ensure the success of medical and occupational rehabilitation, the BGW – the occupational insurer – offers its clients to accompany them at the workplace. This aims at transferring the working methods, which the rehabilitant has acquired during rehabilitation and are therefore partly new to him, into operational practice and at verifying their fitness for practical applicability. Apart from that, this shall facilitate to identify factors jeopardizing reintegration and to beneficially influence them, if possible. Work is resumed with the approval by the client in question and their employer, accompanied by a specialized workplace attendant. Depending on the severity of the health impairment and on the prevailing contextual factors, such care is provided on an hourly or daily basis for one or up to several weeks. Thereby, the workplace attendant refers the client to the most reasonable and gentle mode of working that is possible. Moreover, the workplace attendant takes care of potential difficulties arising during the stage of resuming employment, in order to work out strategies early on for ensuring the success of rehabilitation and for transferring such strategies to operational practice, jointly with all parties involved, including the BGW rehab managers. The potential need for qualification, following the motto of “Occupational placement comes before qualification”, is thereby identified at an early stage and in a purposeful way. Principal Experience and Summary: Workplace care facilitates highly practice‐oriented reintegration; Difficulties in the reintegration process are identified at an early stage; Workplace accompaniment gears prevention very effectively to rehabilitation. Clients as well as employers perceive such support provided by the BGW as being sensible and helpful.
{"title":"Workplace care: a sensible form of support to convalescents from occupational injuries or diseases","authors":"Markus Taddicken","doi":"10.1017/idm.2014.28","DOIUrl":"https://doi.org/10.1017/idm.2014.28","url":null,"abstract":"In order to ensure the success of medical and occupational rehabilitation, the BGW – the occupational insurer – offers its clients to accompany them at the workplace. This aims at transferring the working methods, which the rehabilitant has acquired during rehabilitation and are therefore partly new to him, into operational practice and at verifying their fitness for practical applicability. Apart from that, this shall facilitate to identify factors jeopardizing reintegration and to beneficially influence them, if possible. Work is resumed with the approval by the client in question and their employer, accompanied by a specialized workplace attendant. Depending on the severity of the health impairment and on the prevailing contextual factors, such care is provided on an hourly or daily basis for one or up to several weeks. Thereby, the workplace attendant refers the client to the most reasonable and gentle mode of working that is possible. Moreover, the workplace attendant takes care of potential difficulties arising during the stage of resuming employment, in order to work out strategies early on for ensuring the success of rehabilitation and for transferring such strategies to operational practice, jointly with all parties involved, including the BGW rehab managers. The potential need for qualification, following the motto of “Occupational placement comes before qualification”, is thereby identified at an early stage and in a purposeful way. Principal Experience and Summary: Workplace care facilitates highly practice‐oriented reintegration; Difficulties in the reintegration process are identified at an early stage; Workplace accompaniment gears prevention very effectively to rehabilitation. Clients as well as employers perceive such support provided by the BGW as being sensible and helpful.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90889415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Motor Vehicle Accident Fund (MVA Fund) started operations on 1 January 1987 to service third party cover from funds earned from a levy on fuel. Originally called the Motor Vehicle Insurance Fund, the MVA Fund has been going through profound change in order to deliver services that meet the expectations of its stakeholders. Over the years, the governing Act underwent reviews as a response to feedback from both the public and stakeholders. Currently the Fund is governed by the Motor Vehicle Accident Fund Act No. 15 of 2007, which is a hybrid of both a fault-based and a no fault compensation system. Severe Injuries MVA Fund has a total of 1 589 claimants who suffered severe injuries during road crashes.. Role of MVA Fund in management of the severely injured The Act has put emphasis on medical treatment and rehabilitation as one of its core mandates. The timeliness of medical attention and rehabilitation results in improved claimants’ outcomes. Some of the objectives of the Fund in managing these claimants include among others: • Restoring claimants to highest possible level of functionality• Vocational rehabilitation• Return to work• Social rehabilitation Achievements by Botswana MVA Fund Despite the challenges faced by developing countries, the Fund managed to: • Remain sustainable hence continuing to deliver on its mandate• Support the severely injured by: ○ medical and rehabilitation cover○ loss of income o enhancement of quality of life e.g. house/workplace modification o providing social and welfare care○ advocacy role• Build capacity in both government and non-governmental organisations as a long-term investment in the management of the severely injured. The Fund continues collaborating with relevant stakeholders and international bodies for best practice in managing these claimants.
{"title":"DM for severely injured claimants in the Botswana motor vehicle accident fund","authors":"Cross Kgosidiile","doi":"10.1017/idm.2014.60","DOIUrl":"https://doi.org/10.1017/idm.2014.60","url":null,"abstract":"The Motor Vehicle Accident Fund (MVA Fund) started operations on 1 January 1987 to service third party cover from funds earned from a levy on fuel. Originally called the Motor Vehicle Insurance Fund, the MVA Fund has been going through profound change in order to deliver services that meet the expectations of its stakeholders. Over the years, the governing Act underwent reviews as a response to feedback from both the public and stakeholders. Currently the Fund is governed by the Motor Vehicle Accident Fund Act No. 15 of 2007, which is a hybrid of both a fault-based and a no fault compensation system. Severe Injuries MVA Fund has a total of 1 589 claimants who suffered severe injuries during road crashes.. Role of MVA Fund in management of the severely injured The Act has put emphasis on medical treatment and rehabilitation as one of its core mandates. The timeliness of medical attention and rehabilitation results in improved claimants’ outcomes. Some of the objectives of the Fund in managing these claimants include among others: • Restoring claimants to highest possible level of functionality• Vocational rehabilitation• Return to work• Social rehabilitation Achievements by Botswana MVA Fund Despite the challenges faced by developing countries, the Fund managed to: • Remain sustainable hence continuing to deliver on its mandate• Support the severely injured by: ○ medical and rehabilitation cover○ loss of income o enhancement of quality of life e.g. house/workplace modification o providing social and welfare care○ advocacy role• Build capacity in both government and non-governmental organisations as a long-term investment in the management of the severely injured. The Fund continues collaborating with relevant stakeholders and international bodies for best practice in managing these claimants.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89463555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Each year, JobAccess, an Australian Government initiative delivered by WorkFocus Australia, manages funding applications for equipment, training or workplace modifications to break down employment barriers for people with disability. Employers are concerned by the perceived cost of employing people with disability - a 2011 AHRI survey found that only 14.83% of respondents believed that there was no perception in their organisation that employees with a disability are high risk or potentially expensive – and many employers are not aware that the Australian Government funds eligible requests placed via JobAccess. The analysis in this paper shows just how much of a difference can be made with just $1,000… not that much money when the upside is creating sustainable employment for people with disability. This paper breaks down what can be achieved with this sum and has wider applications for employers, employment providers or countries considering implementing such a programme. JobAccess is a free service to Australian employers and people with disability and, as well as administering the Employment Assistance Fund, it provides advice and support on all matters disability employment.
{"title":"The $1,000 tipping point: what can be achieved with this sum to break down employment barriers for people with disability","authors":"Heather D. Hill","doi":"10.1017/idm.2014.21","DOIUrl":"https://doi.org/10.1017/idm.2014.21","url":null,"abstract":"Each year, JobAccess, an Australian Government initiative delivered by WorkFocus Australia, manages funding applications for equipment, training or workplace modifications to break down employment barriers for people with disability. Employers are concerned by the perceived cost of employing people with disability - a 2011 AHRI survey found that only 14.83% of respondents believed that there was no perception in their organisation that employees with a disability are high risk or potentially expensive – and many employers are not aware that the Australian Government funds eligible requests placed via JobAccess. The analysis in this paper shows just how much of a difference can be made with just $1,000… not that much money when the upside is creating sustainable employment for people with disability. This paper breaks down what can be achieved with this sum and has wider applications for employers, employment providers or countries considering implementing such a programme. JobAccess is a free service to Australian employers and people with disability and, as well as administering the Employment Assistance Fund, it provides advice and support on all matters disability employment.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89876800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Australian medical profession is well trained in the assessment and management of a wide range of acute injuries/illnesses. However, the ongoing management of chronic injuries/illnesses and their ultimate assessment for the purposes of Impairment and/or Disability requires a different skill mix and medical perspective. Over the last 2 decades, Australian doctors have become well versed in various methodologies to assess the Permanent Impairment of a claimant/worker/client/patient, as legislated by multiple Australian jurisdictions. The same outcome cannot be said for the assessment and management of injuries/illnesses leading to Disability. Most Australian doctors are not formally trained to understand the concepts of Disability versus Impairment. Some organizations continue to seek Disability medical assessments from the treating doctor only, which may lead to bias and a diminished capacity to return to paid employment. This presentation will cover the issues of Disability assessment and management strategies within Australia, as seen through the eyes of an independent medical assessor.
{"title":"Doctor, I am disabled","authors":"C. Cunneen","doi":"10.1017/idm.2014.64","DOIUrl":"https://doi.org/10.1017/idm.2014.64","url":null,"abstract":"The Australian medical profession is well trained in the assessment and management of a wide range of acute injuries/illnesses. However, the ongoing management of chronic injuries/illnesses and their ultimate assessment for the purposes of Impairment and/or Disability requires a different skill mix and medical perspective. Over the last 2 decades, Australian doctors have become well versed in various methodologies to assess the Permanent Impairment of a claimant/worker/client/patient, as legislated by multiple Australian jurisdictions. The same outcome cannot be said for the assessment and management of injuries/illnesses leading to Disability. Most Australian doctors are not formally trained to understand the concepts of Disability versus Impairment. Some organizations continue to seek Disability medical assessments from the treating doctor only, which may lead to bias and a diminished capacity to return to paid employment. This presentation will cover the issues of Disability assessment and management strategies within Australia, as seen through the eyes of an independent medical assessor.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89879474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: For injured workers facing increased physical requirements the VBG, a German Social Accident Insurance Institution, provides 2 types of outpatient medical treatment for the last phase of rehabilitation. One option is a functionally orientated extended physiotherapy including the opportunity for work-ability testing at the workplace with a gradual increase of workload and working time. Second option is a newly-developed multidisciplinary workplace-related rehabilitation integrating the specific work-relevant functional flows in therapy under the direction of a qualified physician and therapists in rehab facilities. Objective: To evaluate the effects of workplace-related rehabilitation after foot fractures in outpatient rehab facilities. Methods: Data of all completed cases with severe fractures of the calcaneus or the ankle joint, undergoing workplace-related therapy in 2013 (n = 27), were compared to consecutive data of 27 completed cases undergoing extended physiotherapy. Findings: Mean age in both groups was 48 years. In the extended physiotherapy group 14 patients additionally received a work-ability testing directly at the workplace. Mean duration from accident to capacity for work was 169.81 days (SD 60.4) for extended physiotherapy and 176.81 days (SD 49.3) for workplace-related rehabilitation. 23 patients with extended physiotherapy and 26 patients with workplace-related rehabilitation maintained work ability 3 months after achieving full capacity for work. Subsequent rehab measures after regaining capacity for work were needed in 6 cases in the extended physiotherapy group and in one case in the workplace-related rehabilitation group. Discussion: Though no statistically verifiable difference in duration of incapacity for work between both groups was found, the results provide apparently evidence that multidisciplinary workplace-related rehabilitation is more sustainable. It is suggested, that a systematic approach and individually tailored multidisciplinary training of the specific work-relevant movement patterns under constant medical and therapeutic direction lead to more stable rehabilitation results. Conclusion: Further research is needed to consolidate our empirical findings.
{"title":"Workplace-related rehabilitation after foot fractures","authors":"E. Froese","doi":"10.1017/IDM.2014.14","DOIUrl":"https://doi.org/10.1017/IDM.2014.14","url":null,"abstract":"Background: For injured workers facing increased physical requirements the VBG, a German Social Accident Insurance Institution, provides 2 types of outpatient medical treatment for the last phase of rehabilitation. One option is a functionally orientated extended physiotherapy including the opportunity for work-ability testing at the workplace with a gradual increase of workload and working time. Second option is a newly-developed multidisciplinary workplace-related rehabilitation integrating the specific work-relevant functional flows in therapy under the direction of a qualified physician and therapists in rehab facilities. Objective: To evaluate the effects of workplace-related rehabilitation after foot fractures in outpatient rehab facilities. Methods: Data of all completed cases with severe fractures of the calcaneus or the ankle joint, undergoing workplace-related therapy in 2013 (n = 27), were compared to consecutive data of 27 completed cases undergoing extended physiotherapy. Findings: Mean age in both groups was 48 years. In the extended physiotherapy group 14 patients additionally received a work-ability testing directly at the workplace. Mean duration from accident to capacity for work was 169.81 days (SD 60.4) for extended physiotherapy and 176.81 days (SD 49.3) for workplace-related rehabilitation. 23 patients with extended physiotherapy and 26 patients with workplace-related rehabilitation maintained work ability 3 months after achieving full capacity for work. Subsequent rehab measures after regaining capacity for work were needed in 6 cases in the extended physiotherapy group and in one case in the workplace-related rehabilitation group. Discussion: Though no statistically verifiable difference in duration of incapacity for work between both groups was found, the results provide apparently evidence that multidisciplinary workplace-related rehabilitation is more sustainable. It is suggested, that a systematic approach and individually tailored multidisciplinary training of the specific work-relevant movement patterns under constant medical and therapeutic direction lead to more stable rehabilitation results. Conclusion: Further research is needed to consolidate our empirical findings.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84708538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Scotland has historically had one of the highest rates of poor health and corresponding work related absence in the developed world. To address this challenge, the Scottish government formed a specialised unit in 2006, the Scottish Centre for Healthy Working Lives (SCHWL). Functioning as an extension of the government funded National Health System (NHS), SCHWL's principle goal was to engage employers and enable them to protect and improve the health of their employees. Hypothesis: The establishment of disability management services within the National Health Service would create a primary link between medical/health services and employers/employees, resulting in improved timeframes for return to work and reduced absence rates. Methods: The SCHWL established three pilot projects to deliver Vocational Rehabilitation Services across Scotland. This included the provision of disability management services to enable workers to return to or remain in work, with the intention of creating a necessary bridge between the health care system and employers/employees. SCHWL determined that specialised training of health professional staff working within the NHS would be a critical requirement for success. In 2009, SCHWL engaged KMG Health Partners to begin delivery of the NIDMAR education programme to a cross section of staff working within the NHS. KMG has now trained over 50 health professionals who have achieved their Certified Disability Management Professional (CDMP) designation and who work with the NHS across Scotland. Principle Findings: The CDMP's function as a critical link between the traditional health services accessed at the initial stages of an employee's injury or illness. Their primary role facilitates and supports return to work from the initial onset of medical/health treatment. Conclusion: The innovative approach implemented by SCHWL has achieved measurable improvements in the communication process between NHS treating health professionals and employers, employer engagement in the return to work process, and reduced employee timeframes for return to work.
{"title":"The integrated DM approach within the Scottish National Health System","authors":"G. Halsey","doi":"10.1017/idm.2014.47","DOIUrl":"https://doi.org/10.1017/idm.2014.47","url":null,"abstract":"Background: Scotland has historically had one of the highest rates of poor health and corresponding work related absence in the developed world. To address this challenge, the Scottish government formed a specialised unit in 2006, the Scottish Centre for Healthy Working Lives (SCHWL). Functioning as an extension of the government funded National Health System (NHS), SCHWL's principle goal was to engage employers and enable them to protect and improve the health of their employees. Hypothesis: The establishment of disability management services within the National Health Service would create a primary link between medical/health services and employers/employees, resulting in improved timeframes for return to work and reduced absence rates. Methods: The SCHWL established three pilot projects to deliver Vocational Rehabilitation Services across Scotland. This included the provision of disability management services to enable workers to return to or remain in work, with the intention of creating a necessary bridge between the health care system and employers/employees. SCHWL determined that specialised training of health professional staff working within the NHS would be a critical requirement for success. In 2009, SCHWL engaged KMG Health Partners to begin delivery of the NIDMAR education programme to a cross section of staff working within the NHS. KMG has now trained over 50 health professionals who have achieved their Certified Disability Management Professional (CDMP) designation and who work with the NHS across Scotland. Principle Findings: The CDMP's function as a critical link between the traditional health services accessed at the initial stages of an employee's injury or illness. Their primary role facilitates and supports return to work from the initial onset of medical/health treatment. Conclusion: The innovative approach implemented by SCHWL has achieved measurable improvements in the communication process between NHS treating health professionals and employers, employer engagement in the return to work process, and reduced employee timeframes for return to work.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80606903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The primary function of income security organisations is to administer personal injury claims in a commercially viable and cost effective manner, while supporting the receivers of benefits/claimants to achieve a meaningful and durable return to employment. Given the pressures of commercial success in a competitive market measured by effective cost minimisation, to what extent is the level of support offered to individuals claiming benefits impacted by an organisation's purpose to be profitable? The extent of influence exercised by income security organisations in administering claims and driving employment outcomes is limited by jurisdictional legislation and regulations. Furthermore, the requirements to meet compliance requirements can often be detrimental to the quality of management of claims, resulting in a highly administrated framework. This can restrict an organisations capacity to meet individual needs, especially in cases that are not seen as fitting the norm. Considering the conflicting demands imposed by commercial pressures and regulatory frameworks, what is the level of influence that may be exercised by these organisations in facilitating employment outcomes? Employers Mutual have maintained a leading position in the NSW Workers Compensation Scheme, achieving commercial targets, meeting legislative requirements and promoting excellence in employment outcomes through: • Organisational vision – we help people get their lives back;• Focus on support and development of people as front line drivers of performance;• Role design – how we actually do our jobs;• Implementing organisation strategies and designing key support roles aligned to remunerative measures;• Strategic focus on early intervention to facilitate return to work;• Ensuring people receive the full extent of their entitlements, however, are not compensated to excess;• Service level agreements with employers/brokers with a key focus on return to work expectations;• Strong relationships with third party service providers; and• A structured framework that allows flexibility in decision making.
{"title":"What is the level of influence that may be exercised by income security organisations in facilitating employment outcomes?","authors":"Simon Wiltshire","doi":"10.1017/IDM.2014.66","DOIUrl":"https://doi.org/10.1017/IDM.2014.66","url":null,"abstract":"The primary function of income security organisations is to administer personal injury claims in a commercially viable and cost effective manner, while supporting the receivers of benefits/claimants to achieve a meaningful and durable return to employment. Given the pressures of commercial success in a competitive market measured by effective cost minimisation, to what extent is the level of support offered to individuals claiming benefits impacted by an organisation's purpose to be profitable? The extent of influence exercised by income security organisations in administering claims and driving employment outcomes is limited by jurisdictional legislation and regulations. Furthermore, the requirements to meet compliance requirements can often be detrimental to the quality of management of claims, resulting in a highly administrated framework. This can restrict an organisations capacity to meet individual needs, especially in cases that are not seen as fitting the norm. Considering the conflicting demands imposed by commercial pressures and regulatory frameworks, what is the level of influence that may be exercised by these organisations in facilitating employment outcomes? Employers Mutual have maintained a leading position in the NSW Workers Compensation Scheme, achieving commercial targets, meeting legislative requirements and promoting excellence in employment outcomes through: • Organisational vision – we help people get their lives back;• Focus on support and development of people as front line drivers of performance;• Role design – how we actually do our jobs;• Implementing organisation strategies and designing key support roles aligned to remunerative measures;• Strategic focus on early intervention to facilitate return to work;• Ensuring people receive the full extent of their entitlements, however, are not compensated to excess;• Service level agreements with employers/brokers with a key focus on return to work expectations;• Strong relationships with third party service providers; and• A structured framework that allows flexibility in decision making.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80384589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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