Timing is everything, or at least that’s what ‘they’ say. Squeaking into a movie theatre just as the lights dim; or managing to get just enough milk (I mean, right to the very last drop) out of the jug for your cereal (or coffee fix!) in the morning before anyone else in the house gets to it. You might now be asking yourself – What does this have to do with return to work?
As it relates to return to work after an injury or illness, timing is at the very least an important factor to consider. In this case, the ‘they’ include researchers Franche et al., and the Institute for Work and Health (Franche et el., 2005, p. 623*). At OrionHealth, we believe that a timely and well planned graduated return to work (GRTW) can promote a safe and durable return to work. The key factors that we embrace at OrionHealth when considering a return to work for clients are the following:
Start early (Yes, the timing IS important!)
- Start GRTW planning as soon as possible.
- Facilitate contact between the worker and employer. Evidence shows that work disability duration is reduced by “interventions which include early contact with the worker by the workplace” (Franche et el., 2005, p. 623*).
Client and stakeholder involvement
- Actively involve the injured worker and employer with the GRTW set up (increases commitment, accountability).
- Involve all relevant parties in GRTW planning, e.g. worker, employer, doctor and/or specialist, nurse, case manager/adjuster, physiotherapist or other treating professionals.
- Include other stakeholders as appropriate.
Effective and timely communication
- Provide timely written and verbal communication between all parties to ensure everyone is on the same page.
- There is strong evidence that contact between the healthcare provider and the workplace reduces work disability duration and associated costs (Franche et el., 2005, p. 623).
- Actively listen to problems and barriers but facilitate solution-focused and problem solving communication.
Early job site visit (There is that timing piece again!)
- Confirm job demands, clarify expectations, identify and address return to work barriers, develop a return to work plan.
- Evidence to suggest that work disability duration is reduced by “ergonomic workplace visits” (Franche et el., 2005, p. 623).
Job coaching at the work site
- Address barriers; reinforce education and techniques to facilitate success.
Effective graduation of work
- GRTW plan clearly outlined and supported by all parties, with specific and reasonable progression of hours and duties that would empower the injured worker by facilitating success.
- “Strong evidence that work disability duration is significantly reduced by work accommodation offers” which would include graduation of work duties and hours of work (Franche et el., 2005, p. 623).
Set realistic goals and expectations
- Applies to injured worker and employer.
- Facilitates employer support of the GRTW plan.
- Helps improve perception of work readiness by defining success criteria.
- Setting goals collaboratively improves motivation, commitment and cooperation.
Effective work simulation
- Functional program during clinic portion of the program should simulate injured worker’s job tasks as closely as possible.
- Achieve this by an effective interview at assessment and early contact (timing!) with the employer, client/employer involvement in treatment planning, job site visit(s).
While there are a number of important factors to consider when planning and executing a return to work, the above list is not meant to be exhaustive. These factors, however, are at the front of the minds of those working with client’s returning to work at OrionHealth. At OrionHealth, the rehabilitation team or professional will identify and mitigate potential risk factors for the condition at the worksite through modification of the environment or of work patterns and behaviours that may contribute to the condition. They will also address physical and psychosocial contributors.
Why return to work after injury or illness?
At OrionHealth, we believe that a safe, durable return to productive and sustainable work after injury is the ultimate outcome of return to work programs and this outcome is beneficial to the worker, the employer and the referral source.
One of the key “determinants of health” for population health identified by Health Canada is Employment and Working Conditions. Work is a health behaviour. Not only does it provide financial stability, it also provides meaning, purpose, social status, identity, structure, and social interaction to our lives. Return to work is the best composite measure of occupational rehabilitation success. It is an objective measure, and could not be sustained unless other important factors such as management of symptoms, decreased fear of re-injury and increased physical conditioning had been adequately dealt with.
We at OrionHealth also acknowledge the health literature that states that employment status alone is a determinant of health and its importance as having a restoring capacity separate from the strictly monetary benefit of work. The objectives of our Return To Work Support Services Program hence are to:
- Facilitate safe return to pre-injury or alternative work.
- Promote self-responsibility and self management of the individual’s injury, recovery from injury and wellness in general.
- Minimize disability and fear of movement through a gradual increase in physical activity and education.
- Reduce risk of re-injury or re-aggravation of an injury through physical conditioning and education on optimal work habits and body mechanics.
- Help workers develop behaviours and strategies that will improve their ability to return to work sustainably and function independently.
So while the current research related to return to work does not necessarily say that timing IS everything, it is at the very least an important factor to consider for a worker’s overall return to work and healthy lifestyle.
Written by Linda Waithman B. Sc. (OT)
*Franche, R.L., Cullen, K., Clarke, J., Irvin, E., Sinclair, S., Frank, J. and The Institute for Work & Health (IWH) Workplace-Based RTW Intervention Literature Review Research Team (2005). Workplace-Based Return-to-Work Interventions: A Systematic Review of the Quantitative Literature. Journal of Occupational Rehabilitation, 15 (4), 607-631.doi:10.1007/s10926-005-8038-8*
