Getting the Message Right: Evidence-Based Insights to Improve Organizational Return-to-Work Communication Practices

Injured worker participation in assessment during the acute phase of workers compensation rehabilitation: a scoping review

PURPOSE

Rates of return to work (RTW) are declining in the Australian workers compensation system alongside significant economic and social costs, disputes, and secondary psychological injury. Non-medical assessment of workplace injuries now considers psychosocial and workplace factors, and worker participation in the assessment process is limited. This scoping review examines studies regarding non-medical assessment during the acute phase of rehabilitation in terms of costs, disputes, secondary psychological injury, and worker participation.

METHOD

An electronic and manual search of relevant articles across four databases was conducted using PRISMA guidelines, followed by quality assessment.

RESULTS

Of the 1,630 studies retrieved, 12 met the inclusion criteria with most focused on assessment for risk of obstructed or delayed RTW.

CONCLUSIONS

Non-medical assessment in the acute stage of rehabilitation identifies risk for delayed or complicated RTW, overlooking potential for the process of assessment to contribute to disputes and development of secondary psychological injury. Doubt around the capacity of workers to participate objectively in assessment persists. These are aspects of assessment worthy of further exploration for their impact on RTW outcomes.

A Meta-synthesis of Qualitative Research on Effective Return to Work Counseling for Individuals with Work Participation Restrictions - A Systematic Review

PURPOSE

The aim of this systematic review was to summarize the qualitative evidence on factors of effective counseling aiming at work participation for people with chronic diseases and/or disabilities.

METHODS

We conducted a systematic literature search in MEDLINE (PubMed), CINAHL, Web of Science, PsycINFO, and PubPsych in March 2023. Our inclusion criteria stipulated that counseling should be specifically designed for individuals experiencing constraints in work participation and published in German or English between 2013 and 2023. To assess the quality of the included studies, we used the checklist of the Critical Appraisal Skills Programme. We synthesized our findings according to the meta-ethnographic methodology by Noblit and Hare.

RESULTS

Of the 2901 papers found in the systematic search, we included 16 qualitative studies in our meta-synthesis. Studies were conducted in Australia, the USA, Canada, Nordic countries, and Germany. Our "model of the effectiveness of counseling for work participation" consists of four levels. At the extended organizational level, potential factors include the provision of sufficient time and work resources for counselors or contact persons. At the team and stakeholder level, structural collaboration, for example, is crucial. In the counseling dyad, counselors can employ shared decision-making and at the individual level, personal character traits and the client's motivation are exemplary factors.

CONCLUSION

This study provides a comprehensive overview of factors contributing to effective counseling in the context of work participation. The delineation across various levels underscores that effectiveness in counseling is a collective outcome, involving not only the advisor but also other stakeholders.

Perspectives and Experiences of Public Safety Personnel Engaged in a Peer-Led Workplace Reintegration Program Post Critical Incident or Operational Stress Injury: A Qualitative Thematic Analysis

INTRODUCTION

Public safety personnel (PSP) experience operational stress injuries (OSIs), which can put them at increased risk of experiencing mental health and functional challenges. Such challenges can result in PSP needing to take time away from the workplace. An unsuccessful workplace reintegration process may contribute to further personal challenges for PSP and their families as well as staffing shortages that adversely affect PSP organizations. The Canadian Workplace Reintegration Program (RP) has seen a global scale and spread in recent years. However, there remains a lack of evidence-based literature on this topic and the RP specifically. The current qualitative study was designed to explore the perspectives of PSP who had engaged in a Workplace RP due to experiencing a potentially psychologically injurious event or OSI.

METHODS

A qualitative thematic analysis analyzed interview data from 26 PSP who completed the RP. The researchers identified five themes: (1) the impact of stigma on service engagement; (2) the importance of short-term critical incident (STCI) program; (3) strengths of RP; (4) barriers and areas of improvement for the RP; and (5) support outside the RP.

DISCUSSION

Preliminary results were favorable, but further research is needed to address the effectiveness, efficacy, and utility of the RP.

CONCLUSION

By addressing workplace reintegration through innovation and research, future initiatives and RP iterations can provide the best possible service and support to PSP and their communities.

Return-to-Work Experiences in Ontario Policing: Injured But Not Broken

PURPOSE

Police officers and others working in police services are exposed to challenging and traumatic situations that can result in physical and/or psychological injuries requiring time off work. Safely returning to work post-injury is critical, yet little is known about current return-to-work (RTW) practices in police services. This study examines RTW practices and experiences in police services from the perspective of RTW personnel and workers with physical and/or psychological health conditions.

METHODS

We used a purposive sampling approach to recruit sworn and civilian members from several police services in Ontario, Canada. The recruited members had experienced RTW either as a person in a RTW support role or as a worker with a work-related injury/illness. We conducted and transcribed interviews for analysis and used qualitative research methods to identify themes in the data.

RESULTS

Five overarching themes emerged. Two pointed to the context and culture of police services and included matters related to RTW processes, injury/illness complexity, the hierarchical nature of police organizations, and a culture of stoicism and stigma. The remaining three themes pointed to the RTW processes of accommodation, communication and trust-building. They included issues related to recovery from injury/illness, meaningful accommodation, timely and clear communication, malingering and trust.

CONCLUSIONS

Our findings point to potential areas for improving RTW practices in police services: greater flexibility, more clarity, stricter confidentiality and reduced stigma. More research is needed on RTW practices for managing psychological injuries to help inform policy and practice.

Aiming at inclusive workplaces: A bibliometric and interpretive review at the crossroads of disability management and human resource management

Inclusive workplaces rely on the joint optimization of disability management and human resource management. However, disability management has been predominantly investigated as an independent issue, overlooking its interplay with human resource management. The article delivers a bibliometric and interpretive review of the scholarly debate falling at the crossroad of disability management and human resource management, mapping the state of the art of this study domain. Departing from a knowledge core of 91 papers, 6 research streams were identified through bibliographic coupling. They account for the evolution of disability management from a fix-it initiative aimed at fostering return to work of people with disability towards a holistic management approach targeted at inclusiveness. Aligning the hard and the soft sides of disability management and embedding it in the organizational culture are crucial to enact inclusive workplaces and make organizations able to engage people with disability at work.

A Standpoint Approach to Return-to-Work Coordination: Understanding Union Roles

Purpose This study examined how the participation of union representatives impacted return-to-work (RTW) processes, and explored key activities undertaken by union representatives involved in return-to-work coordination. Methods Forty-seven RTW coordinators (RTWCs) participated in in-depth, semi-structured interviews in 2018 as part of a cross-Canadian study investigating their strategies for managing challenges in the RTW process. The study included RTWCs from a variety of organisation types, including unionized organizations. Audio-recordings were transcribed, coded, and analysed using constant case comparison and deviant case analysis leading to the development of findings themes. Results Our findings highlight the role of union representatives in RTW processes and how their activities are seen by other parties involved with work accommodation. First, we describe Union RTWC's administrative functions and the extent of their involvement in RTW accommodation negotiations. Second, we examine how Union and Non-union RTWCs framed the same RTW processes differently, according to their own accountabilities. Finally, we identify the positive ways that union participation figured into the RTW process, including playing a role in identifying viable modified work and serving as a trusted party to help reluctant workers engage with RTW plans. Conclusions We introduce a standpoint perspective to shed light on how Union and Non-union RTWCs approached accommodation issues and consider acknowledgement of power relations as a starting point for managing divergent interests.

Strengthening supervisor support for employees with common mental health problems: developing a workplace intervention using intervention mapping

Background

This study presents the development of a workplace intervention to strengthen supervisor’s support for employees with common mental health problems (CMHP). CMHP have been increasing over the last years, resulting into negative work outcomes, such as absenteeism or reduced work performance. To date, organisational interventions have been promising in preventing these negative work outcomes, however it is yet unknown in what way the role of workplace stakeholders, in particular supervisors, can be strengthened. This study contributes to the literature of interventions on an organizational level which uses a preventative approach by promoting stay at work among employees with CMHP through supervisor support.

Methods

we applied the intervention mapping (IM) approach, by actively involving workplace stakeholders (employees with CMHP, supervisors and occupational health professionals) through the development process and the use of Integrated model of behaviour prediction for employers. All six steps of IM are followed and thematic analysis was used to analyse interviews and focus groups.

Results

Based on a comprehensive needs assessment, the intervention resulted in an online guideline, with five step-wise themes on how to support employees with CMHP to stay at work (SAW). The guideline addressed the most important and changeable actions using the Integrated model of behaviour prediction. The guideline presents how to signal and address problems in the workplace and find solutions by stimulating autonomy of employees, explore job accommodations and ask for occupational support. In addition, basic conditions on how to create mentally healthy workplaces were presented. Coaching sessions by occupational health professionals, that include practical strategies using the best available evidence, were identified by the stakeholders.

Conclusions

This SAW-Supervisor Guideline-intervention responds to the need of supervisors to be supported in their role, responsibility and ways to support employees with mental health issues, through a behaviour-oriented, preventative approach. Intervention mapping provided a systematic process to identify, structure and prioritize factors of supervisor support, resulting in a novel workplace intervention. The active involvement of workplace stakeholders throughout the process resulted into a well-received intervention. The theoretical framework provided practical ways to induce supportive behaviour of supervisors, bridging theory with practice.

Promoting Factors to Stay at Work Among Employees With Common Mental Health Problems: A Multiple-Stakeholder Concept Mapping Study

Most individuals affected by common mental health problems are employed and actually working. To promote stay at work by workplace interventions, it is crucial to understand the factors perceived by various workplace stakeholders, and its relative importance. This concept mapping study therefore explores perspectives of employees with common mental health problems (n = 18), supervisors (n = 17), and occupational health professionals (n = 14). Per stakeholder group, participants were interviewed to generate statements. Next, each participant sorted these statements on relatedness and importance. For each group, a concept map was created, using cluster analysis. Finally, focus group discussions were held to refine the maps. The three concept maps resulted in several clustered ideas that stakeholders had in common, grouped by thematic analysis into the following meta-clusters: (A) Employee’s experience of autonomy in work (employee’s responsibility, freedom to exert control, meaningful work), (B) Supervisor support (being proactive, connected, and involved), (C) Ways to match employee’s capacities to work (job accommodations), (D) Safe social climate in workplace (transparent organizational culture, collective responsibility in teams, collegial support), and (E) professional and organizational support, including collaboration with occupational health professionals. Promoting stay at work is a dynamic process that requires joined efforts by workplace stakeholders, in which more attention is needed to the interpersonal dynamics between employer and employee. Above all, a safe and trustful work environment, in which employee’s autonomy, capacities, and needs are addressed by the supervisor, forms a fundamental base to stay at work.

The Association Between Case Manager Interactions and Serious Mental Illness Following a Physical Workplace Injury or Illness: A Cross-Sectional Analysis of Workers' Compensation Claimants in Ontario

Poor mental health is a common occurrence among workers recovering from a work-related injury or illness. The objective of this cross-sectional study was to estimate the association between adverse interactions with workers' compensation case managers and experiencing a serious mental illness 18-months following a workplace injury or illness. A cohort of 996 workers' compensation claimants in Ontario Canada were interviewed 18 months following a disabling work-related injury or illness. Perceptions of informational and interpersonal justice in case manager interactions were defined as the primary independent variables, and Kessler Psychological Distress (K6) scores greater than 12, indicative of a serious mental illness, was defined as the outcome. Multivariate modified Poisson models estimated the association between perceptions of adverse case manager interactions and a serious mental illness, following adjustment for sociodemographic and work characteristics and pre-injury mental health. The prevalence of serious mental illness at 18 months was 16.6%. Low perceptions of informational justice, reported by 14.4% of respondents, were associated with a 2.58 times higher risk of serious mental illness (95% CI 1.30-5.10). Moderate and low perceptions of interpersonal justice, reported by 44.1% and 9.2% of respondents respectively, were associated with a 2.01 and 3.57 times higher risk of serious mental illness (95% CI moderate: 1.18-3.44, 95% CI poor: 1.81-7.06). This study provides further support for the impact of poor interactions with claims case managers on mental health, highlighting the importance of open and fair communication with workers' compensation claimants in ensuring timely recovery and return-to-work.

Workplace improvements to support safe and sustained return to work: Suggestions from a survey of workers with permanent impairments

BACKGROUND

Roughly 10% of occupational injuries result in permanent impairment. After initial return to work (RTW), many workers with permanent impairments face RTW interruption due to reinjury, unstable health, disability, and layoff. This study used open-ended survey data to: (1) explore workplace factors identified by workers as important levers for change, some of which may previously have been unrecognized; and (2) summarize workers' suggestions for workplace improvements to promote sustained RTW and prevent reinjury.

METHODS

This study included data from workers' compensation claims and telephone surveys of 582 Washington State workers who had RTW after a work-related injury involving permanent impairment. The survey was conducted in 2019, about a year after claim closure. We used qualitative content analysis methods to inductively code open-ended survey responses.

RESULTS

The most frequent themes were: safety precautions/safer workplace (18.1%), adequate staffing/appropriate task distribution (16.2%), and safety climate (14.1%). Other frequent themes included ergonomics, rest breaks, job strain, predictability and flexibility in work scheduling practices, employer response to injury, social support, communication, and respect. Many workers reported that they were not listened to, or that their input was not sought or valued. Workers often linked communication deficiencies to preventable deficiencies in safety practices, safety climate, and RTW practices, and also to lack of respect or distrust. In counterpoint, nearly one-third of respondents reported that no change was needed to their workplace.

CONCLUSIONS

Policies and interventions targeting worker-suggested workplace improvements may promote safe and sustained RTW, which is essential for worker health and economic stability.