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Furlan AD, Harbin S, Vieira FF, Irvin E, Severin CN, Nowrouzi-Kia B, Tiong M, Adisesh A. Primary Care Physicians' Learning Needs in Returning Ill or Injured Workers to Work. A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:591-619. [PMID: 35511378 DOI: 10.1007/s10926-022-10043-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
Primary care physicians are uniquely positioned to assist ill and injured workers to stay-at-work or to return-to-work. Purpose The purpose of this scoping review is to identify primary care physicians' learning needs in returning ill or injured workers to work and to identify gaps to guide future research. Methods We used established methodologies developed by Arksey and O'Malley, Cochrane and adapted by the Systematic Review Program at the Institute for Work & Health. We used Distiller SR©, an online systematic review software to screen for relevance and perform data extraction. We followed the PRISMA for Scoping Reviews checklist for reporting. Results We screened 2106 titles and abstracts, 375 full-text papers for relevance and included 44 studies for qualitative synthesis. The first learning need was related to administrative tasks. These included (1) appropriate record-keeping, (2) time management to review occupational information, (3) communication skills to provide clear, sufficient and relevant factual information, (4) coordination of services between different stakeholders, and (5) collaboration within teams and between different professions. The second learning need was related to attitudes and beliefs and included intrinsic biases, self-confidence, role clarity and culture of blaming the patient. The third learning need was related to specific knowledge and included work capacity assessments and needs for sick leave, environmental exposures, disclosure of information, prognosis of certain conditions and care to certain groups such as adolescents and pregnant workers. The fourth learning need was related to awareness of services and tools. Conclusions There are many opportunities to improve medical education for physicians in training or in continuing medical education to improve care for workers with an illness or injury that affect their work.
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Affiliation(s)
- Andrea D Furlan
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada.
- KITE, University Health Network, Toronto, ON, Canada.
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Shireen Harbin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Fabricio F Vieira
- Faculty of Medicine, State University of Maringa, Avenida Colombo, 5790, CEP 87020-900, Maringa, PR, Brazil
| | - Emma Irvin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Colette N Severin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Margaret Tiong
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Anil Adisesh
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Occupational Medicine, St Michael's Hospital, Toronto, ON, Canada
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Mattila-Holappa P, Kausto J, Aalto V, Kaila-Kangas L, Kivimäki M, Oksanen T, Ervasti J. Alternative duty work as workplace-initiated procedure to reduce sickness absence. BMC Public Health 2021; 21:1154. [PMID: 34134668 PMCID: PMC8207644 DOI: 10.1186/s12889-021-11181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/02/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose Alternative duty work is a procedure that enables an employee with a short-term disability to perform modified duties as an alternative to sickness absence. We examined whether the implementation of an alternative duty policy was associated with reduced sickness absence in the Finnish public sector. Methods Two city administrations (A and D) that implemented an alternative duty work policy to their employees (n = 5341 and n = 7538) served as our intervention cities, and two city administrations (B and C) that did not implement the policy represented the reference cities (n = 6976 and n = 6720). The outcomes were the number of annual days, all episodes, and short-term (< 10 days) episodes during the 2 years before versus the 2 years after the intervention year. We applied repeated measures negative binomial regression analyses, using the generalized estimating equations method and the difference-in-difference analysis to compare the intervention and control cities (adjusted for sex, age, type of job contract, occupational class). Results During the five-year study period, the number of sickness absence days and episodes increased in both the intervention and control cities. Covariate-adjusted analysis of relative risk showed that the overall increase in post- versus pre-intervention sickness absence days was smaller in intervention City A, RR = 1.14 (95% CI = 1.09–1.21) than in control cities B and C, RR = 1.19 (95% CI =1.14–1.24), group × time interaction p < 0.02. In intervention City D, we found a corresponding result regarding all sickness absence episodes and short-term sickness absence episodes but not days. Conclusions This follow-up suggests that implementing an alternative duty work policy may marginally decrease employees’ sickness absences. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11181-1.
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Affiliation(s)
| | - Johanna Kausto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ville Aalto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Tuula Oksanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
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Durand MJ, Coutu MF, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Kirouac L, Paquette MA, Nastasia I, Coté D. Insights into the Sustainable Return to Work of Aging Workers with a Work Disability: An Interpretative Description Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:92-106. [PMID: 32347441 DOI: 10.1007/s10926-020-09894-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose A sustainable return to work (S-RTW) following prolonged work disability poses particular challenges as workers age. This article provides a synthesis of the factors and issues involved in a S-RTW process for aging workers following such a disability. Methods Using interpretive description methods, a critical review was conducted of the literature specifying return-to-work factors and issues for aging workers with regard to four major causes of work disability (musculoskeletal disorders, common mental disorders, cancer or other chronic diseases). The initial review concerned the 2000-2016 literature, and was subsequently updated for November 2016-December 2018. To further explore and contextualise the results of this literature review, four focus groups were held with stakeholders, representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. Results Fifty-five articles were reviewed and 35 stakeholders participated in the focus groups. Returning to work and staying at work appear to be particularly challenging for aging workers, who face notable issues and stigma concerning their ability to meet work demands, as well as their mobilisation and engagement in these processes. Such findings echo in many ways the main assertions of the literature on aging at work, except those regarding the transformation of capacities with aging, which is not mentioned in relation to workers with a work disability. The influence of healthcare and compensation systems on the S-RTW of aging work-disabled workers has also received little attention to date. Conclusions The results underscore that aging workers with a disability are frequently vulnerable in terms of their health or their jobs. Intersectoral efforts are needed to remedy this situation to keep them at work.
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Affiliation(s)
- Marie-José Durand
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-France Coutu
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Dominique Tremblay
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Laurie Kirouac
- Department of Industrial Relations, Université Laval, 1025 avenue des Sciences-Humaines, Québec, QC, G1V 0A6, Canada
| | - Marie-Andrée Paquette
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
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Gray SE, Brijnath B, Mazza D, Collie A. Australian General Practitioners' and Compensable Patients: Factors Affecting Claim Management and Return to Work. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:672-678. [PMID: 30715662 DOI: 10.1007/s10926-019-09828-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose General Practitioners (GPs) play an important role in personal injury compensation systems yet system processes have been perceived as burdensome. Objectives were to (1) determine attitudes of Australian GPs on health benefits of return to work (RTW) after injury/illness and (2) identify associations between GP characteristics and agreement with issues surrounding treating compensable patients. Methods Cross-sectional postal survey of 423 Australian GPs to determine agreement with issues associated with compensable patients (including patient advocacy, conflicting opinions between GPs and compensation systems, fitness-for-work certification, and refusal to treat). Results The vast majority of GPs agreed there was a health benefit to early RTW. GPs with 16-20 years' experience had significantly higher odds of agreeing that the certificate of work capacity is the primary method of communication between RTW stakeholders (OR 2.36 [1.13-4.92]) than those with greater experience. 49% of GPs agreed they should be able to refuse to treat compensable patients. Female GPs had significantly lower odds (OR 0.60 [0.40-0.90]) of agreeing with right to refuse than male GPs, as did those from remote or regional practices (OR 0.43 [0.20-0.94]; OR 0.60 [0.39-0.92]) than GPs from urban practices. Conclusions Reducing administrative barriers identified by Australian GPs and improving communication with compensation systems will likely have a positive impact on their refusal to treat compensable patients.
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Affiliation(s)
- Shannon E Gray
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, 3004, Australia.
| | - Bianca Brijnath
- Department of General Practice, Monash University, 1/270 Ferntree Gully Rd, Notting Hill, 3168, Australia
- National Ageing Research Institute, 34-48 Poplar Rd, Parkville, 3052, Australia
- School of Occupational Therapy and Social Work, Curtin University, Building 108 Brand Dr, Bentley, 6102, Australia
| | - Danielle Mazza
- Department of General Practice, Monash University, 1/270 Ferntree Gully Rd, Notting Hill, 3168, Australia
| | - Alex Collie
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, 3004, Australia
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Papagoras H, Pizzari T, Coburn P, Sleigh K, Briggs AM. Supporting return to work through appropriate certification: a systematic approach for Australian primary care. AUST HEALTH REV 2019; 42:164-167. [PMID: 28263703 DOI: 10.1071/ah16247] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/12/2017] [Indexed: 11/23/2022]
Abstract
Primary care practitioners play a critical role in supporting return to work (RTW) and minimising the detrimental physical and psychosocial sequelae of unnecessary and prolonged work absence in injured and ill workers. Accurate and consistent certification of capacity is an essential component of this role that has been scrutinised recently given the identified variation in certification practices between and within professions. This Perspective outlines the importance of correct certification of capacity for injured workers and provides a RTW flowchart to support systematised and appropriate certification. The flowchart is aimed at primary care practitioners (e.g. general practitioners or physiotherapists). The flowchart was developed at the Transport Accident Commission and WorkSafe Victoria as a guide for Australian primary care practitioners when certifying capacity. A more systematised approach to certification coupled with professional education and support may reduce variations and inaccuracies in certification, improve RTW rates and reduce the increasing burden of disease related to workplace injuries.
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Affiliation(s)
- Harry Papagoras
- Health Strategy Group, WorkSafe Victoria, 222 Exhibition Street, Melbourne, Vic. 3000, Australia.
| | - Tania Pizzari
- Health Strategy Group, WorkSafe Victoria, 222 Exhibition Street, Melbourne, Vic. 3000, Australia.
| | - Paul Coburn
- Health Strategy Group, WorkSafe Victoria, 222 Exhibition Street, Melbourne, Vic. 3000, Australia.
| | - Kevin Sleigh
- Health Strategy Group, WorkSafe Victoria, 222 Exhibition Street, Melbourne, Vic. 3000, Australia.
| | - Andrew M Briggs
- Health Strategy Group, WorkSafe Victoria, 222 Exhibition Street, Melbourne, Vic. 3000, Australia.
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Hudon A, Lippel K, MacEachen E. Mapping first-line health care providers' roles, practices, and impacts on care for workers with compensable musculoskeletal disorders in four jurisdictions: A critical interpretive synthesis. Am J Ind Med 2019; 62:545-558. [PMID: 31074020 DOI: 10.1002/ajim.22972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND First-line health care providers are the primary access point for workers' benefits. However, little is known about their impact on quality of care and return-to-work. Our objective was to critically compare literature on the practices of first-line providers for workers with musculoskeletal injuries in Ontario and Quebec (Canada), Washington State (United States), and Victoria (Australia). METHODS A critical interpretive synthesis of peer-reviewed scientific literature was conducted. The search across six databases yielded 59 relevant publications that were critically appraised. RESULTS Three themes emerged: 1) how policies about first-line health care providers' modulate worker access to care, 2) how these providers' roles, practices, and training shape disability management, and 3) how the quality of care and disability outcomes are evaluated. CONCLUSIONS First-line health care providers have a critical influence on workers' trajectories of care. A focus on their role while taking the complexity of the context into account will help orient future policy changes.
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Affiliation(s)
- Anne Hudon
- Faculty of Applied Health SciencesSchool of Public Health and Health Systems, University of WaterlooOntario Canada
- Faculty of LawCivil Law Section, University of OttawaOntario Canada
| | - Katherine Lippel
- Faculty of LawCivil Law Section, University of OttawaOntario Canada
| | - Ellen MacEachen
- Faculty of Applied Health SciencesSchool of Public Health and Health Systems, University of WaterlooOntario Canada
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