RTW Knowledge Base
RTW Knowledge Base
Home Employee Employer Treater Insurer View All Types About Champions Contact
Approaches and Interventions
Workplace based early intervention programs get people back to work sooner

At a glance:
A systematic program for managing sickness absence can help people get back to work sooner. Successful programs need to focus on early intervention, improving communication, and providing modified duties. The program needs to be correctly implemented, not just well designed.
Perspectives:
Employee
Your return to work is likely to be more successful if you participate actively in the process. This can be hard to manage when you're in pain, and if communication at work is not good. Think about what you can do to contribute positively to the situation – it's best not to leave your return to work in someone else's hands.

To achieve a good return to work outcome it is important that modified duties are available, communication in the workplace is clear, and rehabilitation
rehabilitation
The process of helping a person back to their former abilities and quality of life (or as close as possible) after injury or a medical condition.
 is focused on getting you back to your normal activities.

If you haven't been off work for very long, these issues might not sound terribly important. You might not be worried, for example, whether it takes one week or two to return. The research shows, however, that the longer people are away from work, the less likely they are to return. Getting back to work needs to happen early, preferably within a few weeks.
Employer
Having a well designed program for managing sickness absence is important, and so is making sure that it's implemented correctly. Programs don't always run smoothly, and they require support and the attention of management. Reviews, monitoring and follow up are usually required.

An active return to work program can reduce sickness absence, especially if it provides an early intervention.

To manage good return to work outcomes it is important that modified duties are available, communication in the workplace is clear, and rehabilitation is focused on getting the employee back to normal activities.

The research shows, however, that the longer people are away from work, the less likely they are to return. Getting back to work needs to happen early, preferably within a few weeks.

Return to work is likely to be more successful if the employee actively participates in the process. This can be hard to manage when they are in pain and if communication is not good. Think about what you can do to contribute positively to the situation.
Treater
Encourage employers to set up programs that coordinate and manage return to work. This can reduce sickness absence. Be aware that successful programs require significant investment from employers – they need detailed planning and careful monitoring to make sure they are implemented correctly.
Insurer
Improved return to work outcomes can be achieved by workplace based interventions. These can coordinate the efforts of different players such as treatment professionals, employees, and managers. Such interventions can also simplify the provision of modified duties by making it clear who is responsible for arranging them, and how this can be done.

Systems don't work well unless they are supported and carefully monitored. It can be helpful to encourage companies to check regularly on how well their return to work program is operating.
Original Article, Authors & Publication Details:
Serena McCluskey1, A. Kim Burton2 and Chris J. Main3 (2006)

The implementation of occupational health guidelines principles for reducing sickness absence due to musculoskeletal
musculoskeletal
Involving the muscles and the skeleton. This term includes the limbs, neck, shoulders and back. 'Musculoskeletal problem' refers to many different conditions that can affect the tendons, muscles and related structures.
 disorders.
Occupational Medicine;56(4):237-42.

1Centre for Public Health Research, University of Salford, Allerton Building, Frederick Road Campus, Salford M6 6PU, UK.
2Centre for Health and Social Care Research, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK.
3Calderbank Research Unit, Keele University, 67 Palatine Road, Manchester M20 3JQ, UK.
Background, Study Objectives, How It Was Done:
Most people with musculoskeletal conditions remain at work or return within weeks. A small number of people have difficulty returning and might remain away for some time.

Medical care often focuses on the physical condition, and don't always address non-physical factors that cause long term absence from work. These include anxiety about pain and what it means, distress,
distress
Severe suffering, pain, anxiety or sorrow
  depression,
depression
A symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection. Major depression is likely to interfere significantly with everyday activity, with symptoms including insomnia, irritability, weight loss, and a lack of interest in outside events. The disorder may last several months or longer and may recur, but it is generally reversible in the short run.
 and poor coping skills.

Other factors over which medical care has little influence include job dissatisfaction and a lack of support in the workplace.

This study investigated whether managing some of these factors could improve return to work outcomes.

Five manufacturing sites belonging to a large pharmaceutical company in the UK were chosen for the study. The intervention
intervention
A treatment or management program. Interventions often combine several approaches. In this field approaches include training in problem solving, adaptation of work duties, graded activity, an exercise and stretching program and pain relief.
 was implemented at two sites, and the other three served as controls.

Some elements of the intervention are detailed below

1. Occupational health nurses were employed as case managers
2. Sickness absentees with work-related conditions were invited to the occupational health department to discuss their condition.
3. Occupational health nurses received four weeks training in case management. This included education about pain, negative beliefs and attitudes, evidence based practise, and how to offer advice on keeping active.
4. Occupational health nurses were provided with a manual and checklists to help them delivery their service.
5. Modified work duties were provided for up to two weeks. If problems persisted for longer, a general practitioner was consulted.
6. Occupational health nurses made contact with treating general practitioners, informing them of the program and allowing communication with workplace supervisors.

During the study approximately 300 employees were absent from work due to musculoskeletal problems. 81 were contacted, and 54 received the intervention. The remainder either declined or were deemed ineligible.

The program was only implemented successfully at one of the sites, from which almost all participants were drawn. The intervention protocol was not followed correctly at the other site, and most workers who should have been contacted were not.
Study Findings:
On average, return to work took 4.5 days less for people who were involved in the intervention. This result was statistically significant.
Conclusions:
Injured employees get back to work more quickly when they are included in a return to work program that provides early intervention, modified duties, and improved communication.

At the worksite where this program was introduced successfully, sickness absence was reduced. At the worksite where protocol was not followed, levels of sickness absence were similar to the control sites. This suggests that the correct implementation of a program is as important as its design.
References:
PubMed Abstract
Total Votes for this Article: 13 Average Rating: 2.8
Poor                               Excellent