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Workplace Factors
Co-operation between a union and management resulting in a successful early intervention model

At a glance:
This study tested a program that aimed to reduce the time lost from work 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.
 injuries in hospital employees. The program was run by a committee that included hospital managers and union representatives of the workers. The program encouraged early action after an injury and offered medical treatment and workplace changes.

While the program was running:

         Work time lost from musculoskeletal injuries was reduced by 46-67% in medical science professionals. Compensation payments were reduced by 48-73%.
         Among nurses, work time lost from musculoskeletal injuries and money paid in compensation were both reduced by 27-44%
Perspectives:
Employee
A simple positive early 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.
 approach to return to work helped people achieve early successful return to work.  This was a partnership approach between the union representatives and management.  Partnership between unions and management has been a strong feature of the Canadian system.  Key features in this model were good medical care, regular communication, and early return to work.  
Employer
This study demonstrated improved return to work results through an early approach of supporting people back to work.  The underlying feature of this model was a partnership between the union and management.  This approach has been shown to improve outcomes in other studies.  Simple measures such as communication, a coordinated team, and a company-wide system helped streamline this cost effective system. 
Treater
Return to work outcomes are improved when the workplace takes a proactive approach to managing return to work.  Treating doctors can encourage workplaces to develop effective systems by providing constructive feedback, communicating appropriately, and supporting return to work.
Insurer
Demonstrating the effectiveness and cost effectiveness of return to work programs motivates employers to develop effective company-wide systems for return to work.  Communication with senior management provides the company leaders with information about what they can do to improve the company's well being, company strategies, and return to work outcomes.  In turn this improves the company's bottom line productivity and profitability.
Original Article, Authors & Publication Details:
Davis PM*, Badii M*, Yassi A*.

Preventing disability
disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 from occupational musculoskeletal injuries in an urban, acute
acute
A condition develops quickly and is often of short duration. The opposite of acute is chronic, which refers to a long term problem continuing for months to years.
 and tertiary care hospital: results from a prevention and early active return-to-work safely program.
Journal of Occupational & Environmental Medicine 2004;46(12):1253-62.

*Occupational Health and Safety Agency for Healthcare, Vancouver, British Columbia, Canada.
Background, Study Objectives, How It Was Done:
Healthcare workers are at high risk for musculoskeletal injuries. This study tested a program that aimed to

         Prevent injuries, and 
         Reduce the time lost from work when an injury occurred

The program was designed by the Occupational Health and Safety Agency for Healthcare in Canada and trialled in a large hospital. The program involved early intervention, medical treatment, workplace changes and evaluation. Workplace changes included changes to the layout of the workplace and the hours worked, equipment used, tasks performed and training. The program was run cooperatively by the managers of the hospital and the union representatives.  The researchers believed the cooperative approach would improve the results.

The researchers

1.       Measured the amount of time employees lost from work due to musculoskeletal injuries in the year after the program
2.       Compared the time lost in the year after the program to time lost in the three years before the program was put in place 
3.       Measured the number of injuries and amount of compensation paid to workers
4.       Compared the number of injuries and compensation to statistics for a similar hospital that did not run the program 
5.       Divided the hospital staff into three groups: registered nurses, medical science professionals (radiographers, physiotherapists, pharmacists etc) and support staff (administration employees, cleaners, tradespeople etc) and studied each group separately
Study Findings:
The study found that nurses and health science professionals with injuries stayed off work for less time once the program had been introduced. At the hospital where the program was not being trialled the amount of time lost from work due to injuries did not decrease.

During the program, 362 registered nurses and 93 health science professionals suffered musculoskeletal injuries at work that made them eligible to participate in the program.

For registered nurses:

         57% of registered nurses with injuries that caused them to lose time from work chose to take part in the program.
         The total time lost from work due to injuries decreased by between 27 and 44% under the program.
         The total amount of compensation paid decreased by 27-44%, a saving of between $150,000 - $300,000 (Canadian dollars).

For health science professionals:

         59% of health science professionals with lost time injuries chose to take part in the program.
         The total time lost from work due to injuries was decreased by 37-67% under the program.
         The total amount of compensation paid decreased 48-73%, a saving of between $42,920-$218,180.
Conclusions:
The program successfully reduced the hours lost from work by hospital employees due to musculoskeletal injuries. It achieved this by:

         Acting quickly in response to injuries 
         Setting up work-based interventions, including medical treatment for injured employees and changes to their working environment
         Basing their changes on scientific evidence and evaluating how well the program was working

The cooperation between the workers' unions and the managers of the hospitals improved the results by including the feedback of workers and improving the relationship between the workers and the employees.
References:
PubMed Abstract
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