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A controlled case study of supervisor training to optimise response to injury in the food processing industry

At a glance:
A skills training sessions for supervisors in a meat packing plant significantly reduced new injuries and disability
disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 in the following months.

Supervisors were taught how to communicate with workers about workplace injury and safety and to modify work duties to accommodate injury.
Perspectives:
Employee
This study looked at the effect supervisor training had on reducing workplace injuries and getting people back to work.

Supervisors had two 2-hour sessions of training that included understanding back pain and treatment, communicating better with workers and learning to solve problems. This in turn helped supervisors to better understand injured workers and their pain, assist workers in getting back to work and adjust work practices to prevent injuries.

Encouraging your workplace to provide simple training for supervisors will help prevent injuries and improve the workplace.
Employer
Employers, supervisors and return to work coordinators need to understand workplace injuries and their effects. Communication, listening and problem solving skills are important in creating an atmosphere in the workplace where open discussion about return to work issues can occur. Supervisors can then plan and set goals with injured workers for returning to work.

The employer has a significant role in assisting an injured worker to formulate realistic goals considering the injury, the workplace and the type of worked performed.

In this study a simple but effective set of skills gained by supervisors in two 2-hour sessions greatly improved return to work rates and lessened new claims in the meat packing industry.

The structure and content of the workshops is outlined below. The basic themes are:

  • Communicating with workers about pain and injury:
  • Understanding the nature of 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.
     pain and discomfort:
  • Problem Solving using ergonomic
    ergonomic
    Designing activities and the workplace in a way to minimize discomfort. i.e. Adapting work tasks, hours, or workstation to accommodate people. An ergonomic computer workstation allows the person to work in the best position to relieve load on the muscles of the neck and arms.
     principles (i.e. adaptation of the workplace and work tasks to accommodate an injury)
  • Maintaining communication
Treater
The study suggests that the supervisor's response to workplace injury is important in determining the success or failure of workers recovery. It shows the importance of supplying workplace supervisors with basic skills for understanding injury and helping workers return to work.

Important elements of the training were communication and problem solving skills. The workshops also provided supervisors with an understanding of musculoskeletal injury, its course of recovery and the pain and discomfort suffered.

If you sense there are difficulties with returning to work because workplace support is lacking, it may be worth recommending the workplace invests in staff training in return to work management.
Insurer
One of the most important factors in return to work success is the attitude of supervisors in the workplace. Supervisors play an important part in reducing new claims and assisting people back to work.

Two 2-hour workshops giving supervisors an understanding of sprains
sprain
Injury to ligaments caused by overstretching or overuse. The ligament is usually stretched but may be torn.
 and strains
strain
Injury to a muscle in which the muscle fibres tear or become irritated as a result of overstretching or wrenching
 and communication and problem solving skills reduced new claims and costs from new injuries in a meat packing company with over 400 employees.
Original Article, Authors & Publication Details:
W. S. Shaw1,2 M. M. Robertson1, R. K. McLellan3, S. Verma1and G. Pransky1,2(2006).

A controlled case study of supervisor training to optimize response to injury in the food processing industry. Work; 26(2):107-14.

1Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA 01748, USA
2University of Massachusetts Medical School, Department of Family Medicine and Community Health, 55 Lake Avenue North, Worcester, MA 01655, USA

3Dartmouth Hitchcock Medical Center and Dartmouth Medical School, One Medical Center Drive, Lebanon, NH 03756, USA
Background, Study Objectives, How It Was Done:
In the 1980s, an early study of return to work after injury noted that workplace factors, including the supervisors input and worker satisfaction, influenced return to work. The present study conducted a more formal analysis of the impact of supervisor training, to see whether improving knowledge and skills changed outcomes for injured workers.

The study divided 23 supervisors and their employees from a food processing plants production department (meat cutting and packing) into two groups. Each group included about 400 employees, and 11 or 12 supervisors. Both groups of supervisors participated in a four-hour training workshop that emphasised communication skills and ergonomic accommodation (adaption of the workplace and/or work duties and hours) for workers reporting injuries or health concerns.

The second group of supervisors (Group 2) participated in the workshop seven months after the first group (Group 1). This allowed the authors of the study to

  • assess the injury and disability rates in periods before and after the training took place for each group
  • compare the new cases or claims between the two groups in a 7 month period in which Group 1 supervisors had completed the training and Group 2 had not.
The authors of the study then looked at the outcomes for Group 1 and Group 2 from the insurance claims data. They defined three periods to assess the results of the training:

  • Period 1 = The 7 month period before training of Group 1
  • Period 2= Only Group 1 has completed the supervisor training. This period is the 7 months after Group 1 has completed the training and before Group 2 does the training.
  • Period 3 (starts at 14 months) = Group 2 has also completed the supervisor training. This period is the 7 months after Group 2 has completed their training.

The authors of the study expected that there may be some transfer of information from Group 1 to Group 2 in Period 2, as both groups worked in the same plant, had meetings together, ate lunch together, etc.

The workshops taught supervisors that supportive, proactive, and collaborative communication with employees about uncomfortable postures, activities or workspace layout that could cause musculoskeletal pain would reduce disability costs and improve employee morale, productivity, and length of employment.

Areas included were:

Communicating with workers about pain and injury:

This section highlighted the importance of early reporting and response to injury. Supervisors set up a private and confidential meeting with an employee, using active listening skills, expressing support and willingness to help, and including a specific plan for following up the initial contact.

Understanding the nature of musculoskeletal pain and discomfort:

This section tried to provide an understanding of the issues in management of musculoskeletal pain. Supervisors were informed that the course of recovery from musculoskeletal conditions can be variable, in many cases precise medical diagnosis
diagnosis
The process of identifying a medical condition or disease by its symptoms, the findings from a medical examination, and from the results of various diagnostic procedures.
 is not possible, and those suffering from persistent or recurring pain can become frustrated. Information about the broad range of treatments available and provider types was also provided.

Problem Solving using ergonomic principles

Supervisors were taught to solve problems in steps by:
  1. identifying the problem
  2. analysing the problem
  3. generating potential solutions
  4. selecting the best solution and planning
  5. implementing the solution
  6. evaluating the success of the solution

Maintaining communication

Supervisors were taught that holding an initial return to work meeting between the supervisor, employee and others to clarify any activity restrictions or modifications, address any concerns from the worker, and plan follow up discussions about the return to work arrangements is important for workplace re-integration.

Case simulations in small groups were used to discuss and provide suggestions for preventing workplace disability.
Study Findings:
Reduction in number of claims:

Period 2: The employees of supervisors in Group 1 showed a 47% reduction in the number of new workers compensation claims filed in the 7 month period after the supervisor training workshops, while the employees of Group 2 supervisors only had a 19% reduction in new claims.

Period 3: After Group 2 supervisors were trained new claims were reduced by a further 19%, making a total reduction of 38% compared with the period before the study began.

In both groups, the number of existing claims (those made before the study) stayed much the same during the study.

Types of claims:

Of the injury claims, more than half were work-related, soft-tissue disorders, including sprains, strains, inflammations, carpal tunnel syndrome.
Carpal Tunnel Syndrome
A condition characterized by pain and numbness in the hand and sometimes the forearm. It is caused by pressure on the nerve which connects the arm to the hand (through the carpal tunnel) and gives sensation to the hand, thumb and three fingers
 and other repetitive injury cases. There were no significant differences in injury type between the groups following the training workshops.

Reduction in disability costs:

Group 1: Costs for disability and time off work for new claims dropped in Group 1 by 25% in the 7 months after they were trained. Costs for this group dropped even further (by 76%) in period 3, after Group 2 had also been trained. Costs from new claims were reduced more in Group 1 than in Group 2.

Group 2: Showed no reduction in costs from new claims between periods 1 and 2 as expected but did have a substantial (36%) reduction in injury costs between periods 2 and 3 (the 7 months after they had received the training).
Conclusions:
Workplace organisation and support networks are known to influence success rates for return to work activities following time off work from injury. However there has been little research into methods for encouraging supervisor support and participation in these activities.

Although workers expect their supervisors to provide personal support and help adjust the workplace in the event of injury, many workers experience mixed responses from supervisors to musculoskeletal pain and discomfort.

Sprains and strains make up a large proportion of workplace injures, but because these problems have uncertain causes, variable symptoms and treatment, and may be short or long term problems supervisors can find it difficult to respond to them.

Earlier studies showed that how a supervisor responds to work injury influences whether an injured worker has a rapid return to work or prolonged disability. Supervisor and co-worker support can reduce the likelihood of disability while lack of supervisor support can be a risk factor for workers developing low back pain. In some cases, the impact of the supervisor's response on disability was more important than either the severity of the injury, or the quality of medical care. Because workers list supervisor responsiveness as an important issue in return to work, this study set out to find out how effective a supervisor training workshop could be in improving supervisor responsiveness and reducing disability.

The supervisor-training program provided education and training for both management and supervisors at a meat packing plant to help them respond better to workers injuries. The program included suggestions for communication with employees and problem solving skills to help get injured employees back to work.

When supervisors were trained to properly respond, communicate and problem solve with employees new disability claims were reduced by 47% and active lost-time claims by 18%.

The message in brief:
  • The study results make a strong case for supervisor training contributing to lower injury rates.
  • This study shows a substantial reduction in injury claim frequency after training of supervisors.
  • Improving communication between supervisors and workers is an effective prevention strategy in workplaces with high physical work demands (in this case meat cutting and packing).
References:
PubMed Abstract
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