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Employee perspectives on the role of supervisors in preventing work disability

At a glance:
How can supervisors help workers recover and return to work after injury?

  • There is no substitute for the involvement of immediate supervisors in the return to work planning process.
  • Supervisors should maintain contact with absent workers even when it is unlikely they will return to work early.
  • Involving workers and their workmates in a cooperative approach to planning workplace adjustments is more effective than standard approaches and health professional involvement.
Perspectives:
Employee
The study found that an employee will return to work earlier if their supervisor understands their pain, shows concern and is able to work with them to adjust the workplace to accommodate their injury.

Even simple things such as a get well card and a phone call when away from work improves communication. Making sure that your supervisor can contact you, and maintaining your contact with the workplace will help your recovery and assist an early return to work. Tell your supervisor about your pain, if your movement is restricted and if any modifications to the job are required for you to return to work. This will help your supervisor to understand your situation and accommodate you.
Employer
Return to work coordinators and health professionals are no substitute for an injured workers direct supervisors involvement in their return to work.

The supervisor's response to workplace injuries influences the quality and speed of the workers recovery and may be the single most important influence in whether they return to work.

This study provides evidence that workers believe their supervisors actions show how the company values them. If supervisors are negative or unsympathetic to an injured worker then employees feel that the company does not value them. A simple gesture like sending a get well card or making a phone call can communicate concern and improve return to work rates.

This study strongly suggests that communication, listening and empathy skills must be included when training supervisors in injury management and return to work. The most important thing you can do to reduce absences due to work injury is to train supervisors in communications skills.
Treater
The supervisor's response to a workplace injury is an important contributor to patient recovery and the success or failure of return to work. This study strongly suggests that the most important elements of disability
disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 management and return to work training for supervisors are communication, listening and empathy skills.

Encouraging workplaces to invest in supervisor training that includes communication skills will improve injured patients' health.
Insurer
Return to work coordinators, human resources departments and health professionals are not a substitute for direct supervisor involvement in return to work.

A supervisor's response to a workplace injury influences the quality and speed of the injured worker's recovery and may be the single most important contributor to success or failure in return to work.

This study strongly suggests that communication, listening and empathy skills should be included in training supervisors regarding work disability management and return to work.
Original Article, Authors & Publication Details:
W. S. Shaw1,2, M. M. Robertson1, G. Pransky1,2and R. K. McLellan3 (2003).

Employee perspectives on the role of supervisors to prevent workplace disability after injuries. Journal of Occupational Rehabilitation;13(3):129-142

1Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts.

2Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts.

3Center for Occupational and Environmental Health, Exeter Hospital, Exeter, New Hampshire.
Background, Study Objectives, How It Was Done:
Interviews were held with 30 employees from four industries with relatively high physical work demands and high injury rates. The companies were located in the North-eastern United States and varied in size, health and safety practices and level of risk of injury. Participating firms included a synthetic fabrics manufacturer, a food processing and packaging plant, a network of residential nursing centres, and a discount clothing retailer. Most interviewees had jobs with moderate to high physical workloads.

Interviews were conducted to identify aspects of supervisor involvement that might help or hinder workers efforts to recover and resume their normal work after injuries.

Of the 30 employees interviewed, 12 had an existing work-related health problem and 13 reported experiencing with a work-related health problem in the past. No employees declined the interview.
Study Findings:
This study assessed how employers respond to work injuries from the workers point of view and found that:

  1. There is no substitute for the involvement of immediate supervisors in the return to work planning process.
  2. Supervisors should maintain contact with absent workers even if they do not return to work early.
  3. Involving co-workers in a cooperative approach to adjusting the workplace to accommodate injury is more effective than standard approaches and doctors advice.
Supervisor training programs to prevent injury-related disability should focus on communication. Supportive communication from supervisors that acknowledges the employees pain, expresses concern, asks for the employees input, and responds to the employees concerns is likely to improve return to work outcomes for work-related injuries and illnesses.

Even the best return-to-work programs may be seen negatively by employees if accompanied by supervisor mistrust or miscommunication.

Some specific training was suggested:

  1. problem solving skills training
  2. active listening skills
  3. ergonomic training to help them suggest initial work modifications
  4. methods for monitoring and adjusting workplace modifications after return to work.
Supportive communication from supervisors that shows concern, involves employees in solutions and understands pain will improve outcomes.

Eleven major themes were extracted from the interviews.

Of the 11 themes, seven describe elements of communication or emotional support (e.g., validation, shared decision-making), but only four described specific actions that are forms of support (e.g., accommodation, coordinating with medical providers).


Supervisor Role After Injuries.

Common Themes Extracted From Interviews With Employees
Accommodation of restrictions (23%)

The Supervisor:

  • assigned me to a light duty that was boring and repetitive.
  • provided light duty or modified work.
  • adhered to restrictions.
  • created a temporary position for me.
  • coordinated with other departments for job rotation.
Communication (12%)

The Supervisor:

  • was approachable.
  • had an open door policy.
  • gave me a chance to talk about it.
  • listened to me.
  • communicated with me.
Responsiveness (12%)

The Supervisor:

  • responded quickly.
  • didn't ignore my complaints.
  • sent me to see a doctor/nurse.
  • went with me to the clinic.
  • was involved.
Concern for employee welfare (12%)

The Supervisor:

  • encourages early reporting of injuries.
  • leads group in morning exercises.
  • allows employees to speak out about 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.
     concerns.
  • puts production demands above safety concerns.
  • has no knowledge of ergonomic risks.
Empathy/Support (9%)

The Supervisor:

  • expressed concern.
  • was supportive.
  • had a positive attitude.
  • looked forward to seeing me back.
  • was sympathetic.
Validation (9%)

The Supervisor:

  • believed my problem was real.
  • knew it was difficult to be on restricted duty.
  • understood my concerns.
  • recognised the physical demands of my job.
  • knew I would take some time to heal.
Fairness/respect (8%)

The Supervisor:

  • didn't pressure me.
  • didn't make me feel like a burden.
  • told me my job wasn't in jeopardy.
  • was fair.
  • took me seriously.
Follow-up (5%)

The Supervisor:

  • called me at home to keep in touch.
  • checked in with me daily.
  • followed up to avoid miscommunication.
  • made sure paperwork was complete.
  • asked if I was improving
Shared decision-making (4%)

The Supervisor:

  • was willing to work with me.
  • gave me control over what I could do.
  • talked to me about the type of tasks I could do.
  • helped me decide which actions were best.
  • helped me feel my way back to work.
Coordinating with doctors (4%)

The Supervisor:

  • provided checklist to my doctor for modified duty.
  • called my doctor to offer suggestions.
  • helped me get a doctors appointment.
  • called my doctor to clarify job restrictions.
  • sent me to the nurse but didn't follow up.
Obtaining co-worker support (2%)

The Supervisor:

  • helped others understand my light duty job.
  • neutralised co-worker complaints.
  • helped get co-worker support.
  • got suggestions from co-workers about things I could do.
  • made sure that co-workers were helpful.
 
Conclusions:
Accommodating medical restrictions with appropriate work tasks was identified as a way that supervisors can help employees return to work after injury most often by workers. Supervisors' ability to provide modified duties may be limited by engineering constraints, production demands, time limitations or organisational policies. However supervisor training in return to work management should not only recommend improved communication and accommodation of injuries, but also suggest ways to overcome organisational barriers.

Workers who had experienced the recent onset of a disabling condition listed “responsiveness of the supervisor' as a major determinant in their decision to return to work. The supervisor plays a key role in encouraging co-worker support for injured workers.

Supervisors may view workers returning from an injury or illness in a negative way because they are not as productive and need special attention and support. There is some evidence that longer work absences can occur if there is conflict between supervisors and employees concerning job performance, or workplace organisation.

Lack of contact by employers while away from work leads people to feel they are forgotten and not wanted.  However, good levels of support reduce the level of injury and increase the likelihood of return to work after injury.

Evidence from this study shows that a person-oriented leadership style, which focuses on human relations, is better for managing workplace disability. Just attending health and safety training is not enough to assist supervisors to make a difference. Communication and listening skills are needed.

These aspects of management may not come easily to all managers, so the study recommends training of staff in this area.
References:
PubMed Abstract
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