Back Injuries & RTW
Work Safe Week 2013 For the respect of others please ensure your mobile phone is switched off or on silent. In the event of an emergency a Convention Centre team member will direct us to the nearest Evacuation Assembly Area which is under the freeway next to the South Wharf car park, or the grassed area in front of Melbourne Exhibition Centre. Please remain seated until directed to leave. Please note recording of this session is not permitted. Presentations for most seminars will be available on our website after the conclusion of Work Safe Week 2013. Later this afternoon you ll receive an email inviting you to complete our evaluation. We ask you to complete this and help us to improve Work Safe Week. As a thank you, you ll go into the draw to win a $100 Coles Group and Myer gift card.
Back Injuries & RTW Dr Kevin Sleigh WorkSafe
Is Work Good for Your Health and Wellbeing? Strong evidence base that work is generally good for physical and mental health and wellbeing Worklessness is associated with poorer physical and mental health Work can be therapeutic and can reverse the adverse health effects of unemployment G. Waddell1 and K. Burton2 (2006) Overall, the beneficial effects of work outweigh the risks of work, and are greater than the harmful effects of long-term unemployment or prolonged sickness absence G. Waddell1 and K. Burton2 (2006)
Not working is bad for you Increased mortality from cardiovascular disease Suicide Increased rates of: Cardiovascular disease Respiratory disease Mental health disorders Somatic complaints Family impact
Why is RTW important? Return to work rates for Victorian injured workers
WorkSafe GP Survey Findings & GP Initiatives
GP Survey - General Attitudes Towards RTW Belief Action Clarity of role 93% strongly agree work is good for health and wellbeing. 92% strongly agree they try to help patients back to work as soon as safely possible because it s important for their recovery. BUT.. Only 69% claim (strongly agree) they have a clear understanding of their role in helping patients back to work. 26% slightly agree. Discussing return to work: 56% at first consultation 13% at 25% recovered 24% at 50% recovered 7% at 75% recovered
GPs Perception of Employer and Patient Attitudes GP Feedback about Employers 41% strongly agree that employers want injured workers back BUT less (27%) strongly agree they adhere to restrictions in certs and fewer still (22%) have confidence in the RTW Coordinator and (17%) consider the employer proactive in getting them back What does this mean for employers? You need to show your worker s GP that: GP Feedback about Employers 41% strongly agree that employers want injured workers back - you genuinely care about the welfare of their patient - you want to assist in their patient s RECOVERY (of which RTW is an important part) - your workplace is safe - there are suitable duties available at your workplace - medical restrictions for current work capacity will be followed - you WILL continuingly monitor their patients RTW progress and make adjustments where required - their patients will be supported throughout their recovery and RTW - you are competent and know your limits BUT less (27%) strongly agree they adhere to restrictions in certs and fewer still (22%) have confidence in the RTW Coordinator and (17%) consider the employer proactive in getting them back
WorkSafe GP RTW Engagement strategy 1 4 Public Awareness Support WorkSafe campaign development & delivery Commence planning future campaigns - staged approach to build on previous campaigns Reduce Red Tape Scope: GP smart form requirements Consult medical software vendors about smart form integration Explore creation of GP portal 2 Partnerships Continue partnerships with GPV, RACGP, AFOEM, RACP Explore development of new partnerships & collaborations 5 Provider Engagement 6 Implement RTW case conferencing Build referral pathways Support Support ISCRR RTW & Role of GPs research study 3 Certification Stakeholder engagement: planning and delivery Redesign and align TAC & WorkSafe certificate to focus on capacity Explore Med cert smart-form & medical software integration Professional Development Evaluate Pilot GPV CPD program Extend GP CPD in a phased approach to other Medicare Locals Design GP RTW support program
Public & GP Awareness Campaign
Network Providers Occupational Physiotherapy > Better RTW rates - 10% better 3 months after first treatment and 5-15% better at 6 months compared to general physiotherapy Network Occupational Therapy > Improved function - less growth in attendant care costs compared to claims that received non-network OT treatment Network Pain Management Programs > Improved access - An average of only 17 days wait between approval of a program by the Agent and the initial assessment > Improved function - Individuals require less income support & treatment (including physio) 12 months after completing the program
Network Providers Network providers: > possess the skills and experience to manage injured workers > focus on improving health and return to work outcomes > receive additional training and support from WorkSafe and TAC > Physio s can certify capacity following the first certificate Includes: > 200 occupational physiotherapists and 17 network Occupational Therapists across Melbourne and regional Victoria > multidisciplinary network pain management programs at 6 locations in Melbourne GPs can refer patients directly to network providers Worker choice
Predictive Factors for RTW The strongest predictive factors for a RTW are > the individual s expectations, > the number of days of sick leave taken in the past, > Somatic (bodily) disorders, and > a high level of life satisfaction and sense of coherence A. Hansen1, C. Edlund2 and M. Henningsson3 (2006) Work 26(2):179-190 If workers with low back pain had good expectations about their recovery they returned to work after fewer days on sick leave than those with poor expectations about recovery D. P. Gross1 and M. C. Battié1 (2005), Work-related recovery expectations and the prognosis of chronic, low back pain within a workers compensation setting, Journal of Occupational and Environmental Medicine; 47:428-433
What this means for RTW Coordinators At the appropriate time discuss with your worker their expectations about RTW don t leave this up to others Don't ignore what the workers tells you Use this information in your RTW planning If a worker is not confident about RTW or is not expecting to RTW, you need to work extra hard to support them and their treaters and provide them with good reasons to hold an alternative view about RTW!
The Communication Triangle Employer Injured Worker Treating Health Practitioner
Communicating with your worker s GP Acute Back Injury Would a GP conference be of use? If so, talk with your Agent to arrange Offer to accompany your worker to a GP and have a standard letter of referral to go with worker to GP Customise RTW arrangements and have ready for GP Be sure that GP knows that you have range of suitable duties available. Speak to GP if you can Know your workplace and available duties Provide GP with pictures, videos, etc. of workplace and be able to describe the physical requirements of duties Assure GP that worker will be appropriately supervised, monitored and supported while on restricted duties and will comply with any restrictions. Afterwards, remain in touch with GP even if you don t always get through.
Communicating with your worker s GP - Ongoing Back Injury Prepare for contact with introductory fax or letter Include copy of Worker s Medical Authority from claim form Include a short list of key issues you wish to discuss Ask for a suitable time for the doctor to be available Be prepared to address payment issues Keep your appointment time
Key Questions to ask your Injured Worker about their back injury When do you think you will RTW? What do you understand is the problem? What has you doctor told you that you should do to recover? What are you doing at present? (activity level) What do you think you could do at work? How can I (we) (employer) assist recovery? When does your doctor think you might be able to return to some work? AVOID: Any emphasis on words like injury, hurt, harm, rest, disability, don t hurry back
Want the GP s to work with you? Don t forget the GP survey findings You need to show your worker s GP that: you genuinely care about the welfare of their patient you want to assist in their patient s RECOVERY (of which RTW is an important part) - your workplace is safe there are suitable duties available at your workplace medical restrictions for current work capacity will be followed you WILL continuingly monitor their patients RTW progress and make adjustments where required their patients will be supported throughout their recovery and RTW you are competent and know your limits.
Key questions to ask your Worker s GP Think about the results of WorkSafe s GP survey have you addressed their concerns? What is the injury? (diagnosis in layman s terms)? What is the treatment plan? What is patient doing at present? i.e. what is the current activity level? What do you think patient could do? What are appropriate restrictions? Do you think patient could be able to do..? How can I (employer) assist recovery? Is a referral to likely to be required?
Virgin Airlines (RTW with a back injury- Example)
Award Winning Examples in RTW Employers PMP Print Varian Confoil RTW Coordinators Libby McLean (Form 700)
Getting Help Call your WorkSafe Agent Call WorkSafe s Advisory service - 1800 136 089 Register for WorkSafe RTW Newsletter Visit the WorkSafe RTW microsite - http://www.howtoreturntowork.com.au/ Access AFOEM s Health Benefits of Work Consensus Statement and view signatories - http://www.racp.edu.au/page/afoem-health-benefits-of-work Call your employer association(s)
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Work Safe Week 2013 Don t forget the evaluation form that you will receive via email. We ask you to complete this and help us to improve Work Safe Week. As a thank you, you ll go into the draw to win a $100 Coles Group and Myer gift card.