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Improving return to work outcomes, the Knowledge Base, and the world wide movement to reduce work disability

Why change the status quo?

After sick leave, most people return to work quickly and do well.

A small but significant proportion is off work for long periods and may remain off work permanently.

  • The costs of staying off work for a long time are substantial for the individual, their workplace, their family and community.
  • There are consequences for physical and mental health
    mental health
    Emotional wellbeing. Ability to cope with difficulty and enjoy life. THe absence of a mental health problem.
     (slower recovery from the illness or injury, weight gain, loss of fitness, increased morbidity and mortality, isolation, depression).
  • The children and family are affected
  • There are consequences for the workplace including the impact on morale, productivity, profitability, and motivation.
  • The impacts on the community include financial costs, health and productivity effect, and the broader consequence of how the community perceives itself.
Countless studies have shown that getting back to work as soon as possible after an injury or illness is in everyone’s best interests.

What influences return to work?

Traditional approaches expect that medical treatments will manage an injury or illness and determine whether the person is able to return to work. Over the last 20 years we have come to understand the many other factors that influence return to work results.

Beliefs, attitudes and approaches have a real and measurable influence on whether a person is able to return to work successfully. All of the following can influence what happens with return to work

  • the person with the injury
  • the organisation they work for
  • the treating practitioners
  • the system that covers the injury

Bringing about change through use of this website:

There is a substantial amount of information about what helps people return to work. However, much of the information is tucked away in the research literature. People who deal with return to work regularly often understand the most effective strategies, but they can still find it difficult to influence others who have more traditional views.

Change comes about over time. It is helped by knowledge, improved incentives to change and a shared approach.

Knowledge brings about change

Being knowledgeable about return to work issues improves return to work outcomes.

When a doctor is knowledgeable about the best medical approach for back pain, they help the patient recover more quickly and return to work earlier.

When a return-to-work coordinator is knowledgeable about the most effective return-to-work programs, they can implement effective strategies in the workplace

When a person with an injury is aware of what they can do to help themselves they are more confident and have better outcomes.

The articles on this site provide a substantial amount of information about return to work. We expect people who read the articles will gain valuable knowledge from these articles.

Attitudes and incentive to change:

Although knowledge is important, beliefs and attitudes often have a larger bearing on return to work.

When a claims manager understands what a distressed person is going through they will be more likely to try to assist.

If a person with back pain believes certain activities may harm their back, they are less likely to return to their old interests, and return to work is less likely to be successful. Correcting mistaken beliefs will have a positive impact on them returning to their job.

We hope that the knowledge provided on this website will help foster more accurate beliefs and positive attitudes among workers, employers, treaters and insurers. We have included articles that help give an insight into the issues faced by people dealing with work-related health problems. Understanding is an impetus for change.

A shared approach to change:

In the area of return to work it is common for stakeholders to feel others are to blame for the problems that occur. In 2006 a UK report on workplace health issues [1] found that

94% of GPs believed that employers are not doing enough to prevent employees going on sick leave

85% of employers thought GPs were too quick to sign sick certificates.

Working together produces better results.

Public health campaigns work by providing information to all so that groups of people can work together with a common understanding and common goals.

When patients, doctors and employers all understand that an early return to work is important, then return to work is more likely to be successful.

If a person with an injury is encouraged to rest by their family, they are more likely to do so. If everyone is informed about the importance of activity, the person is more likely to be active.

In 1997 a major article was published on return to work for people with back pain. The article concluded that “getting all the players onside” was the major change needed to reduce work disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 from back pain. That issue remains the issue today.

Many of the articles on this site have been included to encourage a shared understanding of the ways return to work can be improved. Sharing the articles that you find on the website will help this process.

Choice of articles for this website:

There have been hundreds of studies performed in this area, and they could not all be included on the site. Studies were chosen based on the following considerations:

  • The scientific quality of the study
  • Relevance to people reading the site
  • The people who will use the information
  • The topics relevance to return to work
In some cases, several studies have been done on the same topic, of which one was chosen for the site, according to the criteria above.

Part of a worldwide approach:

This project is part of a worldwide move to improve return to work results. Treating practitioners
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
 , governments, unions and employers have been active in many countries in this area. Examples of the work initiatives undertaken internationally include:

International Collaboration – IDMSC (The International Disability Management Standards Council) was established by senior representatives of business, labour, government, and other stakeholder groups from a range of counties in 2003. IDMSC aims to reduce the human and economic costs of disability in the workplace through international collaboration. Australia, Austria, Canada, Germany, Ireland, New Zealand, Singapore, Switzerland, and the United Kingdom are active participants.

Canada. A collaborative approach between unions and employers led to the development of NIDMAR (National Institute of Disability Management and Research). NIDMAR has developed a range of tools to assess, support, and train in the field of return to work.

US. The “Sixty Summits” is a project underway in the US and Canada, with major meetings of return to work stakeholders to help shift the way return to work is dealt with in North America.

UK. A series of major reviews of work and health have been commissioned, to improve the community’s understanding of return to work.

Europe. Europe has been a major research centre for work disability over the last ten years, from Sweden to Norway to The Netherlands and Spain.

This website has been commissioned in Victoria, Australia. A major implementation program supported active use of the ‘Knowledge Base’ site in Victoria. However, it is expected the information and resources of the site will contribute to improving work disability in other regions and countries.

Our hope is that this site supports parties working together to reduce the burden of work disability.

Mary Wyatt and Robert Hughes

On behalf of the Knowledge Base Project Team

[1] Health of the workplace; Norwich Union Healthcare report 2006

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