Teaching student program planners about risk management isn't much fun. Maybe a little help from legos and a focus on campus resources will help. This presentation has been tailored to the needs of different student groups over the years. Developed by Allison B. Peters in 2011.
Teaching student program planners about risk management isn't much fun. Maybe a little help from legos and a focus on campus resources will help. This presentation has been tailored to the needs of different student groups over the years. Developed by Allison B. Peters in 2011.
Improving Patient Safety and Quality Through Culture, Clinical Analytics, Evi...Health Catalyst
According to the Centers of Disease Control (CDC), an estimated 70,000 patients die each year from hospital-associated infections (HAIs): contrast the CDC statistic with the fact that only 35,000 people die each year in the U.S. from motor vehicle accidents. Learn key best practices in patient safety and quality including: patient safety as a team sport, the added challenges of healthcare being the most complex, adaptive system, and how culture, analytics, and content contribute to improve outcomes and lower costs.
I designed this presentation to raise awareness on anxiety and depression, including other mental health issues.
We are facing a global crisis on mental health and people aren't talking about it nearly enough. Employers also aren't aware of the many stresses that modern life places on some of their staff.
They need to take mental health more seriously in the workplace.
This presentation is dedicated to JewWario, Justin Carmical who committed suicide only recently. He was suffering from depression.
These PowerPoint presentations are intended for use by crime prevention practitioners who bring their experience and expertise to each topic. The presentations are not intended for public use or by individuals with no training or expertise in crime prevention. Each presentation is intended to educate, increase awareness, and teach prevention strategies. Presenters must discern whether their audiences require a more basic or advanced level of information.
NCPC welcomes your input and would like your assistance in tracking the use of these topical presentations. Please email NCPC at trainings@ncpc.org with information about when and how the presentations were used. If you like, we will also place you in a database to receive updates of the PowerPoint presentations and additional training information. We encourage you to visit www.ncpc.org to find additional information on these topics. We also invite you to send in your own trainer notes, handouts, pictures, and anecdotes to share with others on www.ncpc.org.
This handbook is aimed at assisting those on the governing body of an organisation to: • gain clarity about the interaction of governance and risk management • avoid confusion in the responsibilities of those with an oversight role and those with an implementation role • achieve focus on embedding risk management within the strategic framework. ISO 31000:2009 Risk Management—Principles and guidelines and the related handbook, HB 436:2004 Risk management guidelines—Companion to AS/NZS ISO 31000:2009 deal with the implementation aspects of a risk management framework, and will assist entities to focus on operational risk management. Governance Institute’s publication Enterprise Risk Management1 also provides a framework for approaching the implementation of risk management. This handbook deals with the link between the deliberations of boards and their oversight of management and the alignment of risk management practices with strategic objectives throughout the organisation. This guide is not intended to advise directors on how to create an enterprise risk management system or a technical management-led risk process — these are more suited to development by management. It is intended to assist boards to integrate their governance and risk management frameworks. This in turn will assist organisations to achieve strategic focus, by providing boards with the information they need and ensuring ongoing ownership of risks by all employees in relation to achieving strategic objectives. The questions that conclude each section are included for consideration and to prompt directors’ thinking. Directors will need to decide if they are relevant to their circumstances.
In this presentation I gave in the 3rd Edition: Advanced Model Validation Conference, I first introduced the regulatory expectation on model risk aggregation and the general industry practices, and then discussed the typical qualitative approach with key enhancement opportunities highlighted.
Improving Patient Safety and Quality Through Culture, Clinical Analytics, Evi...Health Catalyst
According to the Centers of Disease Control (CDC), an estimated 70,000 patients die each year from hospital-associated infections (HAIs): contrast the CDC statistic with the fact that only 35,000 people die each year in the U.S. from motor vehicle accidents. Learn key best practices in patient safety and quality including: patient safety as a team sport, the added challenges of healthcare being the most complex, adaptive system, and how culture, analytics, and content contribute to improve outcomes and lower costs.
I designed this presentation to raise awareness on anxiety and depression, including other mental health issues.
We are facing a global crisis on mental health and people aren't talking about it nearly enough. Employers also aren't aware of the many stresses that modern life places on some of their staff.
They need to take mental health more seriously in the workplace.
This presentation is dedicated to JewWario, Justin Carmical who committed suicide only recently. He was suffering from depression.
These PowerPoint presentations are intended for use by crime prevention practitioners who bring their experience and expertise to each topic. The presentations are not intended for public use or by individuals with no training or expertise in crime prevention. Each presentation is intended to educate, increase awareness, and teach prevention strategies. Presenters must discern whether their audiences require a more basic or advanced level of information.
NCPC welcomes your input and would like your assistance in tracking the use of these topical presentations. Please email NCPC at trainings@ncpc.org with information about when and how the presentations were used. If you like, we will also place you in a database to receive updates of the PowerPoint presentations and additional training information. We encourage you to visit www.ncpc.org to find additional information on these topics. We also invite you to send in your own trainer notes, handouts, pictures, and anecdotes to share with others on www.ncpc.org.
This handbook is aimed at assisting those on the governing body of an organisation to: • gain clarity about the interaction of governance and risk management • avoid confusion in the responsibilities of those with an oversight role and those with an implementation role • achieve focus on embedding risk management within the strategic framework. ISO 31000:2009 Risk Management—Principles and guidelines and the related handbook, HB 436:2004 Risk management guidelines—Companion to AS/NZS ISO 31000:2009 deal with the implementation aspects of a risk management framework, and will assist entities to focus on operational risk management. Governance Institute’s publication Enterprise Risk Management1 also provides a framework for approaching the implementation of risk management. This handbook deals with the link between the deliberations of boards and their oversight of management and the alignment of risk management practices with strategic objectives throughout the organisation. This guide is not intended to advise directors on how to create an enterprise risk management system or a technical management-led risk process — these are more suited to development by management. It is intended to assist boards to integrate their governance and risk management frameworks. This in turn will assist organisations to achieve strategic focus, by providing boards with the information they need and ensuring ongoing ownership of risks by all employees in relation to achieving strategic objectives. The questions that conclude each section are included for consideration and to prompt directors’ thinking. Directors will need to decide if they are relevant to their circumstances.
In this presentation I gave in the 3rd Edition: Advanced Model Validation Conference, I first introduced the regulatory expectation on model risk aggregation and the general industry practices, and then discussed the typical qualitative approach with key enhancement opportunities highlighted.
How to Improve Quality of Services by Integrating Common Factors into Treatme...Scott Miller
Presentation by Dr. Bruce Wampold about how the outcome and quality of psychotherapy can be improved by adding common factors to the treatment. Wampold documents the lack of difference in outcome between competing treatment methods AND the relatively large contribution made by common factors to outcome.
- A brief and concise report on Narrative Therapy which includes a brief introduction, therapeutic goals, therapeutic relationships, therapeutic techniques and procedures
- For USTGS 1st semester 2013-2014
CBR is a strategy within general community development for the rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities
Dr Anne Greer: Consultant Child and Adolescent Psychiatrist
Dr Andrew Dawson: Child and Adolescent Psychotherapist
Ms Kirsten Davie: Family Therapist
MCN Child Protection West of Scotland and Greater Glasgow Clyde Health Board
Managing mental health claims and return to work is a challenge for most employers. This slide show demonstrates some positive strategies that can reduce the human and financial cost of psychological disability claims. Organizational Solutions Inc has great success in assisting our clients in the management of disability claims of all varieties physical and psychological in nature.
Presented by Dr. Katharine Gillis at our annual Women in Mind conference on women's mental health.
She was appointed Chair of the
Department of Psychiatry at the University of Ottawa
in 2009, Interim Head, Department of Psychiatry,
Ottawa Hospital in July 2013; and is a national leader
on psychiatry education.
Dr Ian Sturgess: Optimising patient journeysNuffield Trust
In this slideshow Dr Ian Sturgess, Director at IMP Healthcare consultancy, explores how we can better understand admitted flow streams and optimise patient journeys.
Dr Sturgess spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
This workshop was presented at the Queensland Mining Industry Health and Safety Conference 2014 and presents progress on the Working Well Program and ways to support mental health in the workplace.
The Interprofessional Team Immersion (IPTI) offers students across 13 health professions opportunities to apply their skills in cross-professional communication, teamness, and patient-centered engagement. The experience is characterized by high stakes cases carefully designed to cultivate an atmosphere conducive to rapid teambuilding and compassionate patient care. Within a safe learning environment, faculty and students acquire understanding of roles and responsibilities as well as skills to manage complex cases. This presentation will describe and demonstrate the rationale, design, and implementation of IPTI over a three-year period. Findings suggest significant increase in IPTI students’ perceptions of cooperation, resource sharing and communication skills for team-based practice. Programmatic evaluation substantiates the value students place on practicing interprofessional clinical skills before and while in their clinical-community rotations. Debriefing sessions with standardized patients enhanced students’ knowledge and appreciation for patient engagement and shared decision-making culminating for some in scholarly products. In total, findings provide beneficial insight for other interprofessional educational and collaborative practice initiatives taking place at the University and in the community. Learn more about IPEC at University of New England ipec(at)une(dot)edu or follow us on Twitter @UNEIPE
Justice or Just Us: Understanding Bias and Managing Health Professional Lice...Harry Nelson
Presentation to the National Medical Association on the issue of bias in Medical Board and other health professional licensing and enforcement and recommendations for preventing and managing investigations.
The background, key features and main steps of the concise analysis method are described, discussed and applied in this module together with the main tools used during a concise analysis (timeline, guiding questions, constellation diagram, and statements of findings).
Exercise programs for people with dementia: What's the evidence?Health Evidence™
Health Evidence hosted a 90 minute webinar examining the effectiveness of exercise programs for people with dementia. Click here for access to the audio recording: https://youtu.be/jC8HhC2XFrE
Dorothy Forbes, Professor, Faculty of Nursing, University of Alberta, Edmonton led the session and presented findings from her latest Cochrane review:
Forbes, D., Forbes, S. C., Blake, C. M., Thiessen, E. J., & Forbes, S. (2015). Exercise programs for people with dementia. Cochrane Database of Systematic Reviews, 2015(4), CD006489.
As the population ages, the number of people suffering with dementia will also rise. Not only will this affect quality of life of people with dementia but will also increase the burden of family caregivers, community care, and residential care services. Exercise interventions have been identified as a potential way of reducing or delaying the progression of dementia and its symptoms. This review examines two questions: do exercise programs for older people with dementia improve cognition, activities of daily living (ADLs), challenging behaviour, depression, and mortality in older people with dementia? and; do exercise programs for older people with dementia have an indirect impact on family caregivers' burden, quality of life, and mortality?
Similar to "When it all goes wrong" - Review of the barriers to return to work (20)
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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"When it all goes wrong" - Review of the barriers to return to work
1. “When it all goes wrong”
Review of the barriers to return to
work within the healthcare industry
Tony Johnston
Principal Health & Safety Adviser
Queensland Health
2. Outline
• Defining the problem • Method
– No lift – Literature review
– Investment in equipment, – Common resources used
training within AUS
– BUT, Increasing WC – Draft tool
• Background • Findings
– Safety model
– Statistics
– Traditional vs systems
– Complex case review
– Predicting RTW outcomes
Flags models • Future directions
Questionnaires
5. Healthcare Industry… Lost time
Total Cost of Claims
>20 days
RTW
70%
>45 days
RTW
50% >70 days
RTW
35%
6. Objective
• Develop a tool to predict / identify barriers impacting
return to work
– User:
Injury Management Team (Strategic)
Rehabilitation Coordinator (Operational)
– Categories and language to inform decision making
– Structured, targeted rehabilitation plans.
– Educate decision makers
– Organisational improvement
7. Barriers to RTW… Literature
• 20-30% persistent adverse consequences
• Strong predictive factors:
– Catastrophising
– Expectations/perceptions
– Financial incentives
– Physical demands of work
– Loss of contact with work
• 5-9% chronic problems regardless of initial injury.
• Psychosocial obstacles impede progress, not because
there is more serious injury.
– Often unrelated to incident or injury
8. Barriers to RTW… Literature
• Beliefs:
– major underlying pathology.
– avoidance of activity will help recovery.
– need for passive physical treatments rather than active self-
management.
• Other post-accident factors:
– Psychological maintaining variables: depression, anger.
– Other adverse events, e.g. further trauma, independent illness,
bereavement, frustrating legal proceedings.
• Quality of care:
– Failure to provide positive mobilisation and rehabilitation.
– Iatrogenic treatment factors: poorly organised care,
inconsistencies, ambiguities and failure to answer patient's and
family's worries
10. Industry Guidelines
• Flags models
• Biopsychosocial factors
• Personal and Environmental
risk factors
11. Flags Models
Red flags Black flags
• Medical • Context
– Serious pathology (people, systems, policies)
– Co-morbidity – RTW policy
– Failure of treatment – Threat to financial security
– Litigation
– Compensation system and
qualification criteria
– Lack of contact with
workplace
12. Flags Models
Yellow flags Blue flags
• Psychosocial / Individual • Work Area / Perception
– Beliefs, thoughts, feelings, – Social support at work
behaviours – Unpleasant work
(pain & injury) – Job satisfaction
– Coping strategies – Excessive demands/low
– Psychological distress control
– Sick role – Unhelpful management
– Passive role in recovery style
13. Biopsychosocial
Body Functions &
Activity Participation
Structures
Environmental
Personal Factors
Factors
Work & Non-work Individual /
Medical
environment psychological factors
14. Biopsychosocial
Individual / Work & Non-work
Medical psychological factors environment
Biological / Attitudes &
Workplace
medical beliefs
Treatment & Emotions RTW process
Diagnosis
Health
Behaviours Co-Workers
Providers
Compensation
Family
issues
15. Barriers Analysis Tool
Purpose
• Psychosocial obstacles impede progress, not because
there is more serious injury. (Burton etal 2009)
– May be unrelated to incident or injury
• Identifying flags/barriers complements the diagnosis
– Relevance as a contributor to the persistence of the problem
– Facilitate problem solving, not prescriptive
– Referral to appropriate assessment and intervention
• Used to identify specific obstacles to:
– Recovery
– Activity
– Work
16. Barrier Analysis Tool (Draft)
Demographics
DOI
Individual/ factors Factors
Medical Rehab Workplace Factors
RTW status
•Severe symptoms/pain
•No TMP •Management support
Restrictions
•Co-morbidities
• •Contact with worker
System Factors No definitive diagnosis
•Perception of for recovery/RTW
• report injury •SDP
•Worker does notNo timeframerecovery limited / unavailable
• •Multiple injuries •Management not aware of rehab
•Employer doesPerception about RTW
not investigate incident
• •Psychological
•Rehab delayedCommunicationinjury/overlay
obligations/benefits
•Unrealisticnot
•TMP will expectations
•Co-worker support
•Claim determination delayed support/participate in RTW
•Social issues for case
•Frequent treatment•Demanding job (physically or
•No single person responsible(transport,
•Not
•Responsibility family)complying with treatment
not clear psychologically
•Total incapacitatedManagement responsibility for rehab
•Inadequate plan/goal/timelines • >2 weeks
•Admin focus rather than person focus
•Funding for RTW
•Insurer not communicating/coordinating
•Insurer reactive, not proactive
17. Barrier Analysis Tool…
Method
Complex Case Review
•File review complex cases with Rehab Coordinator
– > 2 weeks time lost
•3 sites (metro and regional)
•Barriers identified
•Action plan documented
•Data collated and evaluated
– Local issues
– Strategic impact
23. Barrier Analysis Tool
Complex Case Review
Outcome:
•Tool practical and easy to use
•Identifies barriers
– Point-in-time
– Potential future concerns
•Encourages case planning and documentation
•Identifies barriers at individual, work area and organisational
level
•Educational tool for Rehab Coordinator, Management
– Individual factors Workplace factors & System factors
24. Barrier Analysis Tool
Global Issues
• Individual factors • Workplace factors
– Will not participate in – Management does not
Rehabilitation support RTW
– Unrealistic expectations – Suitable duties
– Will not communicate directly limited/unavailable
with employer – Management not aware of
benefits
• Medical/rehab factors – Co-workers do not support
– TMO does not support RTW RTW
– Physically demanding job
• System Factors – Management not responsible
– Rehab delayed for rehab
– Claims determination delayed
25. Conclusion / summary
• Rehab coordination can • Education all involved
have a critical bearing on – Line managers
the outcome – Rehab coordinators
– Employment policy • Influence
– Social contact – Health providers
– Nature of work – Insurers
– Coordination of RTW
care
26. Future Direction
• Ongoing trial
• Review/modify individual elements for barriers specific to local
environment
– Utilised by other organisations
• Integrate into Rehab Coordinator training
– Case review and documentation
– Prompt for case planning
• Collation of data to inform organisational needs
– Policy changes
– Education and training: Managers, Rehab Coordinators
– Influence external stakeholder: Insurer, TMO
27. Bibliography
• ACC (NZ). 2006. Return to work and pschosocial issues. Available:
http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_providers/documents/guide/prd_ctrb113170.pdf
.
• FOREMAN, P., MURPHY, G. & SWERISSEN, H. 2006. Facilitators and Barriers to Return to
Work: A literature review.
• KENDALL, N., LINTON, S. J. & MAIN, C. J. 1997. Guide to Assessing Psychosocial Yellow Flags
in Acute Low Back Pain: Risk Factors for Long-Term Disability and Work Loss. . Available:
http://www.kendallburton.com/Library/Resources/Psychosocial_Yellow_Flags.pdf.
• WORKCOVER (NSW). FACTORWEB - Personal and environmental risk factors. Available:
http://www.workcover.nsw.gov.au/formspublications/publications/Documents/factorweb_5523[1].pdf
.
• WORKCOVER (SA). Considering biopsychosocial factors [Online]. WorkCover South Australia.
Available:
http://www.workcover.com/site/treat_home/injury_management_by_health_discipline/key_principles_for_
[Accessed 2012].
• WORKCOVER (SA). 2007. A guide to assessing and managing red and yellow flags for workers
compensation patients. Available:
http://www.workcover.com/custom/files/AssessingManagingRedYellowFlags_201004231418832.pdf
.
Editor's Notes
Abstract The healthcare industry is a dynamic and complex industry and although considerable efforts have been made to improve health and safety injuries still do occur. Generally, most workers can return to normal duties without any issues; However, successful return to work outcomes are often impacted by a wide variety of factors such as the nature and characteristic of the injury, characteristics of injured person, physical and psychosocial work demands, medical and therapeutic interventions, work organisation, workers compensation process. This presentation will overview the available literature and proposes a conceptual model for evaluating workplace rehabilitation systems (strategic level) and return to work plans (operational level). Objectives: To develop a conception model to assist rehabilitation practitioners to identify the barriers impacting return to work for injured healthcare workers. Method: A review of the literature was conducted of identify available models for identifying barriers and facilitators impacting return to work. The core dimensions were assessed and a model developed and trialled for use at: Strategic level for evaluating workplace rehabilitation systems; and Operational level for return to work planning.
Healthcare is a dynamic and complex environment A lot of activity has occurred to support safe moving and handling of people Union marketing campaigns Regulations Guidelines And you may have heard from previous speakers, or previous conferences some fantastic outcomes Significant reductions in Workers’ compensation costs in the order of 30-80% premium Improved satisfaction at work, and longevity …
Healthcare continues to be a hazardous industry And it does not seem to be getting any easier Average days lost per claim increasing from 20 days in 2007 24 days in 2011 And costly. From a litigation perspective Conversion to common law are increasing from 2.3% in 2007 5.5% in 2011
One research suggested the 80:20 rule also applies 20 percent of the claims attribute to 80% of the costs You can see from the graph, A good proportion of cost attribute to the Medical Expenses claims But majority of costs towards the longer tail claims ….. And no doubt the majority of time and effort managing the claims Long tail claims present a number of issues Complex and difficult RTW Frequently the obstacles impeding RTW have little to do with the initial injury Even work related injuries such as musculoskeletal and mental health conditions have been shown to benefit from activity‐based rehabilitation and an early return to suitable work. Research also shows that long‐term work absence, work disability and unemployment are harmful to physical and mental health and wellbeing. Further more, Return to work statistics indicate, the longer someone is off work, the less likely they become ever to return. Data concludes the following: Off longer than 20 days the chance of ever getting back to work is 70%; Off longer than 45 days the chance of ever getting back to work is 50%; and Off longer than 70 days the chance of ever getting back to work is 35%. So the big question is ….. why
Psychologically or behaviourally determined by: Personality Perception of symptom Pain Psychiatric disorder Work, leisure, family issues Financial issues Legal issues
Behaviours Perception of symptoms, treatment and outcome System factors Medical language, “instability” Legal proceedings – Attorney-ogenic disability – legal advice to stay of work in preference for better outcome at settlement Compensation system Medical model Prove injury/illness for claim to be accepted Perpetuates a sickness model Insurance systems and civil law are based on physical biological model, ignoring psychological and social factors Can hinder or cause injuries to worsen
It is easy to first consider the barriers to RTW lie completely with the injured worker. They must have had a pre-existing condition They should have know better Or even worse … their a malingerer or “secondary gain” However this approach does not provide solutions for returning the worker to meaningful work. And is similar to the shift in safety preventative models from a traditional “careless worker” approach towards a systems approach reviewing various root causes or contributing factors
NSW WorkCover – FACTORWEB – personal and environmental risk factors (based on NZACC) WORKCOVER (NSW). 2008. FACTORWEB - Personal and environmental risk factors. Available: http://www.workcover.nsw.gov.au/formspublications/publications/Documents/factorweb_5523[1].pdf . WORKCOVER (SA). 2007. A guide to assessing and managing red and yellow flags for workers compensation patients. Available: http://www.workcover.com/custom/files/AssessingManagingRedYellowFlags_201004231418832.pdf . WORKCOVER (SA). Considering biopsychosocial factors [Online]. WorkCover South Australia. Available: http://www.workcover.com/site/treat_home/injury_management_by_health_discipline/key_principles_for_all_health_providers/considering_biopsychosocial_factors.aspx [Accessed 2012]. Adapted from WorkCover NSW FACTORWEB COMCARE – References NZACC
3 necessary elements for successful RTW Value Expectancy Self-efficacy Interventions address basic coping strategies, perceptions about the “work role” following injury Blue flags In the contact of an injury may delay recovery, or constitute a major obstacle Perceptions of not only the job demands, but also the social context of work (management and co-workers)
International Classification of functioning, disability and health. Standard language for describing health and health-related states. The ICF model combines two constructs for disability Medical model – directly caused by disease, trauma or other health condition Social model – socially created problem and not at all an attribute of an individual Each have a natural direction towards the solution or treatment approach Biological individual social With disability viewed as outcomes of interaction between the health condition and contextual factors
Major categories under each of the headings
More about the concept and use of the flags model …..
With increasing age increasing number of claims of longer duration 40 yrs + around 9%, whereas <40 yrs 5.6% Interestingly the 60 yrs + group have one of the higher numbers on MEO claims
Psychological claims 29% of claims are 100+ days -- this may relate to the compensation criteria to prove illness and reasonable management action Whereas the back, leg and arm injuries are all very similar
Individual roles Reporting severe symptoms Comorbidities impacting recovery (pre-existing) Social issues Medical Lack of timeframes for RTW Psychological injury / overlay Injury not improving with treatment Workplace Physically demanding occupations Systems Insurer reactive Insurer not proactive in contacting stakeholders Rehab delayed.
Individual: Will not participate One site with significant legal and union participation in claims process Expectations (esp in Government) Injured workers expecting redeployment Managers expecting ill health retirement Communication PPI claims … email communication Especially in smaller districts with few staff and limited Medical Regional areas with few options for TMO and specialists System delays Parallel processes, esp complex PPI / Grievance process investigation Resources – High case numbers in some areas Delegations for financial sign-off Workplace Budget and funding SDP SDP not available esp operational areas: physical job, limited transferable skills Nursing: CPR issue Managers not aware of obligations (and cost impact on premium) Co-workers: SDP seen as preferable “light duties” Mx responsible – premium not devolved, no financial ownership/consequence