Return-to-Work

Our Approach and Philosophy

Aim Physiotherapy and Work Health Solutions apply expert knowledge to the assessment of stakeholder needs and delivery of strategic rehabilitation services, by a multi-disciplinary team, within a biopsychosocial framework, to help achieve agreed, mutually beneficial goals.  Our approach involves the collaborative development and early implementation of outcome-focused, individualised solutions that carefully balance stakeholder needs to optimize health and financial outcomes for individuals, organisations and overall scheme performance. Aim Physiotherapy and Work Health Solutions recognise that the most important treatment modality for musculoskeletal injuries is returning to as much of the patient’s usual activity, including work, as soon as possible. The early identification of barriers and facilitators to injury recovery and rehabilitation progress, assist the development and implementation of appropriate targeted rehabilitation services and strategies that are founded on evidence-based decisions and best practice.  A coordinated, participatory approach to problem solving and service delivery maximizes the timeliness and effectiveness of implemented solutions. Stakeholder satisfaction, a quality focus, risk management, effective communication and continuous improvement processes underpin all Aim Work Health Solutions business and rehabilitation activities. We recognise and respond promptly to changing work and needs (e.g. relapse, time off work, illness behaviours and disengagement) and address these with appropriate activity and services. A flags framework (red, orange, yellow, blue, black, multiple) is used to help identify and address psychosocial risk factors which may present as barriers to recovery and rehabilitation and return to work progress.

Workplace Focus

An injured or ill worker’s recovery and return to productive work are key objectives of the occupational rehabilitation process.  From the outset, the focus of rehabilitation is remain at work or return to work.  The initial assessment focuses on building cooperative relationships, in which the interests, strengths and obligations of all parties (worker, employer, insurer, and other service providers) are established.

Aim Physiotherapy and Work Health Solutions recognise that the workplace is the most appropriate and effective place to rehabilitate injured employees and will deliver a return to work as soon as possible following a work-related injury or illness.

The benefits of return-to-work and work maintenance

A systematic review completed by Waddell and Burton found strong evidence that advice to continue usual activities of daily living despite pain can give equivalent or faster symptomatic recovery from acute symptoms, less recurrences and less work loss than ‘traditional’ medical treatment ². Patients with pain and at work demonstrate better outcomes than patients with pain who are not working ¹⁰. Further, the employer benefits from the employee’s RTW through retention of the worker’s skills, knowledge and experience.

Work is part of the recovery process

Far from being an end goal in itself, there’s sufficient evidence to suggest that work is actually an important part of the rehabilitative process after injury or illness. In fact, claimants who re-enter the workforce and no longer need their claim payments can benefit from a higher income, a greater sense of self-worth, and an overall improved sense of health and wellbeing. One additional benefits of getting back to health and work after injury or illness is reduced claim costs and insurance premiums.

Early Intervention

Early intervention for injured workers improves health, social, financial, interpersonal and intrapersonal outcomes by promoting recovery and preventing long term disability and work loss. There is an abundance of research to support the benefits of early return to work of injured workers.

Aim Physiotherapy and Work Health Solutions use an early intervention approach to injury management and occupational rehabilitation, based on a sports injury model. Our approach involves Physiotherapy assessment of injuries sustained, either at the workplace or in our clinic within 24 hours of injury and identification of suitable light/modified/alternate work duties. If initially seen at a clinic, our Physio will attend workplace within 48 hours injury for identification and negotiation of suitable duties.

The benefits of our early intervention approach to injury management and occupational rehabilitation include:

1. Appropriate match of skill set facilitating early diagnosis and appropriate rehabilitation advice.
2. Early identification of suitable work duties to allow the worker to remain at or return to work.
3. Early implementation of appropriate treatment and rehabilitation program.
4. Early communication with supervisor and with treating medical practitioner.
5. Decreased chronicity of injuries.
6. Decreased treatment and rehabilitation costs.
7. Decreased complexity of rehabilitation and claims management.

Our past experience includes implementation of an early intervention injury management model. This program delivered a 25% decrease in lost work time at one of South Australia’s largest employers, where advanced injury management systems and on-site health services had already existed for 20+ years.

The bio-psycho-social (BPS) rehabilitation model

The BPS approach to rehabilitation has been operating successfully in return-to-health and return-to-work programs for some time. The BPS approach to rehabilitation aims to enhance a person’s health and wellbeing following injury or illness, so they can get back on their feet and away from what can sometimes be seen as a cycle of dependency.

Underscoring the BPS approach to rehabilitation is the recognition that biological, psychological (including thoughts, emotions and behaviours),  social (including socio-economic, socio-environmental and cultural) factors all play a significant role in human functioning when it comes to managing or recovering from disease, illness and injury.

As a result, attention to the psychological, social and environmental factors at play when helping people who are on claim benefits to recover and ultimately return to health and work. By looking well beyond the injury or illness itself, a BPS approach to rehabilitation helps provide balanced assistance. The aim is to connect with the social, psychological and environmental issues affecting a customer’s return-to-health and work.

By gaining a better understanding of how people live their lives, we are equipped to provide the type of assistance most likely to aid the recovery and rehabilitation process. An important part of this process is to gain a good understanding of a customer’s relationship with their employer and the working environment they will return to. Where appropriate, we may work with the employer to identify potential problem areas, and any tools or modifications to the workplace that might accelerate the customer’s return-to-work.

The BPS rehabilitation model also recognises that a return to work isn’t the end of a return-to-health journey. In fact, it’s been proven that work actually enhances overall health and wellbeing, including restoration and improvement in self-esteem and self-worth.

Refs

APA 2010 (a) RTW background paper 2010 The Ageing Australian Workforce, Australian Physiotherapy Association (APA), Position Paper.