A Journey to the Future of Injury Management from an
International Perspective
18 March 2013: EBIM Conference
Nikki BrouwersInteract Injury Management
International Best practice includes:
• Building supervisor capability
• Early intervention/strong assessments
• Integration of OHS/Injury management
Canadian Research
• Proves that the strongest predictor to RTW is motivation due to job satisfaction. The role of the supervisor is critical.
• Other predictors to RTW include:1. Co morbidity2. Family History3. Personality4. Expectations
Diagnosis is not a predictor of RTW (OECD,2007)
• In employment in the UK, 26 % have a health condition or disability
• Of those not seeking work, 49% have a health condition of disability
• Of those unemployed and seeking work, 30% have a health condition or disability
Early intervention
• Dame Carol Black recommends referrals at 4 weeks to assess barriers to RTW and to develop a RTW
• The Dutch triage at 6 weeks
• The Germans triage at 2 weeks
German approach: Prevention of claims
• Greater than 2 weeks of sick leave = disengagement
• “ Yellow card “ for workers on sick leave to encourage communication between worker, employer and Doctor
• Results=Decreased workers compensation claims
• Role of supervisor and HR critical
Germany’s Lead on Disability Management
• Different history to Australia• Target of 5% or greater employees must
have a disability• Therefore a natural tendency to re-
engineer roles/job descriptions• No longer one job=one person• Australia needs to look at innovation
in job design
Australian experience at injury management early intervention
• Study by Casey, 2012, showed the average delay to referral is 33 months from DOI.
• Early intervention continues to focus on the medical model.
• Right service at the right time at the right price
New employer
• Retraining occurs outside the workplace in contrast to Germany where all retraining occurs “on the job”
• Philosophically believe that training outside of work, the worker remains stigmatised and therefore never return to work.
• UK( Black) recommends early intervention for seeking new employer before termination.
Malaysia’s research
• Success factors related to Early intervention and Evidence based practices
• Able to quantify for every $1 spent on early intervention there is a $1.43 savings
New Zealand: Better @ work trial
• A strong early intervention program
• Evaluation showed statistically significant results
• Fit for selected work certificates rose by 4.5%
• Probability of patient needing weekly compensation decreased by 14%
• Cost of weekly compensation decreased by 21% in cases lasting 90-180 days
NZ: lessons learnt
• The role of the Occupational Therapist was crucial for the success of the pilot
• The electronic medical certificate was crucial for success
Ageing Workforce: The elephant in everyone’s room
• Aged 45 plus
• Evidence clearly supports the following strategies for 50 plus age group:
• 1. Supportive not directive
• 2. Utilisation of Worktrial
• 3. Classroom not appropriate for learning, require self paced learning or on the job training.
Vulnerable Workers, reference Canada
• Education level of staff: the postcode effect• The work-related injury rate for young people
who were out of school and who did not complete high school was three times higher than those who had completed High school
• For young workers who left school after Year 10 the injury rates were almost double compared with those still in school
• Age, type of shift and the number of hours of worked were not factors for injury risk.
Integration of OHS and injury management
• Consistency of language
• Consistency of measurement
• Alignment of goals from HR
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