Recent research from the Institute for Work and Health reinforces evidence that patients who are optimistic about recovery following an injury will actually recover and return to work faster than patients who are less optimistic— a finding that should be recognized in case management decisions.
As noted by the Institute for Work and Health:
Dr. Jason Busse has recently completed a study offering their Somatic Pre-occupation and Coping (SPOC) questionnaire to patients with broken shin bones (i.e. tibial shaft fractures) about their experiences with symptoms, coping abilities and recovery beliefs. Tibial fractures were selected because they are the most common type of long bone fracture and they tend to disproportionately affect young people in the workforce.
Six weeks after surgery, researchers administered the 27-item SPOC questionnaire to 359 patients and linked the questionnaire scores to the patients’ outcomes.
The results? The six-week SPOC scores were a more powerful predictor of recovery and return to work than age, gender, fracture type, smoking status or the presence of multiple injuries.
According to Busse, two questions are central: Can we modify patients’ beliefs? And will such changes result in improved outcomes? “If we can do these two things, then we have something very exciting,” he says. “This study provides strong evidence that there’s more to people’s experience of recovery from injury than simply tissue repair.”
Source: Institute for Work and Health
This study reinforces common research findings, and employer experiences, that employees’ expectations and fears about returning to work better predict how long they’ll be out of work moreso than most (if not all) other factors, including a clinical diagnosis.
What we are identifying is that a medical diagnosis does not tell you how long an employee will be off work. If it did, there would not be cases in which one employees ask for accommodations to return to the job while a second, similarly injured employee, takes a disability absence leave. With diagnosis held constant, the only difference between the two employees is motivation.
This behaviour is completely understandable when you adopt the employee’s point of view. Anytime a person is fearful of something, they will avoid it. If they are fearful of reinjury, stigma, non-supportive supervisors, or being unable to perform their job duties in the future, they are going to delay their return until these concerns are addressed. And it is unlikely that they, themselves, will take steps to address these concerns.
At the same time, some factors are beyond the employee’s conscious control. For example, they may feel anxiety and are concerned that they will fail, or guilt and the concern that they are imposing upon co-workers.
Employers need to understand these barriers and talk to employee about how to overcome them. A good start is asking ask open-ended questions, be good listeners and stay connected with injured employees who are off the job. Without that, the employee may not feel they owe you any loyalty.
Some other helpful information:
From the Canadian Office of the Chief Human Resources Manager, the following fundamentals of a return-to-work plan offer guidance in its creation.
A return-to-work plan is a tool for managers to proactively help ill or injured employees return to productive employment in a timely and safe manner:
- A number of employees can safely perform productive and meaningful work while they are recovering.
- Returning to work is beneficial to the employee and is part of the recovery process.
- Different situations require different solutions.
The priority is to return the employee to the position he or she held prior to the absence. In this way, the employee can return to his or her routines, workplace and co-workers. If this is not possible, however, other alternatives, in order of desirability, are to return the employee to:
- A modified job in the same workplace;
- A different job in the same workplace;
- A similar job in a different workplace; or
- A different job in a different workplace.
Return-to-work plans are intended to be transitional and have a fixed duration. Permanent actions are defined as accommodation. Return-to-work plans must include the following information:
- The employee’s objectives, to be met gradually until he or she achieves the final goal of fully resuming the job tasks performed before the absence, or, alternately, starting the new job if returning to the former position was not possible. The employee’s abilities, functional limitations and restrictions are taken into account and are to be adjusted according to the employee’s progress;
- The action required to meet these objectives includes the responsibilities of the employee, the manager and all of the co-workers assigned to support the employee;
- The time frame to meet these objectives, which establish the deadline for measuring the employee’s progress. It is important for the plan to have a start and end date. Time frames and expectations must respect the employee’s abilities, be clearly stated for the duration of the plan and be revised as needed;
- To the extent possible, absences for medical checkups must meet the return-to-work plan implementation requirements;
- The return-to-work date and agreed work schedule;
- If applicable, all action to be taken to mitigate identified barriers, e.g., special equipment, required training; and
- The signature of the employee and the manager.