Workplace Rehabilitation Model
Effective Australia uses a model of workplace rehabilitation aimed at an early and safe return to work for injured workers.
Beliefs about work and disability
Underpinning Effective Australia’s approach to workplace rehabilitation is a belief that work is an important aspect of our personal and social life that is good for us financially, good for our health, supports inclusive, cohesive and prosperous families and communities, and is a fundamental right. At Effective Australia we also believe that there are very few individuals, if any, in our society that are unemployable with the right support, accommodations and encouragement, and that while workplaces can occasionally be a catalyst for injury, they are also a solution and can support recovery.
Approach to rehabilitation
Wherever possible work should be incorporated into the therapeutic approach and the pre-injury employer should be the primary focus of work options.
Interventions which are strongly focused on returning people to work improve participants' chances of returning to full duties and staying at work1. At Effective Australia we also know the importance of expectations, and we help shape these through our knowledge that almost any disability can be accommodated in the workplace with the right supports, combined with a work as therapy approach. If an individual expects to return to work they are far more likely to return2.
Evidence supports the concept that early intervention, the offer of suitable employment together with the engagement of key parties (worker, employer, doctor, insurer and other providers) in implementing an injured workers’ return to work significantly reduces the duration and associated costs of claims3, including improving social and health outcomes for the workers concerned4.
Workplace rehabilitation is a service delivery model that involves a designated rehabilitation consultant responsible and accountable for coordinating services designed to achieve a cost effective, safe, early and durable return to work for the injured worker.
Effective Australia’s model of service delivery has as its foundation the Principles of Workplace Rehabilitation5 addressing service provision, organisational and administrative infrastructure, staffing arrangements, and quality framework.
Our providers have the qualifications, experience and expertise appropriate to deliver and coordinate services based on the definition of workplace rehabilitation developed by the National Occupational Health and Safety Council6:
“Workplace rehabilitation is a managed process involving early intervention with appropriate, adequate and timely services based on assessed need, and which is aimed at maintaining injured or ill employees in, or returning them to, suitable employment.”
Effective Australia’s providers deliver specialised expertise in addition to that which is provided by the employer and insurer. Services are largely delivered at the workplace by:
- Identifying and designing suitable duties for the worker to assist employers to meet their obligations in providing suitable employment to injured workers
- Identifying and coordinating rehabilitation strategies that ensure workers are able to safely perform their duties
- Promoting an early return to work of the worker
- Forging the link between the insurer, employer and treatment providers to ensure integration of all injury management activities and a focus on return to work
- Arranging appropriate retraining and placement in alternative employment when the worker is unable to return to pre-injury duties
- Considering all aspects that have an impact on the worker returning to work
Recovery and rehabilitation continuum
While success and progress oriented, we recognise that services may move back and forth through a service delivery continuum of assessment of need, planning, active implementation and review of services and re-evaluation. This requires effective communication, decision-making, financial accountability and informed purchasing of service and resources. Cooperative and respectful communications are critical when there are a number of stakeholders and progress is not always predictable7.
As progress cannot always be clearly anticipated in the rehabilitation of disabilities goal setting plays an important role in recovery and restoration. At Effective Australia we believe in the importance of goals that are specific enough to be meaningful and measurable, task oriented where practical, realistically achievable, collaboratively developed with the worker and employer as well as incorporating medical and scheme expectations, and incorporating short term time boundaries. Goals provide a framework for key parties to work together to support the person back to work. Setting a range of goals incorporating motivating factors provide a greater level of personal satisfaction and motivation8.
Effective’s approach to goals uses as its starting point suitable employment that is based on evidence – primarily bio-medical and incorporating a range of bio-psychosocial strengths, considers barriers and risks – also bio-psychosocial, development of strategies to overcome barriers and risks while maximising strengths, the implementation of actions and steps necessary to achieve strategies, and the review and evaluation of all of these to check that service expectations and goals are being achieved.
Effective’s policies and procedures reflect the workplace rehabilitation model, incorporate the principles of service delivery, and reflect evidence based practice throughout the continuum of service delivery.
Service Delivery Continuum
While the focus at Effective Australia is always on moving toward a durable return to work, injuries and issues related to recovery and restoration to the workplace and the community can both progress and regress. This service delivery continuum recognises that a flexible and individualised approach is needed to achieve maximum success.
Assessment of Need
Effective Australia’s early, accurate identification of risks and needs ensures the most appropriate intervention is applied to achieve a safe return to work. We use a range of bio-psychosocial assessment tools that are, wherever possible evidenced and are matched to the specific needs of the client to maximise return to work outcomes cost and time effectively.
Return to Work Planning
Effective return to work Planning is aimed at maintaining an injured worker in the workplace or returning them to work by involving key parties in documenting a realistic return to work goal and aligning resources and actions so that rapid, cost effective, safe and durable return to work is achieved.
Effective’s successful implementation of return to work services is an
- outcome oriented,
- solution focussed,
case management approach within the workplace rehabilitation model.
The aim of Implementation activities is rapidly, safely and durably and cost effectively returning people to work by implementing planned solutions to barriers, identifying activities that are not delivering progress, and supporting reconsideration of requirements to enhance the return to work goal.
Review and Evaluation
Effective’s review approach drives a thorough evaluation of process, outcomes, cost effectiveness and wherever possible impacts so that customers and clients receive services that are beneficial, fit for purpose, timely, and goal oriented – and that goals support client and customer needs.
Effective Australia uses a combination of outcome and process evaluation techniques (Program Evaluation Methodology) in order to:
- understand, verify or enhance the impact of services provided (outcome)
- improve delivery mechanisms so that they will be more efficient and/or less costly (cost effectiveness)
- verify that what was planned is actually being implemented and determine reasons why not
- re-evaluate the aim of the program (has the goal been achieved, is the goal still the most valid, do relevant stakeholders still support the goal)
- produce data and/or evidence to test or increase motivation for a direction or to identify directions that should be avoided in future
- produce valid comparisons between approaches to decide which approach is best
- fully examine and describe programs for learning and service improvement purposes so that good practice can be replicated and poor practice eliminated
At Effective we believe regular reviews and reporting are important so that relevant stakeholders are aware of what is working and what is not, any changes to goals, barriers, risks, strategies, actions and steps, and that everyone is working collaboratively in a common direction for a rapid, safe and durable return to work.
Durable Return to Work / Outcomes
Effective Australia is committed to maximising return to work through durable outcomes maintained by both the worker and the employer wherever this is possible. A provider must check prior to closing a file that has resulted in a return to work that the return to work is durable and identify any needs that are expected to maintain durability.
Once a worker resumes work ongoing monitoring of progress is essential. As a general rule, 13 weeks post injury provides reasonable expectation of ongoing durability of a return to work.
1. Durand M-J, Loisel P. Therapeutic return to work: Rehabilitation in the workplace. Work: Journal of Prevention, Assessment & Rehabilitation. Vol 17(1) 2001, 57-64. 2001
2. A. Hansen, C. Edlund and M. Henningsson. Factors relevant to a return to work: A multivariate approach. Work; 26(2):179-190. 2006Serena McCluskey,
3. A. Kim Burton and Chris J. Main, The implementation of occupational health guidelines principles for reducing sickness absence due to musculoskeletal disorders. Occupational Medicine; 56(4):237-42, 2006
4. Franche R-L , Cullen K , Clarke J , MacEachen E , Frank J , Sinclair S , Reardon R; Institute of Health and Work, Workplace-based Return-to-work interventions: A Systematic Review of the Qualitative and Quantitative literature. Ontario, 2004.
5. Approval of Workplace Rehabilitation Provider Within the New Workers Compensation System: General Guide, WorkCover NSW, 2008
6. National Occupational Health and Safety Council (NOHSC): 3021. Guidance Notes for Best Practice Rehabilitation Management of Workplace Injuries and Diseases, April 1995
7. Pransky G, Shaw W, Franche R-L, Clarke A. Disability prevention and communication among workers, physicians, employers, and insurers--current models and opportunities for improvement. Disability & Rehabilitation 2004;26(11):625-34. 2004
8. R. J. Siegert and W. J. Taylor. Theoretical aspects of goal-setting and motivation in rehabilitation. Disability & Rehabilitation; 26(1):1 – 8. 2004