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Published in:

01-09-2007

Changing to an Outcome-focused Program Improves Return to Work Outcomes

Authors: Pamela Joy Tschernetzki-Neilson, E. Sharon Brintnell, Calvin Haws, Kathryn Graham

Published in: Journal of Occupational Rehabilitation | Issue 3/2007

Abstract

Objectives: The purposes of this study were to: (1) evaluate the effectiveness of changing a Return to Work (RTW) program’s focus to one that was “outcome-focused”, and (2) to determine which factors collected in the facility’s database were most predictive of RTW. Methods: A total of 13,428 client files were extracted from Millard Health’s database which included data on two cohorts of subjects: those in the program before and after the change in focus had been made. This was to determine whether significant improvements in outcomes were achieved. Variables that were hypothesized to be predictive of RTW were selected based on previous published literature. Analyses included ANOVA’s, logistic regression analysis and Pearson correlation. Results: Statistically significant improvements in RTW, total temporary disability claims, client satisfaction, efficiency of services and scores on the Perceived Disability Index (PDI), Short Form-36 (SF-36) and Visual Analogue Scale (VAS) for perceived pain were found. Variables that were predictive of RTW included: more efficient services, completion of a worksite visit, having the worker participate in the visit, availability of modified duties from the employer, fewer absences from the program and better scores on the PDI, SF-36 and VAS. The most predictive variable of RTW was sores on the PDI indicating lower levels of perceived disability. Conclusions: Changing to an outcome-focused program improved various outcomes in this RTW program. Several factors predict the outcome of RTW and these should be considered in treatment planning.

Green-McKenzie, J., Rainer, S., Behrman, A., & Emmett, E. (2000). The effect of a healthcare management initiative on reducing workers compensation costs. Journal of Occupational and Environmental Medicine, 44, 1100–1105.CrossRef

Gross, D. P., & Battie, M. C. (2005). Functional capacity evaluation performance does not predict sustained return to work in claimants with chronic back pain. Journal of Occupational Rehabilitation, 15, 285–294.PubMedCrossRef

Gross, D. P., & Battie, M. C. (2006). Does functional capacity evaluation predict recovery in workers’ compensation claimants with upper extremity disorders? Journal of Occupational and Environmental Medicine, 63, 404–410.CrossRef

Schwartz, R. K. (1993). Return-to-work programs. Work, 3, 2–8.

Scully-Palmer, C. (2000). Outcome study: An industrial rehabilitation program. Work, 15, 21–23.PubMed

King, P. M. (1993). Outcome analysis of work hardening program. The American Journal of Occupational Therapy, 47, 595–603.PubMed

Jang, Y., Wenshu, L., Hwang, M.-T., & Chang, W.-Y. (1998). Factors related to returning to work following a work-oriented occupational therapy program for individuals with physical disabilities. Journal of Occupational Rehabilitation, 8, 141–151.CrossRef

Durand, M.-J., & Loisel, P. (2001). Therapeutic return to work: Rehabilitation in the workplace. Work, 17, 57–63.PubMed

Catchlove, R., & Cohen, K. (1982). Effects of a directive return to work approach in the treatment of workman’s compensation patients with chronic pain. Pain, 14, 181–191.PubMedCrossRef

10.

Goodman, G., Browning, M., Campbell, S., & Hudak, H. (2005). Evaluation of an occupational rehabilitation program. Work, 24, 33–40.PubMed

11.

Sang, L. S., & Eria, L. P. Y. (2005). Outcome evaluation of work hardening program for manual workers with work-related back injury. Work, 25, 297–305.PubMed

12.

Caruso, L. A., Chan, D. E., & Chan, A. (1987). The management of work-related back pain. The American Journal of Occupational Therapy, 41, 112–117.PubMed

13.

Lichter, R. L., Hewson, J. K., Radke, S. J., & Blum, J. (1984). Treatment of chronic low back pain. A community-based comprehensive return-to-work physical rehabilitation program. Clinical Orthopaedics, 190, 115–123.

14.

Sachs, B. L., David, J. F., Olimpio, D., Scala, A. D., & Lacroix, M. (1990). Spinal rehabilitation by work tolerance based on objective physical capacity assessment of dysfunction a prospective study with control subjects and twelve month review. Spine, 15, 1325–1332.PubMedCrossRef

15.

Edwards, B. C., Zusman, M., Hardcastle, P., Twomey, L., O’Sullivan, P., & McLean, N. (1992). A physical approach to the rehabilitation of patients disabled by chronic low back pain. The Medical Journal of Australia, 156, 167–172.PubMed

16.

Niemeyer, L. O., Jacobs, K., Reynolds-Lynch, K., Bettencourt, C., & Lang, S. (1993). Work hardening: Past, present, and future-the work programs special interest section national work hardening outcome study. The American Journal of Occupational Therapy, 48, 327–336.

17.

Pransky, G., Gatchel, R., Linton, S., & Loisel, P. (2005). Improving return-to-work research. Journal of Occupational Rehabilitation, 15, 453–457.PubMedCrossRef

18.

Shrey, D., & Lacerte, M. (1995). Principles and practices of disability management in industry. Winter Park, FL: GR Press.

19.

Arnetz, B. B., Sjorgren, B., Rydehn, B., & Meisel, R. (2003). Early workplace intervention for employees with musculoskeletal-related absenteeism: a prospective controlled intervention study. Journal of Occupational and Environmental Medicine, 45, 499–506.PubMedCrossRef

20.

Molde, H. E., Grasdal, A., & Eriksen, H. R. (2003). Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: A 3-year follow up study. Spine, 28, 2309–2315.CrossRef

21.

Gatchel, R. J., Polatin, P. B., Noe, C., Gardea, M., Pulliam, C., & Thompson, J. (2003). Treatment and cost effectiveness of early intervention for acute low-back pain patients: A one-year prospective study. Journal of Occupational Rehabilitation, 13, 1–9.PubMedCrossRef

22.

Gates, L. B. (2000). Workplace accommodation: A social process. Journal of Occupational Rehabilitation, 10, 85–98.CrossRef

23.

Hlobil, H., Staal, J. B., Spoelstra, M., Ariens, G. A., Smid, T., & van Mechelen, W. (2005). Effectiveness of a return-to-work intervention for subacute low-back pain. Scandinavian Journal of Work, Environment & Health, 31, 249–257.

24.

Retrieved April 2, 2007 from http://www.millardhealth.com

25.

Drew, D., Drebing, C. E., Ormer, A. V., Losardo, M., Krebs, C., Penk, W., & Rosenheck, R. A. (2001). Effects of disability compensation on participation in and outcomes of vocational rehabilitation. Psychiatric Services, 52, 1479–1484.PubMedCrossRef

26.

Donabedian, A. (1981). Criteria, norms and standards of quality: What do they mean? American Journal of Public Health, 71, 409–412.PubMedCrossRef

27.

Donabedian, A. (1988). Quality assessment and assurance: Unity of purpose, diversity of means. Inquiry, 25, 173–192.PubMed

28.

Donabedian, A. (1988). The quality of care: How can it be assessed? Journal of the American Medical Association, 260, 1743–1748.PubMedCrossRef

29.

Bartlett, E. E., Grayson, M., Barker, R., Levine, D. M., Golden, A., & Libber, S. (1984). The effects of physician communication skills on patient satisfaction, recall and adherence. Journal of Chronic Diseases, 37, 755–764.PubMedCrossRef

30.

Aharony, L., & Strasser, S. (1993). Patient satisfaction: What we know and what we still need to explore. Medical Care Research and Review, 50, 49–79.CrossRef

31.

McKinnon, A. L. (2000). Client values and satisfaction with occupational therapy. Scandinavian Journal of Occupational Therapy, 7, 99–106.CrossRef

32.

Adams, J. H., & de Williams, A. C. (2003). What affects return to work for graduates of a pain management program with chronic upper limb pain? Journal of Occupational Rehabilitation, 13, 91–106.PubMedCrossRef

33.

Dionee, C. E., Bourbonnais, R., Freemont, P., Rossignol, M., Stock, S. R., & Larocque, I. (2005). A clinical return-to-work rule for patients with back pain. Canadian Medical Association Journal, 172, 1559–1567.CrossRef

34.

Hansen, A., Edlund, C., & Branholm, I. B. (2005). Significant resources needed for return to work after sick leave. Work, 25, 231–240.PubMed

35.

Rusch, M. D., Dzwierzynski, W. W., Sanger, J. R., Pruit, N. T., & Siewart, A. D. (2003). Return to work outcomes after work-related hand trauma: the role of causal attributions. Journal of Hand Surgery, 28, 673–677.PubMedCrossRef

36.

Schultz, I. Z., Crook, J., Meloche, G. R., Berkowitz, J., Milner, R., Zuberbier, O. A., & Meloche, W. (2004). Psychosocial factors predictive of occupational low back pain disability: Towards development of a return to work model. Pain, 107, 77–85.PubMedCrossRef

37.

Heymans, M. W., de Vet, H. C.W, Knol, D. L., Bongers, P. M., Koes, B. W., & van Mechelen, W. (2006). Workers’ beliefs and expectations affect return to work over 12 months. Journal of Occupational Rehabilitation, 16, 685–695.PubMedCrossRef

38.

Krause, N., Dasinger, L. K., & Neuhauser, F. (1998). Modified work and return to work: A review of the literature. Journal of Occupational Rehabilitation, 8, 113–139.CrossRef

39.

Friesen, M. N., Yassi, A., & Cooper, J. (2001). Return-to-work: The importance of human interactions and organizational structures. Work, 17, 11–22.PubMed

40.

Donald, C., Voaklander, A., Beauline, P., & Lessard, R. A. (1995). Factors related to outcome following a work hardening program. Journal of Occupational Rehabilitation, 5, 71–85.CrossRef

41.

Gilbert, S., Kerley, A., Lowdermilk, A., & Panus, P. C. (2000). Nontreatment variables affecting return-to-work in Tennessee-based employees with complaints of low back pain. Tennessee Medicine, 93, 167–171.PubMed

42.

Graly, J. M., Yi, S., Jensen, G. M., Gibson, M., & Laborde, T. (1994). Factors influencing return to work for clients in a work hardening center. Work, 4, 9–21.

43.

Vendrig, A. A. (1999). Prognostic factors and treatment-related changes associated with return to work in the multimodal treatment of chronic back pain. Journal of Behavioral Medicine, 22, 217–232.PubMedCrossRef

44.

Tait, R. C., Pollard, C. A., Margolis, R. B., et al. (1987). The pain disability index: Psychometric and validity data. Archives of Physical Medicine and Rehabilitation, 68, 438–441.PubMed

45.

Pollard, C. A. (1984). Preliminary validity study of the pain disability index. Perceptual and Motor Skills, 59, 974.PubMed

46.

McHorney, C. A., Ware, J. E. Jr., Raczek, A. E. (1993). The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 31, 247–263.PubMedCrossRef

47.

Finch, E., Brooks, D., Stratford, P., et al. (2002). Physical rehabilitation outcome measures: A guide to enhanced clinical decision making (2nd ed). Toronto: Canadian Physiotherapy Association.

48.

Falardeau, M., & Durand, M. J. (2002). Negotiation-centred versus client-centred: Which approach should be used? Canadian Journal of Occupational Therapy, 69, 135–142.

49.

Loisel, P. (2005). Intervention for return to work-what is really effective? Scandinavian Journal of Work, Environment & Health, 31, 245–7.

Title: Changing to an Outcome-focused Program Improves Return to Work Outcomes
Authors: Pamela Joy Tschernetzki-Neilson
E. Sharon Brintnell
Calvin Haws
Kathryn Graham
Publication date: 01-09-2007
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 3/2007
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-007-9094-z

At a glance: The STEP trials

Springer Medicine

Changing to an Outcome-focused Program Improves Return to Work Outcomes

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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