A Journey to the Future of
Injury Management from an
International Perspective
18 March 2013: EBIM Conference
Nikki Brouwers
Interact 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 morbidity
2. Family History
3. Personality
4. Expectations
Predictors to RTW cont..
• Unimportant factors include:
• Financial incentives
• Business environment
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 reengineer 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
Thankyou
• Nikki Brouwers
• 02 9460 2444
• nikki@interactgroup.com.au