title: Can we enhance the ability to return to work among workers with stress-related disorders? Disability management practices in education, hotel/motel, and health care workplaces. Association between clinical and work-related interventions and return-to-work for patients with musculoskeletal or mental disorders. From Evidence to Community Practice in Work Rehabilitation: The Quebec Experience Disability case management: an impact assessment in an automotive manufacturing organization. Early Workplace Intervention for Employees With Musculoskeletal-Related Absenteeism: A Prospective Controlled Intervention Study Multidisciplinary Rehabilitation for Subacute Low Back Pain: Graded Activity or Workplace Intervention or Both?: A Randomized Controlled Trial
abstract: Background Stress-related disorders are widespread and responsible for high societal costs e.g. sick leave payment and reduced productivity . The aim of this study was to evaluate the effect of an intervention program on return to work or labour market . Methods In a controlled interventional study design we compared 72 emotionally distressed patients , who received support during 2006 , with 89 control individuals who had also been sick listed for emotional distress .  Intervention was provided by trained psychologists and social workers who were in continuous dialog with the patients , providing counselling e.g. on decisions concerning resumption of work , support to families , participation in meetings with the workplace . Basically , the controls and the intervention group share the same access to welfare benefits . The main outcome was time to return to labour market ( TTR ) . Results The baseline characteristics were similar in the two groups . There were no differences in the rate of resuming work between the two groups . About 80 % in both groups had returned to the labour market after one year . Conclusion An intervention program with psychological stress management and case management did not improve work capability compared to usual care . Work resumption as a single outcome probably is an insensitive parameter of intervention management quality , and should be supplemented by other data on different aspects of treatment BACKGROUND The high costs and the impact of work disability have become a growing concern for workplaces . As a result , workplace disability management approaches have been developed to lower disability costs , protect the employability of workers , and promote early return to work . METHODS A stratified r and om sample of 455 employers in education ( n = 157 ) , hotel/motel ( n = 110 ) , and health care ( n = 188 ) sectors who completed a mailed Organizational Policies and Practice s ( OPP ) question naire is reported . The OPP question naire asked questions about eight workplace disability management practice s. The article examined the multi-dimensionality , internal consistency , and discriminant validity of the OPP and compares disability management practice s across the three sectors . RESULTS The OPP question naire showed good internal consistency ( Cronbach 's alpha = 0.95 ) and discriminant validity . A one-way analysis of variance ( ANOVA ) for each of the eight subscales demonstrated that there were statistically significant differences between the sectors in ergonomic practice s ( F ( 2,452 ) = 15.8 , P < 0.001 ) , disability case management ( F ( 2,452 ) = 4.6 , P < 0.01 ) , return to work ( F ( 2,452 ) = 10.3 , P < 0.001 ) , and people-oriented culture ( F ( 2,452 ) = 4.5 , P < 0.01 ) . CONCLUSIONS On examining disability management practice s in education , hotel/motel , and health care sectors , the OPP seems to be a promising instrument that can be used to assess and monitor how employers are managing disability OBJECTIVE The aim of this study was to explore what characterizes patients receiving clinical interventions vs combined clinical and work-related interventions in a cohort of sick-listed subjects with musculoskeletal or mental disorders . Factors associated with return-to-work were also analysed . DESIGN A prospect i ve cohort study . METHODS A total of 699 newly sick-listed patients responded to a question naire on sociodemographics , measures of health , functioning , work ability , self-efficacy , social support , work conditions , and expectations . The 3-month follow-up question naire included patients ' self-reported measures of return-to-work , work ability and type of interventions .  The most frequent International Classification of Diseases-10 diagnoses for patients ' musculoskeletal disorders were dorsopathies ( M50 - 54 ) and soft tissue disorders ( M70 - 79 ) , and for patients with mental disorders , depression ( F32 - 39 ) and stress reactions ( F43 ) . RESULTS Patients with mental disorders who received combined interventions  returned to work to a higher degree than those who received only clinical intervention . The prevalence of work-related interventions  was higher for those who were younger and more highly educated . For patients with musculoskeletal disorders better health , work ability and positive expectations of return-to-work were associated with return-to-work . However , combined interventions did not affect return-to-work in this group . CONCLUSION Receiving combined interventions increased the probability of return-to-work for patients with mental disorders , but not for patients with musculoskeletal disorders . Better health , positive expectations of return-to-work and better work ability were associated with return-to-work for patients with musculoskeletal disorders Background The causes of prolonged disability due to back pain are multiply determined , involving medical , social , and environmental factors . Possible solutions to the problem of prolonged back pain disability have emerged from recent research but few efforts have been made to transfer evidence -based programs to large community setting s. Objective This article describes three phases of the process of transfer of evidence from rehabilitation research to community practice in the province of Quebec . Methods and Results Phase A : Based on literature review and expert knowledge , the Sherbrooke model was developed and assessed through a population -based , r and omized clinical trial . Results at 1-year follow-up showed quicker return to regular work and improvement of quality of life ; the 6-year follow-up showed the cost-effectiveness of the method .Phase B : Based on the Sherbrooke model experience and recent evidence , a new program addressing the disability paradigm was developed and implemented in the province of Quebec ( Canada ) . Results at 1- and 3-year follow-ups showed that only 24 % of workers were not working owing to their musculoskeletal disorder . The program is presently being tested through a population -based , r and omized clinical trial in a population of construction workers . Phase C : To implement the program at a provincial level , a network for management , research and education in work rehabilitation was developed . An external assessment is presently planned to evaluate return to work and economic outcomes and quality of implementation of the program in various setting A multifaceted disability management program was instituted at an automotive manufacturing organization to control rising workers ' compensation costs . A pilot program showed major cost savings over a 9-month period . When total and component disability leave rates were calculated as a percentage of the available workforce and tracked on a weekly basis over the subsequent 3 years , total disability leave rates fell by nearly 50 % . This was largely attributable to an approximately 50 % decrease in the extended ( > 1-year ) disability leave rate and a 75 % decrease in the workers ' compensation leave rate . A novel approach to biostatistical analysis showed a good fit of weekly disability leave rates to a Poisson r and om variable distribution with an identifiable break point at about 1 1/2 years after observation for extended disability leaves and at 2 years for workers ' compensation leaves . This biostatistical approach may prove generalizable to tracking leave rates in other organizations Sickness absenteeism caused by musculoskeletal disorders ( MSDs ) is a persistent and costly occupational health challenge . In a prospect i ve controlled trial , we compared the effects on sickness absenteeism of a more proactive role for insurance case managers as well as workplace ergonomic interventions with that of traditional case management .  Patients with physician-diagnosed MSDs were r and omized either to the  intervention group or  the reference group offered the traditional case management routines . Participants filled out a comprehensive question naire at the initiation of the study and after 6 months . In addition , administrative data were collected at 0 , 6 , and 12 months after the initiation of the project . For the entire 12-month period , the total mean number of sick days for the intervention group was 144.9 ( SEM 11.8 ) days/person as compared to 197.9 ( 14.0 ) days in the reference group ( P < 0.01 ) . Compared with the reference group , employees in the intervention group significantly more often received a complete rehabilitation investigation ( 84 % versus 27 % ) . The time for doing this was reduced by half ( 59.4 ( 5.2 ) days versus 126.8 ( 19.2 ) , P < .01 ) . The odds ratio for returning to work in the intervention group was 2.5 ( 95 % confidence interval 1.2–5.1 ) as compared with the reference group . The direct cost savings were USD 1195 per case , yielding a direct benefit-to-cost ratio of 6.8 . It is suggested that the management of MSDs should to a greater degree focus on early return to work and building on functional capacity and employee ability . Allowing the case managers a more active role as well as involving an ergonomist in workplace adaptation meetings might also be beneficial Study design . Population -based r and omized controlled trial . Objective . To assess the effectiveness of workplace intervention and grade d activity , separately and combined , for multidisciplinary rehabilitation of low back pain ( LBP ) . Summary of Background Data . Effective components for multidisciplinary rehabilitation of LBP are not yet established . Methods . Participants sick-listed 2 to 6 weeks due to nonspecific LBP were r and omized to workplace intervention ( n = 96 ) or usual care ( n = 100 ) .  Workplace intervention consisted of workplace assessment , work modifications , and case management involving all stakeholders . Participants still sick-listed at 8 weeks were r and omized for grade d activity  ( n = 55 ) or usual care ( n = 57 ) . Grade d activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles . Outcomes were lasting return to work , pain intensity and functional status , assessed at baseline , and at 12 , 26 , and 52 weeks after the start of sick leave . Results . Time until return to work for workers with workplace intervention was 77 versus 104 days ( median ) for workers without this intervention ( P = 0.02 ) . Workplace intervention was effective on return to work ( hazard ratio = 1.7 ; 95 % CI , 1.2–2.3 ; P = 0.002 ) .  Grade d activity had a negative effect on return to work ( hazard ratio = 0.4 ; 95 % CI , 0.3–0.6 ; P < 0.001 ) and functional status . Combined intervention had no effect . Conclusion . Workplace intervention is advised for multidisciplinary rehabilitation of subacute LBP . Grade d activity or combined intervention is not advised
target: The DM program has shown to be effective and efficient .
  Nevertheless , some components are emphasized more than others ; job accommodation , facilitation of transitional duty , communication between all stakeholders , health care provider advice , early intervention , and acceptance , goodwill and trust in the stakeholders , in the organization , and in the disability management process
background: BACKGROUND Disability management ( DM ) is a systematic method to ensure job-retention and job-reintegration in competitive employment for individuals with a disability .
  There is evidence that ' returning to work ' has a positive impact on the individual , the company and on the society .
  However , a clear overview of the efficacy and efficiency of the DM programs is scarce .
  OBJECTIVE To systematic ally review the efficacy and efficiency of the disability management programs .