Nicole Matoushek PT MPH CSHE CEES
Posts: 723
Joined: January 15, 2005
From: St. Petersburg, FL
Status: offline
|
Work Integration/Work Transition Programs
Work integration/Work Transition programs are a specialized form of return to work programs for injured workers. Like work hardening and work conditioning programs, work integration programs involve the development of a plan of care to recondition the injured worker in order to return to work following a work-related injury. Unlike traditional work hardening and work conditioning programs, work integration/Work transition programs use real work activities and equipment and provide a graduated plan and work schedule for the individual to regain strength and endurance, and improve positional tolerances, by performing work activities. This approach allows the individual to be productive at the workplace, and provides a forum for addressing pain limitations and pain behaviors, which may prevent or inhibit return to work.
The program works by evaluating the clinical factors, injury factors, ergonomic risk factors and work tasks of an injured worker who can not easily return to his or her pre-injury level of work function. By evaluating the injured worker’s functional deficits, injury characteristics, critical job demands and ergonomic risk factors, the rehabilitation professional can develop a scheduled progression of work duties that will allow progressive reconditioning and adequate tissue healing, while allowing the worker to remain productive and safe at the workplace. Work integration programs are a very effective method in injury management, as they provide prompt return to work, productive work duties and an opportunity for injury resolution, all of which can significantly influence the overall cost of the injury claim.
Work Integration Defined
The term “integration” refers to the “formation, coordination or blending of components into a functioning or unified whole”. Hence, “Work integration” refers to the formation, coordination or blending of the clinical features, ergonomic risks, work tasks and work organization components of an injured worker into a functioning or unified whole. By providing a systematic process of coordinating all of the factors that may potentially interfere, or influence the successful return to work of an injured worker, the end product is a fully functioning, “whole” worker who is safe and appropriate to return to work. The injured worker is integrated back to full work duties over a period of time, using real work tasks. This integration allows for progressive reconditioning and full tissue recovery, while providing real and productive work.
Program Implementation
Program implementation involves the assessment and management of the clinical features, ergonomic risks, the work tasks and the work organization factors that interfere with the injured worker’s ability to perform full duty tasks. The injured worker is progressed from a no duty or light duty situation to full duty. Work integration may be indicated if an injured worker presents with functional limitations in strength, endurance, diminished activity tolerance or pain behaviors that prohibit a safe and successful return to work. The program candidates are most commonly in the sub acute or chronic phase of injury healing. However, there may be indications for work integration for the acutely injured worker. Work integration/Work transition programs are implemented at the worksite, as opposed to the clinic environment. Work integration programs use real work activities and equipment. Typical work integration programs typically require 4- 8 weeks of supervised care.
The referral for the work integration can come from the employer, the case manager or adjuster or the physician. If the rehabilitation professional is at the worksite or already treating the injured worker in therapy, the rehabilitation professional has an opportunity to identify appropriate candidates that would benefit from this program. The rehabilitation professional should communicate to the physician, employer and case manager if he or she identifies a candidate who will benefit from a work integration program.
Components of Work Integration/Work Transition Programs
The components of the work integration program are described below. This program requires the cooperation, and consent, of not only the injured worker, but the ordering physician, insurance carrier and the employer.
• Work Data
• Functional Assessment
• Injury Characteristics
• Ergonomic Risk factors
• Injury Risk
• Work Organization factors
• Recommendations
Work Integration/Work Transition Plan of Care
The work integration/work transition plan of care involves the assessment, development and management of all of the components of return to work. A typical example of a work integration program is as follows. A warehouse worker is receiving rehabilitation following a laminectomy he acquired after he injured his back lifting at work. The worker is 6 weeks post-op and the physician has kept the worker completely out of work. The critical job demands include; material handling of objects ranging in weight from 25 to 100 pounds, driving a forklift and performing product logging duties. At this time, the physician returns the worker to work with lifting restrictions of 50 pounds and a follow up in one month. The employer is concerned about re-injury and lost production.
The rehabilitation professional evaluates the functional status of the injured worker, the injury characteristics, the ergonomic risk factors and work organization factors. In this case, the functional limitations of the injured worker include: maximal lift of 50 pounds and limitations in standing, walking, twisting and forklift driving. The injury characteristics include a post surgical condition in the sub-acute stages of healing and no prior medical history or post operative medical complications. The ergonomic risk factors of the job include material handling, overhead lifting and forklift driving. The work organization factors include a flexible work schedule in which work tasks can be under control of the employee and there is opportunity for alternating work tasks.
The objective of the work integration plan of care is to provide a structured work and rehabilitation plan of care, in which the more physically demanding work tasks are progressively increased in frequency, intensity and duration over time, while subsequent decreases in the frequency, duration of the less physically demanding tasks are made, thus providing an opportunity for the injured worker to recondition while performing active, real work duties. In this example case, product logging duties is the least physical of the work tasks, so in the initial stages of the plan, the injured worker will spend more time logging products and less time performing material handling and forklift driving activities. As the plan progresses, the injured worker will spend less time logging products and more time with forklift driving and material handling activities. This progressive plan of alternating duties and gradually increasing physical work requirements allows for a period of reconditioning. In addition, the rehabilitation professional designs a schedule for a month’s time to limit the worker’s lifting to 25 pounds during week one, 35 pounds during week two, 45 pounds during week three, and 50 pounds during week four. The work integration program and plan may continue for several weeks or months, until the worker is at full duty with no restrictions.
Summary
Work integration/work transition programs are a specialized form of return to work programs for injured workers. Work integration programs involve the development of a plan of care specifically designed to recondition the injured worker to facilitate return to work following a work-related injury. Work integration programs utilize real work activities and equipment and provide a graduated plan and work schedule for the individual to regain strength and endurance, and improve positional tolerances, by performing actual, real work activities. This approach allows the individual to be productive at the workplace, and provides a forum for addressing pain limitations and pain behaviors, which may prevent or inhibit return to work. Work integration programs are a highly affective method of containing work-related injury rates and costs.
References:
[URL=http://www.ergorehabinc.com]www.ergorehabinc.com[/URL]
Nicole Matoushek MPH, PT
_____________________________
Nicole Matoushek, PT, MPH, CSHE, CEES
http://www.ErgoRehabinc.com
http://www.ErgoRehabBlog.com
http://www.ComputerAccessoriesOnlineStore.com
|
Printable Version
All Forums >> [RehabEdge Forum] >> Open Forum >> Work Transition/Work Integration programs: article 
Work Transition/Work Integration programs: article - 
New Messages
No New Messages
Hot Topic w/ New Messages
Hot Topic w/o New Messages
Locked w/ New Messages
Locked w/o New Messages
Post New Thread
Reply to Message