Return to work: building on the world’s best research to improve knowledge

Statistics indicate that return to work rates have not improved in Australia over the past five years. In recent years, the focus of research internationally has been in two areas: what workplaces could do to better support people who have been unwell to return to work; and what we can do to empower workers to have more control in the return to work process.

Return to work is one of the Institute for Safety, Compensation and Recovery Research’s (ISCRR) priority areas and we have a number of research projects. One is with the Institute for Work and Health (IWH) in Canada to update an extensive systematic review of the literature they completed in 2004. This earlier review led to the development of the globally recognised tool, the Seven Principles of Return to Work, which are as follows:

1. The workplace has a strong commitment to health and safety, which is demonstrated by the behaviours of the workplace parties.
2. The employer makes an offer of modified work (also known as work accommodation) to injured/ill workers so they can return early and safely to work activities suitable to their abilities.
3. RTW planners ensure that the plan supports the returning worker without disadvantaging coworkers and supervisors.
4. Supervisors are trained in work disability prevention and included in RTW planning.
5. The employer makes an early and considerate contact with injured/ill workers.
6. Someone has the responsibility to coordinate RTW.
7. Employers and healthcare providers communicate with each other about the workplace demands as needed, and with the worker’s consent.

Since this earlier work was completed, there has been a growth in the research literature on return to work and ISCRR is now working with the IWH to update the initial review for workplace-based return to work programs and also to extend it to include literature on what works at a system level, eg actions by a regulator. The findings of the review will help determine whether the original Seven Principles need to be modified.

Another centre famous for its research on preventing work disability is the Liberty Mutual Research Institute for Safety outside Boston where Bill Shaw has been working on skills and behaviours needed by supervisors to help workers return to work for some time. Bill is one of the investigators on a project being led by ISCRR Development Grant recipient Dr Venerina Johnston, who is looking at the supervisor role in relation to RTW after a mental disorder or musculoskeletal injury.

I have a personal interest in this area. With colleagues at the University of Queensland and Flinders University, we are conducting a study of the effect of adding self-management training to the usual occupational rehabilitation. This project came about after I read an article by Elizabeth Kendall which said that humanitarianism had been lost in vocational rehabilitation. Working with rehabilitation service providers IPAR, Nabanet, Recovre and Konekt and with Arthritis Victoria, we are running training programs from Stanford University which aim to teach people skills in managing their health and their health providers, as well as two new modules on return to work and navigating the compensation system. We will see whether this makes a difference to readiness for return to work.

Clearly, doctors play a huge role in return to work. Led by Danielle Mazza, the Department of General Practice at Monash will be conducting an ISCRR study on GP knowledge, attitudes and practice in Australia, compared with the UK and Canada. One of the investigators on this project will be Professor Sir Mansel Aylward, who is an RTW pioneer from Wales, well known internationally. Toronto - Boston - Cardiff - Melbourne: all right, it may not be Max Factor, but we will be building on the best research in the world to improve knowledge in Victoria on return to work.

*Professor Niki Ellis is the CEO of Institute of Safety, Compensation and Recovery Research. Ellis - one of Australia’s leading occupational physicians and an expert in assisting organisations to manage workplace stress - was appointed as CEO in February 2010. In 2008, Professor Ellis utilised her consultancy experience in organisational stress management to co-develop and present the four-part ‘Stressbuster' series for ABC TV.