An Ergonomics Perspective on Return To Workon Return-To-Work

Darcie Jaremey, AEPMatthew Ross, CPE

Workers’ Compensation Board of Nova Scotia

Agenda

• Introduction• Injury Data and Return-to-Work Systems• SPICE Model• Transitional Duties• Participatory Ergonomicsp y g• Public Consultation• QuestionsQuestions

WCB of Nova Scotia

• Nova Scotia’s workplace injury p j yinsurance provider

• Cover 18,000 employers and 300 000 workers300,000 workers

• Not for Profit• 100% Funded by employers – NO

tax dollars

• Lawsuit protection for employers

• No fault protection for workers

Our Mission

We inform and inspireWe inform and inspire Nova Scotians in the

prevention of workplace injury, but if it occurs we

support those whose lives it touches bylives it touches by

championing a timely return to safe and

h lth khealthy work.

Workplace Injury

• Is any personal injury or medical y p j ycondition arising out of and in the course of employment caused to a worker p yresulting from the interaction with their work environment.

Participation & Consultation

Compliance Assurance

Management Support of Resources

Medical Management

Health & Safety Corporate Policy

Tools, Techniques &

Skills

yManagement System

Education & TrainingDocumentation

Program Management

Evaluation / Audit Process

Nova Scotia’s Injury Epidemic

In 2008, there were:An injury every

17,

• 31,753 registered claims 17minutes

– 87 people injured every day

• 8,050 were time-loss claims– 22 serious injuries every day

• 29 fatalities

When Injury Occurs: Our Goal

When the worker’s

functional abilities match

Length oftime to

achieve RTW (Claim

• Pre-Injury Employer • Initially - Transitional duties

• Work of Value• Rehabilitativeabilities match

the job demands

(Claim Duration)

Rehabilitative• Finally - Pre-injury or suitable duties

Return-to-Work (RTW) Systems

• Injury management/RTW systemj y g y– Employers proactively help injured workers stay at

work or return to productive and safe work when h i ll iblphysically possible.

• System based on philosophy: injured workersSystem based on philosophy: injured workers can safely perform productive work during process of recoveryy

RTW Management: SPICE Model

• Simplicity – The concept that simple benign conditions treated in a complicated fashion become complicatedcomplicated fashion become complicated

• Proximity – The need to keep the worker associated with the workplace

• Immediacy - The need to deal with industrial claims in a timely manner

• Centrality All parties involved with workers need to share a• Centrality - All parties involved with workers need to share a common philosophy and ultimate goal of returning the individual back to gainful employment as soon as possible.

E t Th t th t i di id l ft f lfill th• Expectancy – The concept that individuals often fulfill the expectation placed on them.

Proximity: Keeping the Worker Integrated

Good for the Proximity – The need to keep the worker associated with the

Integrated

Worker

G d f th

worker associated with the workplace

Good for the Employer

Good for the WCB

Good for the NS EconomyNS Economy

Immediacy - Time is of the EssenceThe longer a worker is off work, the more complex the condition

bbecomes

Window ofOpportunity

Immediacy - The need to deal with industrial claims in a timely manner

Centrality – Focus on Common GoalyBy working together with a keen focus and commitment to the common goaland commitment to the common goal

Worker Employer

Safe & Timely

Primary Care

Physiotherapy

Case Worker

Appeal System RTWPhysiotherapy

Other Health Care Providers

Appeal System

Centrality - All parties involved with workers need to share a common philosophy and ultimate goal

of returning the individual back to gainful employment as soon as possible.

Expectancy – Consistent MessagingMessaging

Case Worker

Expectancy – The concept thatI j d concept that

individuals often fulfill the expectation placed on them.

Injured Worker

Comprehensive RTW Management

15

SPICE

MedicalDisability Advisor

Early PsychosocialScreening & Intervention

Direct AccessTo

Physiotherapy

Collaborative Partnerships

with Employers

Dr. NSContractExpectation

Management

ServiceProvider

AccountabilityTiered

Services&

EPSManagement Accountability

SPICE

Injury-RTW Cycle

• The key to an effective t t kreturn-to-work

approach is to identify work-related riskwork-related risk factors that lead to the injury j y– Breaking this cycle is

essential

Transitional Duties

• Effective method to achieve successful outcomes with return-to-workoutcomes with return-to-work

• Functional basis ideal for musculoskeletal injuriesinjuries

• Works with the SPICE model components• Availability of transitional duties can impact• Availability of transitional duties can impact

injury durations

Transitional Duties

• Ensure focus is on “abilities” not “disabilities”• Transitional duties should be value-added to

an organization• Hierarchy of transitional duties; same

position/department idealT iti l d ti t h i• Transitional duties are temporary changes in responsibilities, not a new job

Functional abilities should be re assessed in a– Functional abilities should be re-assessed in a timely manner

Developing Transitional Duties

• Achieving a safe and timely Return to Work may require creativity:– Temporary task change (Transitional

Duties) OR– Modification within current job (reduce

difficult task through work design) OR– Entirely different job (Suitable Work)

Components of Transitional Duties

• Several options available to develop your transitional duties:transitional duties:– Functional Job Description/Analysis, Job Site

Analysisy– Functional Abilities Report (from physiotherapist)

• If the nature of the injury limits transitional j yduties development, ensure suitable work is value-added– until functional abilities allow for transitional duties

Transitional Duties OptionsEmployer

Modifying Job DemandsPhysiotherapist

Assessing Abilities vs Job Demands

FunctionalAbilities

Job Demands = Eliminate duties from

usual job

Eli i t d ti f

=

= Eliminate duties from usual job + add duties from another job

Assign another job

= Match = Safe

=

Assign another job

Assign duties from various other jobs

= No Match = Unsafe

Match = Safe

How do we break the RTW-Injury Cycle

• Incident investigation is keyEff ti t l i d t l• Effective root cause analysis and control measures to mitigate the riskM l k l t l i j i b fit f• Musculoskeletal injuries can benefit from a participatory ergonomics approach to mitigate risksrisks

What is Participatory Ergonomics?

• Process of involving and encouraging key personnel in identifying and solving problemspersonnel in identifying and solving problems with work-related hazards– Method to break the injury-RTW cycleMethod to break the injury RTW cycle

• Effective approach to reducing hazards that can lead to injuriescan lead to injuries– Reduce MSIs, WCB claims, lost time from work

Before/After Pictures

24

Implementing Participatory Ergonomics

• A recent, systematic review of literature suggests that these are the most important insuggests that these are the most important in implementing PE:– Organizational support– Resource commitment– Open communication about the PE program

Assistive in developing appropriate• Assistive in developing appropriate Transitional Duties based on functional abilities

Keys to Success with Ergonomic Change Teams

• Further, it is suggested that these are key critical features in a successful ergonomicscritical features in a successful ergonomics team:– Address Key Barriers to the processAddress Key Barriers to the process– Create PE teams with appropriate members– Involve a PE champion to guide and monitor the p g

process

Developing your Ergo Program, cont

– Provide trainingInvolve the right people in the overall PE– Involve the right people in the overall PE processDefine team members responsibilities– Define team members responsibilities

– Make decisions using group consultationOrganizational Readiness– Organizational Readiness

– Management SupportECT Ch i– ECT Champion

– Employee buy-in– Proactively eliminating risk factors

Musculoskeletal Injury Consultation PaperConsultation Paper

Department of Labour and Workforce Development

W k ’ C ti B d f NWorkers’ Compensation Board of Nova Scotia

Consultation Paper• To solicit feedback on potential approaches

to musculoskeletal injury prevention in Novato musculoskeletal injury prevention in Nova Scotia

• To be released early May for consultation –y ywill be available on the web, electronically and as a surveyIf i h t h f th i f ti t• If you wish to have further information or to receive a copy email at:

• Matt ross@wcb gov ns caMatt.ross@wcb.gov.ns.ca