Professional Boundaries in Workplace Rehabilitation and Injury

Prevention

AgendaProcesses Involved in workplace rehabilitation and

injury prevention.

OT role Allied health and their roles Stakeholders and their roles

Issues of working in a MDT team including:- Blurring of roles- Issues of communication - Biomechanical Vs. holistic approaches

The impact that these issues have on OT practice.

Processes of workplace rehabilitation and injury prevention

Queensland workers compensation schemeQueensland compensation (Q-comp) Insurance companies (such as Work cover)

Workers compensation covers:Injury at workPsychological injury at workTravel to and from work

(www.qcomp.com.au; 2013)

Return to Work Process

www.workcoverqld.gov.au; 2013

Workplace injuryReport to supervisorMake a claimInsurance company accepts/ rejects claimObtain workers compensation medical certificate Referral to Allied Health ProfessionalWorkplace Rehabilitation Injured worker returns to either:• Current job (same job or new role) • New job (similar role or new role)

Case Study Back injuryWithdrawn from co-workersLack of interest in activities outside of workAnxious about workStress of unemployment possibilityGuilt of no longer contributing to organisation .

OT to consider:Psychosocial Issues Factors that effect RTW process and compound

the length of days off work.Ostiguy, (2010); Bade & Eckert, 2008)

OT Role – One on one sessionsInitial consultationSubsequent consultationReassessment/ program reviewComplex occupational therapy assessmentComplex occupational therapy

intervention Specialised hand/ upper limb therapy

consultationGroup education sessionsIndependent case review (www.qcomp.gov.au; 2013)

OT role (continued)Communication/ consultation with

stakeholdersCase conferences with stakeholdersProgress reportStandard reportComprehensive reportPrescription of supportive devicesExternal Case management

(www.qcomp.com.au; 2013)

Allied health team membersRegistered approved providers include:PhysiotherapistOccupational therapistExercise physiologistsPsychologistsChiropractorsOsteopathsPodiatristsYou may also work with others including (but not limited to)DentistsNursing staffSpeech pathologists Rehabilitation counselors

www.workcoverqld.gov.au; 2013; www.qcomp.com.au,2013))

Exercise Physiologist

OT PT Psychologist

Rehabilitation Counselor

SW

Workplace Evaluation AssessmentFunctional Capacity EvaluationReturn to work facilitationSuitable Duties PlanVocational AssessmentsJob Seeking

Job preparation ServicesJob placement Service

MDT roles and the importance of communication.How to refer to another allied health professional.Practitioners working in rural communities-

blurring roles:- Inadequate access to a team of specialist medical,

rehab and support staff.- Inadequate physical access to stakeholders,

injured worker and employer.- OT’s need a broad range of skills as a lack of

specialised services. - Limited professional development.

Issues to consider

(Ciccarelli, M & Dender, J, 2010)

Activity Time!Get into groups . (5-6

individuals)4 Questions will be

asked (2 now and 2 at the end)

First group to all stand up and answer the question wins a point.

Team with the most points at the end wins a surprise.

• Client• Insurer• Nominated treating doctor• Injured worker• Injured workers supervisor• Injured workers line manager• RTW coordinator (If larger company)• Allied health staff• Any specialised services

Main Stakeholders

(www.workcoverqld.gov..au,2013)

Professional Boundary IssuesCrossover of roles between all stakeholders

leading to conflict- Understanding and appreciating professional

roles - Identify each stakeholders interests goals- Identify possible barriers to goal achievement. - Effective communication.

Conflicting stakeholder advice can enhance fear and avoidance of injured worker.

(Ciccarelli & Dender, 2010; Bade & Eckert, 2008; Suter, Arndt, Arthur, Parboosing, Taylor & Deutschlander, 2009; Tyulin, Stwine & Eckberg, 2009)

Professional boundary IssuesBio-psychosocial model- Biological- Psychological and;- Social factors

Biomechanical approach Vs Holistic approach-OT offer valuable holistic approach-Issue of time constraints and other stakeholders taking a biomechanical approach.

(Tyulin, Stiwne, & Ekberg, 2009; Bade & Eckert, 2008;

SummaryRoles of team members cross over.Your team includes not only allied health, but

includes all stakeholders.Good communication is key to reduce conflict

between blurring roles.There are many barriers in work

rehabilitation and injury prevention to using a holistic approach. The OT role is important.

Activity time!

References Ciccarelli, M & Dender, J. (2010). Contextual factors influencing early

return to work in the rural and remote sector. International journal of social security and workers compensation. Vol 2, No.1. p 17-28.

Matcher, K. et al. AOTA. An historical perspective. http://www.aota.org/About.39983.aspx,

Suter, E., Arndt, J., Arthur, N., Parboosingh, J., Taylor, E., & Deutschlander, S. (2009). Role understanding and affective communication as core competencies for collaborative practice. Vol 23, no 1. doi. 10.1080/13561820802338579 p. 41-51

Bade, S., & Eckert, J. (2008). Occupational therapists critical value in work rehabilitation and ergonomics. Journal of prevention, assessment and rehabilitation. Doi 10519851/08. p101-111

Tjulin, A., Stiwne, E.E., & Eckberg, K. (2009). Experience of the implementation of multi-stakeholder return to work programme. Journal of occupational rehabilitation. Doi. 1007/5109260099195.

References Institute of health and work (2004) Workplace based return to work

interventions. A systematic review of the qualitative and quantitative literature. Ontario

Barnett, K., Hoardtaker, A. L/. Spoer, J & Parnis, E (2010). Discussion paper: The role of the workplace in return to work. Report prepared for Workcover SA. Australian institute for social research. Available at www.workcover.com/publicdownload. Aspx>id=3901

AFOEM position statement (2010). Realising the health benefits of work Queensland Compensation Website. www.qcomp.com.au Workcover website. www.workcoverqld.com.au Solutions to common workplace issues: A manual to enhance workforce

management (2010). CAOT publications. Ottawa Charter. Canadian Association of Occupational Therapists. Elisabeth Ostiguy.

Mental health coordinating council; psychological injury management guide (2010). Retrived from http:pimg.mhcc.org.au