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Abstract
Objective This study describes the process and outcomes of the implementation of a strengthened disability management policy in a large Canadian healthcare employer. Key elements of the strengthened policy included an emphasis on early contact, the training of supervisors and the integration of union representatives in return-to-work (RTW) planning.
Design The study applied mixed methods, combining a process evaluation within the employer and a quasi-experimental outcome evaluation between employers for a 3-year period prior to and following policy implementation in January 2012.
Participants Staff in the implementation organisation (n=4000) and staff in a peer group of 29 large hospitals (n=1 19 000).
Outcomes Work disability episode incidence and duration.
Results Both qualitative and quantitative measures of the implementation process were predominantly positive. Over the 6-year observation period, there were 624 work disability episodes in the organisation and 8604 in the comparison group of 29 large hospitals. The annual per cent change in episode incidence in the organisation was −5.6 (95% CI −9.9 to −1.1) comparable to the annual per cent change in the comparison group: −6.2 (-7.2 to –5.3). Disability episode durations also declined in the organisation, from a mean of 19.4 days (16.5, 22.3) in the preintervention period to 10.9 days (8.7, 13.2) in the postintervention period. Reductions in disability durations were also observed in the comparison group: from a mean of 13.5 days (12.9, 14.1) in the 2009–2011 period to 10.5 days (9.9, 11.1) in the 2012–2014 period.
Conclusion The incidence of work disability episodes and the durations of work disability declined strongly in this hospital sector over the 6-year observation period. The implementation of the organisation’s RTW policy was associated with larger reductions in disability durations than observed in the comparison group.
- disability management
- workplace intervention
- injury prevention
- Canada
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Footnotes
Contributors CAM conceptualised and designed the study, interpreted the data and wrote the first draft of the paper. KS, ML, AC and ML contributed to data collection and data interpretation. JE contributed to the analysis of the study data and provided interpretation. All authors contributed to the review and revision of the paper.
Funding Funding support for the study reported in this paper was provided by the Canadian Institutes of Health Research (Grant No. 123365). KS is funded by the Medical Research Council (MC_PC_13027 & MC_UU_12017/15). The Institute for Work & Health operates with support from the Government of Ontario.
Competing interests None declared.
Ethics approval University of Toronto.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.
Correction notice This article has been corrected since it was first published. The Funding statement has been added back in and Kathryn Skivington's affiliation has been corrected.