Building and Maintaining Capacity | ReIntegrate

Internal & External Communications

Tilia Boussios — Mon, 06 Oct 2008 07:23:00 GMT

No matter how well crafted a Return to Work Policy is, a simple breakdown in communications between any of the parties during the process can result in misunderstandings arising about the current position, the intentions of one of the parties, the promises made, or the targets set. As a consequence the process can easily off the rails.

For this reason effective internal and external communications are considered critical to the optimal operation of return to work and job retention programmes. An organisation needs to map out the communications network that could be involved in the case of an employee developing a health condition that necessitates long-term absence and subsequent return to work. A good way to go about this is to produce a protocol of the communication channels and the information that needs to be coordinated through these channels in order to achieve a successful return to work.

The protocol should address both internal and external communications including communications with the absent worker and external service providers including medical services and allied health services. The protocol should also specify the nature of the information to be communicated and the restrictions on distribution e.g. case notes or confidential issues.

At the worksite, the operational aspects of the return to work programme requires consistent and accurate internal communications among:

Employees,
Managers,
Supervisors,
Worker representatives,
Those with functional responsibilities such as HR professionals, Health and Safety Officers and Occupational Health Staff where relevant

Effective external communications can require an employer to keep in contact and develop relationships with:

Treating physicians,
Claims managers,
Rehabilitation service providers,
Lawyers,
Insurance providers
EAP provider.

The employer can influence an earlier return to work by providing treating physicians with functional job descriptions, job safety procedures, and transitional work options for injured workers.

Good communication of information should begin at the point of injury or onset of illness and end when the ill or injured worker has made a successful return to work, including a satisfactory adjustment to accommodations and/or worksite modifications. Once accidents or illness occur the person responsible for return to work must coordinate all steps in the work return process beginning with the initial report of injury or illness.

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Information must be communicated during each of the following steps in the return to work process.

1. Emergency Treatment Illness /injury
2. Report illness/injury
3. Documentation of Injury
4. Early Worker Contact
5. Information to doctor regarding job demands of workers.
6. Medical clearance
7. Co-ordination of RTW processes
8. Designing the RTW plan
9. Retraining identification
10. Case management and monitoring
11. Case closure

Below is a description of each of the steps that can be involved in the job retention or return to work process and the communication tasks involved.

1. Emergency Treatment Illness / Injury

In the case where an injury or incident occurs at the worksite the main activities relate to first aid. After this has been administered successfully it is essential that a number of communication task are undertaken:

Contacting the family doctor,
Communicating to the worker’s family,
Completing the incident log,
Informing senior management,
Early reporting to HR, Health and Safety, and Occupational Health.

2. Reporting Illness or Injury

In all case where illness or injury results in a reduction in the work capacity of an employee early reporting of this is essential. This information is most often the responsibility of the immediate supervisor of the worker concerned. It is useful to explicitly list those who should be informed at this in the return to work policy. The parties concerned at this point could include Health and Safety, HR, Payroll and the person responsible for return to work coordination.

3. Documentation of the Absence Process

In good practice organisations the information required to coordinate the early intervention and return to work processes is usually management through the Absence Information Management System (See section on this topic). Important considerations in designing information collection and sharing procedures, regardless of whether they are electronic, paper based or face to face procedures, are:

Compliance with data protection requirements,
Ensuring that the privacy of the individual is protected,
Gaining informed consent of the individual for the appropriate release of information,
Putting in place effective information security provisions,
Specifying a records retention and destruction timeframe,
Anonymising all information being released in reports.

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4. Early Worker Contact

The first contact with the absent worker should occur within 3 days of absence. One way to make this work is to place a responsibility on the absent worker or a representative to make contact with the person responsible for return to work and let him or her know where things stand. If after 6 weeks it is necessary to escalate the return to work process further then it becomes essential to gain authorisation from the employee to make contact with treating medical practitioner.

5. Communications with Treating Professionals

This is probably one of the most challenging aspects of the communications process. Very often health professionals are not comfortable releasing information on their clients to a third party or alternatively they do not see themselves as having a role in the return to work process. One way to resolve this is to provide information to the professional about the work place and the job and ask a set of narrowly specified questions about the worker’s readiness to meet the demands of the job and what would constitute suitable duties for the person currently. Another avenue for eliciting this information is to give the worker a ‘Worker Capability Form’ and ask him or her to complete it with the help of the treating health professional and return it to the person responsible for the return to work process. In this way the communication takes place directly between the worker and his or her doctor but the information is directly relevant to return to work options.

6. Medical Clearance

The communications task in relation to gaining medical clearance to embark on the actual return to work activities differs depending on whether the company has its own Occupational Service or whether it relies on the medical treating professional of the employee. In the case where ‘fitness to return to work’ is being certified by the company’ own Occ. Health service, it is essential that the ‘ground rules’ are established with the provider prior to embarking on any particular cases. In particular it is important to clarify that return to work is seen as part of the rehabilitation process and that it is not about a worker being fully fit before returning to work. In the event that the company does not have its own Occupational Health service the strategies described in the previous paragraph are probably most appropriate.

The communications protocol should also specify who in the company receives and processes information on medical certificates and who liaises with the employee’s doctor.

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7. Co-ordination of RTW Processes

It is essential that one member of staff takes responsibility for coordinating the return to work process. Any other approach is likely to result in misunderstandings and a breakdown in communications with the employee. The designated return to work coordinator should also receive training in the return to work process and the interventions, adaptations and supports that are possible. The RTW Coordinator should also be a skilled communicator capable of negotiating, mediating and facilitating constructive problem solving. In some countries the RTW Coordinator is required to have a recognised accreditation. More details about this are available from the website of the National Institute of Disability Management and Research in Canada(see www.nidmar.ca/education/education_background/background_information.asp). The RTW Coordinator is responsible for liaising with medical and allied health, legal representatives, insurers, line supervisors, co-workers and the returning employee. He or she should also keep an continuing log of activities and agreements with all parties. In many cases company or the insurer will contract with an external case manager to act as the RTW Coordinator.

8. Designing the RTW Plan

The first major communications task in the design of the RTW is to bring together the expertise and skills that are required to adapt the workplace, the organisation of the job and to build capacity in the returning worker. It is important for the RTW coordinator to establish relationships with a variety of external experts who can provide input including ergonomists, assistive technology experts, functional capacity evaluators etc. The second major task is achieving the agreement of all parties to the plan. This can involve liaising with worker representative or unions to get the go ahead for adapted duties and/or the placement of the worker in a transitional work position. Clear goals and time frames are necessary and a formal sign off on the plan should be achieved with all concerned committing in writing to the plan.

9. Retraining Identification

Building the capacity of the returning worker could well involve equipping the returning worker with new skills to cope with changed responsibilities. This is particularly the case when it has been decided that the best alternative is to redeploy the worker to another position within the company. For example, it may be agreed that the employee should move from a front line position to a support provision which requires IT skills that the worker does not have. The communication tasks involved include convincing with the worker to accept redeployment as an option, working with the HR department to identify a suitable position, negotiating with the union or worker representatives to accept the redeployment option, preparing the future supervisor to accept the worker in the new position, organising to carry out a transferrable skills analysis to identify the skills and knowledge that the employee already has that are relevant to the new position and the new skills required for the job. One of the key communication skills required by the RTW Coordinator in this process is being able to provide realistic but sensitive feedback to the employee about his or her strengths and needs. Effective demands analysis, functional capacity evaluation and vocational assessment are key elements of the redeployment process.

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10. Case Management and Monitoring

A return to work plan needs to be closely monitored and any changes in the circumstances and agreed targets or interventions must communicated efficiently to the RTW Coordinator or case manager. This requires open line of communication between the employee who is returning to work and the supervisor. In addition the supervisor must have a good relationship with the worker and be able to accept feedback about the impact of interventions and adaptations. It is usually best to provide a confidential channel of communication to the employee either through an EAP service or through a staff member who is assigned the role of mentor. The RTW Coordinator must act as the central node of communications, taking care of issues of confidentiality and the need for people to know. The progress of the RTW plan should be documented so that if any challenge is made to due process at a future date. The key in this process is making sure that if anything is not working out remedial actions can be taken.

11. Case Closure

At the closure of the case there are a number of important communication tasks. Firstly it is essential that the employee is aware that the RTW plan has been completed and that a long term support plan is being put in place. Secondly, a case closure report should be produced. This should provided to any external actors who have been involved in the case and to HR. A summary of the case including time frame, costs, challenges and outcomes should be placed on the Absence Information Management System. The lessons learnt from the case should be communicated to everybody in the company with an interest in the return to work programme including HR, Health & Safety personnel, Occupational Health providers, general management, supervisors, external services and the Board of the Organisation. Finally, changes to current procedures which would have made the RTW process easier should be integrated into the company’s continuous improvement plan.

References

If you wish to read more about Internal and External Communications Procedures, you can access the Related Bibliography link on the right side of the screen.

Developing Organisation Resources

Tilia Boussios — Mon, 06 Oct 2008 07:23:00 GMT

Effective return to work policy and procedures depend upon adequate resources and infrastructures being in place. Many of these resources and infrastructures already exist within most organizations, but they need to be enabled to orient themselves towards return to work. Providing the appropriate resources is not necessarily costly exercise, but it is vital to the success of return to work that they have been put in place.

The major organizational resource for promoting return to work is the development of an effective policy. However, to back up this policy other organizational resources are necessary and these include:

Having a budget dedicated to implementing return to work policy
Having a designated reintegration management function
Providing appropriate training to those who operate the return to work policy
Having an agreed approach between Management and Worker Representatives
Implementing an effective Management Information System on absence and return to work
Having knowledge of available external supports
Having continuity of approach to return to work

Though there is some cost involved in developing organizational resources for return to work, it should be noted that there are many benefits and savings to having an effective return to work procedure. Firstly, the costs of absence in terms of productivity losses to the organization are reduced. Secondly, the replacement costs for staff who do not return to work are avoided. Over time, the upfront investment costs of developing a policy are more than offset by the savings associated with returning people to work in a safe and timely manner. Thirdly, having an effective return to work policy, the employer is in compliance with legislation in the area of discrimination. Fourthly, there are benefits to the organization in terms of improved health and safety procedures that can have the effect of reducing accidents and occupational disease. In addition, there are considerable financial and other benefits for the absent worker.

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Budget: Successful return to work programmes need an adequate and specific budget if they are to function effectively. Budget should be made available to cover items of expenditure such as training for return to work coordinators, training or retraining for the returnee, workplace adaptations and assistive technologies. In many cases there is external financial support available for some of these measures, but the employer will need to have a budget to support to meet some of the expenditure concerned.
Designated Reintegration Management Function: Research has shown that where there is a designated person or team responsible for managing the reintegration process, the process becomes more effective. This function is responsible for all aspects of the process, i.e. for maintaining contact with the ill or injured employee, liaison with external agencies providing medical and vocational rehabilitation, co-ordination of internal services and functions (OSH, HRM, training, line management) and provision of job design and job placement services.
Training: Training for the function of return to work management is essential, as this is a relatively new concept and it is unlikely that the necessary skills would be available without such training. Training courses for return to work coordinators are available in Ireland and elsewhere [reference]. These courses deal with issues concerning the process of return to work, the hard and soft skills required to liaise between the various stakeholders in the return to work process, and they will provide a knowledge of the various legal provisions, benefits and resources available to support the return to work process. In addition to training for the return to work coordinator, there may also be a need to provide some awareness raising training in relation to the issues of disability for the work force at large in the organization.
Agreed Approach between Management and Worker Representatives: Where there is regular liaison between management and labour, it is very helpful to conclude an agreement regarding return to work practices in this forum. This helps ensure wide support for the policy of reintegration. Even in smaller organizations where the industrial relations process may be less formal, it is essential that there is at minimum, a clear understanding between management and the work force regarding the provisions of the return to work policy. Failure to agree a bipartisan approach to return to work will usually leads to the conflict over specific cases, and a fair lanes of affective return to work process.
Management Information System: It is vital to have a management information system which gives reliable and timely information on health related absenteeism. Important types of information include duration and frequency of absenteeism, causes of absenteeism, and case details. In addition, it is useful to structure the information system in such a way that the entire process of absence and return to work is documented in a systematic way. This enables a database of successful approaches to return to work to be built up and used for future organizational learning.
Having a Working Knowledge of Available External Supports: There are many potential supports available to both the employer and employee to help in the returned to work process. These include advice on the specifics of return to work, financial support for making workplace adjustments, productivity related wage supports and support for the retraining of the individual absentee. Is important that the return to work function in an organization is aware of where to go to obtain such support.
Having Continuity of Approach to Return to Work: In many organizations where return to work is managed successfully, the success of the process is often dependent upon one are a small number of people. There is a need to ensure that that good succession planning takes place with regard to return to work so that if the designated return to work coordinator, for example, leaves the organization, there is an adequate infrastructure and human resource to enable the process to continue in a productive way over time.

References

If you wish to read more about Developing Organisation Resources Processes, you can access the Related Bibliography link on the right side of the screen.

Absenteeism Information Management System

Tilia Boussios — Mon, 06 Oct 2008 07:22:00 GMT

An Absenteesim Information Management (AIM) system is a management information system which gives reliable and timely information on health related absenteeism.

Why do we need an AIM system?

It is vital to have one in place if you want to have a successful return to work programme in your organisation. The reason being that if all the relevant information about a case is not recorded, how do you know what progress is being made? How do you make the right decisions about what interventions are needed? How can you show what interventions your organisation has taken to assist the injured or ill person in returning to work?

What basic information should we record?

Important types of information that need to be recorded in the AIM system include, duration and frequency of absenteeism, causes of absenteeism, and case details.

The effective operation of the return to work programme in any organisation requires careful attention to information management. While many organisations have HR or absence information databases they are rarely comprehensive enough to support effective return to work. If you want to build a comprehensive AIM System, to support your return to work programme, then you should ensure it includes basic data such as the following:

Length of Absence
Causes of Absence
Contacts with:
- The Absentee
- The Insurer
- Primary Care Providers (e.g. physiotherapist,
- Occupational Health Physician (e.g. G.P.)
- Lawyer
- Allied health services (e.g. Private health insurer)
- Case manager
- Family members

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What complex information should we record?

The more complex information that an AIM system should include is explained below:

A process checklist to monitor progress in the absence/return to work process: There should be a generic checklist of actions that needs to be completed within certain time scales once a case of absenteeism occurs. This needs to be updated on the AIMS system for each individual case.
A log of interventions: A list of actions that have been taken by the organisation, including a description of the action, the date it occurred and the responsible person
An ‘ability to work’ training needs and functional ‘capacity profile’ of the returning worker: A functional capacity profile assesses the worker's ability to perform work and their tolerances to a variety of real and/or simulated work activities
A job demands analysis: A profile of the physical and psycho-social characteristics and demands of the job
A specification of required accommodations and supports
Relevant legal issues
A record of the costs and benefits of the process
A record of problems and challenges encountered and the solutions implemented
Evaluation data: If the return to work programme is not evaluated then it cannot be continuously improved