GETTING BACK TO WORK AFTER INJURY-ON-DUTY. Dr. Marcus Wong Director Occupational Health Centre Hong Kong East Cluster
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1 GETTING BACK TO WORK AFTER INJURY-ON-DUTY Dr. Marcus Wong Director Occupational Health Centre Hong Kong East Cluster
2
3 What goes through the mind of the injured nurse and her supervisor?
4 What should I do now? Do I need to report it? Would my supervisor believe me? How will my colleague think of me? Why did it happen? Is it me or the workplace? My hand is still hurting. Do I need to see a doctor? I do not want to be seen as trouble maker!
5 Why did it happen? Did she do any wrong? Report, investigation, manpower, boss Troubles! Need to do investigation and prevention but how? Is my workplace safe? Is she hurt badly? How long is she going to be off work?
6 What are the challenges they face in return-towork?
7 16 weeks to see orthopedics, 20 weeks to see physio!!! I feel so bad! No one understands what I am going through! Dr. A told me not to go to work. Dr. B said I could try. Who to follow? I am still feeling weak. Perhaps I should wait till I am scared of getting injured again. Is my work safe? My lawyer asks me to continue sick leave for more compensation.. Dr wrote me light duty but my boss said NO
8 What would other workers think? What can I do in helping her returning to work? Is she fit to resume her duty? Can someone tell me? What duty can she do or not do? How long is it going to last? Doctor wrote her a light duty. How is it arranged?
9 Establishment of Occupational Health Service in Hong Kong East Cluster IOD Rehabilitation service Comprehensive occupational health service
10 A New Model For Injured Worker Advanced equipment Multidisciplinary team Evidencebased system A one-stop integrated return-to-work model
11 Multidisciplinary Team Orthopedic specialist OH practitioner Case manager Pain Specialist Occupational Therapist Physiotherapist
12 Equipment For Assessment Ultra-sound Scanning Machine BTE Primus RS Body Composition Scale BTE EvalTech
13 Equipment For Treatment Acupuncture Whirlpool Shock Wave Laser Therapy Hot Magner (magnetic + heat therapy) Neck and Pelvic traction Therapeutic Ultrasound
14 Equipment For Physical Training Upper Limb Ergometer Whole Body Vibration Machine Huber Lower Limb Ergometer Pilates Reformer
15 Equipment For Work Rehabilitation Jacobs Ladder Work Sample (VCWS 9) Workcube Biometrics Work Well System (VSWS 19)
16 Evidence- based operational system Standardized reporting system Early contact of injured worker Timely access to treatment Individual case management Tailored rehabilitation & return-to-work plan Modified duty arrangement Workplace assessment & intervention
17 Reporting System Staff reports to supervisor after injury Supervisor reports to hospital via Advanced Incidents Response System within 14 days OHC case manager captures the incident in the AIRS and takes action
18 Contact of Worker Designated person contacts the injured worker once the report is received Invitation to OHC if needed
19 Access To Treatment Medical appointment can be arranged within 2 days Treatments start right after consultation if needed
20 Tailored Rehabilitation Based on the worker s impairment and residue function Job specific Both medical and occupational rehabilitation
21 Case Management and Return-To-Work Plan Highly Individualized Case conference to align RTW plan Presence of RTW coordinator Psychological support Communication with other parties Negotiation with supervisor and assistant in making RTW arrangement
22 Modified Work Temporary arrangement Consider working hours, shift, pace, task, environment Specific advice on the restriction, limitation and capacity of the worker in RTW
23 Workplace Assessment and Intervention To eliminate or control the hazard in the workplace Ensure health & safety of injured worker and coworkers at work Provide solution for employer
24 Outcome Nov 11 Oct 13
25 Characteristic of injury 99% Musculoskeletal (needle stick injury excluded) Head & Neck 8% Trunk & Back 27.8% Upper limb 40% Lower limb 23.5 Fracture 7.5%
26 Return-to-work Overall 98.5% with 1.5 % ill-health retirement Time to return-to-work 1 Month 3 Month 6 Month Any work 92.5% 97.6% 98.1% Full work 55.2% 77.8% 91%
27 Sick leave 5549 days, 89d/100 FTE in 2006 Remark: FTE = full time equivalent 3084 days, 38.8d/100 FTE in 2013
28 Patient Satisfaction Overall services Good or above 99% Excellent 70% Areas most appreciated Psychosocial support Professional guidance on rehabilitation Personal health advice
29 Today s Overview 1 Workers and supervisors have negative perception on injury-onduty 2 Multiple barriers exist in the return-to-work process 3 A one-stop integrated return-towork model is adopted in HKEC 4 High return-to-work rate, sick leave reduction, highly satisfied staff are observed with this model
30 Q & A
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