Occupational Therapy Solutions to Common Workplace Issues A Manual to Enhance Workforce Management
Ottawa 2010 All rights reserved No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission of the Canadian Association of Occupational Therapists. Published by CAOT Publications ACE Ottawa, Ontario For additional copies, please contact: Elisabeth Ostiguy Director of Professional Affairs Canadian Association of Occupational Therapists lostiguy@caot.ca (613) 523-2268 ext 223 (800) 434-2268 ext 223 www.caot.ca Canadian Association of Occupational Therapists 2010 Printed in Canada
Introduction We re facing a skilled labour shortage. All of a sudden employers are recognizing that it s not good enough anymore to talk about being best practice, you actually have to be best practice. People who can t balance [work/life] have lower levels of job satisfaction. They are less committed to their organisations, and less loyal They report higher job stress and they re more likely to be absent from work as well as take a higher number of days off. the incremental increase in absenteeism because of not being able to balance cost Canadian companies about $4 billion a year in direct costs. (Duxbury, 2010) Workplace health strategies have become increasingly important to Canadian businesses. The last two decades have witnessed a change in the nature of work due to globalization and advances in technology, and the changing demographics of the workforce. Correspondingly, the type and incidence of work-related illnesses and injuries have also changed. Every year, businesses spend over $11 billion on benefits for employees and the cost of prescription and non-prescription drugs increases by 5-10 per cent on an annual basis. These numbers do not consider the costs of absenteeism, reduced quality, and lost productivity (Health Canada, 2003; Institute for Work and Health, 1998-1999). Occupational therapists recognize that the health of the employee and the work environment is determined by a range of interacting factors. The choice, performance, organization, and satisfaction in occupations are influenced by the relationship between people and their environment (CAOT, 2002). Occupational therapists approach workplace issues with this unique perspective that considers the occupation, the needs of the individual worker, work group and the organization. Occupational therapists offer solutions to common workplace issues through programs and activities that can include ergonomics, nutrition and wellness, pain management, stress management, counseling, workplace safety equipment, health and safety policies, and life skills training. Occupational therapists assist employers and others working with the worker such as union representatives, health and safety personnel and insurers to determine the needs and concerns of the worker and organization. The profession s belief in the inter-relationship among the person, occupation, and the environment uniquely positions occupational therapists to provide quality and cost-effective solutions for workplace issues. Occupational Therapy Solutions to Common Workplace Issues 3
4 Occupational Therapy Solutions to Common Workplace Issues
Foreword Occupational therapy in Canada is based on a model of practice that maintains the interaction between the person and their occupations with the social, cultural, physical and institutional environment. Occupational therapy is uniquely positioned to provide services to workplaces to initiate and develop multiple-level strategies for promotion of employee and organizational health and to provide cost-effective and practical solutions to work place issues such as presenteeism/chronic absenteeism, disability management, stress reduction and return-to-work, among others. Occupations are groups of activities and tasks of everyday life, named, organized, and given value and meaning by individuals and a culture. Occupations include everything that people do to occupy themselves, including looking after themselves (self-care), enjoying life (leisure), and contributing to the social and economic fabric of their communities. Occupations are the core domain of concern and the therapeutic medium of occupational therapy (CAOT, 2002). Occupational therapists are university educated and understand the effects of factors such as disease and injury on the ability of individuals as well as groups and communities to engage in the occupations of life. Occupational therapists are increasingly called upon to arrange for workplace accommodation for all types of workers maximizing their occupational performance on the job. Advances in assistive technology and shortages of skilled labour will increase the demand for workplace accommodation for people of all levels of ability. As the workforce ages, there will be an increasing need to accommodate older workers to extend their work life. Occupational therapists are educated to: Empower people to believe in the value of who they are and assist them in continuing to do what is necessary and important to them. Deal with the whole person in the context of their life, home and work. Bring to the workplace an understanding of the impact of injury and illness on worker roles. How do occupational therapists work? By understanding the impact of disease and injury on the ability of individuals, groups and communities to engage in daily activities. By using evidence based processes that focus on participation goals. By allowing individuals to participate in developing intervention goals in order to reach their maximum potential. Occupational Therapy Solutions to Common Workplace Issues 5
Who should read this manual? Occupational Therapy Solutions to Common Workplace Challenges is for Employers Managers Supervisors Human resources personnel Union representatives This manual is a useful human resource tool to support a positive contribution by all workers to their workplace. The goal is to provide practical information and outline ways to address common concerns that challenge the retention of employees, return-to-work after disability leave, effective productivity and the well being of workers. How should you use the manual? This manual was developed as a reference for human resources managers and union representatives who face common workplace challenges. Depending on the issues faced, some sections are more relevant than others. The manual is not all inclusive and the Canadian Association of Occupational Therapists proposes to provide regular updates on how occupational therapists can provide cost-effective and quality solutions to work place challenges. The manual is designed to educate and help you deal effectively with common challenges in the work place. 6 Occupational Therapy Solutions to Common Workplace Issues
Contents Workplace Issues are Costly.............................. 9 Recognizing and Addressing Health Place Issues................ 9 Chronic Presenteeism/Absenteeism................... 9 Managing disability............................ 10 Return-to-work............................... 11 Mental health issues............................ 12 Stress reduction............................... 12 Workplace accommodation....................... 13 Finding an Occupational Therapist........................ 14 References........................................ 14 Occupational Therapy Solutions to Common Workplace Issues 7
8 Occupational Therapy Solutions to Common Workplace Issues
Workplace Issues are Costly Enormous human and economic costs of disability and lost productivity are a reality in the workplace. Workers who experience injuries and illnesses are frequently away from their employment longer than necessary. Some never return-to-work even though they could be productive with changes in job tasks, equipment or workspace. There are some employees who return-towork and are unable to continue for a variety of reasons (National Institute for Disability Management and Rehabilitation (NIDMAR), 2003). The Association of Workers Compensation Boards of Canada (AWCBC) reported 373,000 lost time accidents in 2001 with direct benefit costs of $11 billion (AWCBC, 2002). Recent insurance company data shows that 49 per cent of disabilities claims are attributed to a mental health disability. Return-to-work services have increasing importance to individuals and employers with costs of disabled workers reaching $11 billion from workplace accidents (according to the Association of Workers Compensation Boards [AWCBC, 2002]) and workplace mental health costs estimated at $33 billion to the Canadian economy. Recognizing and Addressing Health Place Issues Chronic Presenteeism/Absenteeism Jackie woke up to a buzzing alarm clock, feeling worse than she had the day before. Fever. Chest cough. Exhaustion. And this was only Wednesday. Three more interminable shifts before she could take a couple of days off work to rest and try and beat back this virus, whatever it was. She closed her eyes again. If only there weren t bills to pay. This employee is about to become a case of workplace presenteeism again. She ll be present in body, alright, but not in mind. And over time, she ll fail to meet work expectations, and she will be the reason that four of her colleagues become infected with the virus she s carrying. American studies suggest that presenteeism cuts a worker s productivity by a third or more. Costs for the American economy are up to $150 billion US per year, as workers struggling with health problems perform well below capacity. The fallout is reduced quality of products and services, breakdowns in customer service, and a greater likelihood of workplace injuries leading to medical expense. Absenteeism (especially absenteeism due to physical and mental health issues) also appears to be a substantive problem for Canadian employers, Occupational Therapy Solutions to Common Workplace Issues 9
with high levels of absenteeism (defined as three or more days of absence in the six months prior to the study being conducted). Occupational Therapy Solutions Occupational therapists will work with the employee to understand the cause of the absenteeism. They will develop techniques to address the factors to ensure presence and attention at work. They will tailor the solutions to the employee s personal needs and workplace requirements. Managing Disabilities Sandra suffered a minor stroke at work and has been off on disability leave for the past six months. She is now back to her old self and is anxious to get back to work. Disability management applies to disability prevention or early intervention after the onset of a disability or a serious illness. The goal is for people to be able to maintain their job or return-to-work after a disability or serious illness in a coordinated, cost-effective and timely fashion. O ccupational Therapy Solutions Occupational therapists bring a unique brand of understanding of the relationship between individuals, their work, workplace and health issues associated with the injury and/or illness. They take into consideration all factors including the nature of the job, the abilities of the employee and work place factors to determine how to return the individual to a productive role. The occupational therapist can suggest an appropriate job match, appropriate accommodations and develop a realistic return-to-work plan. 10 Occupational Therapy Solutions to Common Workplace Issues
Return-to-work Naveed is a 37 year old office worker who injured his back ten years ago. He was off initially for a year. When he returned to work, he was withdrawn from co-workers and lost interest in any activity outside of work. Recently he re-injured his back and confided to a co-worker that he was anxious about returning to work. The disability cycle of doctor visits, tests and treatments, coupled with the stress and feelings of guilt that can accompany the perception that one is no longer contributing to the organization, tend to weaken patients both physically and psychologically. Studies indicate that the probability of return to any form of employment decreases rapidly with the passage of time away from work. Occupational health and safety experts have shown unequivocally that early return-towork (RTW) benefits personnel by facilitating more rapid recovery. Employees also benefit from better job satisfaction coupled with increased productivity, longer retention and a higher likelihood of return to regular duties. Return-to-work services enable the re-integration of individuals into the workplace following an absence due to physical or mental health issues. The co-ordination of return-to-work services is critical for the success of return-to-work. Collaboration between the worker, employer, and health care providers, such as occupational therapists, may take place outside of the workplace and/or within the work environment. Occupational Therapy Solutions Occupational therapists can work with injured employees, such as Naveed to ensure a smooth and quick transition back into the workforce through solutions such as: Conduct an evaluation of the workplace to measure the employee s capacity to sustain performance in response to defined work demands. Develop return-to-work strategies tailored to the employee s needs and work place requirements. Work with employers and workers to plan and implement return-to-work strategies. Occupational Therapy Solutions to Common Workplace Issues 11
Mental Health Issues Maria is a 23 year old employee who has a difficult time concentrating on tasks and shows signs of depression. Maria fears her mental health problems will begin to negatively impact her job performance. Mental illness is the leading causes of disability in Canada and depression and anxiety disorders account for more than two thirds of short term disability claims. Mental health problems may range from mild or transient issues with little impact on performance to severely debilitating problems at work. Mental illness and addiction rank first and second as leading causes of disability in Canada. Depression and anxiety disorders account for more than two thirds of short term disability claims. Occupational Therapy Solutions Occupational therapists can help both employers and employees to reduce this impact and improve conditions at work through solutions such as: Determining factors that contribute to Maria s condition. Helping Maria identify her strengths and abilities. Working with Maria and the employer on implementing effective work accommodations. Monitoring the work environment to promote maximum contribution. Developing strategies to problem-solve occupational and interpersonal issues that may arise in the workplace. Stress Reduction George worries about how he is going to pay for three children, currently in high school, to go to college. He is constantly looking for overtime and other opportunities to earn more money. The stress of worrying about his finances is making him unpleasant with co-workers. Stress not properly handled can lead to decreased work capacity and to health and social problems. One in five workers may experience a stress related illness during a given year. As many as one in two Canadians perceive work to be stressful to some degree. 12 Occupational Therapy Solutions to Common Workplace Issues
Another source of stress is work life conflict when the practical aspects associated with time crunches and scheduling conflicts (e.g. role interference), create a feeling of being overwhelmed, overloaded or stressed by the pressures of multiple roles (e.g. role overload, caregiver strain). Occupational Therapy Solutions Occupational therapists can make a positive contribution to minimize the negative effects of family and workplace stress factors by Working with the worker to identify stressors Providing the tools for the individual to deal with stressors in a positive manner Implementing prevention strategies Workplace Accommodation Nick had injured his thumb on the job. He was determined to continue working despite pain and the risk of further injury. Employers in Canada have a duty to accommodate up to the point of undue hardship. Reasonable accommodations enable employees to meet their job requirements. Many accommodations can be made with little or no overhead cost to the employer Occupational Therapy Solutions Occupational therapists use a person-centered approach to analyze issues in current job performance. Occupational therapists perform home, school and work site visits, recommend modifications, assistive technology, and ergonomic tools and materials, to enable meaningful and cultural relevant engagement in occupations in chosen environments. For example, an occupational therapist is able to meet his specific needs by proposing a custom-made thumb stabilizing orthosis, made from a thermoplastic material thin enough not to interfere with the wearing of work gloves. Occupational Therapy Solutions to Common Workplace Issues 13
Finding an Occupational Therapist There are 12,000 occupational therapists offering services across Canada. Occupational therapists can be found through the CAOT OT Finder service. (http://www.caot.ca/default.asp?pageid=3622 ) Occupational therapists serve their clients by looking at how they can ethically and safely collaborate with various stakeholders (both public and private) in new ways to create powerful, reciprocal relationships that allow Canadians increased access to occupational therapy services (Casey and Jongbloed, 2007; Varga-Toth, 2007). Resources American Occupational Therapy Association, Work Programs Special Interest Sections. (2007), Functional Capacity Evaluation, retrieved from http://www.aota. org/consumers/whatisot/wi/facts/35117.aspx Association of Workers Compensation Boards of Canada (AWCBC) (2002), Key Statistical Measures for 2002. Retrieved from http://www.awcbc.org/common/assets/ ksms/2002ksms.pdf Canadian Association of Occupational Therapists (CAOT). (2004), Workplace health and occupational therapy [Position statement], retrieved from http://www.caot. ca/default.asp?pageid=1137. Canadian Council on Integrated Healthcare. (2002), A discussion paper on workplace health, retrieved from http://www.ccih.ca/docs/ccih%20-%20discussionpaper_on_workplacehealth_lastversion.pdf Duxbury, Linda (2010), Leader profiles and Quotable Quotes : Linda Duxbury, Carleton University School of Business retrieved from www.labour.gc.ca on August 18, 2010 Health Canada. (2003), Trends related to health spending and prevention strategies, retrieved October 21, 2003 from http://www.hc-sc.gc.ca/hppb/fitness/work/ main_c_e.html Institute for Work & Health, Ontario Society of Occupational Therapists & College of Occupational Therapists of Ontario. (2008), Working together: Successful strategies for return to work National Institute for Disability Management and Rehabilitation, online education, retrieved on October 2, 2003 from http://www.nidmar.ca/education/education_online/online_background.asp. Townsend, E.A. & Polatajko, H.J. (2007), Enabling Occupation II: Advancing an Occupational Therapy Vision for Health, Well-Being, & Justice through Occupation. Ottawa, ON: CAOT Publications ACE. Watson, Diane E. (2000), Evaluating Costs and Outcomes, Demonstrating the Value of Rehabilitation Services, The American Occupational Therapy Association Inc. Wisenthal, A. (2004). Occupational therapy provides the bridge back to work. Occupational Therapy Now, 6(4), retrieved from http://www.caot.ca//default. asp?pageid=1185 14 Occupational Therapy Solutions to Common Workplace Issues