laura eyles - injury treatment - early intervention as a framework for managing psychological injury...
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Laura Eyles, Senior Rehabilitation Consultant, Injury Treatment presented this at the National Workers' Compensation Summit 2014. The Summit focused on minimising workplace injury claims through establishing a successful safety culture and embrace working towards successful outcomes should a workers compensation claim arise. Find out more at http://www.informa.com.au/nwc14TRANSCRIPT
Early Intervention as a Framework for Managing Psychological Injury in the Workplace
Presented by:
Ms Laura Eyles, Senior Rehabilitation Consultant/Psychologist
27 February 2014
Session Objectives
Early Intervention: Research and Trend Analysis
Implications of a Traditional Approach to Early Intervention
Injury Treatment Pilot project results
Design and Application of an Early Intervention System
Outcomes of Psychological Early Intervention Frameworks
Incident occurs or illness reported
Notification to the Agent if
compensatory
Assessment of the claim Application of
appropriate clinical intervention
Commencement of treatment and
occupational rehab
Momentum w RTW and
Treatment
Injury Resolved
RTW on full hours and Duties
Worker completes
documentation
Supervisor forwards
documentation to Mgt
Management contacts HR
Research and Trend Analysis
Industry Performance Statistics – 2011 / 2012 (HWCA 2012)
• 67% of injured workers agreed management would help injured workers’ RTW (decreased from 71% in 2009/2010)
• 66% of injured workers agreed their employer had clear policies and procedures about returning injured workers to work
• 62% agreed that management would spend time and money on making the workplace safe (decreased from 66% in 2010/2011)
2010/2011 2011/2012
Durable RTW 86% 75%
Pre-injury duties 73% 67%
Non-durable or non-RTW 14% 25%
Mean length of time of durable RTW (NB: 2003/2004: 159
days – IW’s are taking longer to RTW than a decade ago
145 days 149 days
Mean length of time of non-durable RTW 68 days 76 days
Early Intervention Psychological Injury Context
Psychological Injury
Circumstance where one’s normal cognitive, behavioural or emotional functioning is
overwhelmed by demands. Normative and effective strategies for self regulation
become overwhelmed and prove less effective.
Early Intervention Psychological Injury Context
• Psychological injuries account for approximately 1/3 of the total cost of all claims. Largest rate of claim declinature – what happens next?
• Most psychological injury claims do not result from a significant traumatic event or critical injury. Research shows injuries develop over a 6-month period or more, often in response to a variety of workplace and personal factors.
• The longer an employee is off work the less likely they are to return.
• Recent increases in claims related to ‘work pressure’ now account for 50% of the total psychological injury claims.
The EI Context
• Reduce overwhelming demands;
• Increase access to normative and effective strategies for self regulation;
• Remain focused on a Vocational and Employment context
Traditional vs Best Practice Approach
Traditional Cost Best Practice Interventions
delivered
Focus on speed of
notification
Fears around a
reporting culture
Slow/multi-layered
decision making
Dependency on
people
Operational KPI’s are
not linked to EI or
claims durations
Lack of clinical
relationships /
stakeholders unclear
of expectations and
responsibilities
Extended periods of
unfit certification
Reduced
productivity =
financial loss
Delays in claims
notifications
Workplace strategy
not implemented /
not progressive
Extended periods of
claim durations
Lack of diagnosis
/objective medical
information
Delays in obtaining
clinical opinions &
EBT
Interventions delivered and
measured
Focus on speed of intervention
Clear expectation and
responsibility
Systemic approach
Effective risk categorisation
Evidence based resources &
intervention
Barrier mitigation &
management
Systemic employee engagement
Effectively informed teams
Prepared & empowered leaders
An organisational culture open to
EI
Early Intervention Context and Benefits
Pilot Study
Early Intervention Injury Treatment Pilot Study
Multi-national organisation employing over 30,000 staff nationally
200 claims registered per month
Staff work across a range of industries
Partnered with Injury Treatment for their NSW business in January 2011 with rollout occurring in June 2011
Pilot Study – 2011/12
2010/2011 2011 / 2012
Total no of claims in NSW 162 174
Average days incident – notification 26.8 days 17.1 days
Average days unfit to SD’s (lost time) 19.2 days 5.19 days
Average days from notification – PID’s certification
138.67 days 45 days
Average weekly benefits $1025.54 $942.17
Average total claims costs $5836.18 $2790.55
Application
Design and Implementation
Gap Analysis
Clear expectations & responsibilities of employees and management
Documented early intervention psychological injury & illness management policy and procedures
Efficient psychological injury notification / case screening processes
Expert clinical suppliers
Communication & marketing
Prevention / Continuous Improvement
Responsibilities and Psychological Injuries
How does this model work on the ground?
What is the skill level of my managers?
How do I measure success?
Are KPI’s linked to injury management?
What communication needs to occur and when?
What training needs to occur to up-skill my leaders?
What is our process for identifying those at risk of psychological injury?
What is the skill level of supervisors to identify and raise a psychological concern?
What do we consider to be a psychological case risk?
What is our process when somebody sustains a psychological injury?
What are our timeframes that this should occur within?
Application of the right resource
Who makes this decision?
Is our decision evidence based?
What timeframe have we set?
Do we use psychological early intervention assessments?
Do our suppliers (medical/rehab/treatment) understand our business and model?
Outcomes
Early Intervention Expected Outcomes
Diagnosis and medical intervention = RTW success
Early psychosocial screening may identify those at risk of long term disability
Subsequent early psychological intervention may curb long term disability
Systematic identification of workers at risk of developing biological, psychological and social barriers to return to work
Targeted / consistent referral for appropriate services
Early Intervention Expected Outcomes
Minimisation of treatment and rehab costs associated with inappropriate or more intensive services than required;
Removes subjectivity of individual Case Managers = uniform system & consistency in barrier assessment and mitigation.
Reduced suitable duties durations = reduced operational costs
Reduced claims durations, durable RTW rates
Maintaining / increasing productivity
Summary Best Practice EI from a Psychological Framework
• Interventions delivered and measured
• Focus on speed of intervention
• Clear expectation and responsibility
• Systemic approach
• Effective risk categorisation
• Evidence based resources & intervention
• Barrier mitigation & management
• Systemic employee engagement
• Effectively informed teams
• Prepared & empowered leaders
• An organisational culture open to EI
Questions?