the role of the workplace in return-to-work: a research perspective

Australian Institutefor Social ResearchInforming decisions.

The role of the workplace in The role of the workplace in return-to-work: a research return-to-work: a research

perspectiveperspective

Dr Kate BarnettDr Kate BarnettDeputy Executive DirectorDeputy Executive Director

Australian Institute for Social ResearchAustralian Institute for Social Research

AISR Seminar Series, July 11AISR Seminar Series, July 11thth 2008 2008


Survey sampleSurvey sample

• 607607 individuals - individuals - 552 552 employees + employees + 5555 managers managers

• Estimated response rate - Estimated response rate - 22% 22% employees and employees and 69%69% managers. managers.

• Total of 10 organisationsTotal of 10 organisations– range of locations (rural, outer metropolitan and range of locations (rural, outer metropolitan and

metropolitan)metropolitan)– mixture of for-profit and not-for-profit agenciesmixture of for-profit and not-for-profit agencies– mixture of small, medium and large organisationsmixture of small, medium and large organisations– providing low to high level residential care and providing low to high level residential care and

community care.community care.


Survey sample by claim historySurvey sample by claim history• 21.2%21.2% of employee sample had of employee sample had past past

workers’ compensation claim and returned workers’ compensation claim and returned to workto work

• 1.8%1.8% with an with an active active claim and had not claim and had not returned to work at the time of the surveyreturned to work at the time of the survey

• 68.5% 68.5% had never been injured seriously had never been injured seriously and had and had no claimno claim history history

• 7.6%7.6% had been had been injuredinjured in their workplace in their workplace but had but had no claimno claim history history..


The Return-to-Work Workplace The Return-to-Work Workplace IndexIndex• Survey instrument designed from findings Survey instrument designed from findings

of literature review and scoping interviews. of literature review and scoping interviews.

• Findings clustered into a 5 themes each Findings clustered into a 5 themes each grouping questions relating to factors grouping questions relating to factors known to affect workplace injury rates and known to affect workplace injury rates and return-to-work. return-to-work.

• The Return-to-Work Workplace Index The Return-to-Work Workplace Index therefore was structured around 5 sub-therefore was structured around 5 sub-Indexes.Indexes.


The Return-to-Work Workplace The Return-to-Work Workplace IndexIndex• The The conditionsconditions of the workplace. of the workplace.• The The degree of controldegree of control or autonomy individual or autonomy individual

workers have in relation to their role and workers have in relation to their role and responsibilities, and how these are undertaken.responsibilities, and how these are undertaken.

• The The cultureculture of the workplace – eg, degree of of the workplace – eg, degree of trust, supportiveness to injured or ill workers, trust, supportiveness to injured or ill workers, quality of communication.quality of communication.

• SafetySafety in the workplace and the in the workplace and the preventionprevention of of injury and illness.injury and illness.

• How the workplace How the workplace respondsresponds to injury or illness, to injury or illness, including provision for return-to-work.including provision for return-to-work.


The Return-to-Work Workplace The Return-to-Work Workplace IndexIndex• Separate surveys provided for Employees and Separate surveys provided for Employees and

Managers.Managers.• Responses provide a snapshot of overall Responses provide a snapshot of overall

organisational climate and capacity to achieve organisational climate and capacity to achieve effective return-to-work. effective return-to-work.

• Further analysis involving tests of significance Further analysis involving tests of significance (eg based on presence or absence of a current (eg based on presence or absence of a current or past workers’ compensation claim, or on work or past workers’ compensation claim, or on work setting) provides more detailed information setting) provides more detailed information about role of workplace in promoting health and about role of workplace in promoting health and safety and its response to injury or illness.safety and its response to injury or illness.


The Return-to-Work Workplace The Return-to-Work Workplace IndexIndex• Employee & Manager surveys shared common Employee & Manager surveys shared common

questions for 3 of the Indexes, remaining 2 questions for 3 of the Indexes, remaining 2 specific to survey of Employees. specific to survey of Employees.

• Feedback from Managers designed to obtain an Feedback from Managers designed to obtain an assessment of their employing organisation’s assessment of their employing organisation’s workplace (as opposed to their experience as workplace (as opposed to their experience as employees of that organisation). employees of that organisation).

• Feedback from Employees designed to capture Feedback from Employees designed to capture perceptions of workplace + their own experience perceptions of workplace + their own experience as workers in their employing organisation.as workers in their employing organisation.


The Return-to-Work Workplace The Return-to-Work Workplace IndexIndexSub-IndexSub-Index Employee SurveyEmployee Survey Manager SurveyManager Survey

I. Workplace ConditionsI. Workplace Conditions

II. Workplace ControlII. Workplace Control

III. Workplace CultureIII. Workplace Culture

IV. Workplace SafetyIV. Workplace Safety

V. Workplace Response to V. Workplace Response to Injury/IllnessInjury/Illness


The Return-to-Work Workplace The Return-to-Work Workplace IndexIndexThe Index can be used as –The Index can be used as –

• A measure of achievements made and A measure of achievements made and challenges that need to be addressed. challenges that need to be addressed.

• A risk management tool through the early A risk management tool through the early identification and management of identification and management of problems.problems.

• A baseline to assess the impact of A baseline to assess the impact of interventions designed to enhance the role interventions designed to enhance the role of the workplace in the return to work.of the workplace in the return to work.


The Return-to-Work Workplace The Return-to-Work Workplace IndexIndexThe Index can be used as –The Index can be used as –

• To quantify the employing organisation’s To quantify the employing organisation’s capacity to design and operate the capacity to design and operate the workplace to prevent or minimise work-workplace to prevent or minimise work-related injury or illness and to achieve related injury or illness and to achieve timely and effective return-to-work (as timely and effective return-to-work (as perceived by its employees and perceived by its employees and managers).managers).


FindingsFindings

• Findings reinforce previous research about Findings reinforce previous research about important role of workplace in relation to RTW, and important role of workplace in relation to RTW, and significant scope that exists for employers to prevent significant scope that exists for employers to prevent injury and to achieve effective return-to-work when injury and to achieve effective return-to-work when this does occur. this does occur.

• Majority of aged care providers studied gave Majority of aged care providers studied gave essentially positive assessment of the aged care essentially positive assessment of the aged care workplace in SA.workplace in SA.

• However, sample included organisations who were However, sample included organisations who were willing to participate, and assessments of the willing to participate, and assessments of the workplace were more negative where an workplace were more negative where an active or active or past claimpast claim for workers’ compensation) existed. for workers’ compensation) existed.


The Return-to-Work Workplace The Return-to-Work Workplace IndexIndex

Sub-IndexSub-Index Employee SurveyEmployee Survey

Total Mean ScoreTotal Mean Score

Manager SurveyManager Survey

Total Mean ScoreTotal Mean Score

I. Workplace ConditionsI. Workplace Conditions 4.24.2 n/an/a

II. Workplace ControlII. Workplace Control 3.53.5 n/an/a

III. Workplace CultureIII. Workplace Culture 4.04.0 4.34.3

IV. Workplace SafetyIV. Workplace Safety 4.24.2 4.34.3

V. Workplace Response V. Workplace Response to Injury/Illnessto Injury/Illness

4.54.5 4.64.6


Workplace Conditions Index - totalWorkplace Conditions Index - totalWorkplace Conditions Index

NB. Includes only those employees with a valid Index score (n=532)

0.02.3

28.4

60.5

8.8

0

20

40

60

80

Very low (<2)

Low (2 to <3)

Moderate (3 to <4)

High (4 to <5)

Very high (=5)

Workplace Conditions Index (categories)

% o

f sam

ple

...


Workplace Conditions Index: with Workplace Conditions Index: with claimclaim• Statistically significant differences on basis of Statistically significant differences on basis of

past or active workers’ compensation claim for 3 past or active workers’ compensation claim for 3 Workplace Conditions IndexWorkplace Conditions Index items – items –

1.1.vibration from equipment - bearing in mind that vibration from equipment - bearing in mind that this was the most positively assessed workplace this was the most positively assessed workplace condition for the sample as a whole (condition for the sample as a whole (pp<.05)<.05)

2.2.being in skin contact with chemicals (being in skin contact with chemicals (pp<.05)<.05)

3.3.slippery floors, loose rugs and other fall-inducing slippery floors, loose rugs and other fall-inducing conditions (conditions (pp<.05). <.05).


Workplace Conditions Index: care Workplace Conditions Index: care settingsetting

• Significant difference in relation to Significant difference in relation to slippery slippery floors, loose rugs and other factors that can lead floors, loose rugs and other factors that can lead to a fall to a fall ((pp<.05) with employees working in <.05) with employees working in residential care settings being more positive residential care settings being more positive than those working in clients’ homes.than those working in clients’ homes.

• Workplaces bringing greater risk of falls were Workplaces bringing greater risk of falls were also significantly associated with employees with also significantly associated with employees with a past or active workers’ compensation claim.a past or active workers’ compensation claim.


Workplace Conditions Index: with Workplace Conditions Index: with claimclaim

Workplace Conditions Index by Claim/No ClaimNB. Includes only those employees with a valid Index score (n=532)

4.1

31.4

58.7

5.8

1.7

27.8

60.8

9.6

0

20

40

60

80

Low (2 to <3) Moderate (3 to <4) High (4 to <5) Very high (5)

Workplace Conditions Index (categories)There was a statistically significant difference between the Index scores for Claim/NoClaim (Mann-Whitney U=21274.5, p<.05).

% o

f valid r

esponses …

..Claim (active or previous)

No claim (never made a claim)


Workplace Control Index: totalWorkplace Control Index: totalWorkplace Control Index

NB. Includes only those employees with a valid Index score (n=544)

9.0

18.6

30.3 31.8

10.3

0

20

40

60

80

Very low (<2)

Low (2 to <3)

Moderate (3 to <4)

High (4 to <5)

Very high (=5)

Workplace Control Index (categories)

% o

f sam

ple

...


Workplace Control Index: Work Role & Workplace Control Index: Work Role & Care SettingCare Setting

• Workplace control factors emerge as the least Workplace control factors emerge as the least conducive to effective return-to-work.conducive to effective return-to-work.

• With exception of those in policy or administrative With exception of those in policy or administrative roles, most aged care workers have restricted roles, most aged care workers have restricted capacity to control how their work day and capacity to control how their work day and activities are structured. activities are structured.

• Staff in residential aged care significantly Staff in residential aged care significantly less likely to agree they could adapt their less likely to agree they could adapt their working hours, and decide when to take a working hours, and decide when to take a break, compared with staff working in break, compared with staff working in clients’ homes or administrative, clients’ homes or administrative, community care offices etc. community care offices etc.


Workplace Control Index: Work Workplace Control Index: Work Role & Care SettingRole & Care Setting

• Care workers reported least flexibility in taking a Care workers reported least flexibility in taking a break, policy/administration staff reported most break, policy/administration staff reported most flexibility in those areas, with nurses somewhere flexibility in those areas, with nurses somewhere in between. in between.

• Staff working in policy or administrative roles had Staff working in policy or administrative roles had greater control over ability to adapt working greater control over ability to adapt working hours than did nurses, care workers and domestic hours than did nurses, care workers and domestic or home maintenance workers.or home maintenance workers.

• Re: the item ‘ Re: the item ‘ I can adapt my working hours I can adapt my working hours within limits’within limits’ -employees who had made a -employees who had made a compensation claim rated their workplace as compensation claim rated their workplace as providing less control over working hours than providing less control over working hours than was case for those with no claim history (was case for those with no claim history (pp<.05).<.05).


Workplace Culture Index: total Workplace Culture Index: total

Workplace Culture Index: EmployeesNB. Includes only those employees with a valid Index score (n=543)

3.9

11.0

21.4

46.4

17.3

0

20

40

60

80

Very low (<2)

Low (2 to <3)

Moderate (3 to <4)

High (4 to <5)

Very high (=5)

Workplace Culture Index (categories)

% o

f sam

ple

...

Workplace Culture Index: ManagersNB. Includes only those employees with a valid Index score (n=53)

0.01.9

18.9

69.8

9.4

0

20

40

60

80

Very low (<2)

Low (2 to <3)

Moderate (3 to <4)

High (4 to <5)

Very high (=5)

Workplace Culture Index (categories)%

of sa

mple

...


Workplace Culture Index: With Workplace Culture Index: With ClaimClaimThe following 6 items of the Index showed a The following 6 items of the Index showed a

statistically significant difference with a claim –statistically significant difference with a claim –• Communication between managers and staff Communication between managers and staff

((pp<.05) – less effective<.05) – less effective• Communication within work teams (Communication within work teams (pp<.05) - less <.05) - less

effectiveeffective• Level of trust within work teams (Level of trust within work teams (pp<.01) - lower<.01) - lower• Workplace bullying (Workplace bullying (pp<.05) - higher<.05) - higher• Work teams are supportive to ill/injured Work teams are supportive to ill/injured

employee employee ((pp<.05) – less supportive<.05) – less supportive• Management/supervisors are supportive to Management/supervisors are supportive to

ill/injured employee ill/injured employee ((pp<.05) – less supportive<.05) – less supportive


Workplace Culture Index: with Workplace Culture Index: with claimclaim

Workplace Culture Index by Claim/No ClaimNB. Includes only those employees with a valid Index score (n=543)

8.9

12.9

23.4

40.3

14.5

2.4

10.6

21.0

47.8

18.1

0

20

40

60

80

Very low (<2) Low (2 to <3) Moderate (3 to <4)

High (4 to <5) Very high (5)

Workplace Culture Index (categories)There was a statistically significant difference between the Index scores for Claim/NoClaim (Mann-Whitney U=21814.5, p<.05).

% o

f valid r

esponses …

..

Claim (active or previous)



Workplace Safety Index: totalWorkplace Safety Index: total

Workplace Safety Index: EmployeesNB. Includes only those employees with a valid Index score (n=544)

1.5

7.4

21.1

52.6

17.5

0

20

40

60

80

Very low (<2)

Low (2 to <3)

Moderate (3 to <4)

High (4 to <5)

Very high (=5)

Workplace Safety Index (categories)

% o

f sam

ple

...

Workplace Safety Index: ManagersNB. Includes only those employees with a valid Index score (n=53)

0.03.8

22.6

67.9

5.7

0

20

40

60

80

Very low (<2)

Low (2 to <3)

Moderate (3 to <4)

High (4 to <5)

Very high (=5)

Workplace Safety Index (categories)%

of sa

mple

...


Workplace Safety – Most positive Workplace Safety – Most positive ratingsratings

• High value placed on workplace safety by High value placed on workplace safety by employing organisations.employing organisations.

• Management was rated as receptive to the Management was rated as receptive to the raising of safety issues. raising of safety issues.

• Training in lifting and the use of lifting Training in lifting and the use of lifting equipment.equipment.

• Provision and availability of lifting Provision and availability of lifting equipment.equipment.


Workplace Safety – Most negative Workplace Safety – Most negative ratingsratings

• inadequate training of managers and inadequate training of managers and supervisors in safety and injury supervisors in safety and injury management (Managers’ Survey)management (Managers’ Survey)

• familiarity with workers’ compensation familiarity with workers’ compensation rights and obligations and processes, and rights and obligations and processes, and processes associated with making a claimprocesses associated with making a claim (Employees’ Survey) (Employees’ Survey)


Workplace Safety Index: with Workplace Safety Index: with claimclaim

Workplace Safety Index (Version II) by Claim/No ClaimNB. Includes only those employees with a valid Index score (n=541)

4.07.3

20.2

44.4

24.2

1.0

7.0

14.1

45.6

32.3

0

20

40

60

80

Very low (<2) Low (2 to <3) Moderate (3 to <4)

High (4 to <5) Very high (5)

Workplace Safety Index - Version II (categories)Statistically significant difference between the Index scores

for Claim/NoClaim (Mann-Whitney U=21838.5, p<.05).

% o

f valid r

esponses …

..Claim (active or previous)



Workplace Safety Index: no claimWorkplace Safety Index: no claimThose with Those with no claim historyno claim history provided significantly more positive provided significantly more positive

ratings about workplace safety and injury prevention on these 6 ratings about workplace safety and injury prevention on these 6 items –items –

• Employees receive enough training in occupational health and Employees receive enough training in occupational health and safety issues (safety issues (pp<.01).<.01).

• Employees receive enough training in Injury prevention (Employees receive enough training in Injury prevention (pp<.05).<.05).• Managers receive enough training in occupational health and Managers receive enough training in occupational health and

safety issues (safety issues (pp<.05).<.05).• Managers receive enough training in injury prevention (Managers receive enough training in injury prevention (pp<.05).<.05).• Employees receive enough training in lifting to prevent injury Employees receive enough training in lifting to prevent injury

((pp<.05).<.05).• Managers listen if employees raise workplace safety issues Managers listen if employees raise workplace safety issues

((pp<.05).<.05).


Workplace Response Index: totalWorkplace Response Index: total

Workplace Response to Injury Index: EmployeesNB. Includes only those employees with a valid Index score (n=442)

0.9 1.8

16.3

33.3

47.7

0

20

40

60

80

Very low (<2)

Low (2 to <3)

Moderate (3 to <4)

High (4 to <5)

Very high (=5)

Workplace Response to Injury Index (categories)

% o

f sa

mple

...

Workplace Response to Injury Index: ManagersNB. Includes only those employees with a valid Index score (n=53)

0.0 0.0

11.3

60.4

28.3

0

20

40

60

80

Very low (<2)

Low (2 to <3)

Moderate (3 to <4)

High (4 to <5)

Very high (=5)

Workplace Response to Injury Index (categories)

% o

f sa

mple

...


Workplace Response IndexWorkplace Response Index

• Both employees and managers more positive Both employees and managers more positive about their organisations’ about their organisations’ response response to to workplace injury and illness and to achieving workplace injury and illness and to achieving RTW, than about their capacity to RTW, than about their capacity to preventprevent injury injury and illness.and illness.

• Employees gave their most positive average Employees gave their most positive average rating to policies encouraging employees to rating to policies encouraging employees to notify as early as possiblenotify as early as possible if they have been if they have been injured. injured.

• Very positive ratings were given to developing a Very positive ratings were given to developing a return-to-work planreturn-to-work plan, , involving supervisorsinvolving supervisors and and the the injured workerinjured worker in that plan, and in that plan, and work work redesignredesign to accommodate the injured worker to accommodate the injured worker. .


Workplace Response IndexWorkplace Response Index

• Greatest barrier to RTW was communication Greatest barrier to RTW was communication processes between management and those processes between management and those managing the worker’s injury or illness. managing the worker’s injury or illness.

• This factor is not within the influence of the aged This factor is not within the influence of the aged care sector alone, and requires collaborative care sector alone, and requires collaborative intervention by all stakeholders.intervention by all stakeholders.

• Managers identified the appointment of a Managers identified the appointment of a Return-to-Work Coordinator as another Return-to-Work Coordinator as another facilitating factor to RTW.facilitating factor to RTW.


Conclusions and Future Directions Conclusions and Future Directions for Aged Care Employers to for Aged Care Employers to considerconsider• Given the trend for most aged care industry Given the trend for most aged care industry

occupations traditionally to have low levels of occupations traditionally to have low levels of control or autonomy, it would be useful to control or autonomy, it would be useful to explore ways in which greater workplace control explore ways in which greater workplace control can be achieved across roles and work settings, can be achieved across roles and work settings, perhaps by establishing a series of pilots to perhaps by establishing a series of pilots to model alternative approaches.model alternative approaches.

• Attention should be directed to addressing the Attention should be directed to addressing the less positive ratings that were given to less positive ratings that were given to workplace bullying (by both employees and workplace bullying (by both employees and managers), and levels of trust between managers), and levels of trust between managers and staff (as perceived by managers and staff (as perceived by employees). employees).


Conclusions and Future Directions Conclusions and Future Directions for Aged Care Employers to for Aged Care Employers to considerconsider• The findings suggest that the aged care sector The findings suggest that the aged care sector

has implemented a range of initiatives to support has implemented a range of initiatives to support effective return-to-work, but should pay greater effective return-to-work, but should pay greater attention to developing and implementing attention to developing and implementing specific RTW policies and procedures.specific RTW policies and procedures.

• Given how positive managers have been in most Given how positive managers have been in most of their ratings, the lower assessment given by of their ratings, the lower assessment given by them to the training they receive in injury them to the training they receive in injury prevention should be interpreted as an urgent prevention should be interpreted as an urgent need for further training on this issueneed for further training on this issue ..


Conclusions and Future Directions Conclusions and Future Directions for for WorkCover SA WorkCover SA to considerto consider• The only workplace condition identified as requiring The only workplace condition identified as requiring

attention by aged care employers related to fattention by aged care employers related to fall-all-inducing inducing conditions. Given continuing trend to provide conditions. Given continuing trend to provide care in the home rather than a residential setting, risk of care in the home rather than a residential setting, risk of falling will be more difficult to contain. This indicates falling will be more difficult to contain. This indicates need for a wider community education campaign by need for a wider community education campaign by WorkCover SAWorkCover SA and and SafeWorkSASafeWorkSA about home and office about home and office conditions that bring the risk of falling.conditions that bring the risk of falling.

• The most negatively rated factor in responding to The most negatively rated factor in responding to workplace injury or illness involved workplace injury or illness involved ineffective ineffective communication processes between those involved communication processes between those involved in the RTW process.in the RTW process. This requires a coordinated This requires a coordinated strategy that could be initiated by strategy that could be initiated by WorkCover SAWorkCover SA and and involving all stakeholder groups.involving all stakeholder groups.


Conclusions and Future Directions Conclusions and Future Directions for for WorkCover SA WorkCover SA to considerto consider• Among the least positive ratings were those assessing Among the least positive ratings were those assessing

how informed employees are regarding workers’ how informed employees are regarding workers’ compensation claim processes, and given the influence compensation claim processes, and given the influence identified by research of this on RTW, there is scope for identified by research of this on RTW, there is scope for WorkCover SAWorkCover SA to work with the aged care industry to to work with the aged care industry to address this information gap. address this information gap.

• There is a role for There is a role for WorkCover SAWorkCover SA to play, in collaboration to play, in collaboration with the Department of Further Education Employment with the Department of Further Education Employment Science and Technology (DFEEST) and the Department Science and Technology (DFEEST) and the Department of Trade and Economic Development (DTED) in bringing of Trade and Economic Development (DTED) in bringing a focus on RTW objectives as part of the development of a focus on RTW objectives as part of the development of the new state-wide skills and workforce development the new state-wide skills and workforce development strategy.strategy.

the role of the workplace in return-to-work: a research perspective

Documents