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Returning People to Work the Right Way

Sylvia BoddenerBSc., BH.Sc (OT)., OT. Reg. (Ont)., GDM, MBA, UHN Altum Health, Senior Director Business Growth

As the hospital-based leader in multidisciplinary assessment and treatment programs that return people to life and work, Altum Health has since its inception, been focused on gaining a better understanding of identifying barriers to recovery and predicting what factors enable positive return to work outcomes … all to reduce the significant burdens that can be associated with work injury and disability. Starting with a pilot study in 2004, in partnership with the Workplace Safety and Insurance Board, we were successful in implementing the role of a return-to-work coordinator into WSIB Hand Specialty Program. We followed with collaboratively building and growing the role of return-to-work coordinators as well as advancing research into what the role can do to best support positive return to work outcomes. 

Further, we made note of and concurred based on what we were seeing in practice  with the Institute for Work and Health (IWH) systematic review and research work that produced the Seven Principles for Return to Work (2007). Seven Principles for Return to work included factors such as a strong health and safety culture and management philosophy, the employer making early and considerate contact with the worker and providing work accommodations so that workers can come back to work early and safely, return to work planners/facilitators (can be internal to the employer or outsourced to third party service providers such as Altum Health) that coordinate RTW plans and to ensure that the return-to-work plan supports the worker and also is sustainable in the work environment, supervisor and manager training in work disability prevention and inclusion in return-to-work plans,  and most importantly that the employer and health care providers communication and collaborate on workplace accommodations (with the worker’s consent).  

There have been numerous articles written as well in the past decade. Cancelliere and colleagues in 2016, completed a large systematic review of research studies published from 2004 to 2013 to identify common prognostic factors for return-to-work across different health and injury conditions and to describe their association with return-to-work outcomes. The researchers found common factors associated with positive return-to-work outcomes were higher education and socioeconomic status, higher self-efficacy and optimistic expectations for recovery and return-to-work, lower severity of the injury/illness, return-to-work coordination, and multidisciplinary interventions that include the workplace and stakeholders. Common factors associated with negative return-to-work outcomes were older age, being female, higher pain or disability, depression, higher physical work demands, previous sick leave and unemployment, and activity limitations. They concluded that expectations of recovery and return-to-work, pain and disability levels, depression, workplace factors, and access to multidisciplinary assessment and treatment resources are important modifiable factors in progressing return-to-work across health and injury conditions.  

Cancelliere C, Donovan J, Stochkendahl MJ, Biscardi M, Ammendolia C, Myburgh C, Cassidy JD. Factors affecting return to work after injury or illness: best evidence synthesis of systematic reviews. Chiropr Man Therap. 2016 Sep 8;24(1):32. doi: 10.1186/s12998-016-0113-z. PMID: 27610218; PMCID: PMC5015229. 

The IWH has further built on their work most recently publishing a practical guide for employers and worksites (2019) to support return to work for employees with musculoskeletal or mental health conditions. This is timely with the ongoing increase in claims for musculoskeletal and mental health conditions and injuries, this one pager is very useful as it provides high-level guidance on effective workplace-based RTW strategies to employers, disability management professionals, return-to-work coordinators, human resources professionals, worker representatives, workers’ compensation and insurance case managers, and other stakeholders with an interest in returning people to work.


At Altum Health, our clinical teams support the worker and workplace stakeholders in return-to-work coordination and planning, job coaching with our occupational therapists and kinesiologists, and our clinicians are able to initially provide active evidence-based care, work tolerance building and functional testing, working together with the worker and workplace parties, ensuring communication and planning for return to work in a collaborative and supportive manner. Altum Health clinicians can also perform job site evaluations, ergonomic assessments and physical and cognitive demand analyses in support of accommodations including modified duties modified working hours equipment and / or workstation modifications. 

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