Evaluation of a Workplace Disability Prevention Intervention in Canada: Examining Differing Perceptions of Stakeholders

Introduction Workplace disability prevention is important, but stakeholders can differ in their appreciation of such interventions. We present a responsive evaluation of a workplace disability prevention intervention in a Canadian healthcare organization. Three groups of stakeholders were included: designers of the intervention, deliverers, and workers. The aim was to examine the appreciation of this intervention by analyzing the discrepancies with respect to what these various stakeholders see as the causes of work disability, what the intervention should aim at to address this problem, and to what extent the intervention works in practice. Methods A qualitative research method was used, including data-triangulation: (a) documentary materials; (b) semi-structured interviews with the deliverers and workers (n = 14); (c) participatory observations of group meetings (n = 6); (d) member-checking meetings (n = 3); (e) focus-group meetings (n = 2). A grounded theory approach, including some ethnographic methodology, was used for the data-analysis. Results Stakeholders’ perceptions of causes for work disability differ, as do preferred strategies for prevention. Designers proposed work-directed measures to change the workplace and work organizations, and individual-directed measures to change workers’ behaviour. Deliverers targeted individual-directed measures, however, workers were mostly seeking work-directed measures. To assess how the intervention was working, designers sought a wide range of outcome measures. Deliverers focused on measurable outcomes targeted at reducing work time-loss. Workers perceived that this intervention offered short-term benefits yet fell short in ensuring sustainable return-to-work. Conclusion This study provides understanding of where discrepancies between stakeholders’ perceptions about interventions come from. Our findings have implications for workplace disability prevention intervention development, implementation and evaluation criteria

WorkCover's physiotherapy forms: Purpose beyond paperwork?

We retrospectively analysed 219 consecutive treatment plans submitted to a large New South Wales workers’ compensation insurer for workers coded by the insurer as suffering from back pain. The purpose was to (i) describe the quality of goals of treatment provided to insurers by physiotherapists for workers with back pain using guidelines provided by the WorkCover Authority of New South Wales (WorkCover); (ii) compare the physiotherapists’ prognoses against prognoses indicated in clinical practice guidelines; and (iii) make recommendations about the communication system between physiotherapists and insurers. The back pain of most treated workers was classified as acute and the majority of physiotherapists estimated that treatment would be of short duration, which is concordant with current treatment guidelines. However, most physiotherapists did not provide precise, measurable or time–specific treatment goals, despite this being emphasised by WorkCover. We propose ways of improving communication practices between physiotherapists and insurers

Teaching evidence-based practice: the teachers consider the content.

OBJECTIVE: To identify the views of evidence-based practice (EBP) experts about information that should be included in EBP courses. DESIGN: A two-round Delphi process. SETTING AND SUBJECT: The panel of experts in teaching EBP residing in developed and developing countries identified through purposive and snowball sampling. MAIN OUTCOME MEASURES: We developed a list of 49 topics representing key educational topics. The panel scored the importance of topics for inclusion in introductory and advanced courses. In the second round, we sent a summary of results to the panel and asked them to re-score in light of the group's responses. RESULTS: We used email to invite 105 EBP teachers to participate in the study. Fifty-one people from 15 countries agreed to participate, and 40 completed the second round. We achieved consensus that formulating clinical questions, searching pre-appraised resources, introduction to systematic reviews and critical appraisal of studies about therapy should be covered earlier in EBP courses while other critical appraisal topics and quantitative decision-making techniques should be left to more advanced levels. CONCLUSION: Experts concur that introductory EBP courses should be simple and certain topics should be avoided. Specifically, critical appraisal and statistical methods should be left to advanced courses

Effectiveness of interventions for preventing injuries in the agricultural industry; a systematic cochrane review

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Effectiveness of interventions in preventing injuries in agriculture - a systematic review and meta-analysis

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