Presence and use of automated external defibrillators in occupational setting, Belgium

Objectives: Few studies focus on out-of-hospital cardiac arrests in the occupational setting. Therefore, this study describes the presence and use of an automated external defibrillator (AED) at Belgian workplaces during the period 2012-2014. Material and Methods: A self-constructed questionnaire was developed and sent to internal prevention counselors. Results: In total, 767 companies filled out the questionnaire. An AED was available in 48.8% of the companies. Presence mainly depended on the number of persons present in the company (both workers and non-workers (e.g., visitors, clients)) and on some occupational cardiovascular risks but was often not based on a well-conducted risk analysis. Training of workers and AED maintenance were provided appropriately. An AED was used for shocking 23 times of which 10 persons survived. Conclusions: Acquiring an AED in the occupational setting is seldom based on a well-conducted risk analysis. Therefore, instructions and criteria are needed to come to a rational decision. Furthermore, a registry on AED utilization in the workplace (e.g., with data on long-term survival) should be set up

Adapting the Sherbrooke model to the Belgian situation

In Canada and the Netherlands, randomized controlled trials proved that the Sherbrooke model is an effective method to induce sustainable work resumption for patients off work over one month due to back problems. The model offered an individually tailored, workplace oriented, step-by-step multidisciplinary return to work strategy. Prior to implementing the model in Belgium, this study aimed at adapting it to the Belgian social security system and labour market needs. A qualitative study was conducted in 2011, with the support of the European Social Fund: discussion groups were organised with sickness absence benefit insurers; employers and workers unions; physicians, ergonomists, psychologists and nurses involved in disability management; and academic experts including the international group of trainees and mentors of the Strategic Training Program in Work Disability Prevention. The meetings aimed at collecting ideas and proposals for model adaptation. For the final model adaptation, the research team relied on a multidisciplinary expert group. To answer company’s requirements a tool was developed making co-workers co-responsible for the worker’s successful work resumption trajectory. To enhance the workers’ own responsibility in the return to work process, a patient return to work diary was designed. To take into account the rising trend in mental health reasons for prolonged sickness absence, the model was opened up to patients irrespectively of the cause of their sickness absence. Belgian employers having limited financial incentives for return to work initiatives when sickness absence periods exceed one month, it was decided to a) implement the model in sectors having difficulties finding suitable personnel due to the labour market scarcity, and b) ask participating companies to commit to fulfil 85% of multidisciplinary work resumption advices and to report in detail on non-followed advices. The Sherbrooke model was mirrored among the Belgian situation and adapted to Belgium’s specific needs. In 2012, the adapted model will be evaluated in a pilot study including five companies employing about 8000 workers in the Antwerp region of Belgium

Searching for consensus among physicians involved in the management of sick-listed workers in the Belgian health care sector: a qualitative study among practitioners and stakeholders

Background In Belgium, the management of sick leave involves general practitioners (GPs), occupational health physicians (OPs) and social insurance physicians (SIPs). A dysfunctional relationship among these physicians can impede a patient’s ability to return to work. The objective of this study was to identify ways to improve these physicians’ mutual collaboration. Methods Two consensus techniques were successively performed among the three professional groups. Eight nominal groups (NGs) gathered 74 field practitioners, and a two-round Delphi process involved 32 stakeholders. Results From the results, it appears that two areas (reciprocal knowledge and evolution of the legal and regulatory framework) are objects of consensus among the three medical group that were surveyed. Information transfer, particularly electronic transfer, was stressed as an important way to improve. The consensual proposals regarding interdisciplinary collaboration indicate specific and practical changes to be implemented when professionals are managing workers who are on sick leave. The collaboration process appeared to be currently more problematic, but the participants correctly identified the need for common training. Conclusions The three physician groups all agree regarding several inter-physician collaboration proposals. The study also revealed a latent conflict situation among the analysed professionals that can arise from a lack of mutual recognition. Practical changes or improvements must be included in an extended framework that involves the different determinants of interdisciplinary collaboration that are shown by theoretical models. Collaboration is a product of the actions and behaviours of various partners, which requires reciprocal knowledge and trust; collaboration also implies political and economic structures that are led by public health authorities.Partnershi

HR managers views and practices in SME's regarding return to work of sick listed employees

Background Little is known about the return to work (RTW) policies implemented in small and medium size enterprises (SME) which have limited resources to define and apply such policies. This study aimed at assessing the existing return to work practices in SME’s and exploring their view regarding the help they could receive from their occupational health service. Methods HR managers of 46 SME’s (23 in Flanders, 23 in Wallonia) employing 100 to 200 employees were contacted for an interview. The manager was asked to fill in a written questionnaire and to comment his/her answers in an open discussion with the researcher. The questionnaire involved three parts: 1°) describing existing rules or procedures when returning to work after sick leave, 2) assessing the manager knowledge of the RTW legal regulations within the occupational health care system, 3) assessing the occupational health physician (OP) involvement in RTW and the enterprise expectations for the future. Results Participation to the survey was accepted in 38 SME’s. In slightly more than half of them a sick leave related policy has been defined. While almost all SME’s have a well-defined procedure for the RTW examination by the OP, only 22 (out of 38) have defined procedures for maintaining a contact with the worker during the sick leave period, only 17 are informing their employees about the possibility to meet the OP during that period, and only 6 are systematically organising a worker-supervisor meeting when the worker comes back at work. Knowledge about RTW regulations is rather poor: 10 managers wrongly think that the OP may check the sick leave medical validity; only 14 managers know that the employer must inform the OP about any sick leave longer than 4 weeks; less than half of the managers have a good knowledge of the pre-return to work visit. Various expectations have been put forward as regard the role of the OH service: knowledge transfer about the regulations, coaching of the supervisors, training managers in carrying RTW talks with the worker, suggesting procedures, etc. Conclusions The lack of knowledge about RTW regulations underlines the need for information campaigns focused on the employers. The participating RH managers are awaiting a more proactive role from their OH service