Adapting the Sherbrooke model to the Belgian situation

Abstract

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