Setting Up a Workplace Disability Program
Contents
1. Setting up a work disability program
Involving the team in solutions
Action planning and implementation
2. Employer-employee partnership
3. Organisational and staff responsibilities
Return to work coordinator responsibilities
Senior management responsibilities
1.Setting up a work disability program
Obtaining commitment
The first step in developing a work disability program is to get commitment from the organisation's leaders. This may include senior management, leaders from the 'factory floor', production and human resources management.
Staff are more likely to be involved if senior management commitment is evident. A written statement of the organisation's approach, backed up by clear policies and procedures, lays an important function.
Management commitment
The best way to engage managers is to present a business case. This is supported by an ethical case for supporting staff with an injury and improving the organisation’s standing with employees and the community.
The business case includes an assessment of the costs of work disability, including:
I. Direct costs such as the WorkCover premium, any wages not covered by the premium and other costs such as health and safety fines
II. Indirect costs, estimated to be four to ten times the direct costs (staff replacement, supervisor time, administration)
Additional benefits of an effective program include:
1. Reduced costs
2. Improved staff morale
3. Freed up supervisors who can concentrate on productivity
4. Improved corporate image
5. Improved customer service through better staff engagement
Other reasons for managing work injuries include:
6. The ethical case for tackling work disability
7. Employers subjected to a general duty of care for their staff
8. The legal case - return to work offers are expected. Regulators are increasingly assessing employer performance, with prosecutions for not offering return to work programs increasing.
Employee commitment
There are a number of ways to get employees and their representative (eg trade union and health safety representatives) involved. The following are key principles:
1. Involve employee representatives at the beginning of the process
2. Involve employees and their representatives in evaluating the problem
3. Involve employees and their representatives in working out solutions
4. If you decide to confine your efforts to a limited section of your organisation, consider how best to inform other employees.
The steps involved
Implementing a work disability program requires an understanding of work injury management programs as well as strong project management skills. There will be a number of barriers to be overcome to implement a comprehensive system. However work done at this end will pay off in preventing the reduced workload as a result of a poorly developed system.
Use of external resources can assist with part or all of the program's implementation. If external resources are used it is important that there be a clear, written understanding of what the external provider will do and what will remain the responsibility of the organisation.
Whether internal or external resources are used, the approach should include the following steps:
· Secure the commitment of senior managers to start the process and see it through
· Gather and analyse data such as surveys, and work disability and claims information
· Develop the organisation’s IT systems to allow gathering of information in the most efficient manner
· Use a range of information to understand the situation within the organisation
· Communicate with staff about the process
· Establish a dialogue with staff to identify specific problems and practical solutions
· Generate an action plan from all the information
· Implement and evaluate any interventions identified
· Create sustainability by training staff in the organisation to run the process
· Understand and develop the organisation's policies and procedures
· Review the process should situations/procedures at work change, eg change of shifts, new equipment.
Any external assistance should be driven by the needs of the organisation. Some organisations may need outside help with the whole approach, whereas others will only require assistance with one or two elements.
Identifying the issues
An informal audit of the issues can be completed by:
1. Analysing the financial costs
2. Understanding the most common injuries
3. Obtaining feedback from employees, supervisors and managers about how things are dealt with (ask if people are satisfied with the current system and what can be improved).
The organisation may already collect information that can be used to understand whether work disability is a problem. For example, consider:
· Are there high levels of work absence? This may indicate a potential problem area.
· Are injuries consistently reported early?
· What is the average time off work and how does this compare to other organisations, or other sites within the same organisation?
Interviewing employees who have sustained an injury, their supervisors and key managers can highlight areas of concern. Ask about the process from initial injury reporting and for obtaining medical treatment, return to work approaches, and support with return to work duties. This information can give crucial insight into the systems (or lack of systems) operating.
A formal audit
Formal audit tools are available, including the internationally recognised CBDMA.
The Consensus Based Disability Management Audit (CBDMA) is a well regarded tool that can be used by organizations as:
1. An evaluation tool, to determine current disability management program performance
2. A corrective tool, to establish where program deficiencies are, highlighting remedial actions required
3. A program promotion tool, maintaining disability management concepts in worker consciousness and demonstrating management's commitment to workplace disability management practices.
Data is collected with three distinct question types: consensus questions, evidence questions, and survey or interview questions.
From the information, employer strengths and deficits are analysed and reported. A list of recommendations is created, providing the company with the next steps to improve outcomes.
Questions can be grouped under three categories:
I. Consensus:
Consensus questions are collaborative and subjective in nature, and are asked at a meeting of equal numbers of management and worker representatives. The questions draw out the views of employees and management. There are 84 consensus questions drawn from the various elements and represent the questions for which data would be hard to find, such as employee beliefs or opinions.
The consensus questions are answered as a group. The auditor will convene managers and workers to discuss their perspectives with respect to these questions.
Participants are expected to reach some agreement on how to respond to each of these questions. This happens with the help of the auditor acting as facilitator.
II. Evidence:
Evidence questions are answered by the auditors only and provide a more objective approach to the analysis. They examine evidence of the disability management practices and procedures in place at the workplace.
Auditors use the questions to guide their fact-finding objectives. Evidence of good practice is evaluated from workplace policy and procedures documents, case files and other pertinent documentation. There are 85 evidence questions in the audit.
III.Survey/Interview:
Auditors use survey/interview questions to gather data from a sample of workers and managers. They assist the auditor to assess the employees' and managers' perceptions of the workplace's disability management approach. There are 11 survey/interview questions in the audit.
Using your own surveys
Using existing surveys can give you an idea of how the organisation measures up in terms of workplace culture.
“Toolbox talks”
In areas with relatively few employees, it may be appropriate to explore work injury management issues in small groups.
There may be pre existing arrangements for consulting with employees and encouraging participation. For example, routine “toolbox talks” can be an opportunity to inquire about this area. Similarly, managers meetings can be used to explore potential issues for this group.
Whatever means are used to assess the ways work injuries are managed, multiple measures should be combined to gather a complete picture rather than rely on one measure of information alone.
Involving the team in solutions
Identifying solutions is best done by involving the organisation's staff and representatives.
Senior management involvement
Senior managers can help drive the process. They need advice about what they can do to assist, which they can gain by:
1. Asking their managers about how people with a work injury are going and what is being done to help them
2. Calling workers with an injury to ask how they are and if the organisation can do anything else to support them
3. Expecting monthly or quarterly reports about case numbers, costs and any planned improvements.
Involving the team in deciding what needs to be done
A good way to decide what needs to be done is to bring together groups of about six to ten employees as a “focus group”. Using information on current problems, seek input on how things can be improved.
What solutions are going to work in the organisation?
Developing solutions can be challenging. A group process that involves relevant groups across the organisation is more likely to succeed.
The overall aim is to draw up recommendations in the form of an action plan. Those in charge of program implementation may need to prioritise solutions, but they should communicate back to staff the results of the plans for continuous improvement, with dates for review.
Possible areas for improvement may include:
1. Further training for return to work coordinators
2. Training of line managers and supervisors, including training in communication
3. A system of obtaining regular feedback from employees with an injury, such as routine surveys
4. A group process to identify a list of modified duties
5. Development of the organisation’s policies and procedures
6. Improved incident investigation
7. Better systems of early reporting and communication
8. Specialist or external support for complex cases
9. Ergonomic advice
10. Improved relationships with health care providers
11. A written list of available modified duties
12. Improved communication channels for people returning to work – eg a weekly catch-up, access to senior staff if there are problems
13. Regular reporting and feedback
14. Regular meetings with claims staff, such as the WorkCover insurer
15. Development of a tick-box list of essential functions of the job for treating doctor to complete. Have this list available on company website to enable employees to take to their doctors.
Action planning and implementation
Developing and disseminating an action plan is an effective way of involving staff and encouraging implementation. Including targets and the work disability in the organisation's business plan increases visibility and early actions let staff know the program will make a difference.
1. Strategic and business plans
Work disability is expensive. Financial and senior managers are often unaware of the significant costs. An awareness of the importance of effective management improves through the inclusion of work disability policy within the strategic plan of an organisation. Targets can be simple or complex. Examples include:
- 10% targeted reduction in days lost
- Improvement in the supervisor management of staff with injuries, as measured by the percentage of return to work case meetings supervisors attend
- 10% reduction in total work disability costs
- Full integration of the work disability policy at a new site.
2. Action plan
An action plan can:
· help to set goals to work towards
· prioritise
· demonstrate the organisation is serious about addressing the issue
· provide a plan that can be reviewed and evaluated.
An action plan is should include:
· what the problem is
· how the issue was assessed
· what the organisation will do about the issue
· how the steps to improve were identified
· key milestones and dates for them to be reached
· a commitment to provide feedback to employees on progress
· a date for reviewing against the plan.
3. Demonstrating through actions
One of the most effective ways of getting good practices into everyday use is for people to see action. Even small actions can let people know the issue is important and being taken seriously. Actions demonstrate commitment, and program implementation is more likely to be successful if people can see and understand the difference the program will make to everyday situations. Consider the following case studies:
- An employee cuts their finger and the cut is deep enough to sever the tendon. The supervisor takes the employee to the hospital, the company doctor organises rapid access to a plastic surgeon and the manager calls the employee the next day to see how he is.
- An employee has a non-work related shoulder problem and has to wait three months to see the surgeon. With her permission the coordinator calls the surgeon's office and asks to be notified about a cancellation. The receptionist phones the next day to advise of a cancellation in two days time. The employee experiences the employer's commitment.
- A supervisor is busy and has ignored two calls from the RTW coordinator to discuss modified duties for a person currently off work. The coordinator speaks with the department manager, who in turn provides clear feedback to the supervisor about his important role in helping people come back to work and that his performance review will take this into account. The supervisor experiences the Department Manager's commitment.
Monitorign and reviewing
The action plan should be shared with management and employees and their representatives, including dates for monitoring and review.
Periodically check agreed actions are being undertaken, for example that meetings are being held or that there is evidence that certain activities have taken place.
How this is done depends upon the solutions that were developed and implemented. It is important to ask those involved whether they feel the solutions are having the desired effect. Discussing the program with a sample of those involved is sensible.
Another way to demonstrate the plan's effectiveness is to review data on employee injuries and days lost from work, and to measure progress against emerging trends or changes in this data.
The program's targets should be periodically reviewed. Targets that are met can be celebrated and success shared. When targets are not met a review of the system to identify gaps should be completed.
The timing of reviews will depend on how long it will take to implement each intervention and how long any impact is expected to take.
2.Employer-employee partnership
A best practice organisational approach to injury management is built on cooperation between all parties. At the heart of this is a commitment from management and staff to look after every individual who experiences a work injury, and to undertake continuous improvement in the work injury, and prevention management systems in place.
A spirit of cooperation takes time to develop. A clearly defined policy is important, but the attitude and approach from management is the major driver.
This section of the handbook outlines approaches that underpin long-term sustainability. Other sections of the handbook provide details on program implementation.
Management input
Senior management provide leadership to the rest of the team. When upper levels of management understand work disability management, review program evaluations and demonstrate a commitment to staff with an injury, the rest of the organisation will follow.
Management input involves regular actions such as reviews of the policy and program, training of staff and ad hoc actions such as following up on an individual employee. Regular actions include:
- Ensuring the organisation has policies and procedures in place. The policy document should be consistent with the organisation's general approach. The policies and procedures need to be known, understood and used.
- Voicing of support from management for work conductedwith employees to resolve return to work issues.
- Training undergone by senior managers so they understand the key issues and how to work with staff to produce successful outcomes. From the human and financial perspectives they should be aware of their contribution and how they can formally and informally work at a policy and individual case level. Financial managers should understand the cost ramifications of long-term disability and work with department, line managers and supervisors to ensure effective practices.
- Discussing disability management and return to work at management meetings. Relevant information includes:
* Number of individuals off work due to illness and injury
* Strategies to facilitate early RTW
* Lost day and modified duties statistics
* Trends in work disability within the organisation
* Area statistics that identify problem areas, or areas where cooperation may be limited.
- Completing program evaluation at defined intervals (eg annually) and management actively reviewing the findings.
- Including disability management and return to work in corporate strategic planning. The strategic plan should take into account implementation issues relevant to work disability management, for example the integration of modified duties into relevant award agreements.
- Actively seeking the input and opinions of employees and unions about injury prevention, return to work care and system improvement.
Employee and union input
Unions, Health and Safety representatives and employees help shape a collaborative approach to return to work management.
Trust is an important platform for employee and union support. Unions can assist individual employees to return to work, but will only do this when they consider it is in the employee's best interest. If they do not trust the organisation they are unlikely to be helpful in return to work matters.
Unions and employees can support return to work collaboration through:
1. Employee and union input into the organisation's policy and procedure development. Policy documents should be relevant, used and responsive to the site's needs. Employees and unions who have a say in the policy and procedure development are much more likely to follow the policies and procedures.
2. Employee representatives support employees to report problems early and support the overall program.
3. Unions can facilitate information transfer. Some unions produce documents for their members, outlining important return to work issues.
4. Employee representatives can play key roles in return to work discussions in complex cases. The employee may have a greater level of trust in a union representative. The union representative may be more experienced in negotiating and be able to suggest alternatives or different duties. In their role they are often aware of employee and employer barriers to return to work, and can suggest ways of overcoming those barriers. When engaged in a partnership approach an employee representative can play a key role. An employee who sees their representative and employer working together to achieve a good outcome for them will gain confidence and motivation.
5. Employees and employer representatives committed to a shared approach will find ways to overcome problems. Line managers not supporting staff will be given clear feedback, with suggestions about what may assist the situation.
A shared approach
Employees and management working together allows:
1. More effective support for employees who need assistance. In complex situations a team approach finds solutions. Employees and supervisors are the two key people involved with return to work. RTW coordinators, area or department managers, human resources and senior staff provide support and input as appropriate.
2. A more streamlined approach to deal with the occasional person who does not comply with the spirit of return to work.
A shared approach can only occur when groups within an organisation trust each other. Whether trust develops or not is based on what occurs and what is done by each group. The following table provides insight into what happens with different approaches.
| What happens at Org A where a shared approach is lacking | What happens at Org B where a shared approach occurs |
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