The return to work

Return to work is a six-step process: 1) Time off and recovery period; 2) Initial communication with the worker by the workplace; 3) Assessment of the worker (work capacity) and his or her work (job demands); 4) Development of the RTW plan with work accommodation measures; 5) Return to work (day 1); 6) Follow-up of RTW (in the following weeks).

Different actors are involved in the RTW process: workplace actors and consultants or experts (health professionals, ergonomists, occupational hygienists). This section will help you coordinate them appropriately.

Introduction and objectives

Addressing return to work (RTW) can be a complex task. However, a better understanding of its principles as well as the interventions and actions to be taken can guide you in your practice

In this section, as illustrated and explained in Figure 5 , the information is organized into three perspectives (global, scientific, and empirical) to describe the three types of information: process, interventions, and organizational practices in RTW.

The contents presented in this section take into account the multidimensional nature (individual, organizational and societal) of work The id: 3292 does not exist and, by the same token, the RTW process and occupational rehabilitation.

They are based on the biopsychosocial model (Engel, 1977). This model recognizes the importance of mobilizing actors and stakeholders from various environments or systems (workplace, health system, insurance system), while considering the worker’s personal traits (physical and psychological).

“Work is good for us.”

In our society, work is generally perceived as “good for us” because it contributes to our personal development as well as to financial and social prosperity.

Most people who WHO World Health Organization work can indeed demonstrate to you by certain economic, social and moral arguments that work improves their well-being, that of their families or their communities.

However, while work can be good for health, there are some negative conditions that can be detrimental to it, such as little support for employees, rigid schedules, lack of clarity in tasks or organizational goals. ( WHO WHO World Health Organization , 2017).

That’s why researchers argue that a change in ideology is needed to justify this maxim, starting with a healthy work environment .

Socio-professional disintegration due to work stoppage would have negative consequences for the worker, such as social isolation, inactivity and mood fluctuations (Ozguler, Loisel, Boureau and Leclerc, 2004).

Indeed, a systematic review of the health benefits of RTW concluded that RTW is good for health while a prolonged period without employment has the opposite effect (Rueda et al., 2012). Thus, RTW can be therapeutic in its own right (Ozguler et al., 2004), provided that the work environment no longer poses a risk to the worker

Objectives of this section

Make recommendations to guide actors in achieving healthy and sustainable RTW for workers

Specific objectives of this section

In terms of process:

  • To provide an overview of core activities and approaches for a healthy and sustainable RTW.

In terms of intervention :

  • Identify effective interventions;
  • Describe the components of these interventions;
  • Understand the benefit of combining intervention components for worker wellness.
  • Understand the factors that influence RTW or length of absence.

In terms of optimal practices:

  • Describe good workplace practices for healthy and sustainable RTW: organizational strategies and actions to be carried out in the workplace by all actors involved.

Return to work perspectives


Figure 5 – RTW Perspectives

The RTW Process refers to a set of principles that characterize healthy and sustainable RTW. Here we take a more holistic, evidence -based perspective to understand RTW macroscopically.

RTW Interventions refer to actions performed by one or more qualified professionals usually outside the organization (e.g., health professionals, ergonomist). They are carried out in collaboration with one or more actors in the workplace (e.g. the absence management manager). The objective is primarily therapeutic in terms of restoring the worker’s abilities and ultimately results in a healthy and sustainable RTW. Here, the data comes from systematic reviews. Their judicious use is rooted in evidence -based medicine (EBM; scientific perspective). The interventions aim, among other things, to increase the quality of life of workers, to reduce the influence of unfavorable factors and to promote factors favorable to RTW.

Workplace practices for healthy and sustainable RTW refer to organizational strategies and actions specific to a stage and a group of actors in the workplace. They aim at AT Assignation temporaire  a change in corporate culture to enable healthy and sustainable RTW. We adopt an empirical perspective here, with the information collected coming from the observation of workplace practices.

Elements of methodology

 

RTW process, a global vision

RTW is seen as a process. It is therefore a sequence of actions carried out by various actors from different systems (health, workplace, insurer). Interventions can be clinical or non-clinical, either inside or outside the workplace.

The implementation of a RTW process aims to:

  • The application of a corporate culture focused on OHS and derived from the principles for a healthy and sustainable RT RT Retour au travail  ;
  • collaboration between actors at AT Assignation temporaire  each stage of the RTW ;
  • knowledge of their roles and responsibilities, but also those of the other RTW actors, in order to facilitate this collaboration.

Strengths and limitations of this section

Strengths:

  • To our knowledge, no other electronic resource meets the objective of synthesizing the best interventions and practices of a healthy and sustainable RTW to reduce the prolonged absence in terms of scientificity. This is a significant advance for the actors involved.
  • The recommendations are situated in the “clinic-workplace” interface and not only on the clinical or workplace side in isolation. They are therefore aimed at AT Assignation temporaire  education on physical and psychological health and safety and its interactions with the work environment or its responsibility. They also aim to educate on the role of the actors for a healthy and sustainable RTW.
  • The recommendations consider specific aspects of healthy and sustainable RTW such as: 1) the targeted health problem (MSD or CMD), 2) the types of effective interventions and components to better understand the complexity of the process and practices of healthy and sustainable RTW, and 3) the outcomes in terms of RTW.

Limitations:

  • Although the recommendations refer to effective interventions that overlap with those used in the psychology community (e.g., cognitive-behavioural programs), the reported outcomes are not solely psychological in nature. It is the integration of psychological expertise into healthy and sustainable RTW practices that is emphasized.
  • The recommendations are not intended for implementation of effective interventions and their components, as the state of knowledge does not permit such a formulation. They are general guidelines.
  • As a result, the recommendations do not take into account the following aspects: 1) the resources available (in the company, in the health system), the policies of the organizations involved or the legislation in force in certain jurisdictions, 2) the advantages and disadvantages of each intervention , and 3) the explanatory mechanisms of the targeted interventions.

Caveats:

Whether you are an actor in the workplace or a qualified professional in connection with the workplace, it is important to be vigilant in the choice and execution of your actions , because the health and safety of the worker depend on it.

All qualified professionals must follow the rules and principles of their code of ethics and professional conduct.

The recommendations are upstream of the reports and scientific articles. Following the recommendations of your field allows you to shed unique light on the delicate or problematic situations of everyday life. They lead to changes in behavior that are essential for a creative and productive field.

A website remains a dissemination tool and cannot replace more active modalities of knowledge transfer to accompany users towards the adoption of evidence -based good practices.

The return to work process...

... in the workplace

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The return to work process...

... for healthcare professionals and insurers

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Appendix

Appendix 4.A Biopsychosocial model

Appendix 4.A

Appendix 4.O - Integrated Prevention Management: A Way Forward?

Annexe 4.O

Label communication between RT players

Appendix 4.K