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The Health Benefits of Good Work

Implications for return to work and alternate duties in risky workplaces

Dr Graeme Edwards FAFOEM-RACP MBBS BMedSci CIME MRO

Senior Consulting Physician in Occupational and Environmental Medicinedrgraemeedwards@optusnet.com.au

2 June 2016

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• Background• What does ‘good’ work mean for

– Injured workers– Doctors and Rehabilitation service providers– Managers and Rehabilitation Coordinators

• Latest research – AFOEM update to November 2015, published 1 March 2016 - and its implications for:– RTW outcomes– Alternate duties in risky work places

Outline

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Rarely intentional In QLD alone, 2014-15, there were:

• 90,000 worker compensation claims• 70 work-related fatalities• 25,000 serious injuries and diseases either causing

• permanent impairment or • requiring more than 7 days off work

• $12.3 billion cost to the Queensland economy

Workplace Injury

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Approximately 57% of all claims were recorded as not requiring certified time away from work

Rehabilitation at Work – 2014-15

Approximately 55% of Construction and Mining claims were recorded as not requiring certified time away from work

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In 2014-2015 – over 97.6% of all injured workers returned to work,

90% to their pre-injury job

All Injury types

– over 88% of injured Mining and Construction workers returned to work in some capacity

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In 2014-2015 – over 88% of all injured workers returned to work, 64%

to their pre-injury job

Psychological Injuries

– only 57% of injured Mining and Construction workers returned to work

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Health Benefits - 2010

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2013

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A safe, healthy, engaged and productive workforce;

andmakes a positive contribution to the

health and wellbeing of the worker and those affected by the worker.

Good Work =

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Engages, and where necessary partners with, key stakeholders

Four Domains - 1

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Engages with the community culture that reflects the local, regional and operational contexts in which the work is performed

Four Domains - 2

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Respects procedural justice and relational fairness; • promoting civility, and is • intolerant of incivility, discrimination and

bullying.

Four Domains - 3

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A form of interpersonal mistreatment:• Rudeness • Ambiguous comments• Breech of workplace norms of respect or professional

behaviour

Incivility:• Breeds contempt • Subverts legitimate authority • Angers bystanders• Can sow the seeds for more serious behaviours to flourish

Incivility

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By design, appropriately balances: • job demands, job control, workplace support and job security; and

Requires:• clear and realistic performance indicators• uses hard and transparent “people productivity metrics”• requires matching “the work” and “the individual”• requires aware managers but not necessarily aware employees• requires managing change effectively

• mental and psychological wellbeing

Life Balance

Four Domains - 4

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• Not all domains need to be prominent for the work to be “good” for the individual’s health and wellbeing

• Not all domains apply equally to all industries

• For a specific industry, when identifying opportunities to enhance the prevalence of “good work”, one or two domains will dominate

The caveats

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Biopsychosocial model of health

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Coats and Lehki identified the1. Conditions of employment2. Nature of the working environment

The effect of good work on mental health

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Low control, high demands, insecurity and low job esteem

Butterworth, P., Leach, L.S., McManus, S & Stansfeld, S.A (2013) Common mental disorders, unemployment and psychosocial job quality: is a poor job better than no job at all? Psychological Medicine. Vol 43: 1763-1772).

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Protective effect of work

Van der Noordt et al: work• Improved general mental health• Reduced the risk of depression

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Cohen et al:1. doctor-patient relationships2. patient advocacy3. pressure on consultation time4. limited occupational health

expertise.

Role of General Practitioners

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The need to perceive

• On average, workers’ compensation case load is less than 2% (1:50)

• Perceived significant discordance between the expected recovery rate and the injured worker’s demonstrated behaviour

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The Problem

Even for experienced practitioners, the importance of various rehabilitation or psychosocial issue may be hidden

or not fully appreciated

Time to transit new knowledge into practice

awareness acceptance adoption mastery

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When practicable, we encourage and accommodate people to remain connected to the workplace while recovering from illness or injury.

Charter of Principles - 1

Facilitates shorter recovery times and prevents unnecessary disability.

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If injured or ill, we promote best practice rehabilitation and injury management for workers.

Charter of Principles - 2

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Integrated Care– Respects the diversity of health care

providers– Minimises the risk of treating one condition

without addressing the impact of others– Manages the challenge of liability boundaries

• Cost shifting• Disputed liability

Rehabilitation at Work

Best Practice

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Rehabilitation at Work

Suitable duties depends on the employer not the doctor

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The quality of information

You have a legal obligation to understand the rehabilitation requirements of your injured

workers …

The information received reflects the question asked

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We understand that good work promotes good health and increases productivity.

Charter of Principles - 3

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The return

Do it properly and your business will benefit …

McKinsey’s comparing their top 25% with their bottom 25%

• 2.2X EBITDA• 2.0X Growth in enterprise/book Value• 1.5X Growth in net income/sales

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The evidence is compelling: good work

improves general health and wellbeing and

reduces psychological distress

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Slide 3 to 6• 2015 Queensland Workers’ Compensation Annual Statistic Report (2024-2015) https://www.worksafe.qld.gov.au/forms-and-resources/statistics/workers-

compensation-regulator-statistics-reports2• 2015 Comparative Performance Monitoring Report 17th Edition http://www.safeworkaustralia.gov.au/sites/swa/about/publications/pages/cpm-17• 2013 Cost of Work-related Injury and Disease http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/940/cost-of-work-related-injury-and-

disease-2012-13.docx.pdfSlides 7 to 15, 23 to 25, and 29 to 30• Realising The Health Benefits of Work 2010 http://www.racp.edu.au/docs/default-source/advocacy-library/realising-the-health-benefits-of-work.pdf• http://www.racp.edu.au/docs/default-source/resources/afoem-pos-what-is-good-work-2013.pdf?sfvrsn=2• http://www.racp.edu.au/docs/default-source/advocacy-library/improving-workforce-health-and-workplace-productivity.pdf• https://www.racp.edu.au/docs/default-source/default-document-library/afrom-benefits-of-work-evidence-for-

publication73e351afbbb261c2b08bff00001c3177.pdf?sfvrsn=4Slide 16• https://www.kidsmatter.edu.au/sites/default/files/public/images/Mental%20Health%20Difficulties-darker.jpgSlide 17• Coats, D & Lehki, R (2008) ‘Good Work’: Job quality in a changing economy. The Work Foundation

http://www.theworkfoundation.com/assets/docs/publications/197_good_work_final2.pdfSlide 18• Butterworth, P., Leach, L.S., McManus, S & Stansfeld, S.A (2013) Common mental disorders, unemployment and psychosocial job quality: is a poor job better than

no job at all? Psychological Medicine. 43:1763-1772. Slide 19• van der Noordt, M., IJzelenberg, H., Droomers, M & Proper, I.K (2014) Health effects of employment: a systematic review of prospective studies. Journal of

Occupational Environmental Medicine. 17:730-736Slide 20• Cohen, D., Marfell, N., Webb, K., Robling, M & Aylward, M (2010) Managing long-term worklessness in primary care: a focus group study. Journal of

Occupational Medicine. 60:121-126 Slide 22• Britt H, Miller GC, Henderson J, Bayram C, Harrison C, Valenti L, Wong C, Gordon J, Pollack AJ, Pan Y, Charles J. (2015) General practice activity in Australia

2014–15. General practice series no. 38. Bettering the Evaluation and Care of Health (BEACH), Sydney: Sydney University Press, 2015. http://ses.library.usyd.edu.au//bitstream/2123/13765/4/9781743324530_ONLINE.pdf

Slide 30• Keller, S & Price, C Beyond Performance: How Great Organizations Build Ultimate Competitive Advantage, McKinsey & Company, 2011, John Wiley & Sons Inc.,

New Jersey.

References / ResourcesDr Graeme Edwards – drgraemeedwards@optusnet.com.au

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Questions?