Visualising the Return-To-Work ProcessPresenters: Dr Richard Cooney, Department of Management, Monash University, Australia; Dr Nifeli Stewart, School of Media and Communication RMIT, Australia;

Tania Ivanka, School of Media and Communication RMIT, Australia.

WHAT WE INVESTIGATED

Effective social problem solving during

Return-To-Work is predicated upon

shared understandings of the RTW

process. The RTW process however

occurs in a multi-actor service system;

such systems are diffuse and shared

understandings are not always evident.

HOW WE INVESTIGATED

The investigation mapped the service process for RTW.

Taking the employer as the actor whose story was to

be told, a synthetic narrative of RTW best practice was

constructed based upon six case studies of best Return to

Work performing Victorian organisations. The employers’

story of Return-To-Work was constructed from interviews

with managers, supervisors and RTW Coordinators in

the six organizations. A Service Design Blueprint was

constructed from the experiences of the interviewees.

WHAT WE FOUND

The WorkCover Authority had an inside-out view of RTW,

starting from the activities that it managed and thinking

‘out’ to the way in which other actors in the service system

interacted with it.

Employers, in comparison, had an outside-in view of

RTW, starting with the policy, procedures and practices

for employee safety and well-being at work and the

identifying the way in which these procedures and

practices could be used ‘in’ the RTW space.

Two different types of problem solving were evident:

1. Social Problem Solving:

This is an interactive process between multiple

stakeholders. Experiential knowledge is widely used in

problem solving. This is done by trialling and refining

solutions.

2. Administrative Problem Solving:

This involves application of the rules and relies on

codified knowledge.

FIGURE 2 – RTW EXPERIENCE MAP

REHABILITATION JOURNEY

RTW Compliance Activities

Culture of health & well-being Return to Work CoordinationManaging incident & injury Outcomes

A number of exemplary activities, stemming from strong company values for the care of employees, informs the success of RTW co-ordination

Figure 3

Exemplary companies manage key relationships with the injured employee, their work colleagues, Treating Health Professionals (THPs), Insurance Agent and Worksafe.

Every employee health condition is treated with the same diligence, whether it leads to a claim or not.

Figure 4

Exemplary companies manage rapid return-to-work achieving better outcomes for employees.

Figure 6

Building mechanisms to support culture

Relationship management

Removing delays in the system

Improving return-to-work outcomes

Hidden delays and recursive loops catch out the new RTW coordinator.

There are inherent delays built into this rehabilitation cycle. Exemplary companies develop relationships and new processes to reduce these delays.

Figure 5

PLANNING FOR RETURN TO WORK

Focussing only on the RTW Compliance Activities phase misses the bigger picture of exemplary activity.

GOVERNANCE OF HEALTH, SAFETY AND WELLBEING

INVESTIGATE ACCIDENT(Initiate worksafe procedure)

PROCEED TO WORK CLAIM

INJURY CYCLE

WELL-BEING INFRASTRUCTURE

TRAINING INTERNAL STAFF

ACCEPTANCE AND PROCESSING OF

CLAIM

CERTIFICATE OF CAPACITY

FULL RETURN TO WORK

MODIFIED RETURN TO WORK

EXIT WORKPLACE

FIGURE 3 – CULTURE OF HEALTH & WELL-BEING (DETAIL)

WELL-BEINGINFRASTRUCTURE

CEO

“Our company's philosophy is to prevent long term injuries by focusing on worplace safety and the general well-being of all our staff.

This involves creating an environment where employees are engaged, their health and wellbeing is supported, they are working safely and working productively.”

Building mechanisms to support culture

IN-HOUSE CLINICS

HEALTH CARE PROVIDERS

FINANCIAL SUPPORT FOR PROFESSIONAL CONSULTATIONS

EMPLOYEE ASSISTANCE PROGRAMS EG. INCOME PROTECTION

POLICIES AND PROCEDURES FOR WORKPLACE REINTEGRATION AND RTW

REPORTING TOTHE BOARD OF MANAGEMENT

SENIOR MANAGERS: REVIEW OHS AND RTW POLICIES, WORKPLACE INCIDENTS, RTW CASES, DEVELOP REPORTING METRICS

MANAGERS AND SUPERVISORS ARE INVOLVED IN RTW

TRAINING AT INDUCTION

OHS TRAINING

MANAGEMENT DEVELOPMENT TRAINING

REGULAR UPDATE TRAINING EG. INSURANCE AGENT PROVIDES TRAINING

GOVERNANCE OF HEALTH, SAFETY AND WELLBEING

TRAININGINTERNALSTAFF

Culture of health & well-being

FIGURE 4 – MANAGING INCIDENT & INJURY (DETAIL)

RTW coord

THP

EmployeeSupervisor

Supervisor

RTW Compliance Activities

Conversations between these parties around the treatment required, the progress of rehabilitations and future goals occurs well before the injury becomes a WorkCover claim.

The focus from the start is upon reintegration into the workplace and successful return-to-work.

“I need to call agent about a

possible claim”

Relationship management

ON THE JOBINJURY

TREATMENT

MONITOR

INJURY CYCLE

INVESTIGATE ACCIDENT (Initiates worksafe procedure)

RTW coord

RTW coord

RTW coord

Employee

RTW coord

Supervisor

PROVIDE RTW INFORMATION

NOTIFICATION

PROCEED TO WORK CLAIM(Initiates workCover procedure)

“I need to call my team member about the work that is available when they come back”

“Will I get my job back? How will I pay the mortgage?”

Managing incident & injury

Manager

DECISION POINT

While focusing on the 'now' each person is also thinking

about 'next steps'.

PLANNING FOR RETURN TO WORK

FIGURE 5 – RETURN TO WORK COORDINATION (DETAIL)

RECURSIVE LOOPS DUE TO INTERNAL FRAGMENTATION:

INSURER DELAYS DUE TO FRAGMENTED PROCESSES

INSURER DELAYS DUE TO WAITING FOR EMPLOYEE, EMPLOYER OR DOCTOR'S ACTION

RECURSIVE LOOPS DUE TO EXTERNAL FRAGMENTATION:

DELAYS DUE TO THE INTERACTIONS BETWEEN DOCTOR INSURANCE AGENT AND COMPANY

REHABILITATION JOURNEY

RTW Compliance Activities

Removing delays in the system

Informing the doctor about the work environment and opportunties to return to work (alternate work for each role).

Employee is informed and involved in the progress of rehabilitation.

Certificate of Capacity links to list of suitable duties for employee.

Existing relationship with insurance agent reduces delays and facilitates the

approval of claims.

PLANNING FOR RETURN TO WORK LEADS TO OFFER OF SUITABLE/MODIFIED DUTIES.

ACCEPTANCE AND PROCESSSING

OF CLAIM

THPAccMng

CERTIFICATE OF CAPACITY

Return to Work Coordination

RTW coord

Employee

4. DIFFERENT EMPLOYER, SAME WORK.

5. DIFFERENT EMPLOYER, DIFFERENT WORK.

FIGURE 6 – OUTCOMES (DETAIL)

Work capacity and relationships restored

Altered work capacity, new relationships established.

Relationships broken, diminished work capacity, no vocational retraining available.

Exemplar companies get more people returning to work (options 1, 2 and 3) than leaving the workplace (options 4 and 5).

Improving return-to-work outcomes

Employee

Employee

Employee

Ex Employee

EXIT WORKPLACE

1. SAME EMPLOYER, SAME WORK (PRE-INJURY EMPLOYMENT).

2. SAME EMPLOYER, SIMILAR OR MODIFIED WORK.

3. SAME EMPLOYER, ALTERNATIVE OR DIFFERENT WORK.

FULL RETURN TO WORK

MODIFIED RETURN TO WORK

Outcomes