Development and Validation of the Return-To-Work/Case Management Inventory

Abstract

<p>Work plays an important role in people’s lives and, according to the World Health Organization, is one of the most powerful social determinants of health and wellbeing. For many individuals, the inability to return to work (RTW) after an injury or illness imposes significant personal and economic costs. While most workers RTW within a relatively short period of time, a small percentage of disability episodes are prolonged, disproportionately costly, and a significant socioeconomic burden on Western nations. In Australia, employers appoint RTW coordinators to manage the RTW process. Therefore, RTW coordinators are well positioned to play a central role in supporting injured workers to RTW. While numerous predictive and clinical decision support tools exist, none of these have been designed to be used by RTW coordinators, limiting their access to evidence-based best practices. The aim of this empirical work was to develop and validate a tool for RTW coordinators to assist them in the identification of workers at risk of prolonged work disability so that limited resources can be directed towards those most in need. Using theoretically derived and clinically meaningful risk factors, expert consultation, and multivariate statistical analysis, the return-to-work/case management inventory (RTW/CMI) was developed and validated. Part 1 of the RTW/CMI is a brief nine-item inventory that can be easily administered by RTW coordinators. The results demonstrated that the RTW/CMI has strong predictive accuracy discriminating between workers with low and high risk of prolonged work disability. While Part 1 of the inventory represents an effort to identify workers at high risk for long-term work disability, most importantly, based on an injured worker’s level of risk and need profile, parts 2 through 5 of the inventory guide appropriate resource allocation and service delivery to best support injured workers in their recovery and RTW. While future research will establish whether administering the RTW/CMI leads to improved outcomes for injured workers, the combined results of this thesis help to bridge the gap between research and application by empowering RTW coordinators to implement evidence-based actions early in the recovery process to ultimately reduce both the personal and socioeconomic burden associated with prolonged work disability.</p>