Poster 90: A community-based pilot trial of a communication tool to facilitate work accommodation after work injuries

Abstract

Objective: To test a simple communication tool to facilitate work accommodation. Design: 6-month cluster randomized trial. Setting: 2 small Canadian cities and 2 large emergency departments. Participants: All medical practices and all firms with ≥30 employees in 1 city, as well as all physicians in 1 emergency department. Workers seen in the other city and emergency department served as controls. Intervention: A paper-and-pencil voluntary tool to facilitate work accommodation endorsed by local medical, labor, and employer associations and by the workers’ compensation board (WCB). Main Outcome Measure: The proportion of injured workers using the tool and interviews with workers and supervisors. Results: 28 of 32 firms, all 3 group practices, and the emergency department consented to test the tool. The tool was used in 90 of 599 (15%) work injuries reported to the WCB by the physicians and in 21 of 424 (5%) injuries reported by study firms. 24 workers were interviewed and compared with 29 controls; they reported increased discussion of modified duties with physicians (50% vs 24.1%, P<.05) and supervisors (62.5% vs 37.9%, P<.05); increased satisfaction with care (75 vs 48.3%, P<.05); and 45% felt the tool was useful. There were no significant differences in sympton severity and time off work. 23 supervisors were interviewed. Most (65%) had discussed modified duties with the worker but only 1 with a physician; 52% felt the tool was useful. Conclusions: Despite widespread endorsement, the tool was used only in a minority of injuries. When used, it increased discussion about work accommodation and about half the workers and supervisors felt it was useful. Effective community implementation of such a tool would require powerful incentives or regulation.