The research generated by the Institute for Work & Health (IWH) doesn’t simply get published in journals and then sit on a library shelf waiting to be retrieved by future researchers and academics. No, IWH research has a very real – and far-reaching – impact on front-line work in occupational health and safety (OHS).
Active knowledge transfer is part of our corporate culture here at the Institute,
says Jane Gibson, director of knowledge transfer and exchange (KTE) at IWH. Through active engagement with stakeholders to strategic alliances with other organizations, the research findings generated by our scientists are put into the hands of key decision-makers in a timely, accessible and useful manner.
This is shown by the many ways in which public institutions both here and abroad use IWH research to improve their delivery of injury prevention and return-to-work services. Included below are some examples, by no means exhaustive, that illustrate just how far that reach is.
Ontario WSIB’s new service delivery model
When the Workplace Safety and Insurance Board (WSIB) in Ontario decided to introduce a new service delivery model to help injured workers recover and return to work more quickly, it wanted to incorporate procedures based on the best evidence available. IWH research played a pivotal role.
When designing staff protocols and determining what to do when in the life of a claim, we certainly relied on the Institute’s research,
says Judy Geary, WSIB’s vice-president of program development. Indeed, researchers from the IWH met regularly with WSIB staff during the design and development of the model to offer advice about the appropriate use of research evidence.
In particular, IWH research on return to work, recovery, claim complexity and interventions was “quite formative in WSIB’s thinking,” says Geary. This included the work of IWH scientists such as Drs. Renée-Louise Franche (now an IWH adjunct scientist), Ellen MacEachen, Sheilah Hogg-Johnson, Emile Tompa and Ivan Steenstra.
The WSIB began rolling out its new model across Ontario last fall and into the spring of 2009. The model includes a number of features that Geary can trace back to IWH research. She gives some examples.
The model adopts a case management framework, in which a case manager assesses, very early in the life of a claim, the degree of WSIB involvement needed to ensure an injured worker’s return to work. IWH research and researchers helped frame the ‘powerful questions’ we ask to determine if an injured worker’s return to work is likely to be straightforward or problematic,
says Geary. We pulled the questions from the research, developed a guide for our staff and then ran it by researchers for confirmation.
If the injured worker and workplace are having difficulty developing a return-to-work (RTW) plan, the case manager can call in an RTW specialist. A newly created role, the RTW specialist acts as an onsite facilitator and mediator between the workplace parties to unearth what the RTW problems are and what it will take to resolve them.
The IWH research leading to the Seven Principles for Successful Return to Work showed that RTW co-ordination is key,
says Geary. The RTW specialist was created directly as a result of that research.
As well, the new model is designed to ensure that an injured worker quickly learns if his or her claim for workers’ compensation benefits has been accepted. This is based on several IWH studies that showed the time to a first decision is related to recovery and return to work.
We’re not sure why an injured worker who has to wait a long time to get a decision is more likely to encounter problems down the road, but the research shows a long delay results in poorer outcomes,
says Geary. So we put a lot of effort into re-engineering the process to enable timely first decisions.
IWH even played a role in the actual roll-out of the new model. KTE Director Jane Gibson, for example, was a member of the team that helped train consultants from the province’s health and safety associations on the model and its basis in research evidence.
For information on the WSIB’s new service delivery model, go to: www.wsib.on.ca/en/community/WSIB/230/ArticleDetail/24338?vgnextoid=6f80e35c819d7210VgnVCM100000449c710aRCRD. [Link updated on 2012-01-10]
OSSA’s fieldwork by regional injury rates
In some regions of Ontario, injury rates for young workers in the service sector are as high as 12 injuries for each 100 full-time equivalent positions (FTEs). In other regions, however, the rate is much less than one per 100 FTEs.
A map of these findings triggered the province’s service sector health and safety association (HSA) to take action. The findings are based on research by IWH Scientist Dr. Curtis Breslin, who estimated service-sector work injury rates for 15- to 24-year-olds in 46 regions across Ontario.
Sandra Miller of the Ontario Safety Service Alliance (OSSA) picked up on the practical implications of Breslin’s work after hearing about it at a meeting of the HSA Liaison Committee — a research exchange forum for HSAs hosted by IWH and including the Centres of Research Expertise. Then OSSA held a workshop, in which Breslin presented the findings to field consultants. The research has since tied into OSSA’s work in a number of ways.
It provoked our field consultants to think about what was going on, especially when they saw big differences in regions that were side-by-side,
says Miller, who is OSSA’s acting vice-president of corporate services, and executive director of innovation. They know the firms in these areas, and it helped begin a conversation with them.
Trudi Farquhar, OSSA’s regional manager of client services for North Eastern Ontario, concurs. I find this type of analysis to be most helpful because it helps me to better understand my region and its related risks,
says Farquhar, whose team deals directly with 800 to 1,000 firms each year. We discussed this in our regional team meetings, and tried to understand where there may be opportunities to focus efforts to better understand injury rates.
She also presented the findings to Ministry of Labour and WSIB staff in Thunder Bay. We had a robust discussion about the research, and brainstormed some ideas and tried to understand some rationale that would make that area of the province generally more at risk than others,
she says. Our intent was to bring more awareness to customers in that region, to open them up to greater prevention opportunities.
One of the goals of this research is to identify regions with higher rates, to help target service delivery. This is, in a way, what OSSA has done. At the time the research was released, OSSA was redesigning its service delivery model and was able to use this knowledge in its decision-making.
There are also opportunities to continue to use this type of information in the future. OSSA staff are building a detailed profile of the service sector across Ontario and plan to capture information on firms’ intent (such as their motivation and knowledge) and abilities (such as their systems or practices) on OHS, says Dean Hamilton, OSSA’s marketing manager.
When we can map injury rates against intents and abilities, it will be a really valuable tool,
he says. For example, if OSSA finds high injury rates and low intent within a particular region, it might signal the need for targeted social marketing campaigns to try and change attitudes, he says.
Miller also points out that the opportunity to hear about research first-hand through IWH’s regular meetings is invaluable, particularly when there are plans to put findings into practical use. We can build relationships directly with the researchers and ask them, ‘We’re going to apply the information this way. Are we interpreting it appropriately?’
Breslin recently received funding to continue his mapping project on a national scale. For more information on OSSA, visit: www.ossa.com (note that OSSA will soon be part of Safe Workplace Promotion Services Ontario as a result of the province’s realignment of HSAs).
Manitoba’s immigrant safety program
While anecdotes often point to emerging problems, statistics can help confirm the extent of a problem, and give extra purpose and support to the solutions.
Such was the case with the Manitoba Immigrant Worker Safety Initiative (MISI), which drew from IWH research on imigrant workers. The initiative, which launched in 2009, offers a variety of free, downloadable resources for immigrant workers, employers and others to help prevent injury and illness.
Manitoba has a high number of immigrants each year relative to its population. At the International Centre of Winnipeg, staff members at its language bank were noticing a growing number of requests to help translate workers’ compensation forms, says Richard Nordrum, project manager of the initiative.
Mike Waite, president and CEO of Safety Services Manitoba, together with the International Centre, applied and received two-year funding from Manitoba’s Workers Compensation Board (WCB). The initiative’s first phase was to research the extent of the problem and investigate safety training programs for immigrants.
What we struggled with was that there was lots of anecdotal information, but we couldn’t find any scientific, Canadian information,
says Nordrum. Even the WCB did not have stats on immigrant workers.
It was timely, then, that last summer IWH published studies comparing immigrants’ working conditions and injury rates with those of Canadian-born workers. One pertinent finding of the research, led by IWH Scientist Dr. Peter Smith, was that immigrant men were twice as likely to seek medical care for work-related injuries than Canadian-born men.
It really supported the need for this kind of programming and initiative,
says Nordrum. The studies also enabled us to increase the level of awareness about our program.
The initiative’s research also showed that there was no cohesive regional immigrant safety program in Canada.
The resources developed by MISI include fact sheets in eight languages, and four manuals about safety and cultural issues that could affect safety. Two manuals are for workers, at two different levels of English proficiency, while two are targeted at employers, OHS professionals and others involved with immigrant workers.
Based on the MISI model, a national initiative called the Canadian Immigrant Safety Initiative (CISI) is being developed by Safety Services Canada. “We really would like to share what we’ve learned and experienced with other provinces,” says Waite.
To access the MISA fact sheets and manuals, go to: www.safetyservicesmanitoba.ca under “Occupational Safety.” For information on the national CISI initiative, contact: mwaite@safetyservicesmanitoba.ca.
Europe bound: EU-OSHA’s guide on MSDs and return to work
The European Agency for Safety and Health at Work (EU-OSHA) is essentially the European Union’s technical agency on OHS matters: monitoring scientific research on workplace risks, and identifying and sharing good practices for addressing those risks. So when EU-OSHA produces a report, it wants to get it right.
This was the case in 2007, when EU-OSHA published a report on the retention, rehabilitation and reintegration of workers who suffer musculoskeletal disorders (MSDs), the most common work-related health problem in Europe. Called Work-Related Musculoskeletal Disorders: Back to Work Report, the guide first looked at the research evidence on effective workplace interventions before summarizing activities at the policy level within member countries.
IWH research was prominent among the cited research. EU-OSHA’s use of IWH evidence is telling,
says IWH President Dr. Cam Mustard. The guidance in the report is anchored to high quality research evidence, and many of the core references for the guidance document are based on systematic literature reviews conducted by the Cochrane Back Review Group housed at IWH.
Vicki Pennick, managing editor of the Cochrane Back Review Group, points out that the EU-OSHA report is just one of many in past years to rely on the group’s reviews to disseminate evidence-based guidelines and best practices. Unlike the EU-OSHA report, which is directed to workplace parties and policy-makers, most of the other guidelines are directed at clinicians. Examples include:
- a 2009 guideline on the early management of non-specific low back pain by the National Collaborating Centre for Primary Care and Royal College of General Practitioners in the United Kingdom;
- a 2009 clinical practice guideline on intervention therapies, surgery and rehabilitation for low-back pain from the American Pain Society; and
- 2008 neck pain guidelines from the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders, sponsored by the World Health Organization.
Because neck and back pain are such important issues and because our reviews really get used a lot around the world, we’re very diligent,
says Pennick. Our reviews have to be of the very highest quality.
To download the full EU-OSHA report on RTW and MSDs, go to: https://osha.europa.eu/en/publications/reports/7807300/view. To access Cochrane Back Review Group information, go to: http://back.cochrane.org.