The Role Of The Employer In Supporting Labour Participation Of Workers With Disabilities: A Systematic Literature Review
1Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, The Netherlands; 2Department of Health Sciences, University Medical Center Groningen, Department of Economics, Econometrics and Finance, University of Groningen, The Netherlands; 3Department of Economics, Vrije Universiteit Amsterdam, Leiden University, The Netherlands; 4Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, The Netherlands
Background: Workers with disabilities often continue to work despite their disabilities. The employer is an important determinant in supporting continued employment. It is of key concern to know which employer characteristics (e.g. supervisor support) and practices (e.g. work accommodations and disability policies) are effective in supporting continued employment of workers with disabilities.
Objective: The aim of this study is to provide a systematic overview of the peer-reviewed literature on employer characteristics associated with labour participation of workers with disabilities, using an interdisciplinary perspective.
Methods: To identify relevant studies a systematic literature search was conducted in the databases PubMed, Web of Science, PsycINFO and Econlit. We included longitudinal observational studies reporting on workers with a health condition or disability. The studies include determinants at employer level (e.g. work accommodations and support) in relation to the outcome variables: labour participation, work functioning, absenteeism or return to work. We describe which employer determinants affect work outcomes of workers with disabilities and discuss whether this differ by type of disease, age, gender and between different countries.
Results: The database search identified 4453 studies. The review is in progress, and based on the first 3000 studies, we have now included 40 full texts. Based on the results of the first studies, employer characteristics and practices in these studies can be divided into four broader groups of employer determinants: (i) company characteristics, (ii) the psychosocial work environment (iii) company policies and practices, and (iv) work accommodations.
Conclusion: This review identified a large variety of employer characteristics on different levels associated with labour participation of workers with disabilities. The full results of this systematic review will be available at the conference.
Factors for a Successful Leadership for a Sustainable, Healthy Working Life
1Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden; 2School of Technology and Health, KTH, Royal Institute of Technology, Stockholm; 3Departure of Sociology and Work Science, University of Gothenburg, Sweden
Aim: The aim of the study is to explore leadership and organizational factors that are of importance for a sustainable work situation with low sick-leave absence, among employee in health care.
Background: Sickness absence and illness have increased in general in Sweden during the last years, and especially within health care sector. Since the 1990’s Sweden, as many other countries in Europe, have introduced economic models that derives from the private sectors to operate in health care, in order to cut unnecessary cost and become more effective. Focus on increased quality in care and at the same time to decrease cost has led to higher pressure on the employee in health care whit rising sick-leave. Therefor it’s important to explore what factors that contributes to maintain a healthy work force.
Method: The study has a qualitative design. The sample consists of eleven first-line managers at two hospitals in Sweden and content analysis was used to analyze the interviews with first-line managers responsible for a ward or a unit. Based on sick-leave data on unit level, units with low or declining sick-leave numbers were identified and the managers’ responsible for that unit were contacted to ask about participation in the study.
Results: Three themes and ten subthemes were identified: Leadership style, organizational structure and economic prerequisites. A servant leadership among managers’ as well as a flexible organizational structure with possibilities to increase staff or decrease the amount of patient, and economic prerequisites where managers could exceed the budget was according to the managers’ successful parts that contributed to a sustainable, healthy workforce.
Conclusion: The result in this study suggest that to maintain a healthy and sustainable workforce with low sickness absence it requires a combination of different strategies that involves leadership factor as well as organizational and economic prerequisites.
Adaptation of a Guide to Equip Employers to Manage the Gradual Return to Work of Individuals with a Musculoskeletal Disorder
Université de Sherbrooke, Canada
Purpose: The gradual return to work (GRTW) of injured workers poses numerous challenges for workplaces. The aim of this study was to provide employers with an adapted tool to support them in managing GRTWs following a musculoskeletal disorder (MSD), by adapting the Guide for estimation of margin of manoeuvre and then establish its acceptability.
Methods: A mixed methods design was used in three phases. 1) The original tool was adapted by taking into account the results of a critical review of the literature on the characteristics fostering adoption of guides by potential users (PUs). 2) Experts practitioners were surveyed about the content and form of the adapted tool. Proposed modifications were then discussed in a group meeting, until consensus was reached on the changes to be made. 3) The acceptability of the latest version was established by conducting semi-structured interview of PUs. A thematic analysis of the verbatim transcript was performed.
Results: 1)From 13 publications, four main characteristics (clarity, format, applicability, and usefulness) were identified from the critical review. 2) Nine occupational therapists expert reached a consensus on 20 modifications, which yielded a second version of the adapted tool comprising an instruction guide and a planning worksheet. 3) The 15 PUs consulted found the tool acceptable overall. They recognized that it allowed them to standardize the management of the GRTW and operationalize the best return-to-work practices. They also identified a few minor changes to make, including recommendations for preparing colleagues and shortening the format.
Conclusion: This study provided a tool that was designed and adapted to employers, taking into account both evidence-based data and expert consensus, which seems to have contributed to its acceptability. The adapted tool fills a real need within companies and further studies could be carried out to improve its format and create a transdiagnostic version.
Workplace Practices and Policies to Support Workers with Physical and Mental Health Conditions: Bridging Research-to-practice Knowledge Gaps
Institute for Work & Health, Canada
Introduction: For more than a decade, the Institute for Work & Health (IWH) has produced a series of systematic literature reviews to identify the most effective workplace approaches to support return-to-work, stay-at-work, and recovery for workers with physical and mental health conditions. However, information gaps remain, posing challenges for workplace parties to implement these programs.
Methods: The current project adapts a model for evidence-informed decision-making that was pioneered by David Sackett for the clinical sciences, to address current research-to-practice knowledge gaps in work disability prevention. Our adaptation of the model considers the best research evidence and integrates it with evidence collected from practitioner expertise and worker experiences to better inform research-to-practice. In addition, IWH and Memorial University have developed a contextualization approach. The evidence gathered and synthesized using these unique approaches allows us to answer the following questions: what works?, will it work here? and, how can we implement this in workplace practice?
Results: Results highlight the impact of this innovative evidence-informed decision-making model as a method to bridge research-to-practice knowledge gaps in work disability prevention. Evidence-based products from two projects, on supporting workers with physical and mental health conditions, illustrate a useful approach to synthesizing and disseminating effective workplace policies and practices.
This primary strength of our approach resides in the use of three sources of evidence: research findings, practitioner expertise and stakeholder experiences. This body of work has advanced our understanding of how workplaces can help their workers remain at or transition back to work successfully after an injury or illness, has influenced key stakeholders in Canada’s workplace health and safety communities, and has led to the development of guides for practice. The full integration of these evidence sources enhances the opportunity for optimal work disability prevention efforts across the life course.
Workplace Practices and Policies to Prevent MSD Disability: Synthesizing Evidence from Workplace Parties.
Institute for Work & Health, Canada
Introduction: Musculoskeletal disorders (MSD) continue to be a major burden for workplaces and workers as well as insurance and health systems. Evidence-informed approaches are desired but research-to-practice gaps remain. One reason for gaps is the necessary research of sufficient quality is often not available. However, evidence-informed practice considers both scientific evidence as well as practitioner expertise. Our objective is to synthesize evidence from the scientific literature, practice evidence (policies and practices), and experiences from stakeholders.
Methods: Evidence from practitioners’ expertise and worker experiences was collected using a web-based survey, focus groups, and interviews with representatives from various stakeholder groups from multiple sectors. We adapted the Public Health Agency of Canada’s best practices portal to structure data collection of workplace practices and policies. Research evidence was gathered from recently completed systematic reviews. Three sources of evidence (research findings, practitioner expertise and stakeholder experiences) are synthesized in this project.
Result: Survey results (n=440) reveal a range of disability prevention practices are in place at various workplaces. However, responses reveal workers and managers do not have similar experiences related to MSD. Recent systematic review results revealed strong evidence that multi-domain interventions encompassing at least two of health-focused, service coordination, or work modification interventions reduced duration away from work for MSD. However the level of evidence was lower for many other interventions. Interview/focus group data (n=28) reveal innovative approaches as well as important implementation challenges.
Discussion: The presentation will focus on current policies and practices described by practitioner and workplace participants as compared to the scientific evidence. The discussion will outline the synthesis of evidence and co-creation (with OHS stakeholders) of a practical guide to help workplaces develop and implement effective practices and policies to help workers with MSD return to work safely.