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Professional Boundaries in Workplace R ehabilitation and Injury P revention

Professional Boundaries in Workplace R ehabilitation and Injury P revention . Agenda. Processes Involved in workplace rehabilitation and injury prevention. OT role A llied health and their roles Stakeholders and their roles Issues of working in a MDT team including: Blurring of roles

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Professional Boundaries in Workplace R ehabilitation and Injury P revention

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  1. Professional Boundaries in Workplace Rehabilitation and Injury Prevention

  2. Agenda • Processes Involved in workplace rehabilitation and injury prevention. • OT role • Allied health and their roles • Stakeholders and their roles • Issues of working in a MDT team including: • Blurring of roles • Issues of communication • Biomechanical Vs. holistic approaches • The impact that these issues have on OT practice.

  3. Processes of workplace rehabilitation and injury prevention • Queensland workers compensation scheme • Queensland compensation (Q-comp) • Insurance companies (such as Work cover) Workers compensation covers: • Injury at work • Psychological injury at work • Travel to and from work (www.qcomp.com.au; 2013)

  4. Return to Work Process Workplace injury Report to supervisor Make a claim Insurance company accepts/ rejects claim Obtain workers compensation medical certificate Referral to Allied Health Professional Workplace Rehabilitation • Injured worker returns to either: • Current job (same job or new role) • New job (similar role or new role) www.workcoverqld.gov.au; 2013

  5. Case Study • Back injury • Withdrawn from co-workers • Lack of interest in activities outside of work • Anxious about work • Stress of unemployment possibility • Guilt of no longer contributing to organisation . OT to consider: • Psychosocial Issues • Factors that effect RTW process and compound the length of days off work. Ostiguy, (2010); Bade & Eckert, 2008)

  6. OT Role – One on one sessions • Initial consultation • Subsequent consultation • Reassessment/ program review • Complex occupational therapy assessment • Complex occupational therapy intervention • Specialised hand/ upper limb therapy consultation • Group education sessions • Independent case review (www.qcomp.gov.au; 2013)

  7. OT role (continued) • Communication/ consultation with stakeholders • Case conferences with stakeholders • Progress report • Standard report • Comprehensive report • Prescription of supportive devices • External Case management (www.qcomp.com.au; 2013)

  8. Allied health team members Registered approved providers include: • Physiotherapist • Occupational therapist • Exercise physiologists • Psychologists • Chiropractors • Osteopaths • Podiatrists You may also work with others including (but not limited to) • Dentists • Nursing staff • Speech pathologists • Rehabilitation counselors www.workcoverqld.gov.au; 2013; www.qcomp.com.au,2013))

  9. Issues to consider • MDT roles and the importance of communication. • How to refer to another allied health professional. • Practitioners working in rural communities- blurring roles: • Inadequate access to a team of specialist medical, rehab and support staff. • Inadequate physical access to stakeholders, injured worker and employer. • OT’s need a broad range of skills as a lack of specialised services. • Limited professional development. (Ciccarelli, M & Dender, J, 2010)

  10. Activity Time! • Get into groups . (5-6 individuals) • 4 Questions will be asked (2 now and 2 at the end) • First group to all stand up and answer the question wins a point. • Team with the most points at the end wins a surprise.

  11. Main Stakeholders • Client • Insurer • Nominated treating doctor • Injured worker • Injured workers supervisor • Injured workers line manager • RTW coordinator (If larger company) • Allied health staff • Any specialised services (www.workcoverqld.gov..au,2013)

  12. Professional Boundary Issues • Crossover of roles between all stakeholders leading to conflict • Understanding and appreciating professional roles • Identify each stakeholders interests goals • Identify possible barriers to goal achievement. • Effective communication. • Conflicting stakeholder advice can enhance fear and avoidance of injured worker. (Ciccarelli & Dender, 2010; Bade & Eckert, 2008; Suter, Arndt, Arthur, Parboosing, Taylor & Deutschlander, 2009; Tyulin, Stwine & Eckberg, 2009)

  13. Professional boundary Issues • Bio-psychosocial model • Biological • Psychological and; • Social factors • Biomechanical approach Vs Holistic approach -OT offer valuable holistic approach -Issue of time constraints and other stakeholders taking a biomechanical approach. (Tyulin, Stiwne, & Ekberg, 2009; Bade & Eckert, 2008;

  14. Summary • Roles of team members cross over. • Your team includes not only allied health, but includes all stakeholders. • Good communication is key to reduce conflict between blurring roles. • There are many barriers in work rehabilitation and injury prevention to using a holistic approach. The OT role is important.

  15. Activity time!

  16. References • Ciccarelli, M & Dender, J. (2010). Contextual factors influencing early return to work in the rural and remote sector. International journal of social security and workers compensation. Vol 2, No.1. p 17-28. • Matcher, K. et al. AOTA. An historical perspective. http://www.aota.org/About.39983.aspx, • Suter, E., Arndt, J., Arthur, N., Parboosingh, J., Taylor, E., & Deutschlander, S. (2009). Role understanding and affective communication as core competencies for collaborative practice. Vol 23, no 1. doi. 10.1080/13561820802338579 p. 41-51 • Bade, S., & Eckert, J. (2008). Occupational therapists critical value in work rehabilitation and ergonomics. Journal of prevention, assessment and rehabilitation. Doi 10519851/08. p101-111 • Tjulin, A., Stiwne, E.E., & Eckberg, K. (2009). Experience of the implementation of multi-stakeholder return to work programme. Journal of occupational rehabilitation. Doi. 1007/5109260099195.

  17. References • Institute of health and work (2004) Workplace based return to work interventions. A systematic review of the qualitative and quantitative literature. Ontario • Barnett, K., Hoardtaker, A. L/. Spoer, J & Parnis, E (2010). Discussion paper: The role of the workplace in return to work. Report prepared for Workcover SA. Australian institute for social research. Available at www.workcover.com/publicdownload. Aspx>id=3901 • AFOEM position statement (2010). Realising the health benefits of work • Queensland Compensation Website. www.qcomp.com.au • Workcover website. www.workcoverqld.com.au • Solutions to common workplace issues: A manual to enhance workforce management (2010). CAOT publications. Ottawa Charter. Canadian Association of Occupational Therapists. Elisabeth Ostiguy. • Mental health coordinating council; psychological injury management guide (2010). Retrived from http:pimg.mhcc.org.au

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