The mandatory provisions in the COID Act put rehabilitation, reintegration, and early return central in the basket of services for compensation of injuries on duty and diseases. The focus from pure medical treatment towards quality of life requires a shift in the mindset of healthcare professionals. It is a milestone worth celebrating. The ailing South African economy has a high number of job seekers, retrenchments, and significantly slow growth. As a result, our clients put significant value on retaining employment.
What is early return to work programme?
An early return to work programme is a system designed for employers to manage the transition of employees who were on an extended leave of absence into the workplace. The general principles are determined by the work environment and can include a gradual increase in responsibilities, adjustable work hours, additional training and workplace adjustment.
Return to work programmes therefore need to be initiated as part of the early rehabilitation programme. Though different companies and rehabilitation services may differ on policy, the principles of return to work are defined by clinical intervention, economics of leave of absence and social integration and acceptance. A successful return to work programme promotes inclusivity, employee well-being and retains talent in the organisation.
How can healthcare professionals treat patients to achieve maximum rehabilitation outcomes without compromising their ability to retain their jobs?
Chronic diseases, injuries, violence and stressful work environments often result in temporary or long-term incapacity. This creates anxiety for the employer, colleagues, and the affected employees. Employers may have to pay a salary for an employee whose work is done by others, colleagues who must take on additional work to assist the sick employee and lastly the employee who cannot cope with the demands of his or her work due to the impact of disease or disability, compounded by fear of losing their livelihood. Early return to work tends to bring harmony to all three stakeholders. It is also important to note the impact of illness on significant others and caregivers, some work because of the number of health professionals, lawyers and employers’ appointments.
Our clients often feel like they are a burden to their support system and perhaps we need to be more efficient and coordinate appointments and treatment programmes better to support employed patients and caregivers. Respect for patients’ time will go a long way towards reducing anxiety, improving rehabilitation outcomes and thus early return to work. It is imperative to have quality-of-life assessments done to establish if patients can successfully resume work in a competent manner.
How can healthcare professionals strike a balance between ethical and economic factors in managing leave of absence from work on medical grounds?
Early referral for rehabilitation is a primary approach that mitigates the economic impact of illness. Several studies across the world have quantified a reduced average length of stay in hospitals through early occupational therapy intervention. Occupational therapists start intervention whilst patients are in the intensive care unit and continue with therapy after discharge from the hospital.
The most common reason for requests for early discharge, abscondments from treatment programmes refusal of treatment in hospitals and community-based programmes is the fear of losing one’s job. Health professionals often undermine the impact of this request, perhaps we need to appreciate what a job means. It forms the primary identity of many adults, anchors social standing and is often the sole means of livelihood.
Secondly working with the employer from the beginning also results high job retention. The patient, the employer, and the occupational therapist focus on a common goal to ease the client back to work. Whilst we have our patient’s interest at heart, it is imperative for healthcare professionals to understand this dynamic when managing leave of absence from work. It is the responsibility of the healthcare professional to provide accurate feedback that assists the employer to make a sound decision.
Case study: “A light duty instruction” without understanding the demands of the job can easily get the patient dismissed from work.
A 32-year-old man, who worked in marketing for a chain store was involved in a car accident and sustained a wrist injury that affected his ability to drive. Whilst undergoing medical treatment three healthcare professionals send reports through sick notes for the employer to put him on light duty. The gentleman was fired. This marketing consultant went back to the treating healthcare professionals for assistance. At this point, he was referred to the occupational therapist to intervene. The first question the employer asked the OT was “What is light duty for a marketing officer who job is to talk and drive”. Though his job was not saved the marketing consultant was assisted in his next job to get reasonable accommodation for the period he was undergoing therapy.
This case study shows that the employer is an important stakeholder that needs to be engaged appropriately during rehabilitation. Occupational therapists are skilled at analysing work, its tasks and adjusting the environment to allow the client to meet the demands of his job in spite of his injury, illness, or disability.
Conclusion
The integrated nature of the ERTW programme allows for creative solutions in a constrained and under-resourced economy. The future of work needs to accommodate the challenges of the current era and its challenges and appreciate the opportunities. It is a cost–effective solution to an early retirement due to frustration and prolonged leave of absence.
The COVID-19 pandemic opened an understanding of alternatives in the workplace that Occupational therapists have been advocating for over the years. Employers are currently more receptive to remote working, flexible hours, use of technology for work. Early return to work ensures that talented individuals are supported and accommodated to contribute to their workplace. We need South Africans to be productive to grow the economy.
Article by: Aluwani Manenzhe
Last Updated on 26 October 2023 by HPCSA Corporate Affairs