Injury on Duty & Rehabilitation

(Disability Management) in HKU

Kamela Ma RN, MW, IBCLC, MPHC, OHNHC, CDMP

Health Education / Occupational Health Nursing Officer

University Health Service

Injury on Duty (IOD)

In the PAST

Expected to stay away from work until fully

recovered.

Lost contact and attachment with Workplace and

society.

Some employees never returned to their work.

Early Intervention

Absence Period

from Work

Chance of

Return to Work

6 months %

1 year %

2 years %

50

20

10

Definitions

Impairment

Any loss or abnormality of psychological,

physiological or anatomical structure or function.

Disability

An impairment that restricts the ability to perform

normal daily activities – one of which is .

work

An impairment need not result in a disability

Examples: glasses, hearing aids, etc.

if accommodations are available.

What is disability management?

The process in the workplace designed

to facilitate the employment of persons

with a disability through

(World Health Organization, 2001)

a coordinated effort and taking into account

individual needs, work environment,

enterprise needs and legal responsibilities.

Disability management

emphasizes both:

Accommodation – changes to the work

environment that enable the returning

worker to be productive – involves other

workplace stakeholders.

Case management or service coordination –

identification of barriers to return to work

and facilitation of services to diminish or

eliminate these (medical, counseling, etc.).

Contemporary Disability

Management

Early intervention.

Early return to work.

When medically and safely feasible,

even before fully recovered.

Temporary job placement /

environment modification.

Gradually return to full duties,

without risk of re-injury.

IOD Rehabilitation:

Hong Kong Trend At a Glance

Very early stage of development.

Voluntary Rehabilitation Programme (VRP).

First launched by Labour Department, HKSAR.

Year Target

Mar 2003 Construction Industry

(Pilot Basis)

Nov 2004 Catering, Transportation &

Manufacturing Industries

Aug 2007 ALL Industries

IOD Rehabilitation:

Hong Kong Trend At a Glance

Hospital Authority

Return to Work Programme

Hong Kong Worker’s Health Centre

Community & Occupational Rehabilitation

Service

HKU Case Management:

Injury on Duty (IOD)

Injured staff reported IOD.

± Medical care and Physiotherapy in UHS.

Dept. send a copy of Form 2/2B to UHS since

July 2010.

Occupational Health Nurse keep record of all

IOD cases (since Nov 2009).

Phone contact: sick leave > 3 days;

Sprain/ strain case

Follow-up: continue SL or IOD affects work

Cases that may require Voluntary Occupational

Health Rehabilitation Service provided by

Occupational Health Rehabilitation (OHR) Team

of UHS:

e.g. Sick leave or Light duty > 30 days

Notifiable Occupational Diseases

Case Management:

Injury on Duty (IOD)

Voluntary Occupational Health

Rehabilitation Service Objectives

Maximize recovery potential.

Return to pre-injury productivity as close

as possible.

Relieve psychological burden on early

return to work.

Prevent complications & re-injury.

Enhance staff morale at workplace.

Minimize sick loss and compensation cost.

Voluntary Occupational Health

Rehabilitation Service

Voluntary.

Individualized plan.

Participant may withdraw at anytime.

Legitimate benefits of injured employee

will not be affected.

HKU staff eligible for medical benefits in UHS.

IOD case reported to Human Resource and Safety Office.

Injured staff with direct physical/psychological effect on work.

Priority to injured staff with light duty or sick leave > 30 days.

Notifiable Occupational Diseases.

Eligibility

Referral By

Employee

Department or supervisor

UHS physicians

Rationale

Provide safe and healthy work environment.

Early intervention.

Early return to work.

Long term cost-effectiveness.

Benefits to Employee

Maintain Reduce

Active & Mobile Tissue Stiffness

Self Esteem Stress

Morale Boredom

Financial Security Depression

Productive Work Life Prolonged sick leave

Benefits to University

Increase productivity.

Eliminate day loss.

Maximize human resources.

Enhance communication between staff of

different levels.

Caring Employer.

Collaboration

Human Resource Section (HRS)

University Health Service (UHS)

OHR Team

Department & Supervisor

Injured Employee

Safety Office

Responsibilities - HRS

Send copy of accident report to UHS when

received from Department.

Inform Labour Department (LD).

Provide appropriate document to LD.

Responsibilities - UHS

Occupational Health Rehabilitation (OHR)

Team in UHS

Multi-disciplinary OHR Team (as appropriate)

Safety Office

Department of injured staff

Other Health Care Professionals

Other optional members as required

Occupational Health

Rehabilitation Team in UHS

Director

Designated Physician

Occupational Health Nursing Officer

Occupational Health Nurse

Physiotherapist as appropriate

HKU members (as appropriate)

Safety Officer (Safety Office)

Supervisor of injured employee

(as co-opted member)

Other Health Care Professionals (as required)

Specialists

Occupational Therapist

Counsellor

Other optional members as required

Multi-disciplinary OHR Team

Assessment (physical, psychological, social

and occupational aspects)

Case management approach

Individualized Rehabilitation plan

Responsibilities - UHS

Responsibilities - UHS

Appropriate rehabilitation treatment

Advise for psychological counselling

Regular monitoring (medical & work condition)

Regular meeting

Review rehabilitation plan and progress

Responsibilities –

Department Head / Supervisor

Play a vital role in employee’s early return to work

Report injury incident to HR by filling in Form 2/2B.

Form 2/2B copy send to Safety Office, Finance &

Enterprise Office and UHS.

Provide UHS OHR Team

Job description

Required skills

Physical demand

Assign appropriate modified duties for the

employee.

Responsibilities –

Department Head / Supervisor

Responsibilities –

Department Head / Supervisor

Facilitate the employee to attend medical and

therapy appointment as required.

Maintain regular contact with employee to

monitor the rehabilitation progress.

Maintain regular contact with OHR Team.

Responsibilities - Employee

Full co-operation of employee: Success of the

Rehabilitation plan.

Understand University’s injury reporting

procedure.

Report any injury to supervisor as soon as

possible.

Responsibilities - Employee

Keep the recommended medical and

therapy appointments.

Maintain regular contacts with supervisor

and OHR Team.

Rehabilitation Process

1. Screening & Assessment

2. Planning

3. Implementation & Monitoring

4. Evaluation

Meet UHS physician/OH nurse for initial

assessment.

Sign consent: collect relevant information and

medical reports.

1. Screening & Assessment

Contact Supervisor:

To obtain employee’s job contents, skills and

physical demand.

To explore the possibility of job duties

re-designing or re-allocation.

1. Screening & Assessment

2. Planning

Individualized rehabilitation plan base on

employee’s situation.

Employee and supervisor are fully involved.

Implementation after agreement with the

employee and supervisor.

2. Planning

Content of Rehabilitation Plan:

Job duties to be allowed / avoided

Number of hours and days of work

Any extra supervision / workplace alteration

required

Rehabilitative treatment

Psychological services

3. Implementation & Monitoring

OHR Team will:

Communicate the plan to supervisor

Monitor the case closely

Review regularly

Keep documentation

4. Evaluation

Plan will cease when the employee’s maximum

recovery potential is achieved.

Employee and supervisor to give feedback.

Rehabilitation service will be reviewed and updated

on regular basis.

Conclusion

Early intervention through a

comprehensive rehabilitation

service is important for IOD

employee.

Return to work safely at the earliest

medically feasible time with a

modified temporary assignment is

beneficial to the injured staff,

colleagues, Department, University

and the society.