Staff and employee perspectives on recovery management: a study of a tertiary health care facility

Lost time from work as a result of sickness or workplace injuries has considerable financial repercussions for both employers and employees. Employers suffer financially when trying to recruit new and/or replacement staff, training new people and ultimately in losing valuable productive employees either temporarily or on a more permanent basis. Employees also suffer financially but more importantly in ways that are much more difficult to measure such as their loss of a productive role, their routine and opportunities to socialize and sense of contributing to the community through their work. Within the multidimensional construct of return to work, it is recognized by employers and health care providers that whether or not a person successfully returns to work after a period of illness/injury depends on a variety of factors. These include worker factors such as the functional capacity of an individual, their health and psychosocial status and overall attitudes towards work. Workload factors include such things as the type of work that is performed, the physical and psychosocial demands of the work and the pace of work, for example. Recovery management is a process whereby the recovery from an illness or injury of a worker is managed by the employer. The goal is to address all of those factors which impact on return to work so the worker can return to work as early as possible and in an environment that is safe. In recognizing this, injury and illness related recovery management strategies require an appreciation of the potentially wide-ranging issues associated with return to work. However, less is known about the strategies that are utilized in enabling an effective and durable return to work. -- The purpose of this thesis was to explore the perspectives of the various stakeholders in the recovery management process including recovery managers, employees and those who supervise those employees when they return to work. Specifically, this thesis was designed to describe the process of recovery management which was implemented in a large tertiary health care institution and which was designed to address absenteeism and return to work after a period of injury and illness. -- Nineteen employees including nine recovery managers and five supervisors and the same number of workers, participated in this study. They all were employed in the health care facility. Each of them participated in a semi-structured interview. The interviews were transcribed and subjected to a thematic analysis. -- The results showed that it was believed by the participants that all stakeholders in the recovery management process should be knowledgeable of the process, in order to avoid delays in the process and miscommunication, particularly when returning to work. Additionally, it was perceived by the participants that it was important for the recovering worker to feel appreciated and to be involved in meaningful return to work activities in order for return to work to be successful. Specific thematic analysis for each group revealed that recovery managers felt that increased workload was an issue for them since the implementation of a recovery management program. The supervisors for their part felt conflicted in trying to meet their production quotas, in addition to accommodating recovering workers in their area. Workers often found the follow-up upon return to the worksite not adequate leading to fears of re-injury or medical setback. Many of the worker participants felt that they had little support from either their supervisor or their assigned recovery manager when they participated in the return to work process. -- In concluding, although the recovery management and return to work process seemed to be supported by the participants in the study, common themes to all stakeholders such as education around the process, effective communication and ensuring the recovering workers felt appreciated when returning to work, were areas that were identified as needing further development