Skip to main content
SpringerLink
Log in

Experience of the Implementation of a Multi-Stakeholder Return-to-Work Programme

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Introduction Employers can use several strategies to facilitate return-to-work for workers on sick leave, but there seems to be limited knowledge of how workplace-based interventions are actually implemented in organisations. One public Swedish employer initiated a return-to-work programme which incorporated interventions suggested by earlier research, e.g. multi-professional health assessment, case management, educational peer-support groups and adapted workplace training. The overall purpose of the study is to analyse how the programme was implemented and experienced in the organisation, from the perspective of involved stakeholders, i.e. supervisors, occupational health consultants and a project coordinator. The objective of this paper is to identify and analyse how these stakeholders perceived that the programme had been implemented in relation to its intentions. Methods A qualitative method was used, consisting of individual interviews with eight supervisors and the project leader. Two group interviews with five occupational health service consultants were also conducted. Results The study revealed barriers to the implementation of return-to-work interventions. Not all of the intended interventions had been implemented as expected in policy. One explanation is that the key stakeholders expressed a more biomedical, individual view of work ability, while the programme was based on a more holistic, biopsychosocial view. Conclusion Implementation of a return-to-work programme is an ongoing, long-term multi-level strategy, requiring time for reflection, stakeholder participation, openness to change of intervention activities, and continuous communication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Loisel P, Durand M, Berthelette D, Vezina N, Baril R, Gagnon D, et al. Disability prevention: new paradigm for the management of occupational back pain. Dis Manag Health Outcomes. 2001;9(7):351–60.

    Article  Google Scholar 

  2. Schultz IZ, Stowell AW, Feuerstein M, Gatchel RJ. Models of return to work for musculoskeletal disorders. J Occup Rehabil. 2007;17(2):327–52.

    Article  PubMed  Google Scholar 

  3. Shaw WS, Feuerstein M. Generating workplace accommodations: lessons learned from the integrated case management study. J Occup Rehabil. 2004;14(3):207–16.

    Article  PubMed  Google Scholar 

  4. Karjalainen K, Malmivaara A, van Tulder M, Roine R, Jauhiainen M, Hurri H, et al. Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. Cochrane Database Syst Rev. 2003;(2):1–19.

  5. Williams RM, Westmorland MG, Lin CA, Schmuck G, Creen M. Effectiveness of workplace rehabilitation interventions in the treatment of work-related low back pain: a systematic review. Disabil Rehabil. 2007;29(8):607–24.

    Article  CAS  PubMed  Google Scholar 

  6. MacEachen E, Clarke J, Franche RL, Irvin E. Systematic review of the qualitative literature on return to work after injury. Scand J Work Environ Health. 2006;32(4):257–69.

    PubMed  Google Scholar 

  7. Franche RL, Baril R, Shaw W, Nicholas M, Loisel P. Workplace-based return-to-work interventions: optimizing the role of stakeholders in implementation and research. J Occup Rehabil. 2005;15(4):525–42.

    Article  PubMed  Google Scholar 

  8. Shrey DE. Worksite disability management model for effective return-to-work planning. Occup Med. 2000;15(4):789–801.

    CAS  PubMed  Google Scholar 

  9. Briand C, Durand MJ, St-Arnaud L, Corbiere M. Work and mental health: Learning from return-to-work rehabilitation programs designed for workers with musculoskeletal disorders. Int J Law Psychiatry. 2007;30(4–5):444–57.

    Article  PubMed  Google Scholar 

  10. Loisel P, Buchbinder R, Hazard R, Keller R, Scheel I, van Tulder M, et al. Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence. J Occup Rehabil. 2005;15(4):507–24.

    Article  PubMed  Google Scholar 

  11. Fixsen DL, Naoom SF, Blasé KA, Friedman RM, Wallace F. Implementation research: a synthesis of the literature. Tampa: University of South Florida, Louise de la Parte Florida Mental Health Institute, The National Implementation Research Network; 2005.

    Google Scholar 

  12. A. Lagen om allmänn försäkring. Stockholm: Regeringskansliet; 1962. p. 381.

  13. Personalkontoret. ReKom Projektbeskrivning. Norrköpings kommun; 2005.

  14. Patton MQ. Qualitative research & evaluation methods. London: Sage; 2002.

    Google Scholar 

  15. Neuman WL. Social research methods. Qualitative and quantitative approaches. USA: Pearson; 2006.

    Google Scholar 

  16. Kvale S. InterViews: an introduction to qualitative research interviewing. Thousand Oaks: Sage; 1996.

    Google Scholar 

  17. Vetenskapsrådet. Forskningsetiska principer inom humanistisk-samhällsvetenskaplig forskning: Vetenskapsrådet; 1990.

  18. Arnetz BB, Sjogren B, Rydehn B, Meisel R. Early workplace intervention for employees with musculoskeletal-related absenteeism: a prospective controlled intervention study. J Occup Environ Med. 2003;45(5):499–506.

    Article  PubMed  Google Scholar 

  19. Krause N, Dasinger LK, Neuhauser F. Modified work and returns to work: a review of the literature. J Occup Rehabil. 1998;8(2):113–39.

    Article  Google Scholar 

  20. Shaw W, Hong QN, Pransky G, Loisel P. A literature review describing the role of return-to-work coordinators in trial programs and interventions designed to prevent workplace disability. J Occup Rehabil. 2008;18(1):2–15.

    Article  PubMed  Google Scholar 

  21. Nordqvist C, Holmqvist C, Alexanderson K. Views of laypersons on the role employers play in return to work when sick-listed. J Occup Rehabil. 2003;13(1):11–20.

    Article  PubMed  Google Scholar 

  22. Holmgren K, Ivanoff SD. Supervisors’ views on employer responsibility in the return to work process. A focus group study. J Occup Rehabil. 2007;4(1):93–106.

    Article  Google Scholar 

  23. Baril R, Berthelette D, Massicotte P. Early return to work of injured workers: multidimensional patterns of individual and organizational factors. Saf Sci. 2003;41(4):277–300.

    Article  Google Scholar 

  24. MacEachen E, Kosny A, Ferrier S. Unexpected barriers in return to work: lessons learned from injured worker peer support groups. Work. 2007;29(2):155–64.

    CAS  PubMed  Google Scholar 

  25. Waddell G, Burton AK. Concepts of rehabilitation for the management of low back pain. Best Pract Res Clin Rheumatol. 2005;19(4):655–70.

    Article  PubMed  Google Scholar 

  26. Lipsky M. Street-level bureaucracy: dilemmas of individuals in public service. New York: Russel Sage Foundation; 1980.

    Google Scholar 

  27. Friesen MN, Yassi A, Cooper J. Return-to-work: the importance of human interactions and organizational structures. Work. 2001;17(1):11–22.

    PubMed  Google Scholar 

  28. Larsson A, Gard G. How can the rehabilitation planning process at the workplace be improved? A qualitative study from employers’ perspective. J Occup Rehabil. 2003;13(3):169–81.

    Article  PubMed  Google Scholar 

  29. Pransky G, Shaw W, McLellan R. Employer attitudes, training, and return-to-work outcomes: a pilot study. Assist Technol. 2001;13(2):131–8.

    CAS  PubMed  Google Scholar 

  30. Shaw WS, Robertson MM, McLellan RK, Verma S, Pransky G. A controlled case study of supervisor training to optimize response to injury in the food processing industry. Work. 2006;26:107–14.

    PubMed  Google Scholar 

  31. Eakin JM. Leaving it up to the workers: sociological perspective on the management of health and safety in small workplaces. Int J Health Serv. 1992;22(4):689–704.

    Article  CAS  PubMed  Google Scholar 

  32. Holmgren K, Dahlin Ivanoff S. Women on sickness absence—views of possibilities and obstacles for returning to work. A focus group study. Disabil Rehabil. 2004;26(4):213–22.

    Article  PubMed  Google Scholar 

  33. Walt G. Health policy. An introduction to process and power. Johannesburg: Witwatersrand University Press; 1994.

    Google Scholar 

  34. Gardner D. Barriers to the implementation of management systems: lessons from the past. Qual Assur. 2000;8(1):3–10.

    CAS  PubMed  Google Scholar 

  35. Sabatier PA. Top-down and bottom-up approaches to implementation research: a critical analysis and suggested synthesis. J Public Policy. 1986;6(1):21–84.

    Article  Google Scholar 

  36. Winter S. Integrating implementation research. In: Palumbo DJ, Calista DJ, editors. Implementation and the policy process. Opening up the black box. New York: Greenwood press; 1990.

    Google Scholar 

  37. Crisp BR, Swerissen H, Duckett SJ. Four approaches to capacity building in health: consequences for measurement and accountability. Health Promot Int. 2000;15(2):99–107.

    Article  Google Scholar 

Download references

Authors’ contributions

ÅT: study design, data gathering, analysis, and writing the manuscript; EES: study design, examining and commenting on the analysis, and contributing to the manuscript; KE: study design, examining and commenting on the analysis, and contributing to the manuscript.

Competing Interests

The authors declare that no competing interests or conflicting interests exist.

Author information

Authors and Affiliations

  1. National Centre for Work and Rehabilitation, Department of Medical and Health Sciences, Linkoping University, 581 83, Linköping, Sweden

    Åsa Tjulin, Elinor Edvardsson Stiwne & Kerstin Ekberg

  2. Department of Behavioural Sciences and Learning, Linkoping University, Linköping, Sweden

    Elinor Edvardsson Stiwne

  3. Helix Vinn Excellence Centre, Linkoping University, Linköping, Sweden

    Åsa Tjulin & Kerstin Ekberg

Authors
  1. Åsa Tjulin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elinor Edvardsson Stiwne
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kerstin Ekberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Åsa Tjulin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tjulin, Å., Edvardsson Stiwne, E. & Ekberg, K. Experience of the Implementation of a Multi-Stakeholder Return-to-Work Programme. J Occup Rehabil 19, 409–418 (2009). https://doi.org/10.1007/s10926-009-9195-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-009-9195-y

Keywords

Search

Navigation