Background Individuals with physical or mental health disabilities may be particularly vulnerable to the impact of COVID-19 on their health and employment. Objectives We examined COVID-19-related concerns for health, finances, and organizational support among workers with no disability, a physical, mental health, or both physical and mental health disability, and factors associated with COVID-19 perceptions. Methods An online, cross-sectional survey was administered to a sample of Canadians in the first wave of the COVID-19 pandemic. Questions asked about COVID-19 perceptions, demographics (gender, age, education), work context (e.g., sector, contract work) and employment conditions (e.g., job stress, control, accommodation needs). Descriptive, multivariable, and nested regression analyses examined factors associated with COVID-19 perceptions. Results A total of 3066 participants completed the survey. Workers with both a physical and mental health disability reported significantly greater health and financial concerns and less organizational support than those with no disability. Workers with a physical disability reported more health concerns and those with a mental health disability reported more financial concerns and less organizational support. Respondents with disabilities also reported significant differences in employment conditions (e.g., more contract work, stress, unmet accommodation needs) than those with no disability. Employment conditions were consistently significant predictors of COVID-19 perceptions and attenuated the significance of disability type in analyses. Conclusions Concerns about the impact of COVID-19 on one's health, finances, and organizational support reflected existing disability inequities in employment conditions and highlight the importance of creating more inclusive employment opportunities for people living with physical and mental health disabilities.

Background: Flagging is a standardized way to communicate the risk of patient violence to workers. We add to the limited body of research on flagging by describing hospitals’ approaches to and challenges with flagging patients with a history of violent behavior. Methods: We used a qualitative case study approach of hospitals in Ontario, Canada and their patient flagging practices. Key informants and our advisory committee identified 11 hospitals to invite to participate. Hospitals assisted in recruiting frontline clinical and allied health workers and managers to an interview or focus group. A document analysis of hospitals’ flagging policies and related documents was conducted. Thematic analysis was used to analyze interview and focus group data. Findings: Five hospitals participated. Of the five hospitals, four had a flagging policy where frontline clinical workers ( n = 58), frontline allied health workers ( n = 31), and managers ( n = 42) participated in an interview ( n = 43) or focus group ( n = 15). Participants described three challenges: patient stigmatization, patient privacy, and gaps in policy and procedures. Conclusion/Application to practice: Flagging patients with a history of violent behavior is one intervention that hospitals use to keep workers safe. While violence prevention was important to study participants, a number of factors can affect implementation of a flagging policy. Study findings suggest that hospital leadership should mitigate patient stigmatization (real and perceived) and perception of patient rights infringement by educating all managers and frontline workers on the purpose of flagging and the relationship between occupational health and safety and privacy regulations. Leadership should also actively involve frontline workers who are the most knowledgeable about how policies work in practice.

PurposeThe purpose of this paper is to use a comparative qualitative case study design to better understand how the observed characteristics of an organization correspond to their score on the organizational performance metric (IWH-OPM), a leading indicator tool designed to measure an organization’s occupational health and safety (OHS) performance.Design/methodology/approachFive organizations were recruited based on their diverse IWH-OPM scores obtained in a previous study. Qualitative data were collected from these cases and analyzed with consideration of OHS leadership; OHS culture and climate; employee participation in OHS; OHS policies, procedures and practices; and OHS risk control. Similarities and differences among organizations were examined in relation to these themes.FindingsThree distinct groups of firms emerged from the cross-case analysis in terms of their overall OHS performance: high, medium and low. Higher firm IWH-OPM scores generally corresponded to better OHS performance in the workplace as observed through qualitative methods.Originality/valueThe findings are a step toward OHS leaders or practitioners eventually being able, based on an organization’s IWH-OPM score, to have a quick understanding of a workplace’s OHS status and of how best to support further improvement.

International research has generated strong evidence that healthcare providers (HCPs) play a key role in the return to work (RTW) process. However, pressure on consultation time, administrative challenges and limited knowledge about a patient's workplace can thwart meaningful engagement. Aim: Our study sought to understand how HCPs interact with workers compensation boards (WCBs), manage the treatment of workers compensation patients and navigate the RTW process. Method: The study involved in-depth interviews with 97 HCPs in British Columbia, Manitoba, Ontario and Newfoundland and Labrador and interviews with 34 case managers (CMs). An inductive, constant comparative analysis was employed to develop key themes. Findings: Most HCPs did not encounter significant problems with the workers compensation system or the RTW process when they treated patients who had visible, acute, physical injuries, but faced challenges when they encountered patients with multiple injuries, gradual-onset or complex illnesses, chronic pain and mental health conditions. In these circumstances, many experienced the workers compensation system as opaque and confusing. A number of systemic, process and administrative hurdles, disagreements about medical decisions and lack of role clarity impeded the meaningful engagement of HCPs in RTW. In turn, this has resulted in challenges for injured workers (IWs), as well as inefficiencies in the workers compensation system. Conclusion: This study raises questions about the appropriate role of HCPs in the RTW process. We offer suggestions about practices and policies that can clarify the role of HCPs and make workers compensation systems easier to navigate for all stakeholders.

Purpose Sensibility refers to a tool’s comprehensiveness, understandability, relevance, feasibility, and length. It is used in the early development phase to begin assessing a new tool or intervention. This study examined the sensibility of the job demands and accommodation planning tool (JDAPT). The JDAPT identifies job demands related to physical, cognitive, interpersonal, and working conditions to better target strategies for workplace supports and accommodations aimed at assisting individuals with chronic health conditions. Methods Workers with a chronic health condition and workplace representatives were recruited from health charities, workplaces, and newsletters using convenience sampling. Cognitive interviews assessed the JDAPT’s sensibility. A 70% endorsement rate was the minimum level of acceptability for sensibility concepts. A short screening tool also was administered, and answers compared to the complete JDAPT. Results Participants were 46 workers and 23 organizational representatives (n = 69). Endorsements highly exceeded the 70% cut-off for understandability, relevance, and length. Congruence between screening questions and the complete JDAPT suggested both workers and organizational representatives overlooked job demands when completing the screener. Participants provided additional examples and three new items to improve comprehensiveness. The JDAPT was rated highly relevant and useful, although not always easy to complete for someone with an episodic condition. Conclusions This study highlights the need for tools that facilitate accommodations for workers with episodic disabilities and provides early evidence for the sensibility of the JDAPT.