Early intervention for back-injured nurses at a large Canadian tertiary care hospital: an evaluation of the effectiveness and cost benefits of a two-year pilot project

Abstract

This study evaluated a two-year multidisciplinary early intervention pilot programme for back-injured nurses employed at a large teaching hospital, using a pre- versus post-programme analysis. The purpose was to ascertain whether this programme could reduce the incidence, morbidity, time lost and cost due to back injuries in the 250 nurses employed on ten targeted high-risk wards. Injuries in the remaining 1395 nurses employed on the other 45 wards were monitored concurrently for comparison. The programme consisted of prompt assessment, treatment and rehabilitation through modified work. Evaluative data were gathered by one research nurse on standardized forms at the time of injury, weekly until return to work, and at a six-month follow-up. Time lost and cost data for up to one-year post-injury were derived from workers' compensation statements. Compared to the two years prior to introduction of the programme, the rates of back injuries and lost-time back injuries decreased by 23% and 43%, respectively, on the targeted wards, while these increased on the control wards. Combined expenditure was 32% lower per injury and 34% lower per lost-time injury for those in the targeted group who consented to take part in the programme compared to their counterparts on the control wards, as the increased assessment and treatment costs per case attributable to the programme were more than offset by the savings in lower compensation (wage loss) costs. This programme thus reduced the incidence and time lost due to back injuries and was cost-beneficial.

Management of Long Term Sickness Absence: A Systematic Realist Review

“…First, a major difficulty when attempting to evaluate the strength of empirical evidence for interventions to reduce LTSA relates to the fact that many studies evaluate multi-component interventions, making it difficult to ascertain which component, if any, is having an effect [30,31]. Second, the majority of effectiveness studies provide very limited information on any underlying organisational contextual factors that may have had an impact on the outcomes [32].…”

A systematic review of occupational safety and health business cases

“…Six articles reported on three studies twice so we included each study only once which left us with 18 articles (23)(24)(25)(26)(27)(28). In one article, four cases were reported, in another three cases, and in one report, three cases were reported, resulting in 26 cases for use in the review (9,11,24,26,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) We excluded cases that: (i) did not concern occupational health but general health interventions such as case studies of influenza vaccination (43)(44)(45)(46)(47); (ii) did not include costs and benefits in monetary terms (48); (iii) did not include productivity measures (49); (iv) did not include the costs of the intervention (50); (v) were economic models only (51); or (vi) had calculated costs and benefits relative only to production (52).…”

“…In the controlled studies, the effect, costs, and benefits of the intervention were measured as those in the intervention group minus those in the control group (32,33,39). However, in one study, we had to recalculate the outcomes because the authors used a before-after comparison in the intervention group only (32).…”

Effects of graded return-to-work: a propensity-score-matched analysis

“…Graded work exposure is deemed to have a therapeutic effect among work-disabled persons as prolonged absence from work worsens physical deconditioning, negatively affects mental health, and increases the risk of receiving a disability pension (3,17,(19)(20)(21). Returning to work with reduced demands allows the worker to re-experience selfefficacy and co-worker support and challenge avoidance beliefs.…”