Clinical Research Directory

SmaRTWork - a Decision Support System to Promote Return to Work Among People Sick-listed With Musculoskeletal Disorders

The objective of this study is to evaluate the effect of an intervention, SmaRTWork, on return to work compared to usual care for individuals who are sick-listed due to musculoskeletal disorders. Potential participants are individuals of working age (20-59 years) sick-listed due to a musculoskeletal disorder (neck pain, low back pain, or widespread pain) for up to 12 weeks living in Norway. The primary outcome will be time to sustainable return to work. We will also evaluate the effect on other work outcomes and health outcomes. We will also interview participants and stakeholders about their experience with the intervention.

Assessment of Activity Limitations, a Basis for Understanding the Need for Sickness Certificate and Rehabilitation

In Sweden mental disorders have the highest proportion of sickness absence and sickness spells. One cause for this is proposed as the lack of knowledge on which activity limitations that have an impact on the ability to return to work. Further, there is a knowledge gap concerning the effect of which early measures from the health system, assessments and early rehabilitation interventions, that enables return to work. Such early measures have been proposed to have a more multidimensional perspective, than to solely focus on specific tasks during a work situation. The aim of the current project is to examine the effect of an early assessment of activity limitations, made by occupational therapists within specialized psychiatric care, at the time for the next prolonged sickness certification. The assessment will be included in the sickness certificate, and results will be compared between the intervention group and a control group. The results are calculated for differences on treatment measures, prevalence of questions from the Social Insurance Agency and changes in the patterns for sick leave spells. Further, the prevalence of activity limitations and the sick listed participants assessments of the effect of the intervention will be presented. The results are expected to lead to more adequate interventions for the individual regarding support to return to work, better routines for assessment and rehabilitation within the health care system, which in turn can facilitate decisions for sickness benefits and further have an impact on the long sick leave spells concerning mental disorders.

A Structured Method for Systematic and Integrated Occupational Safety and Health and Patient Safety Management Systems

The evidence unequivocally supports the association between work environment and patient safety. The negative impact of working conditions on both employee health and quality of care highlights the potential benefits of integrating these areas. It is therefore suggested that integrated systematic occupational health and patient safety management are crucial in managing the challenges faced by healthcare services today. The project aims to assess the effectiveness and cost-effectiveness of a structured method for systematic and integrated occupational safety and health and patient safety management systems (SIOHPS). A process evaluation will be conducted alongside the main study to determine the intervention's specific outcomes and provide transferable guidance to a wider context. The intervention is designed to support both systematic occupational health and patient safety management systems using a Safety II-perspective. The intervention is comprised of several core components, including education to staff, support-functions and management, daily team reflections; as well as audit and feedback. A stepped wedge cluster-controlled design (SWD) will be used, with workplaces as clusters. The SWD will consist of three steps, with four clusters crossing over from the control to the intervention group at each step. All clusters will start as controls. At least twelve healthcare units with at least thirty employees per workplace from two different regions in Sweden will participate in the intervention. Workplaces that provide round-the-clock care are invited to participate in the study. Exclusion criteria are units with plans to implement any other occupational health and/or patient safety improvement work during the project period. At the individual level, inclusion criteria for employees include at least 50% of full-time work at the workplace. The SIOHPS project will contribute to the existing theory on safety culture interventions by considering the integration of these areas. The goal is to contribute to a safe environment for both employees and patients.