TORONTO, October 17, 2003 -- Disability is a multi-factorial problem and isolated treatments are ineffective in preventing disability in the workplace.

This was one of the key messages at the recent Round Table Project on Safe & Timely Return to Function & Return to Work (RTP) Forum held recently in Toronto .

The RTP is an Ontario-based working group that brings together representatives from 15 key sectors in an attempt to improve the system that helps people with illness, injury or disability live full and productive lives.

The two-day Moving to People, Health and Productivity: A Systems Approach to Removing Barriers for People with Disabilities was the fourth Forum held by the RTP and brought together over 50 stakeholders with an interest in improving disability management and workplace health in Canada .

Evidence on the ineffectiveness of isolated treatments and the general failure of the current disability prevention system in Canada was presented by Dr. Patrick Loisel, an orthopedic surgeon and professor at the University of Sherbrooke .

“Disability often results from inappropriate actions and interactions within the system involving several stakeholders interacting with patients during the disability process,” he stated, adding that “no person, disabled or not, should be denied an acceptable working situation.”

Dr. Loisel presented an alternative to current approaches -- the evidence-based Sherbrooke disability prevention model and PREVICAP workplace rehabilitation program that he helped develop and have achieved measurable positive results in Quebec when applied to occupational back pain*.

Participants at the Forum endorsed Dr. Loisel's proposal for an action plan to develop a pilot project for adapting this evidence-based model for Ontario . “To effectively adopt the model for Ontario , we must address not only the evidence, but also the Ontario context,” Dr. Loisel noted. “And we need to involve all players and plan together.”

The Round Table Project will pursue funding for this initiative. In addition to Sherbrooke and PREVICAP, other evidence-based models will also be considered during the Project's strategic planning process.

Forum participants also agreed to continue to work with the Canadian Injured Workers Alliance on the development of a national consultation process to solicit input from disabled workers at the regional level. This would provide data for the development of future disability prevention and management programs.

While the problems experienced by persons with disabilities – high unemployment, and social isolation, for example, – are the most visible signs of a dysfunctional system, other system players are experiencing difficulties as well, says Dr. Doupe, an occupational health physician and founder of the Round Table Project.

Employers experience delays in returning injured workers to work in a safe and timely manner, the roles of the various health professionals in rehabilitation and return to work are not clear, auto insurance costs for rehabilitation have skyrocketed and physicians spend far too much time filling out unnecessary insurance forms, she explains. “The current uncoordinated, silo-like approach to meeting the needs of persons with disabilities doesn't serve anybody and the result is an unnecessary high cost, in human terms and in lost productivity.

“The health professionals, companies, organizations and individuals involved with the Round Table Project have showed an unprecedented level of interest in working together collaboratively,” stated Dr. Lisa Doupe. “It is time to embrace the values of collaboration and cooperation, and to move from talk to action.”

The Round Table Project on Safe & Timely Return to Function & Return to Work is a virtual, multi-stakeholder group working together to improve the systems that help people with illness, injury or disability from any cause to return to life activities and to work. The Round Table is supported through a contribution agreement with Human Resources Development Canada, Ontario Region and works in association with the Ontario Medical Foundation. Dr. Lisa Doupe, Principal, PWR Health Consultants Inc., manages the project.

The September Forum was sponsored by Human Resources Development Canada, Ontario Region, Ontario Medical Foundation, Ontario Medical Association, Dofasco, Canadian Injured Workers Alliance, Institute for Health & Productivity Management, Academy for Health & Productivity Management and Aventis.

  *Loisel P, Durand M-J et al. Disability prevention: New paradigm for the management of occupational back pain. Disease Management Health Outcomes 2001: 9 (7); 351-360

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