Incorporating injured employee outcomes into physical and occupational therapists' practice: a controlled trial of the Worker-Based Outcomes Assessment System

• Published in: Journal of occupational rehabilitation Vol. 16; no. 4; pp. 607 - 629
• Main Authors: Ross, Robert H, Callas, Peter W, Sargent, Jesse Q, Amick, Benjamin C, Rooney, Ted
• Format: Journal Article
• Language: English
• Published: Netherlands Springer Nature B.V 01.12.2006
• Subjects: Administrative expenses; Adult; Clinical outcomes; Clinics; Disability Evaluation; Emergency medical care; Employees; Female; Follow-Up Studies; Health care; Health Care Costs; Health Status; Humans; Intervention; Male; Medical referrals; Mental health; Microsurgery; Middle Aged; Musculoskeletal diseases; Musculoskeletal Diseases - economics; Musculoskeletal Diseases - rehabilitation; Occupational Diseases - economics; Occupational Diseases - rehabilitation; Occupational health; Occupational therapy; Occupational Therapy - economics; Occupational Therapy - methods; Orthopedics; Outcome and Process Assessment, Health Care - economics; Pain; Pain Measurement; Patients; Physical Therapy Modalities - economics; Primary care; Recovery (Medical); Rehabilitation; Return to work programs; Sick Leave; Studies; Therapists; Trends; Vermont; Workers with disabilities; Vermont
• ISSN: 1053-0487; 1573-3688
• DOI: 10.1007/s10926-006-9060-1

Work related musculoskeletal disorders (WRMSDs) remain costly. The Worker-Based Outcomes Assessment System (WBOAS) is an injury treatment improvement tool. Its purpose is to increase treatment effectiveness and decrease the cost of care delivered in Occupational Health Service clinics. The study used a non-randomized (parallel cohort) control trial design to test the effects on injured employee outcomes of augmenting the standard care delivered by physical and occupational therapists (PT/OTs) with the WBOAS. The WBOAS works by putting patient-reported functional health status, pain symptom, and work role performance outcomes data into the hands of PT/OTs and their patients. Test clinic therapists were trained to incorporate WBOAS trends data into standard practice. Control clinic therapists delivered standard care alone. WBOAS-augmented PT/OT care did improve (p< or =.05) physical functioning and new injury/re-injury avoidance and, on these same dimensions, cost-adjusted outcome. It did not improve (p>.05) mental health or pain symptoms or return-to-work or stay-at-work success nor, on these same dimensions, cost-adjusted outcome. Training PT/OTs to incorporate patient-reported health status, pain symptom, and work role performance outcomes trends data into standard practice does appear to improve treatment effectiveness and cost on some (e.g. physical functioning) but not other (e.g. mental health, pain symptoms) outcomes.