Needs assessment for the use of the Checklist Depression for work ability assessment by insurance physicians

Introduction
Work ability assessment of patients with Major depressive disorder (MDD) is complex. In order to give insurance physicians (IP) additional information to support their work ability assessments, the Checklist Depression (CDp) has been developed. In order to prepare the CDp implementation, an analysis of the organisational and social contexts of these doctors should be conducted. The aim of this study was to identify the potential facilitators and barriers in the use of the CDp by IP’s during work ability assessments of sick-listed employees with MDD. 

Methods
Based on semi-structured interviews, a qualitative research was conducted by IP’s and staff IP’s working at least for one year at the Dutch National Institute for Employee Benefit Schemes (UWV). Interviews were divided into characteristics of the potential users (IP’s), the work environment (UWV) and the innovation (CDp). All interviews were audio taped, transcribed and analysed qualitatively.

Results
Ten IP’s and 10 staff IP’s were interviewed (mean age of 53 and 55 years old, respectively). A verbal introduction with colleagues and staff, support from upper management, the increased transparency in work ability assessments with the use of the CDp, having sufficient time for implementation and modification of appearance (colour, plasticised format) and content (clarifying aspects of the examples) of the CDp came up as important facilitators for its use. The fear of the loss of autonomy, lack of added value of the list, high workload, inadequate instructions and lack of time were mentioned as barriers.

Discussion
This analysis of the organisational and social contexts offers information from a broad perspective about the needs of IP’s and staff IP’s with regard to the CDp use and its place of work within UWV. The CDp implementation will take into account theses identified facilitators and barriers in order to facilitate the CDp introduction within the IP’s work ability assessment.