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Work related musculoskeletal disorders are the first cause of occupational disease in France, many of which facing job retention issues. A multidisciplinary return to work program was developed to ease the “therapeutic return to work” of these disabled workers by means of ergonomic adjustments of their workstation. A process evaluation of this pilot program was conducted to assess its feasibility before a wider scale implementation.
Methods
A mixed-methods evaluation was conducted to identify the influence of contextual factors on the implementation of the program’s activities. Quantitative data were collected through management indicators and a survey among the participating occupational physicians (OPs) (n=28). Qualitative data were collected through semi-structured interviews with patients (n=4) and members of the multidisciplinary team (n=3), focus groups with the steering committee (n=2), participant observation of case inclusion (n=2) and grey literature about the program.
Results
Just a half of the expected workers were included in the pilot program due to poor referrals from general practitioners, insurance physicians and employers. A major barrier identified was the absence of timely communication to advertise the program among the stakeholders. Barriers self-reported by the participating OPs were lack of time, lack of conviction, a program perceived as complex, time-consuming and “hard to sell” to the employers. Those results were contrasting with the satisfaction of the included workers, the timely implementation of the program’s activities and the sense of accomplishment reported by the members of the multidisciplinary team.
Discussion
Barriers were identified that could explain the implementation failure despite the relevance of the program. Recommendations were made to the stakeholders to simplify the program, provide incentives to the OPs and conduct a proper communication plan to advertise the program in the community.