WORK-INJURY MANAGEMENT AND RETURN-TO-WORK IN THE MANUFACTURING INDUSTRY IN SELANGOR, MALAYSIA

Abstract

Background: When workers sustained injury while at work, they make effort to return to employment. Some workers return to work faster, while some are slower and some do not make it at all. Work-injury management is vital to ensure successful return-to-work (RTW) among these workers. Key stakeholders must play their role to facilitate this process. This study reports on the nurses, employers and workers’ participation in work-injury management and RTW in the manufacturing industry in Selangor, Malaysia. Objective: The objectives of this study were to examine approaches taken by SOCSO to engage the key stakeholders (nurses, employers and workers with work related injuries) in its RTW programme relating to work-injury management; determine the manufacturing industry’s organisational policy and practices in managing workplace injury, return to work practices and workplace adjustments or modification practices and explore key manufacturing industry stakeholders (nurses, employers and workers with work related injuries) perceptions of their experiences in participating with work-injury management, return to work practices and workplace adjustments or modification practices. Method: A mixed methods design was used for this study. The qualitative method comprised of document review on SOCSO work injuries data, non-participant observations in SOCSO national and regional RTW conferences, and three focused group discussion (FGD) sessions with the employers’ representative and semi structured interviews with seven workers who have RTW following workplace injury and six industrial nurses. The quantitative method comprised of a non-experimental cross sectional descriptive survey on organisational policy and practices in managing workplace injury, RTW practices and workplace adjustments or modification practices. Template analysis was used to analyse focused group discussions (FGDs) and interview data. Both descriptive and inferential statistics were used for quantitative data analysis. Results: SOCSO engages the employers and workers in its RTW programme through various strategies. Its strategies are comprehensive and commendable with an upstream system approach. However, much discussions and debates are still focused on the practical applications of RTW activities, especially in the aspects of work modifications to accommodate workers with injury, challenges on early interventions and implementing RTW at place of work and poor formal communication among managers and workers or within work teams and lack of employer’s support in RTW management at workplace. A total of 392 employers responded to the quantitative survey of this study. The analysis reveals that the employers are passive with their work-injury management and RTW practices (0 %). Only 1.8% (n=7) were proactive in work adjustments / modification practices in RTW. The percentage of employers have a written policy and procedure on RTW is low (7.9 %, n=31). Not all employers, 15.3% (n=60) are aware that SOCSO offers RTW programme to its insured workers. A Mann-Whitney U test indicates that Organisational Policies and Practices (OPP) scores is significantly higher for employers who employ more than 500 workers (U = 11046, p = 0.039, r =.10), are familiar with the Occupational Safety and Health Act 1994 (U = 7478, p < .001, r =.24), have a safety and health committee (U = 4744, p < .001, r =.25), use workers’ injury data to problem solve RTW (U = 6509, p < .001, r =.20) and aware that SOCSO offers RTW programme (U = 6079, p < .001, r =.24). Uncertainties in decision making; commitment to extended roles; deficient knowledge related to process management of RTW and effective communication were the similar themes emerged from the perceptions of management representatives and nurses. Whereas fear of work uncertainties; assuring communication; support and respect between employers and workers were the themes emerged from the perceptions of injured workers. Conclusion: Deficient in knowledge to execute the RTW programme was identified in this study with major concern over transitional work / work modification at organisational level. The work-injury management and RTW programme practices at the level of employers, nurses and injured workers are lacking as there is no consistent process to optimise RTW for injured workers. Accountability, communication and empowerment to manage cases need to be improved. Employers should not be concerned only with company’s profit but ought to invest resources and time to emplace a good RTW programme. This includes training supervisors and nurses as case managers to manage workplace injury and RTW at organisational level effectively. The outcome may reap substantial return of investment in human resources where skilled and experience workers are retained and workers’ productivity can be maximised in long run.