TCS Grant

Targeted Change Strategies for Improving Workers' Compensation Medical Care: Building on the Experiences of the RWJF Workers' Compensation Health Initiative

Key Personnel:
Jay Himmelstein, MD, MPH- Project Director
Jay.Himmelstein@umassmed.edu

Ann Clayton- Project Manager
AnnClayton@aol.com

Allard Dembe, ScD- Director of Research
Allard.Dembe@umassmed.edu

Sharon Fox, PhD- Research Co-Investigator
SharonF@waushosp.org

Background:   As in general health care, a substantial “quality chasm” exists between what is known about providing quality medical care for injured workers and what is actually practiced. Projects funded through the Robert Wood Johnson Foundation (RWJF) Workers' Compensation Health Initiative (WCHI) have confirmed that insufficient attention is being paid to access and quality of care issues for injured workers, especially those with chronic health conditions and disabilities.  WCHI outcomes have also suggested that substantial improvements in workers' compensation (WC) medical care can be promoted through a strategic approach to information dissemination and providing technical assistance and support for system change.  

Project Description :  Building upon the lessons learned through the RWJF-funded WCHI, the primary objectives of this project were: a) to provide assistance to state workers’ compensation systems with the goal of developing and implementing systems to measure and promote the improvement of the quality of health care provided to injured or ill workers; b) to expand the dissemination and use of tools developed as a part of the WCHI through the development of web-based tool kits and training modules for key agency personnel, health care providers, and other stakeholders; and c) to foster development of an enduring research infrastructure for the study of workers' compensation medical care.

Results of Project:

Objective #1- Providing assistance to state WC programs to implement WCHI lessons learned and tools

  • The states of Ohio and Oregon were chosen; we worked with them, in order to assist them, in their development of physician level performance measures, as part of a strategy to improve the quality of health care provided to occupationally injured workers.
  • Additional funding was not provided by the RWJF. Plans were approved for a no-cost extension of the initial grant period to 9/30/04. With the funds available, some assistance will be given to both Ohio and Oregon in the initial planning and design of their projects.

State Applications for Assistance and Results:

Objective #2- Development of training courses for policymakers/agency personnel and employers using lessons and tools from WCHI

  • Training programs developed which contain tool boxes, references, presentional material and group exercises completed.
  • Pilots completed on both training courses in April. Feedback indicated course contained too much material in the hour or hour and a half provided for the training, but students highly valued the material and references. Pilot groups indicated they would be using the materials (38 out of 43) and would recommend the course to others (27 out of 32).
  • Courses were combined into one general orientation course which is located on the webpage http://www.umassmed.edu/workerscomp/Orientation/ .

Objective #3- Foster the development of an enduring research infrastructure for the study of occupational injury and disease medical care delivery

  • Initial meetings and follow-up discussions have been completed with NIOSH and AHRQ concerning collaboration to enhance national infrastructure to conduct occupational health services research.
  • Preliminary plans have been developed for an invited national conference early in 2004 to seek broad participation in establishing a national research agenda on occupational health services research.
  • Presentations have recently been made at a variety of national research and policy conferences, including Dr. Dembe's presentation on August 18, 2003 at the joint meeting of Canadian and American WC officials in Vancouver and Dr. Himmelstein's presentation on worker surveys at the falll meeting of the International Association of Accident Boards and Commissions in San Francisco.

Advisory Committee Members:

  • Christine Baker- California Health, Safey and Worker' Compensation Commission
  • John F. Burton, Jr., PhD- Rutgers University
  • Jennifer, Christian, MD- Webility Corporation
  • Frank Fennerty- Washington Board of Industrial Insurance Appeals
  • Michael Follick, MD- The Abacus Group
  • Liza Greenberg, RN, MPH- URAC
  • Greg Krohm, PhD- IAIABC
  • Gideon Letz, MD, MPH- California State Compensation Insurance Fund
  • William H. Lohman, MD- Minnesota Department of Labor and Industry
  • Kathryn Mueller, MD, MPH- University of Colorado Health Sciences Center
  • Glenn Pransky, MD, MOccH- Liberty Mutual Center for Disability Research
  • Virginia Reno, National Academy of Social Insurance
  • Michael Rothman, The Robert Wood Johnson Foundation
  • Rick Victor, JD, PhD- Workers Compensation Research Institute
  • Edward Welch, JD- Michigan State University
  • Tom Wickizer, PhD, MPH- University of Washington School of Public Health