Project Results

Public Policy Goal

To improve workers' compensation medical care practice patterns, costs, and outcomes by supporting the effective dissemination and widespread adoption of evidence and consensus-based guidelines.

Project Objective

To plan and implement the initial release of the ACOEM guidelines for treatment of the neck, back, upper and lower extremities.

Project Description:

This grant supported the initial dissemination and adoption of occupational practice guidelines developed by the American College of Occupational and Environmental Medicine (ACOEM). These guidelines provide information and guidance for health care providers caring for patients with work-related disorders of the neck, back, upper and lower extremities, and eyes. The guidelines focus on disability management and recovery, as well as diagnosis and treatment. This project involved planning and implementation for initial release of the guidelines, including provider education and the establishment of associated data collection systems.

Key Findings and Accomplishments

• Physicians, mid-level practitioners, and case managers welcomed the development of evidence-based guidelines for prevention, management, and clinical evaluation of common work-related health problems;
• Training courses and seminars using small groups were the most effective way to educate providers and case managers to apply the guidelines but widespread dissemination is best accomplished by using multiple avenues of distribution including press releases, distribution and sale via OEM Press, as well as training courses and seminars;
• Adoption by national medical associations can immediately yield high visibility and press releases can be effective in generating interest;
• Barriers to use of the guidelines exist due to their large size. Other barriers include contradictory insurance company guidelines, varying employer expectations, and acceptance of guideline information by community physicians.

Tools Developed:

The ACOEM Occupational Medicine Practice Guidelines and requisite training information may be obtained by contacting:

ACOEM
1114 N. Arlington Heights Road
Arlington Heights, Illinois 60004
847-818-1800 (phone)
847-818-9266 (fax)
American College Of Occupational And Environmental Medicine

Or can be ordered from:
OEM Press
Beverly Farms, MA
OEM Press

Reports and Publications:

Harris, JS. "Evidence and Guideline-Based Management of Absence from Work." Journal of University of Occupational and Environmental Medicine (Japan) 19, no. 1 (1997): 68-92.

Harris, JS. "The ACOEM Occupational Medicine Guidelines." In Integrated Health Management: The Key Role of Occupational Medicine in Managed Care Disability Management and Integrated Delivery Systems., edited by JS Harris, Loeppke, RR. Boston, MA: OEM Press, 1998.

Harris, JS, Miller, LA. "Sources and Uses of Occupational Medicine Data." In Integrated Health Management: The Key Role of Occupational Medicine in Managed Care, Disability Management and Integrated Delivery Systems., edited by JS Harris, Loeppke, RR, pp. 111-17. Beverly Farms, MA: OEM Press, 1998.

Harris, JS. "Payers' Use of Practice Guidelines." In Integrated Health Management: The Key Role of Occupational Medicine in Managed Care, Disability Management and Integrated Delivery Systems, edited by JS Harris, Loeppke, RR, pp. 242-44. Beverly Farms, MA: OEM Press, 1998.

Harris, JS, Glass, LS, Ossler, C, Low P. "Evidence-Based Design: The ACOEM Practice Guidelines Dissemination Project." Journal of Occupational and Environmental Medicine 42, no. 4 (2000): 352-61.

Harris, JS, Mueller, KL, Low, P, Peplowski, B, Koziol-McLain, J. "Suggested Improvements in Practice Guidelines: Market Research to Support Clinical Quality Improvement." Journal of Occupational and Environmental Medicine 42, no. 4 (2000): 377-84.

Harris, JS, Mueller, KL, Low, P, Koziol-McLain, J, Ossler, C, Phelan, J, Glass, L. "Beliefs and Use of Occupational Medicine Practice Guidelines among Case Managers and Insurance Adjusters." Journal of Occupational and Environmental Medicine 42, no. 4 (2000): 370-76.

Mueller, KL, Harris, JS, Low, P, Koziol-McLain, J, Peplowski, B. "Acceptance and Self-Reported Use of National Occupational Medicine Practice Guidelines." Journal of Occupational and Environmental Medicine 42, no. 4 (2000): 362-69.