Project Results

Public Policy Goal:

To explore the feasibility of establishing a California Work Injury Center to improve the quality of medical care workers with occupational injuries.

Project Description:

The California Department of Industrial Relations (DIR) and the Public Health Institute are exploring the feasibility of establishing a California Work Injury Resource Center (CWIRC). The function of the Center would be to educate the community on issues related to quality of care for injured workers; to convene meetings of California researchers to foster interest in research related to quality of care; and to work with stakeholders to develop a model workers' compensation medical quality improvement project.

Key Findings or Accomplishments:

• Despite an environment in which cost containment concerns were more prominent than quality concerns, this project helped create a greater awareness of both quality problems in the workers' compensation system in California and likely strategies and steps that would be necessary to start measuring, reporting and improving quality.
• Focus groups and a workshop were held to discuss quality of care issues in workers' compensation. One outgrowth of the workshop was an Ad Hoc Work Group on Quality Improvement consisting of the medical directors of the largest provider organizations and networks in the state. This group met and conferred twice to identify early steps in developing standardized quality indicators which could serve as base performance measurement for medical care in workers' compensation.
• All of the stakeholders in workers' compensation were concerned about and dissatisfied with the current quality of care in California, but do not necessarily agree about the cause.
• The project identified four areas or themes for future work:
  • Ensure access to care for all injured workers;
  • Establish systems of accountability for the quality of health care for injured workers;
  • Create incentives for quality and remove system barriers to quality;
  • Provide an infrastructure for quality improvement.

Tools Developed:

Bibliography of references on measuring and improving the quality of health care

Reports and Publications:

Rudolph, L, Dervin, K, Cheadle, A, Maizlish, N, Wickizer, T. "What Do Injured Workers Think About Their Medical Care and Outcomes after Work Injury?" Journal of Occupational and Environmental Medicine, Vol 44, Number 5, May 2002. Appears at Division of Workers' Compensation

Rudolph, Linda, Dervin, Kathy, Cheadle, Allen, Maizlish, Neil, Wickizer, Thomas. "Injured Worker Satisfaction with Care in a 24-Hour Pilot Program." Division of Workers' Compensation, California Department of Industrial Relations, December 2000.

Rudolph, Linda, Dervin, Kathy, Cheadle, Allen, Maizlish, Neil, Wickizer, Thomas. "What Do Injured Workers Think About Their Medical Care and Outcomes after Work Injury?" Division of Workers' Compensation Research Brief (May 2001).

  Rudolph, L, Dervin, K. "Executive Summary of Workers' Compensation Quality of Care Project." Final Technical Report to Robert Wood Johnson Foundation, Workers' Compensation Health Initiative, San Francisco, CA, 2001.

Rudolph, L, Linford-Steinfeld, J, Dervin J. "Utilization Review in California's Workers' Compensation System: A Preliminary Assessment." San Francisco, CA, July 2001. Appears at Division of Workers' Compensation

Improving the Quality of Care for Injured Workers in California: Focus Group Discussions, published November 2001.