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As an occupational health physician helping patients return to function
and to work for more than 20 years, PWR's Dr. Lisa Doupe has a
unique understanding of systemic barriers. She consults with
corporations, communities and governments to identify and resolve
roadblocks. The result is enhanced individual functioning, more
productive workplaces and healthier and safer communities.

Consulting to Organizations

The productivity of people in the workplace increases and the
frustration of managers and workers decreases when organizations
manage organizational health, including the delivery of health care to
workers, and health care costs. PWR can help organizations achieve
significant improvements in productivity through:

• Worker and Workplace Injury Prevention and Rehabilitation
  Programs: PWR will develop and implement best practice
  programs and create feedback loops within the organization to
  prevent other incidents.  When an injury occurs, the feedback
  loop will communicate relevant information to relevant groups,
  such as senior management, occupational health physicians
  and other health care personnel, human resources, engineering,
  and operations.
  
  
• Health Audits: Using a workplace health audit tool, PWR will
  identify the costs - both measurable and hidden -- of ill health,
  disablement and injury in the workplace.
  
  
• Corporate Occupational Business Plans: Productivity gains are
  made when occupational health objectives are aligned with the
  overall business strategy. PWR will work with all workplace
  stakeholders - including senior managers, occupational health
  personnel and union representatives - to develop and
  implement an occupational health business plan that supports
  and strengthens business goals.

Consulting to Communities and Government

Communities and governments have turned to Dr. Doupe to engage
and mobilize stakeholders to work together to remove system barriers
and align their policies and procedures to facilitate safe and timely
return to function and return to work.

• Durham Regional Community Project on Return to Work
  
  
• Physician Education Project in Workplace Health
  
  
• Round Table Projects on Safe and Timely Return to
  Function/Return to Work

1) Durham Regional Community Project on Return to Work   top

Large employers in Durham Region have identified their community
as a pilot site for implementing an initiative that will meet the needs of
local physicians who provide health care to the employers' injured, ill
or disabled workers. A draft vision statement has been developed:
"Strengthening communities by improving the trust and
communication between workplace parties and health care
practitioners." PWR's Dr. Lisa Doupe is a consultant to this process.

2) Physician Education Project in Work & Health   top

As chair of the Ontario Medical Association Section on Occupational
and Environmental Medicine in 1994, Dr. Doupe was instrumental in
setting up a multi-stakeholder initiative, the Physician Education
Project in Workplace Health (PEPWH), {during a stagetgy planning
session 2002 the name was changed to Physician Education Project
in Work & Health} designed to educate physicians about return to
work. At the time, no information or resources were available to
physicians on this subject. The project was set-up in collaboration
with the Institute for Work & Health. Today, PEPWH receives funding
from the Workplace Safety and Insurance Board.

The Project recently published a guide to help physicians assist their
patients in return to work. Injury/Illness and Return to Work/Function: A Practical Guide for Physicians provides information on:

• the physician's role,
  
  
• effective communication with patients, other health
  professionals, employers, government agencies and private
  insurers,
  
  
• goals of rehabilitation and factors affecting patient outcomes,
  
  
• developing a return-to-work plan,
  
  
• availability of income support for patients,
  
  
• documenting and reporting, and
  
  
• key references and resources.

The guide also serves as a resource to other health professionals.

Partners, Physician Education Project in Work & Healthtop

Lead partner:

• Ontario Medical Association Section on Occupational
  and Environmental Medicine

Other partners:

• Ontario Ministry of Labour
• University of Western Ontario
• Employers' Advocacy Council
• University of Toronto
• Workers Health and Safety Centre
• McMaster University and LAMP Occupational Health
  Program
• Canadian Life and Health Insurance Association
• PWR Health Consultants
• Workplace Safety and Insurance Board
• Stelco Inc.
• Ontario Medical Association
• Institute for Work & Health
• Human Resources Development Canada
• Ontario College of Family Physicians
• Ontario Federation of Labour

3) Round Table Project I, II and III on Safe and Timely Return to
Function/Return to Work   top

PWR facilitates the Round Table Project, a multi-stakeholder group
working together to support persons with disabilities in a safe and
timely return to life activities and to work. The major funding partner is
the Federal Government through Human Resources Development
Canada, in cooperation with the Ontario Medical Foundation (OMF).

Stakeholder organizations were invited to participate on the basis of
their significant role in supporting persons with disabilities. The 12
stakeholder groups were persons with disabilities, their families,
voluntary sector, Aboriginals, health care providers, insurers,
consumers, employers, labour (unionized and non-unionized),
academia/research, and the Federal and Provincial governments.

At the first Round Table meeting in April 1998, more than 20
stakeholders learned about each other's roles and identified
preliminary opportunities to work together. They agreed that the
Round Table process should continue and that the focus of effort for
the next phase should be the development of a vision, a common
language and a client-centred service delivery model on safe and
timely return to function/return to work (RTF/RTW).

At the second Round Table meeting in September 1999, stakeholder
organizations developed a vision:

During the meeting, stakeholders formed a strategic action group to
develop the components of an effective, integrated, cross-sector
model of service delivery for safe and timely RTF/RTW.

McMaster University, a Round Table partner and stakeholder, led a
research project on improved service delivery. McMaster researchers
consulted with Round Table stakeholders to identify opportunities
where they could collaborate and cooperate in service delivery to
persons with disabilities. The opportunities involved two-way and
some three-way partnerships between and among stakeholders.

The objective of Round Table Project, Phase III, which commenced in
November 2001, is to test pilot a community-based model for service
delivery to persons who are ill, disabled or injured in the workplace.

As the framework for the service delivery model was being developed
in consultation with stakeholders, an environmental scan, Round Table Project on Safe & Timely Return to Function/Return to Work Phase III Environmental Scan, June 2002 (link here to next page) of recent trends and developments in safe and timely return to function/return to work (RTF/RTW) was conducted. The pace of
change in this area has been rapid in recent years and it was
expected these changes would have significant implications on the
development and implementation of a cost-effective service delivery
model by the Round Table Project.

Six broad developments and trends that impact and cut across all
stakeholder sectors were identified: emergence of a systems approach
to solving community problems; alignment of visions and values that
are inclusive of all Canadians; the re-definition of medicine by
medicine include return to function and return to work; a paradigm shift
from disability and mortality to ability and life; the emergence of
evidence-based models in RTF/RTW; and growing evidence that
individual health drives economic productivity.

The authors make initial observations of the implication of the scan to
a service delivery model.

• In developing the Round Table change process, stakeholders
  may want to consider the evidence-based change used by the
  Tacoma/Deming Partnership in the late 1990s.
• The alignment of vision and values lays a firm foundation for
  action that will lead to the full inclusion of PWDs into the
  workplace, community and society.
• Medicine, a major stakeholder sector, is recognizing the need to
  integrate return to function/return to work in its system and has
  indicated an openness to partner with other stakeholders to find
  solutions to disability issues.
• Evidence-based models, such as the Sherbrooke/PREVICAP
  models in Quebec, provide a tremendous resource as the
  Round Table Project develops a service delivery model for
  PWDs (Persons With Disabilities).
• The ground-breaking work in the area of health and productivity
  is making the connection between the contribution of people’s
  health to economic productivity and has tremendous
  implications for the way in which stakeholder sectors meet the
  needs of not only PWDs but of all people.

The authors conclude that the time to act is now to create a system
that reflects our collective vision for PWDs in Canada.

Knowledge from the environmental scan was communicated to
stakeholders in the Fall 2002. They had an opportunity
to sift-and-sort through the knowledge together (in contrast to the
traditional silo approach to policies and programs) and to develop a
service delivery model for PWDs. In the next phase of the project, the
service delivery model will be implemented in a community setting and
stakeholder will have an ongoing opportunity to provide feedback to
researchers, thereby creating a continuous improvement process.

1. Round Table Project on Safe and Timely Return to Function/
   Return to Work, Phase I Report, June 1998. Executive Summary
   Click here for the full report.
   
   
2. Round Table Project on Safe and Timely Return to Function/
   Return to Work, Phase II Report, March 31, 2000. Executive
   Summary
   Click here for the full report.
   
   
3. Round Table Project on Safe and Timely Return to Function
   Return to Work, Phase III report, Environmental Scan
   
   
4. Round Table Project Moving to Health and Productivity: A Systems Approach to Removing Barriers for Persons with Disabilites Fourth Quarter and Final Report submitted to HRDC Ontario Region, November 2003. Executive Summary.
   Click here for the full report.
   
   

Round Table Project: Partners and Sponsors       top

Round Table I, II, III, Lead Partner and Sponsor:

• Human Resources Development Canada

Round Table I, Partner and Sponsor:

• Ontario Medical Foundation

Stakeholders:

• Assembly of First Nations
• Canadian Association of
  Rehabilitation Professionals
• Canadian Life and Health Insurance Association
• Consumers' Association of Canada
• Employers' Advocacy Council
• McNeil Consumer Products
• Occupational and Environmental Medical Association of
  Canada
• Ontario Insurance Commission
• Ontario Medical Association Section on Occupational
  and Environmental Medicine
• Ontario Ministry of Health
• Persons with a disabilities
• Rehabilitation Council of Ontario
• Ontario Psychological Association
• Toronto Transit Commission
• Workplace Safety and Insurance Board 
• PWR Health Consultants

Round Table II, Partners and Sponsors:

• McMaster University
• Glaxo Wellcome {now Glaxo Smith Klein}
• Rehabilitation Council of Ontario
• Ontario Medical Association

Stakeholders:

• Person with mobility impairment
• Ontario Network of Injured Workers Groups
• Schizophrenia Society of Canada
• Family member of person with disability
• Assembly of First Nations
• Canadian Association of Rehabilitation Professionals
• Occupational and Environmental Medical Association of
  Canada
• Ontario Medical Association
• Rehabilitation Council of Ontario
• Canadian Life and Health Insurance Association
• Glaxo Wellcome
• Employers' Advocacy Council
• Alliance of Manufacturers and Exporters Canada
• Canadian Federation of Independent Business
• Ontario Federation of Labour
• Human Resources Development Canada
• Health Canada
• Ontario Ministry of Community and Social Services
• Ontario Ministry of Health
• McMaster University
• Roeher Institute (York University)
• Workplace Safety and Insurance Board
• Consumers' Association of Canada

Observers:

• Canadian Medical Association
• Office of the Employer Adviser (Ontario Ministry of Labour)
• Office of Worker Adviser (Ontario Ministry of Labour)
• Ontario Ministry of Citizenship, Culture and Recreation

Research partners:

• Dr. Harold E. Hoffman, Occupational and Environmental
  Medicine, University of Alberta
• Dr. Tee Guidotti, Chair, Department of Environmental and
  Occupational Health, School of Public Health and Health
  Services, George Washington University.

Round Table III, Partners: To Be Confirmed top