Jetha Arif, Pransky Glenn, Fish Jon, Hettinger Lawrence J
Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
Department of Work Environment, University of Massachusetts-Lowell, One University Avenue, Lowell, MA, 01854, USA.
J Occup Rehabil. 2016 Sep;26(3):276-85. doi: 10.1007/s10926-015-9613-2.
Background Return-to-work (RTW) within a complex organizational system can be associated with suboptimal outcomes. Purpose To apply a sociotechnical systems perspective to investigate complexity in RTW; to utilize system dynamics modeling (SDM) to examine how feedback relationships between individual, psychosocial, and organizational factors make up the work disability system and influence RTW. Methods SDMs were developed within two companies. Thirty stakeholders including senior managers, and frontline supervisors and workers participated in model building sessions. Participants were asked questions that elicited information about the structure of the work disability system and were translated into feedback loops. To parameterize the model, participants were asked to estimate the shape and magnitude of the relationship between key model components. Data from published literature were also accessed to supplement participant estimates. Data were entered into a model created in the software program Vensim. Simulations were conducted to examine how financial incentives and light duty work disability-related policies, utilized by the participating companies, influenced RTW likelihood and preparedness. Results The SDMs were multidimensional, including individual attitudinal characteristics, health factors, and organizational components. Among the causal pathways uncovered, psychosocial components including workplace social support, supervisor and co-worker pressure, and supervisor-frontline worker communication impacted RTW likelihood and preparedness. Interestingly, SDM simulations showed that work disability-related policies in both companies resulted in a diminishing or opposing impact on RTW preparedness and likelihood. Conclusion SDM provides a novel systems view of RTW. Policy and psychosocial component relationships within the system have important implications for RTW, and may contribute to unanticipated outcomes.
背景 在复杂的组织系统中重返工作岗位（RTW）可能会带来不尽人意的结果。目的 应用社会技术系统视角来研究RTW中的复杂性；利用系统动力学建模（SDM）来检验个体、心理社会和组织因素之间的反馈关系如何构成工作残疾系统并影响RTW。方法 在两家公司内开发了SDM。包括高级经理、一线主管和工人在内的30名利益相关者参与了模型构建会议。向参与者提出问题，引出有关工作残疾系统结构的信息，并将其转化为反馈回路。为了对模型进行参数化，要求参与者估计关键模型组件之间关系的形式和大小。还查阅了已发表文献中的数据以补充参与者的估计。将数据输入在Vensim软件程序中创建的模型。进行模拟以检验参与公司所采用的经济激励措施和与轻工作残疾相关的政策如何影响RTW的可能性和准备情况。结果 SDM是多维的，包括个体态度特征、健康因素和组织组件。在所发现的因果路径中，心理社会组件，包括工作场所的社会支持、主管和同事的压力以及主管与一线工人的沟通，影响了RTW的可能性和准备情况。有趣的是，SDM模拟表明，两家公司中与工作残疾相关的政策对RTW准备情况和可能性产生了递减或相反的影响。结论 SDM为RTW提供了一种新颖的系统视角。系统内的政策和心理社会组件关系对RTW具有重要意义，并且可能导致意外结果。
