Carrougher Gretchen J, Brych Sabina B, Pham Tam N, Mandell Samuel P, Gibran Nicole S
From the *Department of Surgery, University of Washington, Seattle; and †Department of Burn and Plastic Surgery Outpatient Clinic, University of Washington, Seattle.
J Burn Care Res. 2017 Jan/Feb;38(1):e70-e78. doi: 10.1097/BCR.0000000000000410.
Rates of return to work (RTW) after burn injury vary. A 2012 systematic review of the burn literature reported that nearly 28% of all adult burn survivors never return to any form of employment. These authors called for interventions designed to assist survivors' ability to function in an employed capacity. In 2010, our burn center outpatient clinic instituted an intervention aimed to return injured workers to employment within 90 days of their insurance claims. The interventions include patient/family education focused on recovery rather than disability, employer contact and education by the vocational rehabilitation (VR) counselor, physician recommendations for work accommodations, provision of employee status letters, and Activity Prescription Forms (APFs). The purpose of this study is to report on the effectiveness of these interventions. Following institutional review board (IRB) approval, medical records of adults with occupation-related burn injuries and receiving care at a single regional burn center from June 2010 to July 2015 were reviewed. Data on patient and injury characteristics and outpatient VR services provided were collected. The primary outcome of interest was the percentage of patients who RTW; 338 individuals met study entry criteria. The VR counselor evaluated all patients. All patients received an employer letter(s) and APF documentation. Workplace accommodations were provided to more than 30% of patients. RTW rate was 93%, with an average of 24 days from injury to RTW. In an intervention bundle involving the patient, employer, Workers' compensation, and the burn clinic staff, injured workers achieved a high rate of RTW. Although we cannot correlate individual bundle components to outcome, we postulate that the combination of employer/employee/insurer engagement and flexibility contributed to the success of this program.
烧伤后重返工作岗位（RTW）的比率各不相同。2012年对烧伤文献的一项系统综述报告称，几乎28%的成年烧伤幸存者从未恢复任何形式的工作。这些作者呼吁采取干预措施，以帮助幸存者具备就业能力。2010年，我们烧伤中心的门诊设立了一项干预措施，旨在让受伤工人在提出保险索赔后的90天内重返工作岗位。这些干预措施包括以康复而非残疾为重点的患者/家庭教育、职业康复（VR）顾问与雇主的联系和教育、医生对工作便利条件的建议、提供员工状况信函以及活动处方表（APF）。本研究的目的是报告这些干预措施的有效性。在获得机构审查委员会（IRB）批准后，对2010年6月至2015年7月在单一地区烧伤中心接受治疗的与职业相关烧伤的成年患者的病历进行了审查。收集了患者和损伤特征以及所提供的门诊VR服务的数据。主要关注的结果是RTW患者的百分比；338名个体符合研究纳入标准。VR顾问对所有患者进行了评估。所有患者都收到了雇主信函和APF文件。超过30%的患者获得了工作便利条件。RTW率为93%，从受伤到RTW的平均时间为24天。在一个涉及患者、雇主、工人赔偿和烧伤诊所工作人员的干预组合中，受伤工人实现了较高的RTW率。虽然我们无法将各个组合成分与结果相关联，但我们推测雇主/员工/保险公司的参与和灵活性的结合促成了该项目的成功。
