Unit of Social Work, Department of Social Sciences, Södertörn University, Huddinge, Sweden.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2023 Aug 10;18(8):e0290021. doi: 10.1371/journal.pone.0290021. eCollection 2023.
In recent decades, many countries have implemented return-to-work coordinators to combat high rates of sickness absence and insufficient collaboration in the return-to-work process. The coordinators should improve communication and collaboration between stakeholders in the return-to-work process for people on sickness absence. How they perform their daily work remains unexplored, and we know little about to what extent they collaborate and perform other work tasks to support people on sickness absence. This study examines which work models return-to-work coordinators use in primary healthcare, psychiatry and orthopaedics in Sweden.
A questionnaire was sent to all 82 coordinators in one region (89% response rate) with questions about the selection of patients, individual patient support, healthcare collaboration, and external collaboration. Random forest classification analysis was used to identify the models.
Three work models were identified. In model A, coordinators were more likely to select certain groups of patients, spend more time in telephone than in face-to-face meetings, and collaborate fairly much. In Model B there was less patient selection and much collaboration and face-to-face meetings. Model C involved little patient selection, much telephone contact and very little collaboration. Model A was more common in primary healthcare, model C in orthopaedics, while model B was distributed equally between primary healthcare and psychiatry.
The work models correspond differently to the coordinator's assignments of supporting patients and collaborating with healthcare and other stakeholders. The differences lie in how much they actively select patients, how much they collaborate, and with whom. Their different distribution across clinical contexts indicates that organisational demands influence how work models evolve in practice.
近几十年来，许多国家都设立了重返工作岗位协调员，以应对高病假率和重返工作过程中协作不足的问题。协调员应改善病假员工重返工作过程中各利益相关者之间的沟通和协作。他们如何开展日常工作仍未得到探索，我们也不太了解他们在多大程度上协作并执行其他工作任务来支持病假员工。本研究考察了瑞典初级保健、精神病学和骨科中，重返工作岗位协调员使用的工作模式。
向一个地区的所有 82 名协调员（响应率为 89%）发送了一份问卷，内容涉及患者选择、个体患者支持、医疗保健协作和外部协作。采用随机森林分类分析来识别工作模式。
确定了三种工作模式。在模式 A 中，协调员更倾向于选择某些患者群体，在电话会议上花费的时间多于面对面会议，并且协作程度相当。在模式 B 中，患者选择较少，协作和面对面会议较多。模式 C 涉及较少的患者选择，更多的电话联系和很少的协作。模式 A 在初级保健中更为常见，模式 C 在骨科中更为常见，而模式 B 在初级保健和精神病学中分布均匀。
工作模式与协调员支持患者和与医疗保健及其他利益相关者协作的任务分配方式不同。差异在于他们主动选择患者的程度、协作的程度以及与谁协作。它们在不同临床环境中的分布表明，组织需求影响了工作模式在实践中的演变方式。
