INTRODUCTION: Disability management involves is dynamic interactional strategies used to promote an individual’s return to work. These strategies revolve around the person’s health condition and contextual factors for example their employer and the work environment. However, there remains limited literature on the strategies used in the public healthcare sector. Objective: To explore the return to work strategies used at a public sector facility in the province of KwaZulu Natal, South Africa. METHOD: A case study design, with multiple sources of data contributed towards profiling disability management strategies implemented at a central quaternary health care facility. Data collection methods included a file audit, work ability index assessments and semi-structured interviews with employees. Saturation sampling was used to recruit n = 23 employees who had been referred for occupational therapy vocational assessments over a period of 10 years. Data from the file audit were analysed using descriptive statistics and interviews were analysed using thematic analysis. RESULTS: Fifty six percent (n = 38) of the participants that were currently employed at the institution scored between 28 and 38 (moderate) on the Work Ability Index and required job realignments and reasonable accommodations within their current vocations. Twenty two percent (n = 5) scored 7–9 (poor) and were medically boarded or on long-term incapacity leave. CONCLUSIONS: Occupational therapists play a significant role in disability management within public health care facilities. Return to work strategies and reasonable accommodations can improve productivity in the workplace.
Background: Job retention, long-term absenteeism and medical boarding pay-outs are significant concerns for employers with- in the public health care sector of South Africa. Objective: To describe disability management policies, procedures and programmes of employees following impairment and disability in a public-private healthcare facility in South Africa. Methods: An exploratory qualitative study design was used with key informants in senior management and nursing managers (n=12) selected via purposive sampling. Audio-recorded data from semi-structured interviews and a focus group were themati- cally analysed using inductive reasoning. Results: There is poor adherence to occupational health and disability management policies and the current referral process is informal with managers using discretion to manage employees with ill health and acquired disability. The procedures prescribed in the policy and procedure on incapacity and ill-health-retirement need to be followed, and an early return to work programme within the health care facility needs to be implemented. Conclusions: Despite South Africa having many policies on recruitment and reasonable accommodations, there is a lack of implementation of these policies. An integrated disability management policy and programme encompassing health prevention, early return to work strategies, vocational rehabilitation and the implementation of reasonable accommodation is required to ensure that employees who have acquired disabilities or ill health are successful in the workplace. Keywords: Disability management; vocational assessments; return to work.
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