Moving toward virtual interdisciplinary teams and a multi-stakeholder approach in community-based return-to-work care

More efforts are needed to help stakeholders who are geographically isolated from one another become more collaborative in their approach to return-to-work (RTW). A review of the literature on team processes, and insights from the experiences of a federally funded Round Table Project on Safe and Timely Return to Function and Return to Work were used to inform strategies that might enhance collaboration among health professionals and stakeholders in injury and illness management and return-to-work. A case study serves to highlight the individual, identifies the problem and provides a potential solution at the broader service and system levels. It becomes evident that there is a need for a common language as well as policies that emphasize the importance of fostering awareness of interprofessional potentials and contributions of all stakeholders. Establishing shared goals, and building capacity for sustaining collaboration when multi-stakeholders do not function in the same physical location, but work virtually, might maximize effectiveness, efficiency and productivity.     

Towards improved measurement of cognitive and behavioural work demands

Determination of the cognitive and behavioural demands of work is an important part of holistic workplace intervention. Attention to these factors is especially important when developing return-to-work programs for persons with reduced cognitive, behavioural or psycho-emotional capacity, and when designing risk management programs in organizations. Occupational therapists have the background knowledge and skills to assess these components of work, but often lack valid and reliable measurement tools. This paper reports on three field studies that assessed the reliability and validity of ratings made by novice users of the City of Toronto Job Demands Analysis, which includes a measure of cognitive and behavioural work demands. Numerous challenges to accuracy and reliability that are common to empirical measurement were disclosed, including the necessity for clear and strong definitions, and the importance of thorough rater training. Implications for therapist training and mentorship are discussed.     

Work–Family Conflict,Job Insecurity,and Health Outcomes Among US Workers

Previous scholarship has highlighted how work–family conflict (work-to-family conflict and family-to-work conflict) and job insecurity interfere with health outcomes. Little work, however, considers how these stressors jointly influence health among workers. Informed by the stress process model, the current study examines whether job insecurity moderates the relationships between work-to-family conflict and family-to-work conflict and two health outcomes: self-reported physical health and poor mental health. The analyses also consider whether a greater moderating role is played by work-to-family conflict or family-to-work conflict. Using data from the 2008 National Study of the Changing Workforce, we also examine if patterns diverge by gender. Our results show that work-to-family conflict and family-to-work conflict have direct effects on poor mental and physical health. Additionally, we find that the negative effect of work-to-family conflict on poor mental and physical health is stronger for those with job insecurity, while no such relationship was found for family-to-work conflict. We found no evidence of significant gender differences in how these relationships operate. Overall, we contribute to the literature by testing the combined effects of both forms of work–family conflict and job insecurity on poor mental and physical health. We also deepen the understanding of the stress process model by highlighting the salience of the anticipatory stressor of job insecurity.     

Examining Associations Between Discrimination,Social Cohesion,and Health among White LGBT versus POC LGBT Chicagoans

Consistent with the minority stress perspective, lesbian/gay, bisexual, and transgender (LGBT) individuals on average report worse health than heterosexual individuals in several domains, for example, general health, mental health, physical health, and healthcare access. Intersectionality-based research shows that LGBT people of color (POC) are, on average, at even greater risk for adverse health outcomes. Discrimination and social cohesion may be two mechanisms underlying these between- and within-group disparities, given that both constructs are frequently reported within marginalized populations, and that both broadly relate to health. This study used data from the Chicago Department of Public Health to examine broad health differences between White LGBT and LGBT POC, and to test specific models in which social cohesion mediated links between discrimination and health. LGBT POC reported experiencing worse general health, lower access to health care, more experiences of discrimination, and lower feelings of social cohesion than did White LGBT individuals. No mediation effects emerged; however, there was a direct effect of experiencing discrimination on mental health distress. Discrimination exposure inversely related to the feelings of social cohesion.     

Development of a Prediction Model for Hospital Closure Using Financial Accounting Data*

Numerous research studies have examined the use of financial accounting data in the prediction of corporate bankruptcy. Partly due to a lack of available data, however, little work has been done in developing a closure prediction model specifically for hospitals. Using cost reports from the Health Care Financing Administration and a sample of 71 closed hospitals and a matched sample of 71 open hospitals, the current study examines the relationship between 21 financial accounting ratios and hospital closure. Univariate logit results indicate that hospital closure is significantly related to 17 of the 21 ratios one year prior to closure. Results are also presented using a multivariate model, and for the relationships two years prior to closure. The current study provides information helpful to users in identifying financial variables which may be important indicators of hospital closure.