RESUMO
The perceptions of service providers involved in case management services are described here. The service providers included claims managers, occupational nurse consultants, attending physicians, and nurse case managers. The purposes of this phase of the study were to describe these providers' perceptions about the case management program; to organize findings according to the quality assessment model that guided this study (including structure, function, and outcomes); and to identify barriers and facilitators to satisfaction with case management services. Structural factors that affected services included the workers' compensation system, construction of the service team, roles within the program, and individual attributes of service providers. Process factors were conflicts among parties, role of communication, and interaction with workers. Outcomes were described in terms of program efficiency and effectiveness. Data are used to illustrate and explain each of these themes.
Assuntos
Acidentes de Trabalho , Administração de Caso/organização & administração , Doenças Profissionais/enfermagem , Enfermagem do Trabalho/organização & administração , Humanos , Avaliação de Programas e Projetos de Saúde , Washington , Ferimentos e Lesões/enfermagemRESUMO
A major goal of case management programs is the worker's timely return to work. Few studies have examined return to work from the perspective of the injured worker. This article describes the findings from the case management evaluation that describe the return to work experience of workers who sustained catastrophic injuries, or who had secondary conditions or complications following the injury occurrence. Among the factors determined to affect the return to work experience were structural factors (i.e., psychosocial variables including job satisfaction and relationship with employer and coworkers, financial pressures, and system issues such as securing benefits) and process factors (i.e., interaction with service providers and with the workers' compensation system). Outcomes are described in terms of satisfaction with services and return to work.
Assuntos
Absenteísmo , Acidentes de Trabalho , Administração de Caso/organização & administração , Enfermagem do Trabalho/organização & administração , Satisfação do Paciente , Reabilitação Vocacional/normas , Ferimentos e Lesões/enfermagem , Ferimentos e Lesões/psicologia , Humanos , Pesquisa em Avaliação de Enfermagem , Avaliação de Processos e Resultados em Cuidados de Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Washington , Indenização aos Trabalhadores , Ferimentos e Lesões/reabilitaçãoRESUMO
This article describes the findings from a study of injured workers conducted as part of a multifaceted evaluation study of a case management program. The sample consisted of workers who filed a workers' compensation claim between January 1 and September 30, 1995. Data collection consisted of written surveys (n = 45), personal interviews (n = 27), and telephone interviews (n = 16). The findings from this study provided many insights into the injured workers' personal and work experiences, and, in particular, their perceptions of their experience with the nurse case management program. Workers satisfied with services described the nurse case manager (NCM) as having the ability to see the "big picture," to develop appropriate goals, and to anticipate client needs. Dissatisfied workers reported feeling unimportant in terms of service provision. They reported feeling that "the system" did not respond to their needs, and that the NCM was uninterested and disrespectful. This vivid portrayal of workers' experiences and perceptions of case management services provides valuable information about the world view of the injured worker.