The implementation of clinical guidelines concerning return to work after myocardial infarction.

PURPOSE: To examine the implementation, clinical effects, and adherence of occupational physicians to the clinical practice guidelines (CPG) published in 2003 in Israel, regarding return to work following acute myocardial infarction (AMI). METHODS: We analyzed 3 populations referred to Maccabi Health Services occupational clinics for fitness for work examinations following AMI, either before the guidelines were published (group 1), after their first publications in 2003 (group 2) or after they were re-published in Harefuah Journal in 2007 (group3). RESULTS: The documentation among groups 1,2,3 of different parameters like years of education (18.8%, 45.1%. 57.5%, p < 0.001), type of occupation (86.5%, 98.2%, 100.0%, p < 0.001) and New York Heart Association (NYHA) class (69.8%, 81.4%, 92.5%, p < 0.001) has all improved respectively over the years. No significant difference in sick leave was noted between the three populations. CONCLUSION: The CPG should be interdisciplinary in the phase of writing and publication. Economical resources are needed in order to implement CPG.Implications for RehabilitationThe clinical practice guidelines should be interdisciplinary in the phase of writing and should involve all rehabilitation professionals as a team.The clinical practice guidelines need disseminating widely alongside a resource plan in order to implement it.

Fitness for work during the COVID-19 disease: principles and suggested assistive tool for protecting workers during the pandemic era.

OBJECTIVE: Amongst the many intricacies engendered by the COVID-19 pandemic was the posed risk of exposure to SARS-COV2 infections among workers and the need to evaluate fitness for work (FFW) of individuals in high exposure groups or those with background morbidity. A designated task force of the Israeli Association of Occupational Medicine has evaluated the relevant literature and published guidelines concerning medical work restrictions for employees in high-risk occupations during the epidemic of novel COVID-19. METHODS: The study depicts a case series of 17 FFW evaluations performed in Maccabi Health Services occupational clinics using the guidelines formulated by the Israeli Occupational Medicine Association. RESULTS: 17 patients, mainly healthcare workers, whose major health hazards were immunodeficiency, respiratory diseases and pregnancy, were assessed in this case series. We present the essential parameters of these FFW evaluations and discuss decision-making in selected cases. CONCLUSIONS: Applying guidelines in various work settings and health risk levels during the SARS-CoV-2 pandemic allows for both patients' health preservation and efficient workforce deployment.