Searching for consensus among physicians involved in the management of sick-listed workers in the Belgian health care sector: a qualitative study among practitioners and stakeholders
Cooperative Behaviour; Attitude of Health Personnel; Delphi Technique; Sick Leave
Abstract :
[en] Background
In Belgium, the management of sick leave involves general practitioners (GPs), occupational health physicians (OPs) and social insurance physicians (SIPs). A dysfunctional relationship among these physicians can impede a patient’s ability to return to work. The objective of this study was to identify ways to improve these physicians’ mutual collaboration.
Methods
Two consensus techniques were successively performed among the three professional groups. Eight nominal groups (NGs) gathered 74 field practitioners, and a two-round Delphi process involved 32 stakeholders.
Results
From the results, it appears that two areas (reciprocal knowledge and evolution of the legal and regulatory framework) are objects of consensus among the three medical group that were surveyed. Information transfer, particularly electronic transfer, was stressed as an important way to improve. The consensual proposals regarding interdisciplinary collaboration indicate specific and practical changes to be implemented when professionals are managing workers who are on sick leave. The collaboration process appeared to be currently more problematic, but the participants correctly identified the need for common training.
Conclusions
The three physician groups all agree regarding several inter-physician collaboration proposals. The study also revealed a latent conflict situation among the analysed professionals that can arise from a lack of mutual recognition. Practical changes or improvements must be included in an extended framework that involves the different determinants of interdisciplinary collaboration that are shown by theoretical models. Collaboration is a product of the actions and behaviours of various partners, which requires reciprocal knowledge and trust; collaboration also implies political and economic structures that are led by public health authorities.
Research center :
UR Soins primaires et Santé
Disciplines :
Public health, health care sciences & services General & internal medicine
Author, co-author :
Vanmeerbeek, Marc ; Université de Liège > Département des sciences cliniques > Médecine générale
Govers, Patrick ; Université de Liège > Département des sciences de la santé publique > Santé au travail et éducation pour la santé (STES)
Schippers, Nathalie ; Université de Liège > Département des sciences de la santé publique > Santé au travail et éducation pour la santé (STES)
Rieppi, Stéphane ; Université de Liège > Département de science politique > Anal. et éval. des politiques publ.-Méthod. de sc. politique
Mortelmans, Katrien; Mensura Occupational Health Services > Department Research & Development
Mairiaux, Philippe ; Université de Liège > Département des sciences de la santé publique > Département des sciences de la santé publique
Language :
English
Title :
Searching for consensus among physicians involved in the management of sick-listed workers in the Belgian health care sector: a qualitative study among practitioners and stakeholders
Giannakouris K: Ageing characterises the demographic perspectives of the European societies. In: Population and social conditions. edn. Luxembourg: Eurostat Statistics in focus; 2008
Waddel G, Burton AK. Is work good for your health and well-being? London: TSO; 2006.
Schofield RF, Amodeo M. Interdisciplinary teams in health care and human services settings: Are they effective? Health Soc Work. 1999;24(3):210-9.
Cashman S, Reidy P, Cody K, Lemay C. Developing and measuring progress toward collaborative, integrated, interdisciplinary health care teams. J Interprof Care. 2004;18(2):183-96.
San Martin-Rodriguez L, Beaulieu MD, D'Amour D, Ferrada-Videla M. The determinants of successful collaboration: A review of theoretical and empirical studies. J Interprof Care. 2005;19 Suppl 1:132-47.
Xyrichis A, Lowton K. What fosters or prevents interprofessional teamworking in primary and community care? A literature review. Int J Nurs Stud. 2008;45(1):140-53.
Schwarz B, Neuderth S, Gutenbrunner C, Bethge M. Multiprofessional teamwork in work-related medical rehabilitation for patients with chronic musculoskeletal disorders. Journal of rehabilitation medicine. 2015;47(1):58-65.
Anema JR, Van Der Giezen AM, Buijs PC, Van Mechelen W. Ineffective disability management by doctors is an obstacle for return-to-work: A cohort study on low back pain patients sicklisted for 3-4 months. Occup Environ Med. 2002;59(11):729-33.
Mortelmans K, Donceel P, Lahaye D. Disability management through positive intervention in stakeholders' information asymmetry. A pilot study. Occupational medicine (Oxford, England). 2006;56(2):129-36.
Mortelmans K. Enhancing work resumption of patients on sub-acute sickness absence. Intervening in information asymmetry among medical stakeholders involved in disability management in Belgium. Leuven: Catholic University Leuven; 2006.
Donceel P. De bijdrage van de verzekeringsgeneeskundige tot de professionele reïntegratie na een heelkundige behandeling van de lumbale wervelzuil. Leuven: Catholic University Leuven; 1999.
De Graeve D, Maes R, Dierckx G, A D: Ziekteverzuim en het toekennen van arbeidsongeschiktheid. In. Brussel: Federale Diensten voor Wetenschappelijke, Technische en Culturele Aangelegenheden; 1995
Mortelmans K, Masschelein R, Moens G. Samenwerking tussen de bedrijfsarts, verzekeringsarts en curatieve arts. Resultaten van een cross-sectioneel onderzoek bij Belgische bedrijfsartsen. Tijdschrift voor Gezondheidswetenschappen. 2004;2:104-11.
Van de Ven AH, Delbecq AL. The nominal group as a research instrument for exploratory health studies. Am J Public Health. 1972;62(3):337-42.
Dalkey NC. The Delphi method: An experimental study of group opinion. Santa Monica, CA: RAND; 1969.
Davies S, Romano PS, Schmidt EM, Schultz E, Geppert JJ, McDonald KM. Assessment of a novel hybrid Delphi and Nominal Groups technique to evaluate quality indicators. Health Serv Res. 2011;46(6pt1):2005-18.
Kadam UT, Jordan K, Croft PR. A comparison of two consensus methods for classifying morbidities in a single professional group showed the same outcomes. J Clin Epidemiol. 2006;59(11):1169-73.
Landeta J, Barrutia J, Aitziber L. Hybrid Delphi: A methodology to facilitate contribution from experts in professional contexts. Technological Forecasting and Social Change. 2011;78:1629-41.
Fink A, Kosecoff J, Chassin M, Brook RH. Consensus methods: Characteristics and guidelines for use. Am J Public Health. 1984;74(9):979-83.
Hsu C-C, Sandford BA. The Delphi technique: Making sense of consensus. Practical Assessment, Research and Evaluation. 2007;12(10):1-8.
Rayens MK, Hahn EJ. Building consensus using the policy delphi method. Policy, Politics, and Nursing Practice. 2000;1:308-15.
Farmer T, Robinson K, Elliott SJ, Eyles J. Developing and implementing a triangulation protocol for qualitative health research. Qual Health Res. 2006;16(3):377-94.
Corbin J, Strauss A. Basics of Qualitative Research. Techniques and Procedures for Developing a Grounded Theory, 3rd edn. Thousand Oaks, CA: SAGE Publications; 2007.
Bardecki MJ. Participants' response to the Delphi method: An attitudinal perspective. Technological Forecasting and Social Change. 1984;25(3):281-92.
Belgian Safe Work Information Center (BeSWIC) [ www.beswic.be/fr[
Yassi A, Ostry AS, Spiegel J, Walsh G, de Boer HM. A collaborative evidence-based approach to making healthcare a healthier place to work. Hosp Q. 2002;5(3):70-8.
Desomer A, Dilles T, Steckel S, Duchesnes C, Vanmeerbeek M, Peremans L, et al. Dissemination and implementation of clinical practice guidelines in Belgium. In: Health Services Research (HSR). Brussels: Belgian Health Care Knowledge Centre (KCE); 2013.
Storms H, Marquet K, Nelissen K, Hulshagen L, Lenie J, Remmen R, et al. Implementing an electronic medication overview in Belgium. BMC research notes. 2014;7:915.
Rudin RS, Motala A, Goldzweig CL, Shekelle PG. Usage and effect of health information exchange: A systematic review. Ann Intern Med. 2014;161(11):803-11.
Kierkegaard P, Kaushal R, Vest JR. How could health information exchange better meet the needs of care practitioners? Applied clinical informatics. 2014;5(4):861-77.
Reíntégration des personnes en incapacité de travail dans la loi-programme 2014 [ http://www.beswic.be/fr/news-board/reintegration[
Santé et bien-être au travail [ http://www.ssmg.be/cellules-specifiques/sante-et-bien-etre-au-travail[
Vingilis E, Forchuk C, Orchard C, Shaw L, King G, McWilliam C, Khalili H, Edwards B, Osaka W: Development, Implementation, and Formative Evaluation of Pre-licensure Workshops Using Participatory Action Research to Facilitate Interprofessional, Client-Centred Mental Healthcare. Journal of research in Interprofessional Practice and education 2011, 2.1(July). http://jripe.org/jripe/index.php/journal/article/viewArticle/37.
Bridges DR, Davidson RA, Odegard PS, Maki IV, Tomkowiak J. Interprofessional collaboration: Three best practice models of interprofessional education. Medical education online. 2011;16.
Cook K, Stoecker J: Healthcare Student Stereotypes: A Systematic Review with Implications for Interprofessional Collaboration. Journal of research in Interprofessional Practice and education 2014, 4.2(November). http://www.jripe.org/index.php/journal/article/viewArticle/151.
Fassin D: Du déni à la dénégation. Psychologie politique de la représentation des discriminations. In: De la question sociale à la question raciale ? Edited by Fassin D, Fassin E. Paris: La Découverte; 2006
Mairiaux P, Vanmeerbeek M, Schippers N, Denoël P, Tiedtke C, Mortelmans K, et al: Collaboration improvement between general practitioners, occupational physicians and insurance medical advisors for a better management of occupationnal diseases. In. Brussels: Federal Public Service Employment, Labour and Social Dialogue; 2011
Honneth A. The struggle for recognition. The moral grammar of social conflicts. Cambridge: Polity Press; 1995.
de Rijk A, van Raak A, van der Made J. A new theoretical model for cooperation in public health settings: The RDIC model. Qual Health Res. 2007;17(8):1103-16.
D'Amour D, Goulet L, Labadie JF, Martin-Rodriguez LS, Pineault R. A model and typology of collaboration between professionals in healthcare organizations. BMC Health Serv Res. 2008;8:188.
Bodewes WEJ. Formalization and innovation revisited. European Journal of Innovation Management. 2002;5(4):214-23.
Young IM. Responsibility and Global Labor Justice. Journal of Political Philosophy. 2004;12(4):365-88.