Return to Work program for chronic disease and physical injured commercial vehicle driver in Princess Margaret Hospital

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Authors (including presenting author) :
CHAU SL, Lam PM, WAN YH, Chu WY, Wong YC, Cheng WC
Affiliation :
Occupational Therapy Department, Princess Margaret Hospital, Hospital Authority, Hong Kong
Introduction :
Work rehabilitation (WR) is one of the major components of vocational rehabilitation intervention aimed at re-integrating injured workers with work disability into work. One of the designated work rehabilitation centers has been established in Occupational Therapy department of Princess Margaret Hospital (PMH) since 2003 in Hospital Authority. A new pilot Driver Assessment and Rehabilitation (DR) service has also been launched to enhance the WR for chronic disease and physical injured commercial vehicle driver since 1 Aug 2017.
Objectives :
The pilot program offers a comprehensive range of services include work capacity evaluation, work rehabilitation, driver assessment and rehabilitation and vocational resettlement for physical injured commercial vehicle driver, with an aim to facilitate early return to work (RTW) for our patients.
Methodology :
Before 2017, patients with the need for driving assessment were referred to Community Resource Support Service Centre (CRSSC). The waiting time was about 2-3 months and the whole process of WR took about 6-12 months. The new WR incorporated with DR, implemented by a certified driver assessor (occupational therapist) in Princess Margaret Hospital (PMH), took 2-8 weeks to identify clients whose functional deficits clearly precluded safe driving or could lead to unsafe driving. Driver rehabilitation would be provided to enhance functional driver capacity of clients in PMH, e.g. using driving simulator to train deficit areas in simulated traffic conditions. Complex cases requiring comprehensive assessment or vehicle modification would be referred to CRSSC.
Result & Outcome :
Between the period of 1 Aug 2017 and 31 December 2018, a total of 106 physical injured commercial vehicle drivers (101 males, mean age was 54.1 and 5 females, mean age was 53.8) were included for analysis. They were associated with diverse diagnoses including fracture conditions (28.3%), sprained neck and back (23.6%), cerebrovascular accident CVA (14.2%), Cardiac (9.4%), other neurological and medical problems (13.2%)and others (11.3%). Their occupations included taxi-drivers (28.6%), private or public bus drivers (25.1%), medium or heavy goods vehicles drivers (24.4%) and mini-bus drivers (12.1%) and others (9.8%). 72 of them (67.9%) were subsequently referred to Community Resource Service Support Center (CRSSC) for further comprehensive driver rehabilitation, e.g. on-road assessment, vehicle modification. As of 31 December 2018, patients attended 7.2 sessions of WR. After the comprehensive WR program, 44 clients (41.5%) resumed their original job after RTW program and 12 clients (11.3%) change jobs with different nature. Those failing to resume job were referred for further rehabilitation appropriate for the disease conditions, seeking new job, on legal claims, quitted their job, or retired early. Results of our review suggest that a pilot work-rehabilitation program incorporated with driver rehabilitation can facilitate chronic disease and physical injured workers with substantial work-related problems early back to worker role. Moreover it assists those who have restriction on original commercial vehicle license to explore new vocational plan. New service demands and challenges are emerging from the population of driver rehabilitation for people after sustaining injuries or developing diseases

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