Facet      

Description                                            

Program outline

Abilita Program[15] provides a comprehensive system of resources for Workplace Rehabilitation Providers (WRP) to undertake psychosocial triage screening, comprehensive psychosocial assessment, with self-help skills coaching integrated into workplace rehabilitation.

Initial screening / triage

•Workers with psychological injury were referred for Workplace Rehabilitation. WRP utilised ARI.PI at Initial Assessment to prepare matched-care rehabilitation plan.

•A limited number of cases were screened and triaged as the majority were referred late when problems were evident.  

•Majority of cases referred late in claim (median 45 weeks post-injury).

•Abilita's online 7-item triage questionnaire (AB-7) predicts if ARI.PI will identify psychosocial risk factors. It can be used from week 2 post-injury.

Matched care intervention

Overall system:

ARI.PI, the assessment tool, is completed online by worker to identify and measure psychosocial risk factors. The initial Report uses this information to provide a total score out of 200 and the DASS21 subscales. The report collates the responses into chart of 5 biopsychosocial domains; Function, Emotions, Coping, Confidence, Work Perceptions – all amenable to change; with domain Occupational Factors measuring worker and workplace characteristics that inform risk but have minimal capacity to change. The report is used to support the next steps of psychosocial matched care.  

 1. Biopsychosocial Counselling:

•Initial and Profile Reports guide tailored rehabilitation plan

•Coaching content from 16 topics, selected and delivered using Abilita Biopsychosocial Coaching protocol.

•Coaching quantity: 2 to 8 hours based on ARI.PI score

•ARI.PI Impact assessment compares results after Coaching.

 2. Extra healthcare support:

•Runs parallel to medical or allied health interventions

•Communication and collaboration with treatment providers

•High ARI.PI or high DASS 21 triggers additional psychological referral

 3. Extra workplace support:

•Delivered by WRP to address needs of both worker and employer

•Work readiness measured and monitored to guide RTW actions and work upgrades

 4. Case manager's role:

•Use AB-7 triage screening early in claim management

•Refer appropriate cases for ARI.PI assessment and Matched Care intervention

•Receive Abilita Assessment reports to support rehabilitation planning.

Training and Capacity Building  

Online courses available for different roles:

•Case Managers

•Assessment and Coaching Consultants

•Compensation and Rehabilitation Managers

Continuous Quality Improvement

Comprehensive data collection includes:

•Triage results (AB-7)

•Worker and workplace risk data

•Psychosocial assessment results (ARI.PI)

•Locus of emotional disturbance (DASS21)

•Process measures (dates at each point)

•Participant evaluation at Impact

•Intervention outcomes (ARI.PI, DASS21, work status)

This data supports trend, comparative, and cost-benefit analysis for improved efficiencies and reduced costs.

Outcome measures  

•AB-7 triage results

•ARI.PI Impact Assessment score and shifts in BPS domains.

•DASS21 Impact Assessment results (depression, anxiety, stress)

•Influence of duration of claim at time of assessment

•Participant evaluation of program provided

•Upgrade in RTW Capacity certification at completion coaching. Case closure data is not recorded in ABnet database.

Results  

1. Triage:

•AB-7 results (n=24) predicted risk rating with 100% sensitivity and accuracy

 2. ARI.PI Assessment (n=234) at completion of coaching.

•ARI.PI score improved from mean 129 (ARI 3) to 99 (ARI 2), a shift of 30 points

•DASS21 Depression improved from Severe (13) to Moderate (9)

•DASS21 Anxiety improved from Extremely Severe (11) to Severe (8)

•DASS21 Stress improved from Severe (14) to Moderate (11)

 3. Duration of Claim:

•Median time from injury to Initial Abilita Assessment: 45 weeks

•Earlier referrals noted to achieve better outcomes: within 6 weeks mean ARI shift was 43 points, after 12 months mean ARI shift was 20 points.

 4. Participant evaluation at completion of coaching

•91% of participants were satisfied or very satisfied with program.

5. RTW Capacity certification after coaching:

•Initial Assessment: 91 participants certified fit to work

•Post-intervention: 155 participants certified fit to work