How can you – as a GP – ensure the best outcomes for patients recovering from injury? There’s so much you can do, but you need a strategy, and that’s where the Clinical Framework for the Delivery of Health Services (Clinical Framework) comes in.
What is the framework, and who created it?
Originally developed by the Transport Accident Commission (TAC) and WorkSafe Victoria, the Clinical Framework is an evidence-based guide designed to help you support and expedite the recovery of injured workers. It’s based on the best contemporary research and has been widely endorsed by Australian workers’ compensation jurisdictions, as well as peak health associations.
The Clinical Framework provides five key principles that are proven to deliver the best recovery and return-to-work outcomes for injured workers. The principles are:
- measure and demonstrate the effectiveness of treatment
- adopt a biopsychosocial approach
- empower the injured person to manage their injury
- implement goals focused on optimising function, participation and return to work
- base treatment on the best available research evidence.
Read and share the Clinical Framework
At WorkCover WA, we fully endorse the Clinical Framework and encourage you to not only use it, but also share it with your colleagues, patients, their employers and workplace rehabilitation providers.
- Clinical framework for the Delivery of Health Services
- Your role in supporting injured workers – A snapshot of the clinical framework (PDF)
An ongoing review of your patient’s progress and the effectiveness of your injury management plan (every 4-6 weeks) will enable you to identify any areas of concern and adjust your interventions to achieve the best outcomes for your patient. Find out more about Applied resources for GPs.
Traditionally, medical practitioners have adopted the medical model in managing work-related injuries, where the focus is on the injury, symptoms and disability (or an incapacity for work).
The problem with this model is that it does not consider the impact of social and psychological factors on health, work and recovery.
On the other hand, a biopsychosocial approach provides a more balanced approach to formulating an injury management plan that reconciles:
- biological factors (the patient’s physical and/or mental health condition)
- psychological factors (the patient’s personal/psychological wellbeing)
- social factors (the patient’s social situation, pressures and constraints, which includes work).
Your patient has a critical role to play in promoting their own recovery and return to work. Research shows that when injured workers are encouraged and able to self-manage their recovery and work participation, they enjoy better outcomes.
The Clinical Framework identifies ways you can help your patient manage their symptoms, adapt to change in function and return to work. These strategies include:
- reassuring your patient about their injury and the normal course of recovery
- talking about returning to work from your first consultation with your patient
- discussing the health benefits of work with your patient
- together setting goals for recovery and establishing a return-to-work timeframe
- observing, monitoring and challenging unhelpful beliefs.
You might also consider referrals to other health practitioners to help your patient:
- problem solve their own issues
- learn how to pace activities to minimise the risk of relapse
- employ relaxation techniques
- explore and manage potential barriers to recovery
- establish a healthy and consistent sleeping routine
- manage medication use
- establish a regular exercise routine.
Whatever strategies you decide to employ, they should encourage your patient to become active and independent managers of their recovery.
Read our Using the clinical framework to help my recovery (PDF) and Return to work programs for workers brochures for more information.
Experience and research suggest that discussing treatment and return-to-work goals with your patient from your first consultation will improve recovery and outcomes. According to the Clinical Framework, you should:
- develop and set goals in collaboration with your patient
- set goals that are functional and SMART (specific, measurable, achievable, relevant and timed)
- assess progress regularly and reset or modify goals, as necessary.
Read more about strategies for supporting recovery and return to work programs.
It goes without saying, it pays to stay up to date with the latest research so you can modify your approach and strategies based on the best research evidence. When you’re appraising new research findings, remember that:
- systematic reviews provide the most comprehensive and unbiased source of research evidence
- high-quality randomised control trials are the strongest research design for evaluating treatment efficacy.
You’ll find excellent evidence-based clinical guidelines for a variety of injuries and conditions on the National Health and Medical Research Council website.