Disability Case Manager: Full Member of the Revalidation Team
Condition: Vocational Rehabilitation
Study type: Interventional

Summary: 
      The first 4-6 months after an incident which caused a handicap or chronic disease, it is
      important to involve and motivate patients to return to work. After this period, there is a
      major decrease on successful vocational reintegration. To facilitate vocational
      rehabilitation a Disability Case Manager (DCM) may play a major role. The DCM will act as key
      figure between the patient, the multidisciplinary team of the revalidation centre, the
      employers and other back-to-work services. There is need to provide evidence on the value of
      this program. The aim of this study is to test the added value of including a DCM in the
      classic revalidation trajectory, who will focus on early vocational and/or social
      rehabilitation.
    

Detailed description: 
      12.5% of the population is confronted with a handicap or chronic disease which complicates
      quality of life, including the professional activities. 58% of this group is unemployed or
      inactive. The first 4-6 months after an incident which caused a handicap or chronic disease,
      it is important to involve and motivate patients to return to work. After this period, there
      is a major decrease on successful vocational reintegration. After 1-year unemployment,
      vocational reintegration decreases to 20%, which means an early intervention is recommended.

      The classic rehabilitation trajectory is for the greater part directed at regaining patient's
      independence concerning daily activities, housing conditions, hobbies and its family.
      Revalidation is not (or only in the end) focused on back to work.

      The revalidation centre Sint-Ursula, Jessa Hospital, Hasselt developed an interdisciplinary
      methodology 'Back-To-Work', which included an early focus on vocational and/or social
      rehabilitation using a 'Disability Case Manager (DCM)'. The DCM act as key figure between the
      patient, the multidisciplinary team of the revalidation centre, the employers and other
      back-to-work services to facilitate return to work.

      The program is initiated by an interdisciplinary screening at time of hospitalisation.
      Together with the patient, there can be chosen for two revalidation pathways: 1/ focus on
      vocational rehabilitation; or 2/ focus on social participation. The labour pathway includes
      the matching of the persons characteristics and capacity with the requirements of the job,
      followed by a task-oriented vocational training; the social participation pathway consists of
      guidance to alternative daytime activities combined with psychological support in coping and
      acceptance. The combination of these components with the focus on vocational rehabilitation
      and social participation is new in rehabilitation services.

      Previous research, testing the involvement of a DCM, showed empirically better results, with
      more patients going back to work or choosing an alternative job. Even when back to work was
      eventually not possible, those patients reported a better quality of life.

      This project aims at a scientifically validation of the 'Back-To-Work' methodology and the
      role of DCM. Patients with complex neuro-locomotoric conditions and amputations, aged between
      18-62 years, will be asked to participate in a controlled, longitudinal study, receiving
      either a revalidation therapy including the experimental 'Back-to-work' methodology (Jessa
      hospital, campus Sint-Ursula) or a standard revalidation therapy (Revalidation & MS Clinic
      Overpelt, control group). At the start of rehabilitation, at the end of rehabilitation and 6
      months after rehabilitation, data for qualitative and quantitative analysis is gathered.
    

Intervention name(s): Disability Case Manager
Intervention type(s): Other
Intervention description(s): The DCM will act as key figure between the patient, the multidisciplinary team of the revalidation centre, the employers and other back-to-work services in order to increase vocational reintegration after an incident which caused a handicap or chronic disease.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: vocational rehabilitation; back-to-work; social participation; disability case manager