Musculoskeletal health in the workplace

Musculoskeletal disorders or MSDs are the leading cause of work-related health problems in the healthcare sector. The effects for staff, organizations and society include sickness absence, injuries and disability, increased costs, higher employee turnover, lower productivity and staff leaving the healthcare profession.

Risk assessment is at the basis of a comprehensive approach tackling MSDs and includes technical, organizational as well as person-oriented interventions.

 MSDs denote health problems of the locomotor system apparatus, i.e. muscles, tendons, the skeleton, cartilage, ligaments, nerves or peripheral vascular system. Some MSDs are non-specific because only pain or discomfort exists without evidence of a clear specific disorder. Work-related musculoskeletal disorders (WRMSDs) include all MSDs that are induced or aggravated by work and the circumstances of its performance.

Musculoskeletal (MSK) problems remain the most frequent reason why individuals are absent from work, including those with work-related musculoskeletal disorders (WRMSDs or MSDs) and those with chronic MSK problems. This paper aims to examine changes in work and the workforce since 2000; how work impacts on chronic MSK conditions and how we can help people with these conditions to stay at work. While our knowledge of the causes of WRMSDs has increased since 2000, there has been limited workplace action in reducing exposure to hazards.

 A life course approach is needed as individuals of all ages are reporting MSK problems. How people work has also changed and informalization of work contracts has increased with a perceived concurrent reduction in occupational safety and health (OSH) protection. Retaining people at work with MSK problems requires compliance with relevant safety, health and diversity legislation and a risk management approach. Good and open communication within the workplace and identification of other sources of support is also necessary. Considerations must be made at the individual level (internal motivation), organizational level (a supportive manager) and self-management of symptoms.

Why the Mend Me app? The first 85 days after surgery are critical. Mend Me gives you the tools you need to be the driver of your own recovery. Recover faster and better by completing daily exercises, pain management techniques, and other interactive lessons designed just for you. Created by the nation’s leading orthopedic surgeons, nutritionists, physical therapists and other field specialists, Mend Me delivers a 7-15-minute daily lesson that will impact you the most.

Innovations to Improve Access to Musculoskeletal Care

Innovation is a form of realizing a new way of doing something, often ignoring traditional wisdom, in order to meet new challenges. Globally, particularly in emerging economies, the high burden of musculoskeletal conditions and their contribution to multimorbidity continue to rise, as does the gap for services to deliver essential care. There is a growing need to find solutions to this challenge and deliver person-centered and integrated care, wherein empowering patients with the capacity for self-management is critical. Whilst there is an abundance of information available online to support consumer education, the number of sources for credible medical information is diluted by uninformed anecdotal social media solutions. Even with the provision of high-quality information, behavioral change does not necessarily follow, and more robust educational approaches are required.

In this chapter, we examine innovation, its management and the strategic directions required to improve musculoskeletal healthcare at macro (policy), meso (service delivery) and micro (clinical practice) levels. We discuss the critical role of consumer agency (patients and their families/careers) in driving innovation and the need to leverage this through empowerment by education. We provide a snapshot of real-world examples of innovative practices including capacity building in consumer and interprofessional musculoskeletal education and practice; recommendations to transform the access and delivery of integrated, person-centered care; and initiatives in musculoskeletal care and implementation of models of care, enabled by digital health solutions including telehealth, remote monitoring, artificial intelligence, blockchain technology and big data. We provide emerging evidence for how innovation can support systems’ strengthening and build capacity to support improved access to ‘right’ musculoskeletal care, and explore some of the ways to best manage innovations.

We conclude with recommended systematic steps to establish required leadership, collaboration, research, networking, dissemination, implementation and evaluation of future innovations in musculoskeletal health and care.

DOES Mend Me DIGITAL HEALTH SOLUTION SUPPORT PATIENT INCLUSION AND DIVERSITY? For the first time ever, measure your joint range of motion with your smartphone or tablet. Don’t wait for your physical therapist. Assess your recovery from the comfort of your own home with Mend Me’s easy-to-use technology. Track your progress and be led through the activities that will impact your recovery the most. Rehab is achievable when all of the must-do activities are broken down into bite-sized daily lessons that you tackle at your own pace.

With social movements garnering mainstream coverage, there is a heightened awareness around delivering more inclusive products. As people, and creators of digital solutions used by diverse groups of patients, we’ve been forced to take stock. We’ve found ourselves asking, as a digital healthcare company, how are the solutions we create supporting inclusion and diversity? The biggest drawback for seniors when it comes to using technology is, they feel like the design of devices and interfaces is not inclusive…Devices are exclusionary and make the older population feel isolated from modern technology.

For a digital health solution to reach and support patients, it needs to be widely accessible in technology speak, the four principles of accessibility are: perceivable, operable, understandable, and robust. When looking at a healthcare solution, perceivable means that patients are able to understand the information presented—this relates to health literacy. Operable means that those with disabilities and other limitations can still use the technology. Understandable means that the clearest, most concise language is the benchmark—the patient should know what they’re getting, and the program should be logical and intuitive. Robust relates to a mix of technologies that work on various devices, browsers and platforms. In other words, the program isn’t just limited to one type of phone, computer software, or relies on specific add- ones.

No extra, wearable tech required. Technology is more accessible when the injured worker, patient, or user can access the program from devices they already own.

App, platform or program can be used in various browsers, phone types, and devices. Make sure the program doesn’t require the latest smartphone to operate.

Content is written for everyone. Medical content isn’t often written for every patient.

Suitable for all ages. Technology isn’t often designed for senior end-users. Large fonts, high-contrast images, oversized buttons, and subtitles for audio and video help to reach all patients.

There should be diverse representation in the imagery, videos, audio, and language used in patient-facing digital solutions. The patient should be able to see themselves in the app or program they engage with. For instance, if patients are older, from different ethnic backgrounds, male and female, are living with chronic pain, etc.

 Visual– Images, photos, animations, and video are great for engaging patients. Strictly text within a digital solution is not just boring, it’s excluding various types of learners.

Auditory– Learning through listening, and when concepts are explained out loud is a common learning type. Audio lessons, sound bites, or even songs, can help with patient understanding and engagement.

Kinesthetic– Learning by moving, physical activity, and sense of touch is embraced by digital physical therapy programs through video and health metric collection. In-app tools that encourage movement, and can actually measure that a physical therapy exercise is being executed correctly is even better!

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