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An Intervention Bundle to Facilitate Return to Work for Burn-Injured Workers: Report From a Burn Model System Investigation

Carrougher, Gretchen J. MN, RN; Brych, Sabina B. BS; Pham, Tam N. MD, FACS; Mandell, Samuel P. MD, MPH; Gibran, Nicole S. MD, FACS

doi: 10.1097/BCR.0000000000000410
Original Articles: 2016 ABA Papers

Rates of return to work (RTW) after burn injury vary. A 2012 systematic review of the burn literature reported that nearly 28% of all adult burn survivors never return to any form of employment. These authors called for interventions designed to assist survivors’ ability to function in an employed capacity. In 2010, our burn center outpatient clinic instituted an intervention aimed to return injured workers to employment within 90 days of their insurance claims. The interventions include patient/family education focused on recovery rather than disability, employer contact and education by the vocational rehabilitation (VR) counselor, physician recommendations for work accommodations, provision of employee status letters, and Activity Prescription Forms (APFs). The purpose of this study is to report on the effectiveness of these interventions. Following institutional review board (IRB) approval, medical records of adults with occupation-related burn injuries and receiving care at a single regional burn center from June 2010 to July 2015 were reviewed. Data on patient and injury characteristics and outpatient VR services provided were collected. The primary outcome of interest was the percentage of patients who RTW; 338 individuals met study entry criteria. The VR counselor evaluated all patients. All patients received an employer letter(s) and APF documentation. Workplace accommodations were provided to more than 30% of patients. RTW rate was 93%, with an average of 24 days from injury to RTW. In an intervention bundle involving the patient, employer, Workers’ compensation, and the burn clinic staff, injured workers achieved a high rate of RTW. Although we cannot correlate individual bundle components to outcome, we postulate that the combination of employer/employee/insurer engagement and flexibility contributed to the success of this program.

From the *Department of Surgery, University of Washington, Seattle; and Department of Burn and Plastic Surgery Outpatient Clinic, University of Washington, Seattle.

The contents of this report were supported, in part, by Grant Number 90DP0029, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, DC. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.

Address correspondence to Gretchen J. Carrougher, MN, RN, Department of Surgery, UW Medicine Regional Burn Center, Harborview Medical Center, 325 9th Avenue, Box 359796, Seattle, WA 98104. Email:

© 2017 The American Burn Association