Publications listed below include evaluations of the ECHO OEM pilot project and articles that explore the needs and role of health-care providers in supporting their patients in recovery and return to work or stay at work.
Project ECHO Occupational and Environmental Medicine: a qualitative study of healthcare providers supporting workers with work-related injuries and illnesses
Authors: Nowrouzi-Kia B, Carlin L, Furlan AD, Harbin S, Severin CN, Irvin E, Carnide N, Thompson AMS, Adisesh A
Published in: Journal of Occupational Rehabilitation, January 2025
This qualitative study investigated the needs, barriers, and facilitators that affect primary care providers’ involvement in supporting patients’ stay-at-work and return-to-work following injury or illness. It also aims to understand the lived experiences of primary care providers who participated in the Extension for Community Healthcare Outcomes training program for Occupational and Environmental Medicine (ECHO OEM). By examining both the structural and experiential aspects of the program, this study seeks to provide insights into how ECHO OEM influences providers’ approaches to occupational health challenges. Four focus groups and five one-on-one interviews were conducted with healthcare providers participating in ECHO OEM. Audio-recordings were transcribed verbatim and analyzed using an inductive thematic analysis approach. This study was structured according to the COREQ Checklist. We discussed six main themes: (1) Challenges with Engaging with Workers’ Compensation Boards; (2) Return to Work practices; (3) Health and Well-Being; (4) Communication is Important; (5) Perspective from the Workplace; and (6) Feedback on ECHO OEM. ECHO OEM sessions contribute to and impact healthcare providers’ knowledge of supporting injured or ill workers. Topics that deserve further attention include incorporating comorbid physical and mental health conditions, navigating workers’ compensation systems, and supporting specific populations such as military veterans and emergency personnel.
How to cite: Nowrouzi-Kia B, Carlin L, Furlan AD, Harbin S, Severin CN, Irvin E, Carnide N, Thompson AMS, Adisesh A. Project ECHO Occupational and Environmental Medicine: a qualitative study of healthcare providers supporting workers with work-related injuries and illnesses. Journal of Occupational Rehabilitation. 2025 Jan 18. doi: 10.1007/s10926-024-10266-z. Epub ahead of print.
ECHO OEM virtual community of learning for primary care
Authors: Furlan AD, Severin C, Harbin S, Irvin E, Carnide N, Nowrouzi-Kia B, Macdonald S, Thompson A, Liao Q, Smith PM, Adisesh A
Published in: Occupational Medicine, September 2024
Health issues caused and/or exacerbated by work are common in patients seeking primary health care. Yet, primary care providers generally receive little or no training in the assessment and management of occupational injuries and illnesses. Our aim was to conduct a pilot project to develop, implement and evaluate a programme to teach occupational and environmental medicine to primary healthcare providers. We followed the Extensions for Community Healthcare Outcomes (ECHO) model to connect primary healthcare providers with experts in Occupational and Environmental Medicine (OEM). We employed an observational pre-post study design to assess changes in self-efficacy, knowledge, attitudes and beliefs towards OEM. From September 2021 to June 2022, we offered two cycles of 12 sessions each. Participants came from medicine, nursing, psychology, occupational and physical therapy, chiropractic, kinesiology, social work, and pharmacy. Sixty-seven participants completed both pre- and post-ECHO questionnaires. Self-efficacy and knowledge ratings significantly increased after attendance at ECHO compared to the pre-ECHO responses. Attitudes and beliefs were unchanged in most of the items assessed. Participants rated their satisfaction with ECHO between 59% and 97%. Our pilot study demonstrated the challenges in implementing the first ECHO OEM in Canada. Findings show acceptability and satisfaction, improved self-efficacy, and small increases in knowledge, but not overall attitudes and beliefs. There is a need to understand barriers to participation and to target participants with less knowledge and experience in occupational and environmental medicine
How to cite: Furlan AD, Severin C, Harbin S, Irvin E, Carnide N, Nowrouzi-Kia B, Macdonald S, Thompson A, Liao Q, Smith PM, Adisesh A. ECHO OEM virtual community of learning for primary care. Occupational Medicine. 2024 Oct 1;74(7):493-500. doi: 10.1093/occmed/kqae067
What to consider when seeing patients with work-related health concerns
Authors: Rajaram N, Hudon S, Afanasyeva M
Published in: BC Medical Journal, August 2024
Many physicians have not received formal training in occupational medicine, yet they are often asked to help their patients with work-related concerns. Four general questions are presented for physicians to consider when dealing with such issues: (1) Beyond duties to the patient as part of the doctor–patient relationship, what other professional obligations exist? (2) What should and shouldn’t be communicated to employers and other third parties? (3) Are there clear clinical justifications for all recommendations and notes provided? (4) Outside of clinical management, where can patients be directed for more help? Advice is offered to better explain the roles and responsibilities physicians may have in these encounters.
How to cite: Rajaram, N, Hudon, S, Afanasyeva, M. What to consider when seeing patients with work-related health concerns. 2024. BC Medical Journal, 66 (6), 198-201.
Primary care physicians' learning needs in returning ill or injured workers to work. A scoping review
Authors: Furlan AD, Harbin S, Vieira FF, Irvin E, Severin C, Nowrouzi-Kia B, Tiong M, Adisesh A
Published in: Journal of Occupational Rehabilitation, May 2022
Primary care physicians are uniquely positioned to assist ill and injured workers to stay-at-work or to return-to-work. The purpose of this scoping review is to identify primary care physicians' learning needs in returning ill or injured workers to work and to identify gaps to guide future research. We used established methodologies developed by Arksey and O'Malley, Cochrane and adapted by the Systematic Review Program at the Institute for Work & Health. We used Distiller SR©, an online systematic review software to screen for relevance and perform data extraction. We followed the PRISMA for Scoping Reviews checklist for reporting. We screened 2106 titles and abstracts, 375 full-text papers for relevance and included 44 studies for qualitative synthesis. The first learning need was related to administrative tasks. These included (1) appropriate record-keeping, (2) time management to review occupational information, (3) communication skills to provide clear, sufficient and relevant factual information, (4) coordination of services between different stakeholders, and (5) collaboration within teams and between different professions. The second learning need was related to attitudes and beliefs and included intrinsic biases, self-confidence, role clarity and culture of blaming the patient. The third learning need was related to specific knowledge and included work capacity assessments and needs for sick leave, environmental exposures, disclosure of information, prognosis of certain conditions and care to certain groups such as adolescents and pregnant workers. The fourth learning need was related to awareness of services and tools. There are many opportunities to improve medical education for physicians in training or in continuing medical education to improve care for workers with an illness or injury that affect their work
How to cite: Furlan AD, Harbin S, Vieira FF, Irvin E, Severin C, Nowrouzi-Kia B, Tiong M, Adisesh A. Primary care physicians' learning needs in returning ill or injured workers to work. A scoping review. Journal of Occupational Rehabilitation. 2022;32(4):591-619. doi:10.1007/s10926-022-10043-w.