RETAIN Program for Work-related Injuries

(MN RETAIN Trial)

Overseen By Samantha Westphal, RN, BSN, PHN, CLMS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mayo Clinic

Disqualifiers: Legal issues, Informed consent, RETAIN employees, Workers' comp, SSDI/SSI, Self-employed

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

5200 Participants Needed

Trial Summary

What is the purpose of this trial?

MN RETAIN Phase 2 Sub-study is a non-randomized trial to evaluate the impact of RETAIN program expansion and services on workforce retention and reduction of future workplace disability in the state of MN. The program is funded by US Department of Labor (US DOL) and sponsored jointly with the US Social Security Administration. There will be collaboration between partners to implement best practices in early intervention to support injured or ill employees in stay-at-work and return-to-work. MN RETAIN involves a partnership between Mayo Clinic and MN Department of Employment and Economic Development (DEED), MN Department of Labor and Industry (DLI), MN Department of Health (MDH), Workforce Development, Inc. (WDI), and the Governor's Workforce Development Board. MN DEED serves as the main recipient and administrator of the funding within the state with Mayo Clinic, DLI, and WDI, as subrecipients of the grant. (Effective Date: 12/23/2021-05/16/2024) MN RETAIN Phase 2 : This study is a randomized control trial (RCT) to evaluate the impact of RETAIN program expansion and services on workforce retention and reduction of future workplace disability in the state of MN. The program is funded by US Department of Labor (US DOL) and sponsored jointly with the US Social Security Administration. There will be collaboration between partners to implement best practices in early intervention to support injured or ill employees in stay-at-work and return-to-work. MN RETAIN involves a partnership between Mayo Clinic and MN Department of Employment and Economic Development (DEED), MN Department of Labor and Industry (DLI), MN Department of Health (MDH), Workforce Development, Inc. (WDI), and the Governor's Workforce Development Board. MN DEED serves as the main recipient and administrator of the funding within the state with Mayo Clinic, DLI, and WDI, as subrecipients of the grant. During this Phase: additional collaborators: Mathematica Policy Research

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the RETAIN Program treatment for work-related injuries?

Research shows that programs focusing on returning to work after injury, like the RETAIN Program, can lead to better health outcomes and reduced time away from work. Studies have found that structured return-to-work programs and vocational rehabilitation can decrease delays, improve employment outcomes, and reduce unnecessary medical interventions. ^{1 2 3 4 5}

How does the RETAIN Program for work-related injuries differ from other treatments?

The RETAIN Program is unique because it focuses on helping people with work-related injuries return to and stay at work by using strategies tailored to their employment status, rather than just addressing the injury itself. It involves Return-to-Work Coordinators who provide personalized support, which is different from traditional treatments that may not include such comprehensive employment-focused assistance. ^{6 7 8 9 10}

Research Team

Clayton Cowl, MD,MS

Principal Investigator

Mayo Clinic

Laura Breeher, MD, MPH

Principal Investigator

Mayo Clinic

Eligibility Criteria

The Minnesota RETAIN Phase 2 trial is for Minnesota residents who have had or will have surgery affecting their work within the last 12 weeks or next 8 weeks. Participants must have worked in MN at least one day in the past 3 months, be over 18, and employed or active in the labor force. It's not for those with worker's comp having a QRC/DCM, involved in related litigation, unable to consent, employed by certain organizations with return-to-work programs, or on SSDI/SSI.

Inclusion Criteria

Employed or currently in the labor force

I am 18 years old or older.

Has worked at least one day within the last 3 months (80% or more of participants)

Exclusion Criteria

Legal representation/litigation at the time of enrollment related to the medical condition

I am unable to understand and give consent for treatment.

I work for a RETAIN healthcare recipient with a return-to-work program.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants are assigned a dedicated Minnesota RETAIN Return-to-Work Case Manager and referred for additional career and workforce development resources as needed

12 months

Follow-up

Participants are monitored for workforce retention and reduction of workplace disability

12 months

Long-term Follow-up

Participants are monitored for long-term work disability reduction

5 years

Treatment Details

Interventions

• RETAIN Program

Trial Overview This study tests the RETAIN program aimed at helping employees stay at work or return after an injury or illness. It's a randomized control trial assessing if this program can reduce workplace disability and improve workforce retention through early intervention practices implemented by various partners including Mayo Clinic and state departments.

Participant Groups

Group I: Sub Study Group Experimental Treatment 1 Intervention

Individuals will be assigned a dedicated Minnesota RETAIN Return-to-Work Case Manager. Intervention group participants will be referred for additional career and workforce development resources when needed.

Group II: Intervention Group Experimental Treatment 1 Intervention

Individuals will be assigned a dedicated Minnesota RETAIN Return-to-Work Case Manager. Intervention group participants will be referred for additional career and workforce development resources when needed.

Group III: Control Group Active Control 1 Intervention

Individuals will receive a handout with additional job related services; e.g. Job Accommodation Network.

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

Minnesota Department of Employment and Economic Development

Collaborator

Trials

1

Recruited

5,200+

Minnesota Department of Health

Collaborator

Trials

9

Recruited

179,000+

Mathematica Policy Research

Collaborator

Trials

1

Recruited

5,200+

United States Department of Labor

Collaborator

Trials

1

Recruited

5,200+

Minnesota Department of Labor and Industry

Collaborator

Trials

1

Recruited

5,200+

United States Social Security Administration

Collaborator

Trials

2

Recruited

8,200+

Workforce Development, Inc.

Collaborator

Trials

2

Recruited

8,400+

Findings from Research

Returning to work after an injury generally leads to better health outcomes, while unnecessary time off can worsen overall health, benefiting employers, employees, and insurers alike.

Disability duration guidelines, such as those outlined in 'The medical disability advisor--Workplace guidelines for disability duration,' are essential for facilitating a fair and evidence-based return to work process among all stakeholders involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Return to work management of people with temporary disability]. Okreglicka, M.[2011]

The Vocational Improvement Project, a 5.5-year pilot program in Washington State, successfully reduced repeat referrals and delays in vocational rehabilitation for injured workers, while also increasing worker choice and establishing partnerships to enhance outcomes.

Despite these improvements, challenges remain, as retraining plan completion rates are below 60% and only half of the workers earned wages within two years after completing their plans, indicating a need for further enhancements in the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving vocational rehabilitation services for injured workers in Washington State. Sears, JM., Wickizer, TM., Schulman, BA.[2022]

The study presents a new framework for analyzing how health service spending and utilization in work disability management varies across different regions and settings, emphasizing the importance of high-quality healthcare access for effective disability management.

By identifying predisposing, enabling, workplace environment, and need-based factors, the framework aims to help researchers and policymakers understand and improve health care delivery within work disability management systems, particularly in Canada.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Framework for Understanding How Variation in Health Care Service Delivery Affects Work Disability Management. Sharpe, K., McGrail, K., Mustard, C., et al.[2022]

Patients in a hospital-based pain treatment program showed significant improvements, including reduced use of analgesics and fewer hospitalizations and surgeries, compared to those denied treatment by their workers' compensation insurance.

The study, which followed 63 treated patients and 37 untreated patients over 18 months, found that those who received pain treatment were more likely to return to work, highlighting the clinical and cost-effectiveness of such programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pain clinic #13. Comprehensive pain center treatment of low back workers' compensation injuries. An industrial medicine clinical outcome follow-up comparison. Tollison, CD., Kriegel, ML., Satterthwaite, JR., et al.[2011]

A ten-year study in a public utility company with over 5300 employees showed that implementing quality-based diagnostic and treatment protocols led to a 55% reduction in days lost from work and a 51% decrease in new injuries reported.

The program also resulted in a 67% decrease in surgeries performed, a significant increase in surgical success rates, and a cumulative savings of over 4.1 million dollars in lost time and replacement wages, highlighting the effectiveness of quality care in reducing costs and improving outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A quality-based protocol for management of musculoskeletal injuries. A ten-year prospective outcome study. Wiesel, SW., Boden, SD., Feffer, HL.[2005]

The RETAIN Kentucky program, funded by the U.S. Department of Labor, aims to help individuals with non-work-related injuries and illnesses return to work or stay employed, utilizing RTW Coordinators for support.

After nearly 3 years of Phase 1, the program is transitioning to Phase 2, which will last 30 months and build on the insights gained to improve employment retention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

RETAIN Kentucky: A return-to-work and stay-at-work program for people with disabilities grounded in the conservation of resources theory. Rumrill, P., Sheppard-Jones, K., Collett, JW., et al.[2022]

A survey of 1833 workers with soft-tissue injuries in Ontario revealed that while 66% were contacted by their workplace, only 36% were offered modified work arrangements to aid their return after injury.

The most common modifications included reduced hours (24%), flexible hours (25%), and lighter duties (57%), but these temporary changes did not significantly impact the duration of compensation benefits, although offers of arrangements did correlate with shorter benefit durations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modified work: prevalence and characteristics in a sample of workers with soft-tissue injuries. Brooker, AS., Cole, DC., Hogg-Johnson, S., et al.[2019]

The articles highlight the potential for early intervention strategies to help workers with medical conditions avoid prolonged work disability, based on analyses of disability claims data and case studies from 50 employers.

By improving systems to identify and support these workers promptly, stakeholders can significantly influence their job retention and overall outcomes, suggesting a need for evidence-based interventions in the workplace.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Opportunities for Early Intervention to Avoid Prolonged Work Disability: Introduction to the Special Section. Ben-Shalom, Y., Schimmel Hyde, J.[2019]

In the Ontario Life After Workplace Injury Study, 40% of eligible workers with work-related injuries participated in an 18-month follow-up, revealing that 61% were still employed by their original employer, while 23% were not working at all.

Preliminary data showed that longer durations of disability claims were associated with poorer health outcomes and function, highlighting the need for targeted interventions to support these workers' recovery and return to work.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS). Mustard, C., Nadalin, V., Carnide, N., et al.[2021]

A study of 1850 patients with chronic disabling occupational musculoskeletal disorders found that older age, female sex, and extreme disability at admission were significant predictors of failing to retain work one year after treatment.

Other notable risk factors included nonworking status at discharge, antisocial personality disorder, receiving government disability benefits, and dependence on opiate pain medications, which can help tailor individualized treatment plans for better outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prediction of failure to retain work 1 year after interdisciplinary functional restoration in occupational injuries. Brede, E., Mayer, TG., Gatchel, RJ.[2012]

References

1. Poland pubmed.ncbi.nlm.nih.gov

[Return to work management of people with temporary disability]. [2011]

2. England pubmed.ncbi.nlm.nih.gov

Improving vocational rehabilitation services for injured workers in Washington State. [2022]

3. Netherlands pubmed.ncbi.nlm.nih.gov

A Framework for Understanding How Variation in Health Care Service Delivery Affects Work Disability Management. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Pain clinic #13. Comprehensive pain center treatment of low back workers' compensation injuries. An industrial medicine clinical outcome follow-up comparison. [2011]

5. United States pubmed.ncbi.nlm.nih.gov

A quality-based protocol for management of musculoskeletal injuries. A ten-year prospective outcome study. [2005]

6. Netherlands pubmed.ncbi.nlm.nih.gov

RETAIN Kentucky: A return-to-work and stay-at-work program for people with disabilities grounded in the conservation of resources theory. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Modified work: prevalence and characteristics in a sample of workers with soft-tissue injuries. [2019]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Opportunities for Early Intervention to Avoid Prolonged Work Disability: Introduction to the Special Section. [2019]

9. England pubmed.ncbi.nlm.nih.gov

Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS). [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Prediction of failure to retain work 1 year after interdisciplinary functional restoration in occupational injuries. [2012]