This profound paper will help you understand RETAIN
Jennifer Christian MD
Hello all –
I really really hope / recommend that you read – and especially that you request (require?) the “system level” agency people involved in your RETAIN group to read -- pages 1-9 of the attached paper. Please do not dismiss this paper because it concerns workers’ compensation. Those early pages are an admirable piece of crystal clear policy thinking about strategies to improve outcomes for a POPULATION currently being ill-served by the status quo – and accomplish that goal via a series of programmatic initiatives. Isn’t that what you want to do with your RETAIN program?
Tom Wickizer just sent the paper to me; I had never seen it. It is dated 2001, before COHE got underway. Entitled “Improving the Quality of Workers’ Compensation Health Care Delivery: The Washington State Occupational Health Services Project”, it lays out in very clear language the initial rationale for Washington state’s efforts to improve outcomes for injured workers. It answers the question WHY they undertook COHE, and also explains why some supporting initiatives need to be included. The short answer appears on page 8: “These factors argue for adopting a community-based public health approach to quality improvement and injury prevention.” Because Washington’s thinking has become more refined since 2001, today they would no doubt replace the last term “injury prevention” with this one “secondary prevention of adverse secondary consequences of injuries.”
This 17 year old paper leaves unstated two significant policy /strategic issues. Perhaps they weren’t recognized at the time – but they are noticeable now: