Purpose

The Clinical Framework has been established to:

• optimise participation at home, work and in the community, and to achieve the best possible health outcomes for injured people
• inform healthcare professionals of our expectations for the management of injured people
• provide a set of guiding principles for the provision of healthcare services for injured people, healthcare professionals and decision makers
• ensure the provision of healthcare services that are goal orientated, evidence based and clinically justified
• assist in the resolution of disputes

Principles

The Clinical Framework is a set of principles for the provision of health services to injured people.

1. Measure and demonstrate the effectiveness of treatment

Key messages:

1. Treatment should result in a measurable benefit to the injured person.
2. Relevant aspects of the person’s health status that are expected to change with treatment should be measured (such as pain, depression, activities of daily living, health-related quality of life and work performance).
3. When available, outcome measures that are reliable, valid and sensitive to change should be used.
4. Outcome measures must be related to the functional goals of therapy, relevant to the person’s injury, and address the components of the World Health Organisation International Classification of Functioning, Disability and Health.

More about Principle 1

2. Adopt a biopsychosocial approach

Key messages:

1. Healthcare professionals must consider the biological, psychological and social factors that influence a person’s health as part of their assessment and treatment interventions.
2. A biopsychosocial approach improves function, facilitates recovery and maximizes independence, while minimising the risk of long-term activity limitation, participation restriction, or persistent pain.
3. The early identification and management of risk factors helps to address issues that can impact on an optimal outcome.

More about Principle 2

3. Empower the injured person to manage their injury

Key messages:

1. Empowering the injured person to manage their injury is a key treatment strategy and should be incorporated in all phases of injury management.
2. The main ways to empower an injured person are education, setting expectations, developing self-management strategies and promoting independence from treatment.
3. Healthcare professionals need to empower an injured person to actively participate in activities at home, work and in the community as part of their rehabilitation.

More about Principle 3

4. Implement goals focused on optimising function, participation and return to work

Key messages:

1. Goals should be developed in collaboration with, and agreed to by, the injured person.
2. Goals should be functional and SMART – specific, measurable, achievable, relevant and timed.
3. Progress towards goal achievement should be regularly assessed and goals reset or modified as necessary.

More about Principle 4

5. Base treatment on the best available research evidence

Key messages:

1. Healthcare professionals need to use the best available research evidence to inform their decision making.
2. Systematic reviews provide the most comprehensive and unbiased source of research evidence.
3. A high quality, randomised, controlled trial is the strongest research design for evaluating treatment efficacy.
4. Treatments with good evidence for efficacy are preferred over other treatments.
5. Where there is good evidence that treatment lacks efficacy, it should not be used.

More about Principle 5

Expectations

All healthcare professionals providing services to injured people as part of transport accident or workers compensation schemes are expected to adopt these principles within the standards and boundaries of their professional expertise. The principles apply to all compensable injuries regardless of their severity. Healthcare professionals are also expected to adhere to documentation and record keeping standards as required by their relevant professional body.

As part of implementing the Clinical Framework, it is expected that healthcare professionals will communicate with others and work with other healthcare professionals when it is in the interests of the injured person.