Work Disability Management Communication Bottlenecks Within Large and Complex Public Service Organizations: A Sociotechnical Systems Study
Purpose Within large and complex organizations work disability (WD) communication bottlenecks emerge and contribute to avoidable disability days. Our study utilized soft systems methods to better understand communication problems in WD management. Methods Semi-structured interviews were conducted with disability case managers (n = 10), frontline supervisors (n = 15) and human resource/labor relations specialists (n = 5) within three public service organizations. Interview questions asked about organizational WD system structure and communication practices. Thematic analysis was conducted to examine system structure and emergent communication bottlenecks. Results WD communication took place across a number of internal and external stakeholders. Communication bottlenecks tended to concentrate within WD case manager and frontline supervisor activities. Inconsistent communication across organizations, challenges interacting with external stakeholders, mental health disability information exchange, lack of WD communication experience and previous worker performance represented communication bottlenecks that contributed to avoidable disability days. Conclusions To strengthen communication practices, systems-focused responses towards organizational WD management are required.
KeywordsCommunication Work disability management Return-to-work Systems thinking Soft systems methodology
This research was supported by a Healthy and Productive Work Partnership Development Grant, Canadian Institutes for Health Research and Social Sciences and Humanities Research Council of Canada (Grant No. #890-2016-3001).
All authors contributed to study conceptualization. AJ, BY and ML co-led data collection and analysis. AJ led manuscript development. CM, BY, ML contributed significantly to manuscript development and approved the final version published. Each author agrees to be accountable for all aspects of the work including accuracy and integrity of any part of the work.
Compliance with Ethical Standards
Conflict of interest
The authors declare no conflicts of interest.
- 2.Franche R-L, Baril R, Shaw W, Nicholas M, Loisel P. Workplace-based return-to-work interventions: optimizing the role of stakeholders in implementation and research. J Occup Rehabil. 2005;15(4):525–542.Google Scholar
- 6.MacEachen E, Clarke J, Franche R-L, Irvin E. Systematic review of the qualitative literature on return to work after injury. Scand J Work Env Health. 2006;2006:257–269.Google Scholar
- 7.Jetha A, Lamontagne AD, Lilley R, Hogg-Johnson S, Sim M, Smith P. Workplace social system and sustained return-to-work: a study of supervisor and co-worker supportiveness and injury reaction. J Occup Rehabil. 2017;28:486–494.Google Scholar
- 11.Kosny A, Franche R-L, Pole J, Krause N, Côté P, Mustard C. Early healthcare provider communication with patients and their workplace following a lost-time claim for an occupational musculoskeletal injury. J Occup Rehabil. 2006;16(1):25–37.Google Scholar
- 15.Jackson MC. Systems thinking: creative holism for managers. Chichester: Whiley; 2003. p. 378.Google Scholar
- 16.Sterman JD. Business dynamics: systems thinking and modeling for a complex world. New York: McGraw-Hill; 2000.Google Scholar
- 18.Leveson NG. Applying systems thinking to analyze and learn from events. Saf Sci. 2011;49(1):55–64.Google Scholar
- 20.Checkland P, editor. Systems thinking, systems practice. Hoboken: Wiley; 1981.Google Scholar
- 21.Loisel P, Durand MJ, Berthelette D, Vezina N, Baril R, et al. Disability prevention: new paradigm for the management of occupational back pain. Dis Manag Health Outcomes. 2001;9(7):351–360.Google Scholar
- 22.Miles MB, Huberman AM, Saldana J. Qualitative data analysis. Thousand Oaks: Sage; 2013.Google Scholar
- 23.QSR International Pty Ltd. NVivo qualitative data analysis software. 10. ed 2016.Google Scholar