Getting the message right: strategies to improve return-to-work communication

Communication practices are central to disability management. Effective communication from disability managers, frontline supervisors, and workers’ compensation representatives can help with timely and sustained return-to-work (RTW). Yet, workplace stakeholders often report being ill-equipped or inadequately trained to talk to injured workers about disability management and RTW issues. In large organizations, where disability management is more likely to be coordinated by multiple stakeholders, both inside and outside of the organization, challenges to effective RTW communication may be even greater.

This study set out to examine work disability management communication practices in large and complex health-care organizations. Specifically, the study team wanted to explore communication strategies and their impact on the RTW process.

This study took place at two health authorities in British Columbia’s health-care system. The two participating health authorities (there are seven altogether in the province) deliver acute care (for example, in hospitals), long-term care (for example, in nursing homes) and community care (for example, in clients’ homes) across large geographic regions. Within both health authorities, RTW is administered according to a collectively bargained process. It involves the injured worker and a team of workplace stakeholders, which includes the immediate supervisor and a disability management professional (employed by the health authority), an external union representative and a representative from the provincial workers’ compensation system.

The study team conducted hour-long, face-to-face interviews with 40 participants. They included disability management professionals (25 per cent), supervisors (35 per cent), union representatives (12 per cent), workers’ compensation representatives (eight per cent) and workers (20 per cent).

These participants were recruited after a general email was sent out from a workplace representative, inviting anyone interested to contact the research team directly. Several participants were invited via referral to fill gaps in perspectives and functions.

Whether verbal or written, communication was central to disability management. Workers relied on it to understand RTW policies and procedures, and to learn about the roles and responsibilities of different stakeholders in the process. In turn, supervisors and disability managers needed information about the worker’s injury, recovery time, functional limitations and accommodation needs. However, privacy concerns and distrust could lead to barriers in the exchange of information needed for disability management.

In the study, participants spoke of five strategies they use to effectively communicate about RTW.

• Communicating messages of support: Information provided is accompanied by messages of instrumental and emotional support. These include encouragement for the recovery process and reaffirmation of the worker’s importance to the team and the organization. Messages of encouragement are consistently offered across phases of RTW.
• Correctly timing RTW communication: Early conversations with an injured worker are initiated, followed-up with sustained regular communication across all stages of RTW. Communication is not always linear, necessitating different approaches to reiterate the details of a disability management plan and to better understand a worker’s recovery progress. In prolonged disability cases, communication is sustained through regularly scheduled check-ins and reminders of organizational policies.
• Carefully wording messages: Because RTW documentation and information can often be loaded with legal and technical jargon, several strategies are used to help workers absorb information during conversations. These include using simple language, and breaking down and describing each step in the RTW process. Written communication is used to reinforce verbal correspondence. Simplifying communication is even more important when a worker’s injury may have affected cognition or attention.
• Framing messages: Conversations with injured workers emphasize either the benefits of RTW or the downsides of not returning to work. Messages about the benefits to the worker are usually emphasized over messages about negative implications (such as effects on the worker’s finances, social connections and mental health).
• Tailoring communication: The communication strategies above are tailored to the injured worker involved, according to the characteristics of the worker (for example, their age, educational level, job role), their readiness to RTW, their communication style and their level of comprehension of the disability management plan. Workers perceive communication that is generic as more like “reading from a script,” and communication that is personalized as more caring.

In large and complex organizations, providing practical details about RTW policies and procedures is a key component of RTW communication. Just as important are messages of support that provide encouragement and address the RTW barriers that injured workers may perceive. 

Maintaining effective communication practices is an important skill for professionals involved in disability management. Organizations should provide training and coaching to workplace stakeholders on how to use and tailor communication strategies to individual workers.

This study is one of the first to delve into specific communication strategies that can be used by workplace stakeholders to facilitate RTW within large and complex organizational settings. The involvement of diverse workplace stakeholders responsible for disability management and of workers who had previously experienced RTW allowed a range of communication practices to emerge.

A weakness of this study is the absence of injured workers who were unable to successfully return to work. To build on this limitation, research is needed to understand how communication practices may contribute to unsuccessful RTW attempts for injured workers.