Managing Complexity: Manager–Stakeholder Communication, Relational Dynamics, and the Dual Nature of RTW Communication

PURPOSE: The return to work (RTW) process of worker absent due to common mental disorders (CMD) or musculoskeletal disorders (MSD) represents a complex challenge that involves multiple stakeholders. The aim of this study was to examine how managers perceive the factors that facilitate or hinder communication with other stakeholders during the RTW process. METHODS: This qualitative study was based on four focus groups conducted in Canada (Quebec and Ontario) with 18 managers. RESULTS: Thematic analysis identified five themes related to facilitators and seven themes related to communication obstacles. Among the main facilitators, trust, clarity, and collaboration emerged as key elements that support effective coordination and the development of shared solutions. Obstacles, on the other hand, included distrust, ambiguity, and fragmentation, which can compromise the success of the process and increase the risk of tensions or relapses. The manager emerges as a bridging figure, central to the design of workplace accommodations, but whose role depends on the quality of relationships with the employee, colleagues, and other organizational stakeholders, as well as on the institutional support received. CONCLUSION: The findings highlight that strengthening inter-stakeholder communication not only fosters the sustainable reintegration of employees with health conditions but also contributes to the development of more inclusive and resilient organizational environments.