PURPOSE-To explore supervisors' perspectives and decision-making processes in the accommodation of back injured workers.METHODS-Twenty-three semi-structured, in-depth interviews were conducted with supervisors from eleven Canadian organizations about their role in providing job accommodations. Supervisors were identified through an on-line survey and interviews were recorded, transcribed and entered into NVivo software. The initial analyses identified common units of meaning, which were used to develop a coding guide. Interviews were coded, and a model of supervisor decisionmaking was developed based on the themes, categories and connecting ideas identified in the data.
RESULTS-The decision-making model includes a process element that is described as iterative "trial and error" decision-making. Medical restrictions are compared to job demands, employee abilities and available alternatives. A feasible modification is identified through brainstorming and then implemented by the supervisor. Resources used for brainstorming include information, supervisor experience and autonomy, and organizational supports. The model also incorporates the experience of accommodation as a job demand that causes strain for the supervisor.
CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript accommodation decision complexity, which in turn affects the quality of the accommodation option selected. If the employee is unable to complete the tasks or is reinjured during the accommodation, the decision cycle repeats. More frequent iteration through the trial and error process reduces the likelihood of return to work success.CONCLUSIONS-A series of propositions is developed to illustrate the relationships among categories in the model. The model and propositions show: a) the iterative, problem solving nature of the RTW process; b) decision resources necessary for accommodation planning, and c) the impact accommodation demands may have on supervisors and RTW quality.