Organizational change and the risk of sickness absence: a longitudinal multilevel analysis of organizational unit-level change in hospitals

Abstract

BackgroundOrganizational change is often associated with reduced employee health and increased sickness absence. However, most studies in the field accentuate major organizational change and often do not distinguish between and compare types of change. The aim of this study was to examine the different relationships between six unit-level changes (upsizing, downsizing, merger, spin-off, outsourcing and insourcing) and sickness absence among hospital employees.MethodsThe study population included employees working in a large Norwegian hospital (n = 26,252). Data on unit-level changes and employee sickness absence were retrieved from objective hospital registers for the period January 2011 to December 2016. The odds of entering short- (< = 8 days) and long-term (> = 9 days) sickness absence for each individual employee were estimated in a longitudinal multilevel random effects logistic regression model.ResultsUnit-level organizational change was associated with both increasing and decreasing odds of short-term sickness absence compared to stability, but the direction depended on the type and stages of change. The odds of long-term sickness absence significantly decreased in relation to unit-level upsizing and unit-level outsourcing.ConclusionsThe results from this study suggested that certain types of change, such as unit-level downsizing, may produce greater strain and concerns among employees, possibly contributing to an increased risk of sickness absence at certain stages of the change. By contrast, changes such as unit-level insourcing and unit-level upsizing were related to decreased odds of sickness absence, possibly due to positive change characteristics.

Changing to improve? Organizational change and change-oriented leadership in hospitals

“…This is particularly true when the changes are related to management, organizational structures, overall goals and strategies as opposed to merely technological or related to new modes of patient treatment. Regarding job satisfaction, a systematic review of previous studies concludes that the results are mixed (Westgaard and Winkel, 2011;Grønstad et al, 2019). Given our understanding of the changes included in our data as often divergent to the medical professional logic, we believe that higher frequencies of organizational change will be a job demand related to lower job satisfaction for physicians.…”

Association of changes in work due to COVID-19 pandemic with psychosocial work environment and employee health: a cohort study of 24 299 Finnish public sector employees

“…The majority of pre-pandemic studies suggest that organisational downsizing, mergers and changes may adversely affect health of employees, [5][6][7][8][9][10][11][12][13] but in some cases also favourable changes have been detected. 14 15 However, it is unclear how changes caused by COVID-19 pandemic at workplaces may have affected perceptions of psychosocial work environment and employee well-being. We used repeat data from three surveys before and during the COVID-19 pandemic to examine whether working from home, assignment into new tasks and team reorganisations in response to the pandemic were associated with employees' perceptions of psychosocial work environment and health during the pandemic.…”

Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions

“…However, the negative effect may not be significant after a year [ 61 ]; the workers seem to adapt very quickly to their new situation and, as staff job satisfaction is positively correlated with health care quality, both variables may be ensured if the staff expectations regarding the merger benefits are met during the early years after the integration [ 15 , 33 , 61 ]. A recent study demonstrated that unit-level upsizing is related with reduced risk of employee sickness absence [ 63 ]. Additionally, yet small, the increase in job satisfaction immediately after merger approval indicates the success of pre-merger staff engagement.…”