Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers – a case study

Abstract

BackgroundErgonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention.MethodsThe study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses.ResultsThe work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers.ConclusionsEstablishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures.

Care Workers’ Readiness for Robotization: Identifying Psychological and Socio-Demographic Determinants

“…Robotization in healthcare is currently in the contemplative stage, where people recognize the need for change [5,33,34] but have not decided whether to allow it to happen. The nursing field struggles with resource shortages, excessive time pressures and physical strains [13,15,18]. On the other hand, robotizing care tasks would mean profound changes in care practices and even the core of the care profession [35].…”

“…However, developments in artificial intelligence foreshadow significant improvements in robotics [11] and can take care robots to new levels of autonomy and interactivity [12]. A new generation of robots are anticipated to optimize nursing work, a field that struggles with inadequate resources and unergonomic or repetitive tasks [11,[13][14][15][16][17][18].…”

Finnish healthcare professionals' attitudes towards robots: Reflections on a population sample

“…Care for older people has its own specific challenges, such as time pressure in home care (Andersen & Westgaard, 2013) and a heightened risk of clients' or their relatives' violent behaviour (Banerjee et al, 2012). In Finland, a majority (70%) of practical nurses describe their work as too laborious and are considering a change in occupation (Erkkilä, Simberg, & Hyvärinen, 2016).…”

Work demands and health consequences of organizational and technological measures introduced to enhance the quality of home care services – A subgroup analysis

“…Physical work demands had an additional, direct link to low back pain. The overall effect of interventions to improve working conditions and reduce sick leave was negligible, due to parallel measures (e.g., merging home care units, changes to unit management) introduced to rationalize the HCS (Andersen and Westgaard, 2013). One cause of low impact of the work environment interventions was large variation in priorities and beliefs within the organization, from practicing HCWs to municipal administrators, which hampered communication across organizational levels and served as a barrier to effective change management (Andersen and Westgaard, Submitted for publication).…”

“…HCWs in this municipality have been the subject of an ongoing study by our research group. High sick leave has been the norm since the early 2000s, and the municipality introduced a concerted action plan to reduce this sick leave, following inspection and receiving orders from the Norwegian Labor Inspectorate in 2003 (Andersen and Westgaard, 2013). The orders had a particular focus on job demands generating excessive time pressure.…”