Abstract
Background: According to policy and theory, there is need for organizational workplace health promotion (WHP) to strengthen working conditions for all employees. However, earlier studies show it is hard to implement in practice. The aim was to critically analyze and identify interacting mechanisms and obstacles behind failures of organizational WHP projects from system perspectives.Methods: A holistic case study was performed, to critically analyze data from an organizational WHP project approach at a public health care organization. The qualitative data was collected over 5 years and included interviews with key actors (n = 80), focus groups (n = 59 managers), structured observations (n = 250 hours), continuous field observations and documents (n = 180). Questionnaires to employees (n = 2,974) and managers (n = 140) was complementing the qualitative-driven mixed method approach.Results: The analysis shows obstructing paradoxes of alignment and distribution of empowerment during the process of implementation into practice. The obstacles were interacting over system levels and were identified as: Governance by logics of distancing and detaching, No binding regulation of WHP, Separated responsibility of results, Narrow focus on delegated responsibilities, Store-fronting a strategic model, Keeping poor organizational preconditions and support for developments and Isolate WHP from other organizational developments.Conclusions: The following premises can be formulated regarding successful organizational WHP programs. Consider (1) the uncertainty a distributed empowerment to all system levels may create; (2) the distributed impact to define the target and allow broader areas to be included in WHP; and (3) the integration into other development processes and not reducing the organizational WHP to the form of a project.
Highlights
Empirical studies and theoretical developments relating to successful workplace health promotion (WHP) in organizations highlight the importance of integrated focus on strengthening resources for health and developments at all organizational and work system levels [1,2,3]
The key result describes the activities in the planning, active and integrated phases of a WHP project and the analysis shows obstructing paradoxes of alignment and distribution of empowerment during the process of implementation into practice
Organizational WHP programs need to consider the distributed impact to define the target and allow broader areas to be included in WHP
Summary
Empirical studies and theoretical developments relating to successful workplace health promotion (WHP) in organizations highlight the importance of integrated focus on strengthening resources for health and developments at all organizational and work system levels [1,2,3]. The implementation of such organizational WHP approaches can meet significant barriers between and within system levels [5, 6]. This study critically analyzes the implementation of a public organization’s organizational approach of WHP that failed despite high ambitions. The study contributes to development of WHP theory by highlighting the obstructing paradoxes of distributed influence and learning as a necessary condition for empowerment and managerialism as norm in accountable public organizations [7]. According to policy and theory, there is need for organizational workplace health promotion (WHP) to strengthen working conditions for all employees. The aim was to critically analyze and identify interacting mechanisms and obstacles behind failures of organizational WHP projects from system perspectives
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