Organisational conditions for safety management practice in homecare and nursing homes, pre-pandemic and in pandemic

Abstract

The outbreak of COVID-19 pandemic was a major challenge for health care and eldercare service all over the world, regarding prevention of spread of contagion to both the elderly and care workers. This study used a mix method design, aiming to identify important conditions for Occupational Health and Safety Management (OHSM) in practice in home care and nursing homes, in general and regarding the prevention of spread of contagion. The result show how conditions for OHSM differed according to eldercare setting and had stronger importance in homecare, both pre-pandemic and in pandemic. Routines and standardized procedures of OHSM was introduced and improved during the pandemic. The routines and standardized procedures had importance for OHSM and COVID-specific OHSM, especially in homecare (r2: 0,86) but also in nursing homes (r2: 0,39). Team communication of risks, work adjustments and equality climate were also of importance. The OHSM work in homecare was understood as Rooms for re-constructing standardized guidelines to un-standardized settings. The practice of safety work was formed by room for elders’ independent decisions of forming their homes and by room for groupthink shaped by employees’ earlier knowledge experiences and norms. Supportive conditions with equal climate, explicable routines, visual instructions and reflections of OHSM have stronger importance where work environments are unstandardized and work and organizational conditions underdeveloped (i.e. homecare). To better bridge the gap between work as imagine and done in unstandardized contexts, conditions in general and specifically the opportunities to reflect and adapt routines together need to be improved.