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

Gunn Robstad Andersen,Rolf H Westgaard

doi:10.1186/1472-6963-13-477

Gunn Robstad Andersen, Rolf H Westgaard

Open Access

https://doi.org/10.1186/1472-6963-13-477

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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.

Highlights

Ergonomic and work stress interventions rarely show long-term positive effect
The present study aims to contribute to such insight by documenting outcome and processes in a setting where interventions for improved work environment are carried out in an organization that simultaneously strive for production system efficiencies in response to economic constraints
Campaign-related actions are reflected on Norwegian Labour Inspectorate (NLI) and municipal levels, yet separate events initiated on municipal level with consequences for local units are reflected on both municipal and unit levels

Summary

Introduction

Ergonomic 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. Workplace interventions to reduce musculoskeletal complaints rarely achieve their stated objectives or to the extent harmful work exposures are alleviated, such gain tends to be nullified in the longer term. A general aim and a key intervention in both public and private enterprises is a continuous effort to achieve reduced costs and improved quality of their output, whether material goods or services. Such production system interventions or rationalizations (term used in this paper) have a dominant influence on the design of organizations, production lines and workplaces, and are frequently carried out with low priority for worker health effects. The present study aims to contribute to such insight by documenting outcome and processes in a setting where interventions for improved work environment are carried out in an organization that simultaneously strive for production system efficiencies in response to economic constraints

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