Work ability of employees in changing social services and health care organizations in Finland

Employee involvement in innovation activities in hospitals: How perception matters

Employees are a very important source of innovation and essential for the generation, dissemination and implementation of these ideas throughout the organization. This is especially relevant when considering innovation in services during service (co-) creation such as within the healthcare sector. However, perceived employee involvement in innovation (EII) and between stakeholder group interactions in hospitals has not yet been studied in detail. This paper addresses the following research questions: "How do different employee groups perceive their involvement in the innovation process in hospitals and how do their actual involvement levels differ?" and (2) "How do different employee groups perceive their interaction with other employee groups in the innovation process and how do their actual interactions differ?" We analyzed a single typical German research hospital and conducted episodic interviews with employees representing different staff groups. We revealed that while all groups of employees are involved in innovation activities, perception of their involvement in innovation activities differs widely. There is a gap between perception and actual involvement particularly for lower level employees such as nurses. Further, their interaction differs among employee groups and innovation takes place in-group, rather than through group interaction. With our paper, we add to the understanding of perceived EII in hospitals and discuss measures for hospital management to increase EII.

Insight into healthcare design: lessons learned in two university hospitals

Purpose

Hospitals in the developed countries have been subjected to increasing economic pressure. Thus, several hospitals have been forced to improve their production efficiency while coping with limited resources. This paper aims to illustrate challenges and insight associated with health care (HC) facility design (FD) in two publicly funded hospitals.

Design/methodology/approach

In this study, 14 interviewees from two Finnish university hospitals were interviewed. Both hospitals had implemented Lean methods and recently undergone rigorous renovation projects and were seen as ideal study targets.

Findings

Both hospitals had managed to carry out successful indoor environment design. However, logistics, navigation, health information technology, scheduling, budgeting and outsourcing challenges had arisen. An outpatient care approach and customer-driven operational needs are beneficial and guide FD in the target hospitals. Lean thinking offers the necessary fundamental framework for integrating operational design as a part of FD.

Research limitations/implications

Due to the relatively small sample size of the interviewees in this study, post occupancy evaluations in a larger target group should be conducted in the present hospitals. Furthermore, the communication with the interviewees may be considered qualitative due to the research approach based on interviews and content analysis.

Practical implications

Hospital design should focus on developing aesthetic, durable and adaptable facilities that support work processes. The hospital management needs to ensure that architects and designers possess enough HC expertize and are able to interact with clinicians. FD projects should be led and organized more systematically, while project communication between all stakeholders should be more transparent and facilitated by – preferably – a hospital staff member. Furthermore, an organized forum for HC FD should be used for sharing knowledge. The clinicians must be thoroughly oriented to the new work environment and processes.

Originality/value

This paper brings forth numerous crucial challenges and insight related to management of FD in two university hospitals.

Physicians' occupational stress, depressive symptoms and work ability in relation to their working environment: a cross-sectional study of differences among medical residents with various specialties working in German hospitals

OBJECTIVES

This study aimed to analyse and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties.

METHODS

435 German hospital residents in medical training working in 6 different medical specialties participated in a cross-sectional survey study. Physicians were asked about their working conditions and aspects of mental health and work ability. The Copenhagen Psychosocial Questionnaire, the Work Ability Index, the ICD-10 Symptom Rating and the Perceived Stress Questionnaire were used to measure working conditions, mental health and work ability.

RESULTS

Results show that up to 17% of the physicians reported high levels of occupational distress and 9% reported high levels of depressive symptoms. 11% of the hospital physicians scored low in work ability. Significant differences between medical specialties were demonstrated for occupational distress, depressive symptoms, work ability, job demands and job resources. Surgeons showed consistently the highest levels of perceived distress but also the highest levels of work ability and lowest scores for depression. Depressive symptoms were rated with the highest levels by anaesthesiologists. Significant associations between physicians' working conditions, occupational distress and mental health-related aspects are illustrated.

CONCLUSIONS

Study results demonstrated significant differences in specific job stressors, demands and resources. Relevant relations between work factors and physicians' health and work ability are discussed. These findings should be reinvestigated in further studies, especially with a longitudinal study design. This work suggests that to ensure physicians' health, hospital management should plan and implement suitable mental health promotion strategies. In addition, operational efficiency through resource planning optimisation and work process improvements should be focused by hospital management.

Does transfer of work from a public sector organisation to a commercial enterprise without staff reductions increase risk of long-term sickness absence among the staff? A cohort study of laboratory and radiology employees

BACKGROUND

Privatisations of public sector organisations are not uncommon, and some studies suggest that such organisational changes may adversely affect employee health. In this study, we examined whether transfer of work from public sector hospital units to commercial enterprises, without major staff reductions, was associated with an increased risk of long-term sickness absence among employees.

METHODS

A cohort study of 962 employees from four public hospital laboratory and radiology units in three hospitals which were privatised during the follow-up and 1832 employees from similar units without such organisational changes. Records of new long-term sick leaves (>90 days) were obtained from national health registers and were linked to the data. Mean follow-up was 9.2 years.

RESULTS

Age- and sex-adjusted HR for long-term sickness absence after privatisation was 0.83 (95% CI 0.68 to 1.00) among employees whose work unit underwent a change from a public organisation to a commercial enterprise compared with employees in unchanged work units. Further adjustments for occupation, socioeconomic status, type of job contract, size of residence and sick leaves before privatisation had little impact on the observed association. A sensitivity analysis with harmonised occupations across the two groups replicated the finding (multivariable adjusted HR 0.92 (0.70-1.20)).

CONCLUSIONS

In this study, transfer of work from public organisation to commercial enterprise did not increase the risk of long-term sickness absence among employees.