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Organizational flexibility and health among line managers and employees in health care

Time: Fri 2020-12-11 13.00

Location:, (Swedish)

Subject area: Technology and Health

Doctoral student: Sara L. Fallman , Ergonomi, Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden

Opponent: Docent Dan Hasson, Karolinska Institutet

Supervisor: Lotta Dellve, Skolan för kemi, bioteknologi och hälsa (CBH), Department of Sociology and Work Science, Gothenburg University, Gothenburg, Sweden; Docent Göran Jutengren, Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden; PhD Linda Ahlstrom, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Introduction: Line mangers’ and employees, registered nurses and assistant nurses’, in health care often have a demanding work situation. Sick leave illness and lack of competent staff is a problem. There is a lack of studies on working conditions, such as flexibility and restricted control, from an organizational perspective, (i.e. working conditions formed on a higher level aiming to influence the whole organization) with health care organizations in explicit focus.

Aim: The overall aim was to expand knowledge about how working conditions with specific focus on flexibility and restricted control over work, impact on health and work performance among first and second line managers and employees within health care. In Study I the aim was to generate knowledgeabout the importance of adjustment latitude at work and at home for return to work or regaining work ability for female HSO workers on long-term sick leave. In Study II, the aim was to investigate how restricted decision-making autonomy and conflicting demands impact operational managers’ work performance and health. In Study III, the aim was to examine the associations between managerial work performance and self-rated health or burnout among first line nurse managers. In Study IV, the aim was to identify first line managers’ approaches for maintaining low levels of sick leave among healthcare employees.

Method: Both qualitative and quantitative methods have been used. Studies I–III employed a quantitative longitudinal design of questionnaire data. In Study I, data from a 6-year study was used. Study II is based on data collected at two points in time, approximately one year apart. The analyses in Study III were performed using data from three points in time, approximately one year apart. Study IV, used a qualitative approach in analyses of interviews with first line managers responsible for units with low sick leave among the employees.

Results: The results show the importance of having working conditions that allowed for a flexible work situation and a favorable adjustment latitude among employees. The result showed employee who had more opportunitiesto make adjustment latitudes at work had higher degree of work ability and a higher degree of return to work than those who had fever possibilities for adjustments. First line managers responsible for units with low sick leave among the employees were flexible, and had a holistic approach to meet the employees’ needs for flexible working conditions. Inversely, restricted control in form of top-down control and low control over the own work was associated with lower health, higher degree of burnout and lower ability to perform work.

Conclusions: Organizational flexibility from superiors and top management is important for health because it shapes working conditions that support and facilitate individual line managers and employees’ capability to perform theirwork. In specific, higher opportunities for adjustments of pace and place of work are important for employees’ health. Line managers’ work performancemay be supported by higher organizational flexibility in decision-making while restricted control over work conditions were associated with lower health. A holistic approach in relation to the employees’ needs seems to have positive impact on lower sick leave.