Supporting managerial work and organizing for sustainable working conditions in healthcare (keynote)

• Today, most public hospital organizations struggle with restructurings to decrease the costs and develop quality of care. But studies of successful organizational developments points to the importance of management that are balancing the perspectives of effectivity and quality of care with beneficial working conditions. This is also in line with the Nordic tradition of active collaboration between employers and employees. However, the work environment have become more challenging to handle: work demands and the rates of sick leave and turnover among health care professionals have increased during the last years in Sweden and there is severe difficulties to attract physicians and nurses with specialist competence to stay in their jobs. Leadership of high quality is considered a key conditions for creating more attractive work with beneficial working conditions, employees health and work engagement. However, managerial work in health care are complex and characterized by fragmentation, uncertainties, conflicts of values and loyalties, high- performance pressures, a hectic work pace and long working hours. Linked to these conditions, studies have highlighted perceived stress and high turnover-rates among operational managers. Thus, to build capacity for more sustainable working conditions, managers need organizational preconditions, competence and handling strategies to meet challenges in complex social and organizational working conditions. Recent studies point to the benefit of improved organizational preconditions for health care managers in terms of manageable span of control, shared managerial assignment and support through managerial group, own manager, colleagues and organizational resource functions (e.g. HR, communication). Leadership programs need to support managers’ knowledge, awareness and capacity for organizing beneficial psychosocial work conditions – also during organizational changes. Key-factors and conditions for workers health, wellbeing and engagement have been identified through several literature reviews. However the interactions between individual, group and organizational risk resp. resource factors have strong importance. Therefore, managerial work based on knowledge to handle interactions and combinations of risk and resource factors and accumulated conditions across different organizational levels are needed and crucial for sustainable development. Thus, leadership programs should approach more holistic system theories of sustainable working conditions at individual-, micro-, meso-, exo-, macro- and chrono-levels. Our studies have confirmed earlier studies about leadership that are actively bridging across system-levels to integrate perspectives and serve core purposes have more success in sustainable organizational developments. Consequently, it’s important to keep focus on and support managers work practices to organize increased resources and sustainability. The key-note will present a leadership program that supports managers capacity to apply and adapt the evidence-based knowledge to the own managerial work practice through dialogues and exercises. In line with the NOVO network, the program focus work environment conditions integrated with efficiency and quality improvement. In line with the labour market traditions in the Nordic countries, the program can benefit from being conducted in collaboration between employers, managers and union. Thus, the leadership program is one example of the efforts to further develop Nordic models of sustainable health care.

Ämnesord

SAMHÄLLSVETENSKAP  -- Annan samhällsvetenskap -- Arbetslivsstudier (hsv//swe)

SOCIAL SCIENCES  -- Other Social Sciences -- Work Sciences (hsv//eng)

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