Author(s): Inga-Lill Petterson and Lena Backman                                                               Country:   Sweden

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Yes, the intervention promotes responsible business practices. All three stages of the interventions are based on employee participation and require impetus from the management of companies to be successful.

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

The Worksite Profile method is a self-instructive tool (in a CD-package) with a questionnaire and instructions to improve the work environment and health of employees in occupational settings. It facilitates Systematic Work Environment Management (SWEN), which involves:

·         Making such decisions and taking such measures in the course of everyday work that employees are not injured, do not become ill and are not harmed in any other way.

·         This means observing and considering both psychological and social conditions, as well as work environment issues of a “technical” nature.

·         Work environment management also applies to work not done at a permanent workplace, e.g. transport work or work in other people’s homes.

According to the Swedish Work Environment Act, SWEN is the responsibility of the employer. The aim of the Worksite Profile is to get employees and managers involved to participate in the development and improvement of their own work conditions. The questionnaires have been developed based on extensive research. The intervention is easily applicable and used at a practical level. The method is prepared for self-administration. All instructions needed are included in the CD-package. The self-instructive method has been used by for example Occupational Safety and Health Services, the Swedish Church and smaller enterprises.  

Implementation:

The intervention is carried out in three steps:

(a) Competence programme: The first activity, a competence and training programme, is directed towards a selected group of employees.

(b) Worksite competence circles: The second activity is directed to all worksite staff, the aim of the competence circles is to initiate a learning organisation, &

(c) Local worksite projects: The target of the third activity is the separate worksites and the organisation. As part of the third step, worksite improvement projects, project plans are elaborated jointly by the participating employees.

Each step is a separate activity, connected by a main thread, and implemented successively, each activity being a necessary basis for the next step. Different activities are directed towards the individual, the worksite, and the organisation. As a tool to initiate and stimulate discussions across occupational groups and to assess the stressors, each unit uses the feedback of their baseline questionnaire results, presented as local work quality profiles. The questionnaire is comprehensive, including more than 100 questions about work demands, job control, support, evaluations of quality of care, musculoskeletal, psychosomatic, and stress symptoms, well-being, and measures of personal resources, such as coping, self-esteem, and mastery. Most of the questions have been used in research and some of the scales are internationally known and well established.

Local reference groups, consisting of the unit manager, the project co-ordinator, the innovation leaders (those who undergo the competence and training programme), and representatives of employee groups, support the projects on the worksite level. A support network of all innovation leaders and unit managers is created at the organisational level. The started projects generally refer to issues such as introduction of new employees, quality development, the meaning of quality to employees, customers, routines for staff meetings and communication, and communication between personnel.

Practical applications:

The method can be handled within an organisation. It is easily applicable and used at a practical level. The method is prepared for self-administration and all instructions needed are included in the CD-package.

Innovative aspects:

The questionnaire has been designed so that it can be distributed as a web-based questionnaire if required.

Evaluation (including process issues, outcomes and sustainability):

The Worksite Profile method has been tested in different occupational sectors and at different organisational levels. The method has been evaluated regarding the validity of the questionnaires and regarding the usefulness of the method for Systematic work environment management. The questionnaires have face validity. Using the method, two key factors have been found to be important; time for discussions at the worksite and manager engagement. The method has also been found to be less useful in organisations that faced lack of time and non-engaged managers.

The intervention effects have evaluated in some studies by a comprehensive questionnaire prior to (baseline) and after (follow-up) the intervention. In some cases, research teams, not involved in the implementation, have evaluated the effects of the intervention by questionnaires before and after the programme, using a wide range of measures. The method has been found to be effective leading to sustainable outcomes.

Benefits (including cost effectiveness):

The method is flexible and can be tailored to suit the organisation. The CD-package is economical thereby making it possible for smaller workplaces to buy it.

References:

Petterson, I.L., Donnersvärd, H.Å., Lagerström, M. And Toomingas, A. (2006). Evaluation of an intervention programme based on empowerment for eldercare nursing staff', Work & Stress, 20(4), 353- 369.

The Swedish Work Environment Authority (2003). Systematic work environment management: Guidelines. Work Environment Authority, Publication Services. ISBN 91-7464-432-7. Also available at: http://www.av.se/dokument/inenglish/books/h367eng.pdf

Comments:

Time for discussion at the worksite and manager engagement are essential for the success of this intervention.  Employee feedback is an essential element of the method and is required in all three stages of the intervention. The Worksite Profile method requires impetus from management of companies to be successful. The authors recommend the user to do investments in special consultations to make improvements of the work situation if needed. 

Author(s):    Tom Cox, Raymond Randall & Amanda Griffiths                                          Country: United Kingdom

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

In the UK, the Management of Health and Safety at Work Regulations 1992 and its revision in 1999 require employers to undertake assessments for all risks to health. Managers were advised by the Health and Safety Executive (1995) to include work-related stress in their assessment of risks. This would fulfil both UK and European legal obligations that ask employers to assess and manage any type of risk to workers’ health, including psychosocial risks. The risk management process is driven by active participation of employees in a series of stages: familiarisation (including the formation of the steering group and workplace visits), risk assessment (using methods such as surveys, group discussions and individual interviews), audit of management systems and employee support, action innovation (defining risk reduction interventions on the basis of the risk assessment results) and evaluation). The process promotes a continuous improvement cycle. The tools and methods used to conduct an effective risk assessment are tailored to the size of the group and the nature of the work in the organisation.

Implementation:

At the beginning of the risk management process, a steering group should be established. The central responsibility of this group is overseeing and facilitating the risk management process. Typically, this group is comprised of management, staff representatives (in some cases union representatives), occupational health, health and safety and human resources specialists. Publicity of the risk management project is of central importance; this ensures transparency of the process and recruits the widespread involvement of the organisation. Prior to commencing risk management, considerable consultation between stakeholders and experts should be conducted; with a concentrated focus of setting appropriate expectations, schedules and identifying communication channels.

Risk Assessment: The aim of the risk assessment stage is to identify, for a defined group, significant potential sources of stress (psychosocial hazards) relating to employees’ work and working conditions; and examine their overall indices relating the health of the individual and the organisation. Subsequently, an audit of management systems and employee support is conducted which identifies and assesses current management systems in relation to the control and management of the hazards and the experience of work-related stress, and in relation to the provision of support for employees experiencing problems.

Translation / Action Innovation: The results of the risk assessment are fed back to the organisation and the steering group, which form the basis of discussion among the stakeholders. This information, and the resulting discussion, is used to develop a plan of action (i.e., a package of interventions) that are reasonable and practicable; the aim of which is to reduce likely risk factors for stress in at work. These are also discussed with workers so as they are actively involved in the design of the interventions and have ownership of the actions to be taken.

Intervention/ Risk reduction: Developing an action plan involves deciding upon what is being targeted, the methods being used, those responsible, the proposed time schedule, the resources required and how the intervention will be evaluated. The primary aim of the action plan is in reducing likely risk factors that have the potential to cause stress. The change initiatives identified through this process, can be integrated into existing management plans for change; thus, minimising the degree of disruption within the organisation.

Evaluation: The next step in the risk management process is the evaluation of the action plan.

Practical applications:

The risk management framework has been used effectively to identify and reduce work-related stress (psychosocial hazards) in a number of organisations. It is applicable in large enterprises as well as SMEs.

Innovative aspects:

The process is driven by active participation of employees through all stages, including intervention design. A number of methods are combined in the risk management process. The evaluative step in the risk management process addresses the question of whether the intervention was effective in reducing stress and it allows for the reassessment of the situation and the identification of further problems needing to be addressed. This process of reassessment feeds into a cycle of continuous improvement within the company; thereby yielding a basis for organisational learning.

Evaluation (including process issues, outcomes and sustainability):

The objectives of the evaluation stage are to determine: whether the intervention was implemented effectively, and whether the intervention had any impact on the problems identified during the risk assessment. This can be accomplished through several methods, which can be tailored/adapted to size of the group being assessed and the nature of work in the particular organisational context. Several evaluation tools can be utilized: interviews with key stakeholders, interviews with staff, surveys (including measures of work and well-being used in the risk assessment), group discussions and review of organisational data. The evaluation tools contain three elements, each of which yields important information, specifically, they measure: the level of awareness, participation and reaction to the intervention; the impact of the intervention of changes to working conditions; and whether the intervention has made an impact on the health and wellbeing of employees.

Benefits (including cost effectiveness):

A number of benefits have been demonstrated of the risk management intervention in research and implementation in organisations. The majority of groups involved in the risk management process improved their working conditions, and employees’ reactions to the risk management interventions have been favourable and generally positive. There were observed positive trends towards improvement of employee wellbeing. Additional benefits were observed in regards to the risk management process. Firstly, it was seen as a useful tool for stimulating new ideas and ways of thinking about problems. Secondly, it quantified problems, which could be used to inform prioritisation of the identify issues and the required resources required. Thirdly, it focused efforts and actions to promote a coherent and targeted approach to action. Finally, it yielded a framework for evaluating progress and monitoring change – a strategy that could be used to evaluate employees’ planned and unplanned change.

References:

Cox, T., Randall, R., & Griffiths, A.  (2002) Interventions to control stress at work in hospital staff. HSE report 435 Norwich: HSE books. See www.hse.gov.uk/research/crr_pdf/2002/crr02435.pdf

Comments:

Guiding principles: In planning the risk management there are several guiding principles and practical issues of importance:

·   Work with defined groups: each risk assessment is carried out within a specified and defined group (a department, company or profession).

·   Focus on work not the individual: The aim of  risk assessment is to identify the aspects of work giving rise to stress, not the individuals experiencing stress.

·   Focus on ‘big issues’:  the focus is on problems that staff agree on that staff agree on, rather than individual complaints.

·   Use of reliable measures: all methods of data collection are designed to be reliable and valid.

·   Confidentiality of information given by employees must be guaranteed; thus, data collected must be stored securely and not disclosed.

Risk reduction as a goal: risk assessment tools are designed to provide sufficient detail and context-specific information to allow for intervention design.

Author(s):     Richard Wynne & Rose Rafferty                                                             Country: Ireland

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

In 1989, the Irish Safety Health and Welfare at Work Act was enacted and the Health and Safety Authority was established. Although the legalisation does not directly require employers to act upon occupational stress, its provisions concerning the work environment and working methods do, in effect, cover/ address the psychosocial working environment and, in turn, work-related stress. This legalisation requires employers to do everything reasonably practicable to ensure and protect the health and safety of their employees; this has been interpreted to cover occupational stress.

The impetus for the airport management company to address work-related stress was due to the concerns voiced by employees within the organisation to upper level management. To address this, the company established a group within the organisation known as the ‘stress working group’. The aim of this group was fourfold: firstly, to investigate the issues of stress within the organisation; secondly, to identify the origins and causes; thirdly, to formulate an action plan; and lastly, disseminate information for individuals coping with stress to promote enhanced coping and effective management. This last objective was achieved by developing a booklet, with the assistance to external help agencies, to be published and subsequently distributed to all staff members.

Implementation: 
 

In order to achieve the first three objectives it was decided to undertake a survey. This survey was conducted in two phases:

(1) Piloting the survey: Developing the pilot questionnaire involved two processes. In the first process, a questionnaire was proposed that broadly examined sources of stress, coping health-related behaviours and outcomes of stress. The second phase, involved extensive discussion with the “stress working group” to tailor the questionnaire to the needs and requirements of the organisation and its specific situation. The results of the survey were analysed and the appropriate modification to survey were made.

(2) Survey: The instrument was widely distributed throughout the organisation. The survey was comprehensive and covered the following areas: personal and work-related demography, sources of stress at work, personal life events, coping styles, social support at and outside work, physical health status, psychological wellbeing status, health-related behaviours, and job satisfaction. The survey was constructed based on a series of established scientific measures; however, most of these scales were augmented with additional questions to respectively tailor the questionnaire to the organisation’s specific situation. The survey was used to identify the main psychosocial features of the work environment which were related to reduced health and well being. Additionally, the analysis concentrated on characterising the experience of stress for specific groups in the workforce (e.g., identify ‘at risk’ groups, examining gender, age, company departments, shift work, and grade levels).

Developing an Action Plan: Based on the extensive results of the survey a set of coherent intervention actions were developed. A participative approach was utilised; whereby, the project team was consulted about potential measures and where subsequent action teams set up by the company consulted widely on the formulation of a suitable intervention. This was accomplished in three stages:

1)       The results of the survey were feedback to the “stress work group” through a series of presentations delivered by the consultants.

2)       The consultants drafted several recommendations, which were presented to the survey team. A dual approach to intervention was proposed: a preventative approach and a health promotion approach.

3)       The survey results were presented to employees through a series of meetings and presentations. Additionally, staff members received a summary of the report.

Two action teams were established to examine, amend and implement the recommendations: one for each the health promotion and organisational development approaches. Their function was to examine and prioritise and develop an action plan to implement the outlined recommendations. Training and consultancy input was provided to the teams by the external consultants: both teams were active for one year following their establishment. The main task for the organisational development team was to adapt the recommendations into ongoing programmes which were already established and taking place within the company; and where appropriate and possible develop new ones. For the health promotion team, there primarily objective was to repackage existing services, as opposed to developing new ones: these services included the medical department, the employee assistance programme service, the staff welfare department, and the staff development (training) department. Both teams each produced a report, which transformed the proposed recommendations by consultants into a concrete action plan. These reports outlined both short-term and long-term actions the company wished to undertake.

Practical applications:

This intervention requires expert support in designing the survey and is not readily applicable to smaller organisations where qualitative methods work better.

Innovative aspects:

Two complimentary approaches: a preventative approach and a health promotion approach were used. The peventative approach focuses on organisational development; where action is taken on changing aspects of the working environment, practices and company policies which may lead to stress. The health promotion approach focuses on improving health and welfare services of the company to address work-related stress.

Evaluation (including process issues, outcomes and sustainability):

Formal evaluation was not conducted on this intervention; however, the authors provide anecdotal evidence to the some of the major outcomes/benefits of the interventions undertaken.

Benefits (including cost effectiveness): 
 

The major outcomes of the interventions included redesign of shift schedules, design and implementation of a support manual for new and existing shift workers, implementation of training for new shift workers and for supervisors, and overall improvements in communication practices. The authors noted that although these outcomes did not amount to an evaluation of the intervention, they did, however, indicate that the programme had positive effects.  The two intervention teams reported that the experience of occupational stress had been addressed in an effective manner, although not completely removed. Additionally, it has been observed that a positive result of the intervention was increased awareness of occupational stress and its implications, and the development of a set of skills within the organisation to address these issues more effectively in the future.

References:

Wynne, R. & Rafferty, R. (1999). Ireland: Stress prevention in an airport management company. In C.L. Cooper & M. Kompier Preventing Stress, Improving Productivity: European Case Studies in the Workplace (pg242-263). London, UK: Routledge.  

Comments:

Method requires external expertise and is not readily applicable to smaller organisations. Also no formal evaluation was conducted.

Author(s):    Joanna Pryce, Karen Albertsen, Karina Nielsen                                   Country:  Denmark

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):
 

The Working Environment Act of 23 December 1975 lays down the functions and responsibilities of the institutions, authorities and persons responsible for the working environment in most sectors. Its objective is to ensure that working conditions are such that workers will not be subject, in the short term, to accident or disease or, in the long term, to physical and psychological problems. The Act makes it compulsory for work to be conducted in such a way that employees’ health and safety are protected. The obligation to produce a result implies findings that means and establishing the sort of relationship between the employers and labour organisations (the social partners) which will ensure that health and safety problems at work are solved and working conditions are improved. As in the case of all other working environment problems, psychosocial issues, according to the policy of the Danish occupational safety and health authorities, best addressed by the management and employees of the enterprise, possibly with assistance from their respective organisations, the occupational health service or other external sources.

An approach which can involve multiple stakeholders working together for addressing psychosocial issues is the open-rota system for work scheduling. This approach/intervention was introduced into a Danish psychiatric hospital, with the overall objective of improving employee job satisfaction and work-life balance. Described below is an example of a work scheduling intervention developed to improve work scheduling for nurses; with the broader aim of increasing employee control and influence on their work schedule and, in turn, promote increase job satisfaction and overall experience of work-life balance. This intervention draws upon a participatory approach, whereby participants were actively involved through out the entire intervention process: design, implementation and evaluation

Implementation: 
 

Each of the nursing teams, which voluntarily decided to participate in this project, began by forming a steering group, composed of safety, trade union and project representatives. The steering group was supported by a larger project group of 5-6 employees and two external consultants. The external consultants invited the steering groups to attend a one day workshop during which case studies of work scheduling interventions were presented and discussed.

Following the workshop, the steering groups in collaboration with the larger project groups discussed and, in turn, identified an appropriate work scheduling intervention to be implemented in the nursing teams. The intervention selected by the majority of the intervention groups was implementing an open-rota system. Within an open-rota system employees are asked to schedule their shift preferences into an open (and uncompleted) rota. When completing their preferred shifts into the open-rota, employees were asked to do so responsibly and fairly (i.e., considering the needs and preferences of the work colleagues and the relief required in other departments). Following which, one or two employees had the responsibility of fine-tuning and finalising the rota; this assigned responsibility was rotated between staff members each week.

Practical applications:

The intervention is easily transferable to other teams in other occupational sectors. However, the design and evaluation of the intervention requires external expertise.

Innovative aspects:

The intervention uses the knowledge and expertise of the management and employees of the organisation, with assistance from their respective organisations, the occupational health service and other external consultants to address the psychosocial issues, which is in accordance with the policy of the Danish occupational safety and health authorities.

Evaluation (including process issues, outcomes and sustainability):
 

The aim of the evaluation was to assess the impact of an open-rota scheduling system on the health, work-life balance and job satisfaction of nurses working in a psychiatric ward in Denmark. Eight nursing teams volunteered to participate in the study; four of which were randomly allocated to the intervention condition (where the teams implemented the intervention) and the remaining four to the control condition (where the teams did not implement the intervention). The random allocation was done so that the actual effects of the intervention could be compared between the teams implementing and not implementing the intervention. Participants, in both the intervention condition and in the control condition, were asked to complete a questionnaire survey prior to the intervention and 20 months following.

Additionally, an evaluation of the process involved in developing, implementing and maintaining the intervention was conducted. This was accomplished by recording ongoing discussions between the researcher and the teams, and a series of interviews conducted with members of the teams to identify the potential barriers and facilitators to the process. The outcome measures, used to assess the effectiveness of the intervention, were indices surrounding work scheduling, work-life balance, and health and wellbeing.

Benefits (including cost effectiveness):

The results of the evaluation of the intervention indicate the following observed benefits to the open-rota scheduling system as intervention to enhance employee health, wellbeing, job satisfaction and work-life balance. Employees reported a greater level of satisfaction with their work hours, and, in turn, they were less likely to swap their shift. Additionally, employees working within the open-rota scheduling system reported a significant increase in their work-life balance. Additionally, compared to the non-intervention group (the control group) positive significant differences were observed in the intervention group were: work-life balance, job satisfaction, social support and an overall increase sense of community in the workplace.

The results of the process evaluation demonstrated that employees reported that the open-rota system not only saved time, but also provided them with an insight into how the department operated; thereby suggesting a greater influence and greater overall level of satisfaction. Additionally, it was reported that the open-rota system had resulted in a greater understanding by employees of the availability and utilisation of resources; for example, the cost of absenteeism. Furthermore, it was reported that the open-rota system had resulted in an increase in team awareness within the groups. Based on the overall evaluation of the process-based assessment the authors concluded that the new approach to work scheduling took into account the needs and constraints of the individual, the group and the organisation-at-large.

References:
 

Pryce, J., Albertsen, K., & Nielsen, K. (2006). Evaluation of an open-rota system in a Danish psychiatric hospital: a mechanism for improving job satisfaction and work-life balance. Journal of Nursing Management, 14, 282-288.

Comments:

The findings of the evaluation of the open-rota system suggest this is an effective intervention to enhance job satisfaction, work-life balance, support and cooperation within nursing teams and is applicable to other teams in other occupational sectors. However, as the intervention requires external expertise, it is not ideally suited for smaller organisations;.

Author(s):  Birgit Aust & Antje Ducki                                                                         Country:   Germany

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

Health circles were designed in Germany to facilitate health promotion in the workplace with an emphasis on organisational and psychosocial factors. Health circles are structured discussion groups were employees identify the major health-related problems in the workplace and develop and implement appropriate solutions to address these issues. The areas that are assessed include: lifestyle changes, and changes to the work environment and organisation. The overall aim of the health circles is to improve the working conditions, and thereby improve and promote the health and wellbeing of employees. The Health Circle approach is a flexible approach that can be tailored for various different companies and situations. Assessed outcomes vary according to the requirements of the organisation, in a tailored approach. Typical outcomes include reducing absenteeism, increasing job satisfaction, reducing turnover rates, reducing early retirement, and higher motivation.

This approach was developed as a result of changes in OSH legalisation in Germany during the 1980’s, which placed greater emphasis on prevention activities. This approach was designed using a participative problem solving approach; which is underpinned by the assumption that the employee/ worker are the experts on their work and the management of that work environment. Health circles use this ‘employee expertise’ to develop suggestions to improve the situation at the workplace, and, in turn, promote their health and wellbeing.

Implementation:

Health circles are generally implemented in departments which have specific problems related to absenteeism or dissatisfaction. Health circles are based on structured group discussions of employees, where employees evaluate psychosocial risk factors and define solutions to address the identified solutions. These meetings are conducted under the guidance of a specially trained facilitator, whose primary role is to act as a moderator. Meetings are generally conducted during paid working hours lasting a total of 90 minutes. In most cases, the process includes between 6 to 10 meetings.

The process has 6 steps:

·         Commitment & Infrastructure: A contract is signed between management and employees; thus, ensuring commitment of all parties throughout the intervention process and with the project goals.

·         Needs Assessment: A health surveillance report is produced from company or insurance data; identifying absenteeism rates, length and causes of sick leave, ‘high risk’ departments of absenteeism and the identification of possible psychosocial hazards. Following the health report, an employee survey assessing hazards (both physical and psychosocial), employee health and wellbeing is conducted.

·         Health Circles: A steering group is formed by those responsible for health and safety in the company; with the overall intention of overseeing the process. Approximately, 10-15 participants are invited to each health circle (these include representatives from the employees, company and the union, and the facilitators). Results of the needs assessment provides structure to the discussion; where participants discuss the identified problems, as perceived by a larger number of employees, and develop proposed solutions to the identified issues. These meetings are formally recorded and disseminated to all employees in the affected department. 

·         Feedback to the management team: The management team is informed of the progress and suggestions developed by the health circle. The management team makes the decision on which suggestions will be implemented, and in which order.

·         Implementation of solutions: Proposed solutions are implemented throughout the process. These provide the basis for health improvements.

·         Review and transfer: In the last health circle meeting, all participants are asked to evaluate what has been achieved. Additionally, it is commonplace to conduct a follow up meeting with the participants to complete the evaluation of the process. In some cases, the employee survey is repeated in the department were changes were implemented; thus allowing an assessment of the change in outcomes. 

Practical applications:

Health circles have been applied in hundreds of companies since its inception. Overall, participants report a high degree of satisfaction with health circles. The approach has been demonstrated to be an effective tool for improving the psychosocial and physical work environment and in reducing sickness absence.

Innovative aspects:

Health circles follow a systematic and structured participatory process that uses the expertise of the employee and is actively supported by additional key stakeholders. Health circles utilise both a bottom up and top down approach, and integrating these two methods through the use of social dialogue.

Evaluation (including process issues, outcomes and sustainability):
 

In the last stage (meeting) of the appraoch, the evaluation stage, all participants are asked to evaluate what has been achieved. The objectives of the evaluation stage are to determine: whether the proposed solutions were implemented effectively, and whether the solutions had any impact on the problems identified. Additionally, it is commonplace to conduct a follow up meeting with the participants to complete the evaluation of the process. In some cases, the employee survey is repeated in the department were changes were implemented; thus allowing an assessment of the changes in the outcomes.

Benefits (including cost effectiveness):

Health circles have been found to be an effective tool for the improvement of physical and psychosocial working conditions in many organisations and industrial sectors. Health circles have also been demonstrated to have a positive effect on outcomes; including, enhanced employee health and wellbeing and reduced sickness absence.

References:

Aust, B. & Ducki, A. (2004). Comprehensive health promotion interventions at the workplace: experiences with health circles in Germany. Journal of Occupational Health Psychology. 9(3), 258-270.

Schröer, A., & Sochert, M. (2000). Health promotion circles at the workplace. Essen, Germany: Federal Association of Company Health Insurance Funds

Beermann, B., Kuhn, K., Kompier, M. (1999). Germany: Reduction of stress by health circles. In M. Kompier & C. Cooper (Eds.), Preventing stress, improving productivity: European case studies in the workplace (pp. 222-241). London: Routledge.

Comments:

The Health Circle approach is a flexible approach that can be tailored for various different companies and situations. However, as the intervention requires a specially trained facilitator to moderate group meetings, smaller organisations may not always find this approach viable to implement.

Author(s):      Georg Bauer                                                                             Country:  Switzerland

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

In Switzerland, work health promotion practitioners and a group of Small and Medium Enterprises (SMEs) collectively developed and tested a web-based, standardised toolbox for comprehensive workplace health promotion; with a concentrated focus on the unique needs of SMEs. This toolbox was collaboratively developed by input from researchers, practitioners, employer representatives, trade unions, and governmental representatives. It contains 10 modules which follow the risk management paradigm and have a particular emphasis on psychosocial determinants of health of the working environment. SME vital is underpinned by several key principles:  participation (of all employees); integration (of health circles and employee surveys into organisational structures) into all areas of organisation, project management (following the systematic cycle from workplace health promotion – initiation, analysis, strategy development, implementation to evaluation); and comprehensiveness with equal consideration of individual and environmental measures (aiming at risks and resources as well as individual behaviour and organisational structures).

Implementation:

The toolbox consists of several interrelated modules, basic modules which can be used as a workshop and implementation modules which consist of courses that address health behaviour (i.e., wellness and stress management), personnel development (i.e., team development, and health promoting management style) and organisational development (i.e., participatory job re-design and workplace design).

Phases for the implementation of SME-Vital.

Initiate Workplace Health Promotion: An information brochure is disseminated within the workplace and a “starter workshop” is conducted with top-management for initial motivation for workplace health promotion with the overall aim of conducting an organisational analysis, to establish and outline general goals, and for formulating an implementation plan for the subsequent modules to follow.

Workplace health promotion analysis: Employee and management surveys are distributed; with the aim of developing a bottom-up and top-down approach for promoting healthy working conditions. Management survey examines current work organisation, personnel management practices and employee benefits. Employee survey analyses strengths and weaknesses regarding job task, work organisation, participation, leadership, working climate, and commitment from an employee’s perspective.

Development of a work health promotion strategy: A health circle is used during this phase of implementation, whereby both employee and management discuss and analyse the results of the survey, conduct a problem analysis, outline and set company specific targets for workplace health promotion, and the develop a joint action-plan.

Implementation of the action plan: Depending on the specific needs of company, a variety of approaches can be used: (a) organisational development; (b) personnel development; (c) individual health behaviour (how to guide for wellness-related activities in a company and stress management training); or (d) a combination of methods.

Evaluate the results: This is accomplished by monitoring changes based on a repeated application of employee and management surveys and using the outlined company-specific goals of achievement as a benchmark.

Consolidate and institutionalise workplace health promotion strategy: This is accomplished by engaging companies in a continuous-improvement cycle, by establishing “health circles” as sustainable structure for the workplace health promotion strategy.

Practical applications:

Practical and easy to use by companies by providing concrete guidelines and working materials. Composed of standardised modules which are flexible enough to be combined and adapted according to specific company needs. Being a web-based toolkit without an access/ user fee, this makes access this toolbox readily accessible to all employers; irrespective of the occupational sector or size of company. 

Innovative aspects:

This intervention was developed through a collaborative process of a variety of stakeholders, as a result, such a programme has high practical applicability, is user friendly, and readily accessible. Also, national-level support for SME Vital was secured by using social dialogue in the development phase.

Evaluation (including process issues, outcomes and sustainability):

The toolkit was initially implemented in 10 pilot companies (SMEs). The final assessment was conducted by an external, independent evaluator. A questionnaire covering 8 dimensions of the working environment and containing items addressing the health status of employees was handed out prior to the implementation of the toolkit. In follow up survey (after 18 months), additional items were included, in order to include a process evaluation of the intervention. Additional items included assessed the participants awareness of the programme, their level of participation, the accessibility of the programme, the level of personal competency building, the overall perceived profit derived from the programme, and its impact on the working environment and workers health from an employee perspective. The evaluation of the toolkit revealed several positive outcomes; however, an economic evaluation of the programme has not yet been conducted.

Benefits (including cost effectiveness):

The following benefits derived from SME-Vital have been observed: (a) increase degree of communication between employees and management and the overall improved working climate; (b) increased motivation and performance of employees; and (c) increased competency in coping with demands and ongoing organisational change.

References:

Bauer G, Gutzwiller F. (2006). Arbeits- und Sozialmedizin: Betriebliche Gesundheitsförderung. In: Haisch J, Hurrelmann K, Klotz T (Hrsg.). Medizinische Prävention und Gesundheitsförderung. Verlag Hans Huber, Bern. Herbst.

Bauer G, Schmid M, Lehmann K, Kuendig S, Kissling D. (2004) Entwicklung und Evaluation eines nationalen Programms für betriebliche Gesundheitsförderung in KMU. In: Gesellschaft für Arbeitswissenschaft e. V. (Hrsg.): Tagungsbericht Arbeit und Gesundheit in effizienten Arbeitssystemen. Dortmund: GfA-Press

Comments:

SME-Vital is a web-based toolbox currently available, in German, French and Italian (www.kmu-vital.ch), for free via the internet. This toolbox has been designed for the unique needs of small and mediums-sized companies; however it has also been used by large-sized organisations successfully; making it useful approach for enterprises of all sizes.

Author(s):  José María Peiró                                                                                  Country:  Spain

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

Although the Spanish Law for the Prevention of Risks at Work (Ley de Prevención de Riesgos Laborales – Ley 31 de 8/11/1995) makes no explicit reference to workers’ mental health, it does refer on various occasions to psychological and social aspects as relevant elements in the prevention of risks or as potential sources of risk. The Decree “Regulations of the Preventive Services” (Reglamento de los Servicios de Prevención – 17/1/1997) recognises the relevance of ergonomics and applied psycho-sociology as two of the specialities OSH experts, and establishes the minimum training content for their work.  The laws also establish the need to attend to psychosocial factors in all aspects related to the analysis and prevention of risks at work.

In order to make an organisational diagnosis that facilitates the assessment of risks deriving from psychosocial factors in the workplace, an essential prerequisite is a theoretical model that enables a systematic and comprehensive consideration of organisational phenomena at all levels, and that facilitates the identification of the most effective psychosocial interventions in each case. The AMIGO model (Análisis Multifacético para la Intervención y Gestión Organizacional – Multi-facet analysis for organisational intervention and management), serves as a foundation for the development of a methodology of risk assessment and helps to organise the different strategies and techniques of organisational intervention. It may also facilitate the selection of the most effective approaches in each case and the identification of areas in which the development of new techniques is required. The main characteristics of the AMIGO model are that it distinguishes “hard” and “soft” facets of the organisation, it employs a dynamic perspective of fit and of organisational coherence, it analyses the harmony between person (or group) and organisation not only in issues related to the work system but also in the organisation as a whole, through the consideration of the psychological contract concept. Finally, it offers a comprehensive view of the results that takes into account the demands of the supra-system, of the system itself and of the subsystems of which it is made up, leading to a multilevel approach.

The “Prevenlab-Psicosocial” methodology is a system of analysis, assessment, management and intervention with regard to psychosocial factors relevant to the prevention of occupational risks. It is based on the theoretical conception of the AMIGO model, and aims to provide a system of professional practice that permits the analysis and assessment of risks for specialised intervention by professionals.

Implementation:

The method allows for the development of a professional intervention that is suitable, efficient (using minimum resources for achieving certain results), “user-friendly”, non-invasive for the organisation, and involves feedback processes that contribute to improving the methodology itself and its instruments.  The method is applied in several stages.

1.       In the first stage a screening analysis is carried out, the aim of which is to identify the main facets and components that constitute sources of stress with harmful effects. This exploration can be carried out by means of the “triangulation of informants” method, which involves seeking spontaneous responses from the respondents and then conduct a systematic analysis of facets and components. Its complementary aims are to identify the facets that may represent resources in the intervention and the principal consequences of stress.

2.       In the second phase a detailed analysis and assessment is conducted of those facets and components that have been identified as significant sources of risk. This assessment is also conducted by means of triangulation of informants and, where applicable, of methods. This stage also includes an analysis of possible sensitising factors that increase vulnerability to a given risk for certain people or groups.

3.       In a third stage, an analysis is carried out of significant sources of risk at a collective level (by units or for the organisation as a whole). The appropriate development of this analysis requires prior planning, before the second stage, and needs to take into account the screening analysis. Sometimes, data obtained in the second phase may be relevant for this third phase. The statistical analysis –through aggregation– is carried out at group level.

4.       The fourth stage involves a study of the facets and components of the organisation as a system in their function as resources that may contribute to neutralising or preventing the risks identified. The analysis starts out from the organisational or developmental level and is completed at the individual level, in those cases where this is necessary.

Practical applications:

The method is flexible and can be implemented in any organisation in any sector with the assistance of experts. The application the methodology requires, as a necessary condition, the commitment of the management of the company and of those in charge of the hierarchical lines of all levels and departments. It is important to ensure and to define their collaboration in all of those aspects that will affect the correct and effective application of the methodology. Also important is the involvement and participation of the company’s Health and Safety representative(s); while the support of the company’s Board of Directors is also an important factor. Finally, the employees in those departments or groups that are to participate in the study should be informed of the nature of the study and the implications of their participation.

Innovative aspects:

The order of the stages outlined need not be strictly adhered to; nor is it necessary to carry out each one in its entirety. The stages described are for guidance, and their application must be flexible in order to respond to the needs that the expert considers priority in each case.

Evaluation (including process issues, outcomes and sustainability):

The method is also modular in structure, with each stage is not necessarily being a precursor for the next stage, this allows a flexible design of each plan of analysis and assessment according to the needs, characteristics and restrictions of the client-system. Once the interventions developed using method are implemented in an organisation they are evaluated periodically in the stages outlined above and improvements are made based on their results.

Benefits (including cost effectiveness): 
 

The AMIGO model is useful for the identification and classification of possible preventive interventions to be carried out in an organisation and the facets on which they concentrate. It also facilitates intervention on providing a common scheme for diagnosis and interventions. Nevertheless, in using the model it should be borne in mind that the facets are independent, and that their most important feature is their relationship with one another. This point is especially relevant to the planning of the intervention. Since one of its fundamental elements must be the prior analysis of the effects that a change proposed for one facet will have on the others, and the changes that must be made in them in order to re-establish equilibrium in the system.

References:
 

Peiró, J.M (2000). Assessment of psychosocial risks and prevention strategies: The AMIGO model as the basis of prevenlab-psicosocial methodology. Psychology in Spain, 4(1), 139-166. Also available at: http://www.psychologyinspain.com/content/reprints/2000/12.pdf

Comments:

The method has been designed as a system of professional practice that permits the analysis and assessment of risks for specialised intervention by professionals. Initial investment is required to hire professional where they are not present in-house, post application the interventions derived from the methodology are self sustaining.

Author(s): Ellis Lourijsen, Irene Houtman, Michiel Kompier and Robert Grundemann                 Country:  Netherlands

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

In the Netherlands, work stress has been an important policy issue. It was in 1990, with the enforcement of Article 3 of the Working Conditions Act that work stress became a high priority. This legislation has also promoted risk management at source. Since 1994 the legislation on Working Conditions for amended to fit the European Framework Directive (89/391/EEC), this resulted in more responsibility for employers and employees with respect to risk management and social security aspects. The shift to preventive action is considered effective by many practitioners as well many employers.

Under this legislative framework, a tailor-made and step-by step strategy for risk prevention and management was implemented at in a hospital employing around 850 people in five sectors with the aim of reducing the high absenteeism rates reported. Based on the idea that a risk prevention strategy can only work if it is supported by the entire organisation, a steering committee with a broad based composition was selected to carry out the project. The ‘Healthy Working for Health’ steering committee comprised: the head of the care sector (also chair person), the head of personnel affairs, two supervisory staff members, the organisational expert, a work council member, a nurse, and an operational member of the radiology department and two consultants. The steering committee was responsible for the implementation and progress of the project programme.

Implementation:

From the start, the project programme was integrated into the hospital’s normal working conditions policy. To create support for the project an initial meeting was organised with the complete workforce to explain the goals and structure of the project. To gain a general impression of the problems at work in the hospital, a limited number of staff (all levels), known as ‘key respondents’, were interviewed using existing checklists on job content and organisation of work, on working conditions, on social relations at work and on terms of employment. The interviews were followed up with an organisation wide survey (questionnaire used was based on validated instruments) to analyse stress and health problems in more details. On the basis of the survey, a number of positions were selected for further analysis using the WEBA (Dutch abbreviation for Well-being at work). This method can be used to determine job-related stress risks and learning and developing opportunities. The WEBA method complies with the provisions of Section 3 of the Dutch Working Environment Act.

The results of the survey revealed that there were a number of organisation- related problems, which lead to organisation related and sector-specific health complaints. Although no direct statistical relationship and absenteeism could be demonstrated, the literature on absenteeism suggested that the organisational problems were likely to influence it. Consequently, the choice of measures was based on a ‘multi-track’ policy aimed at both the improvement of working conditions and employee’s physical and mental health, and the intensification of inspection and absentees. An approach that combines three types of measures and positively influences employees’ health and well-being in a more structured manner is an instance of integrated health promotion. Such an approach intends to go further than solely removing health hazards at the workplace.

In order to arrive at a coordinated set of measures, the steering committee first examined the question whether the problems identified could be solved. The criteria used were: whether the cause of the problem was sufficiently clear, what measures could the hospital take, the cost of such measures and the expected (additional) yield. Following this examination, the committee decided to start sub-projects (interventions) to address work pressure, interior climate, physical load, provision of information, working hours and rosters, training and career opportunities, managerial style and lifestyle. The purpose of the sub-projects was to further elaborate and implement measures and solutions. The sequence of the interventions was mainly determined by the clarity of the solutions and time and manpower available to carry out the sub-projects. Each intervention was assigned a steering committee member as a coordinator. Responsibility for the implementation of each intervention was given to a single project group and the progress and coordination of the intervention was monitored by the steering committee.

Practical applications:

The intervention requires external expertise to initiate the process, but the programme is flexible as it relies on in-house expertise in the form of employees and management of the organisation to design and implement the interventions. Such a programme is easily applicable in most large companies across industrial sectors.

Innovative aspects:

The programme uses the WEBA method, which can be used to determine job-related stress risks and learning and developing opportunities. It complies with the local legislative provisions (in this case) Section 3 of the Dutch Working Environment Act). It also allows rules for improvement to be inferred.

Evaluation (including process issues, outcomes and sustainability):
 

The programme was evaluated for a period of 6 months post implementation of the interventions. It involved a repetition of the survey, an analysis of the absenteeism data and cost benefit analysis. Results indicated that the employees expressed significantly fewer complaints related to aspects of job content, emotional stress and appreciation fro working environment. The survey also indicated a number of improvements in the workplace which are (possibly) associated with the measures already implemented. A significant reduction in absenteeism was also found.

Benefits (including cost effectiveness): 
 

More employees thought they were more involved in improving the work situation and were more critical of their work situation. There was a shift in the organisational culture with a move from ‘a wait-and-see attitude’ when it came to bringing about improvements, to actively engaging in bringing change. The overall programme made the employees more aware of what was going on the various departments of the hospital, which led to a better understanding of each other and a more pleasant atmosphere. A cost-benefit analysis conducted indicated an overall financial benefit. The results of the inventions were also expected to continue to bear fruit in the future.

References:

Lourijsen, E., Houtman, I., Kompier, M., and Grundeman, R. (1999). The Netherlands: A hospital, ‘Healthy working for health’. In C.L. Cooper & M. Kompier Preventing Stress, Improving Productivity: European Case Studies in the Workplace (pg85-120). London, UK: Routledge.

Comments:

Middle management felt insufficiently involved in the project, while operational personnel in the steering group could not commit adequate time to discussions. Care must be taken that members of the steering committee represent all sections of the organisations and also are able to commit adequate time to participate in the process.

Author(s):    Carla Dahl-Jørgensen, Per Oystein Saksvik                                                          Country:  Norway

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

Studies focusing on interactive service work that involves face-to-face interactions between employees and customers/clients have shown that employees tend to show symptoms of job dissatisfaction, stress, and emotional exhaustion because they are expected to display or suppress certain emotions in the performance of their jobs. To meet the health challenges and reduce sickness absenteeism among employees in this sector, two organisational interventions were implemented in two different parts of the service sector: municipal government and the retail sector. The interventions varied slightly in their design applied to the different sections of the sample; most notably in the different steps used in the process leading from the preparation phase to the discussion phase.

The overall objective of the intervention was to bring about changes in the factors perceived by employees as causes of stress at work and to bring about organisational changes at the unit level. The method utilised to identity the cause of stress, as perceived by the employees, was a three-step strategy culminating in a meeting where employees and their respective supervisors engaged in group discussion or ‘search conferences’. Additionally, these organisational level interventions were underpinned by three theoretical traditions: (1) a focus on participation, dialogue and workplace democracy; (2)  a primary emphasis on job redesign/ environmental causes of illness, rather than behavioural change aimed at the individual or on expressed symptoms of ill-health; and finally (3) using organisational theory as a method of initiate a learning process within the organisation, whereby improvements can be made in the performance of the organisational tasks and the value system of the organisation.

Implementation:

Prior to the start of the project, initial meetings were held between top-level management and researchers to discuss and outline the aims of the intervention. Subsequently, a letter was distributed to all participants about the nature and objectives of the project. The researchers visited each unit and informed them about the research project. The decision on whether to implement the project was decided at the administrative level of the organisation. All employees and managers accepted to actively participate in the project, throughout the process. Employees were not consulted in regards to the types or content of the intervention, nor whether the intervention should be implemented.

The Municipal Units: The initial phase of the intervention consisted of interviews with employees who had recently or in the past experienced one or more periods of sick leave. With the principle aim being the identification of: the perceived causes of the employees’ absenteeism, and what strategies, measure or precautions were taken at their workplaces on their return. In the second phase of the intervention, an assessment of risk factors and risk persons/groups in the workplace was conducted.  The results culminated in the first two phases of the intervention were applied as inputs into the final step in the intervention process; which consisted of a ‘search conference’ (or dialogue). The objective of the search conference was to identify and define the stress and health problems present in the workplace, and generate local solutions to problems associated with workplace.

The Retail Units: The initial phase of the intervention began with each employee describing a ‘typical working day’ to the researcher. The aim of this preliminary step was to identify stress-provoking incidents over the past three-week period. During the second phase of the intervention, the researcher analysed the collected information and diagnosed the problem. The identified problems were listed, in no particular order of importance, and distributed among the employees. The employees were then asked to discuss the identified problems in pairs or in groups of three at each work unit, and to prioritise possible solutions to the identified problems. A ranking list of the factors that needed to be reformed or changed was compiled, and this list became the basis of the discussion for the third phase. During third stage, managers and union representatives from each establishment were asked to identify one factor they wanted to change, before determining a strategy for how this change could be accomplished. The researchers ensured, through follow up visits, that the work units drew up a strategy for change in accordance with their targeted organisational factor.

Practical applications:

Although the interventions have been used in the retail sector, they is based on principles which are applicable in other organisational sectors and therefore the interventions can be tailored for most organisations.

Innovative aspects:

Prior to the intervention, the cause of stress as perceived by the employees was identified. Additionally, the subsequent organisational level interventions were underpinned on sound theoretical traditions.

Evaluation (including process issues, outcomes and sustainability):

The intervention was implemented into two different types of work units both in the service sector: municipal units and in retail units at a shopping mall. A total of 12 municipal work units participated in the study; eight units were randomly assigned to the experimental group (i.e., the intervention group), the remaining four units were allocated to a control condition (where the intervention was not implemented). While of the 30 retail work units that participated in the study; 17 were randomly allocated to the intervention condition and the remaining 13 to the control condition.  The design of the study consisted of the following steps: pre-survey, interventions, interviews and observation, and post –survey. The variables under investigation, and further explored by the survey, were: job stress, subjective health complaints, burnout, and sickness absenteeism. During the qualitative element of the evaluation, observations in the workplace and unstructured interviews with participants were conducted during the implementation of the interventions. These were subsequently studied, analysed, and discussed among the researchers throughout the data-collection period. Researchers examined participants’ reactions (either positive or negative) to the interventions.

Benefits (including cost effectiveness):

The survey results demonstrated positive changes on two factors for the retail sector employees; namely, depersonalisation and subjective health complaints. However, no significant differences in any of the outcome measures were observed in employees in the municipal units. The qualitative data demonstrated that constraints related to interactional and organisational practices acted as an significant barrier in the full participation of employees in the study during the implementation of the interventions.

References:

Dahl-Jørgensen, C. and Saksvik, P.O. (2005). The impact of two organizational interventions on the health of service sector workers. International Journal of Health Services, 35(3), 529-549

Comments:

Since the decision on whether to implement the project was decided at the administrative level of the organisation and because employees were not consulted in regards to the types or content of the intervention, nor whether the intervention should be implemented, the evaluation does not indicate the potential benefit of the intervention.

Author(s):  Anna-Liisa Elo, Anneli Leppänen, & Pia Sillanpää                                     Country:  Finland

Is the intervention sector specific?

Is the intervention usable with different enterprise sizes?

Yes

Is the intervention equally applicable to both genders?

Is the intervention based on theory?

Yes

Can the intervention approach be adapted/ tailored?

Does the intervention promote CSR and how?

Yes, top management of the organisation need to appoint internal expert groups to clarify the possibilities of satisfying the organisations legal duty and, in turn, promote employee health and wellbeing. These groups are is critical for the success of the intervention.

Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Overview (including risk assessment and law – legal requirements etc.):

Since the implementation of the occupational safety act of 1987, which included several clauses referring to psychosocial factors, it became the employers’ obligation to plan the work and the work environment in a way that not detrimental the physical or mental health of the employees; this was the underlying motivation of the initiation of an intervention seeking to reduce stressors in the workplace, and thereby promoting employee wellbeing and health.  The board of directors of the organisation appointed an internal expert group to clarify the possibilities of satisfying the organisations legal duty and, in turn, promote employee health and wellbeing. This expert group consisted of representatives of management, occupational health personnel, safety personnel and union members. The group collectively decided on utilising a survey feedback process as a method of reducing stressors found in the workplace, and thereby enhance and promote employee health and wellbeing. 

The reduction of stressors, through a survey feedback method, was planned as a two phase process where: (a) the researcher- consultant support the occupational health personnel in the organisation in developing a practical action model; and (b) the occupational health personnel supported the superiors and employees of the participating work units to reduce stressors. This invention consisted of a collaborative initiative between the research-consultant and the personnel in the occupational health department. The researcher-consultant’s primary task was to structure the process, whereas the role of the occupational health personnel was implementing the devised process at the workshop level.

Implementation: 
 

Training Programme for Occupational Health Personnel

A three-day training course for the participating occupational health personnel, consisting of physicians and nurses, was delivered; this was done simultaneously with the model survey. The training course concentrated on the survey feedback as a method and on the process-centred consultative role of the occupational health personnel in the collaborative partnership when working with worksites. In between the training sessions, the OH personnel began their own projects in their own area; these projects were used as training material. Additionally, the training sessions acted an evaluative forum; allowing individuals to discuss the use of the survey feedback method.

The survey feedback method

The survey was carried out using an occupational health questionnaire. This questionnaire was developed to be a useful tool for occupational health personnel to identify and assess problems in the workplace associated to stress; and thereby outline the development needs and necessary actions. The comprehensive version of this questionnaire covers five areas: socio-demographics, perceived work environment, factors modifying stress, response to stress, and the need for work development and individual support. The aim during the development of this questionnaire was to keep it concise and easily applicable as a routine tool, including understandable feedback of the results to the employees.

Following implementation, the feedback of the results was delivered to each work unit over 10 sessions, organised to reach the natural work teams and also to allow shift workers to actively participate in the process either directly prior to or directly following their shift.  The employees, during these feedback sessions, participated in a discussion; with the overall aim of discussing the results of the survey and, in turn, to set developmental aims. Concentrated emphasis was placed on the development of aims that could be achieved through the superiors’ and employees’ own efforts. The aims were defined separately for each department.

An action model outlined the phases of organisational and societal change, which outlines seven implementation phases of the overall intervention.  This action model underpinned the implementation of the survey feedback method. The seven phases were as follows: (1) analysis of need for change; (2) assessment of prerequisites for change; (3) definition of goals; (4) choice of strategy and methods; (5) feedback and interpretation; (6) carrying out the change; (7) evaluation.

Practical applications:

The questionnaire used as the basis of the survey feedback method was consciously developed to be a user-friendly tool for organisations: to guide the identification of stressors in the workplace contributing to poor occupational health of employees, and provided evidence-based guidance on generating possible solutions.

Innovative aspects:

The implementation of the intervention is driven by the organisation, capitalising knowledge of the personnel within the company, and guided by the employees; thus making this process easily applicable at a practical level.

Evaluation (including process issues, outcomes and sustainability):

The evaluation of the intervention was based on both quantitative and qualitative data. Post measurements were carried out three years later in one of the departments where the intervention had been conducted. Additionally, qualitative interviews were conducted with the planning group members, participating occupational health personnel and the department’s directors, charting their opinions on the new model of OHS in health promotion and the overall satisfaction with the survey feedback method. The employees’ opinions were surveyed during routine monitoring of the workplaces and during health examinations.

Benefits (including cost effectiveness):

Using the evidence gathered from one department followed up as a case study, several benefits were demonstrated by this approach. The results of the evaluation demonstrate a change in work content, namely an observed increase in the variability of work, while the overall mental and physical strenuousness load decreased in this department. Further, based on the follow-up, it was observed that the occupational health personnel shifted their working model towards a more active co-operation with the work units. The authors noted at the organisation continued to use the survey feedback method as a routine method of the occupational health service of the company.

References:

Elo, A.L., Leppaenen, A., & Silanpaa, P. (1998). Applicability of survey feedback for an occupational health method in stress management. Occupational Medicine, 48, 181-188

Comments:

The survey feedback method is easily applicable in various different companies and situations.  However, the intervention requires specially trained researchers/consultants and company occupational health personnel. Smaller organisations may not have in-house occupational health units and therefore may not always find this approach viable to implement.