Author(s):  Anna-Liisa Elo, Anneli Leppänen, & Pia Sillanpää                  Level of Intervention: Primary

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.

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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.

Author(s): Simo Taimela, A. Malmivaara, S. Justen, E. Läärä, H. Sintonen, J. Tiekso, & T. Aro          Level of Intervention: Secondary

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 overall objective of the intervention was to identify ‘high’ risk employees of sickness absence; and for those employees identified to provide early treatment and rehabilitation. This was accomplished by conducting a health survey within the organisation. This form of health survey has been used in a large variety of sectors (both public and private), and has been used in predominantly large and medium-sized organisations.

Implementation:

The health survey was administered throughout the organisation. Based on the results of the survey, ‘high risk’ employees were identified. Individuals were classified as ‘high risk’ if they reported one or several listed impairments (musculoskeletal pain, high levels of depression, fatigue, and/or sleep disturbance or problems). Following the health survey identified ‘high risk’ participants were provided with personal feedback on questionnaire results and were invited to a consultation with occupational health services. The consultation was conducted by the occupational nurse, lasting 90 minutes; an occupational physician joined the consultation if and when required. The overall objective of the consultation was to develop an action plan in collaboration with the medical team; and if-and-when needed appropriate referral to a further consultation by a specialist or psychologist was provided. The occupational nurses created a file on each participant throughout the intervention process: regarding attendance and compliance, referrals to further evaluation or interventions, health advice received, and considerations of occupational health services if not further action was required.

Practical applications:

This was a pragmatic trail of interventions that work within the pre-existing structure of an organisation within a human resource framework.

Innovative aspects:

This pragmatic approach to reducing sickness absence provides corporations with the tools to identify risks and risk groups within their given organisation. Expert consultation is provided on how to improve the occupational wellbeing of employees within either the existing framework of occupational health services or within human resource management.

Evaluation (including process issues, outcomes and sustainability):

To assess the effectiveness of the intervention, individuals classified within the ‘at-risk’ group were randomly assigned to either the intervention group (consultation with occupational health services) or to a ‘treatment as usual’ condition. ‘Treatment as usual’ consisted of an optional consultation with the organisations’ occupational nurse or physician on request. The primary outcome measure used to assess the intervention effectiveness was sickness absence collected through organisational records following one year. Additionally, an economic evaluation of the intervention was conducted, using sickness absence as its primary outcome.

Benefits (including cost effectiveness):

The results of the evaluation of the intervention, demonstrated that the occupational health intervention was effective in controlling sickness absence within employees classified as ‘high risk’. The observed difference between sickness absence between the intervention condition and usual care was 11 days. The results of the cost-effectiveness evaluation demonstrated a saving of 43 euro per sickness absence day avoided with available direct total cost data, and 17 euro with missing total cost data imputed.

References:

Taimela, S., Malmivaara, A., Justen, S., Läärä, E., Sintonen, H., Tiekso, J., & Aro, T. (2007). The effectiveness of two occupational health intervention

programs in reducing sickness absence among employees at risk. Two randomised controlled trails. Occupational Environmental Medicine, published on 6

August.

Taimela, S., Justen, S., Aronen, P., Sintonen, H., Läärä, E., Malmivaara, A., Tiekso, J., & Aro, T. (2007). An occupational health intervention program for workers at high risk for sickness absence. Cost-effectiveness analysis based on a randomised controlled trail. Occupational Environmental Medicine, published online Oct. 12, 2007

Comments:

The implementation of this intervention requires the availability of occupational health experts at the organisational level and as such might not be readily applicable to SMEs.