Work Package 3 (WP3): Adjusting work to older workers – on the effectiveness of a learning lab intervention on age management in health care organizations

Education, health care, care of children and the elderly, are the dominating branches in the public sector, and women constitute a large majority of the workers. These jobs are characterized by high cognitive and emotional demands, and are often physically demanding. In the health care sector, non-regular working hours, including shift work, are common and threats/violence has become an increasing problem. New knowledge and methods are introduced at an increasing rate, inducing continuous professional development among jobholders. Due to these extensive physical and psychosocial job demands, health care sector workers are often forced to early work life exit. This is a great challenge in times of recruitment and competence maintenance problems in the health care sector. This calls for the development of improved working conditions, learning possibilities, and adjustment of work, particularly to the functions and needs of older workers. Also, health promoting activities should be tailored to suit this population.

Research on work ability among older workers has mainly focused on the capacity and competence of the jobholder (individual level). Less is known about how employers can adapt the workplace to the needs of elderly workers. There are some research on the significance of work demands/exposure (organizational level) from other cultural settings. Less is known about how improved knowledge, changed attitudes and leadership might influence a long and healthy work life.

Presently there is a debate whether the interventions should focus on the individual or the organization. Experiences from Finland tells us that age management training should focus on the managers and their human resource (HR) partners. Age management courses and training will hypothetically lead to changes in work demands/exposures as well as in managers’ values, attitudes and motivation.

Aim and research questions

With this project, we aim to implement and study a learning lab intervention directed to managers and HR staff in health care organizations. We intend to address the following research questions: is a learning lab intervention, with its bottom-up and action oriented approach, a fruitful way forward for health care organizations who wish to launch or improve their age management strategies? What issues are important to tackle for health care organizations in order to develop and implement such strategies? Which are the most prominent knowledge gaps? Which stakeholders must be involved during the development and implementation of age management strategies? Which are the organizational and individual level factors that enable or hinder health care organizations to develop and implement age management strategies and practices?

The intervention

28 public hospitals and municipal home care services from urban and provincial areas in the South western parts of Sweden will be recruited. One inclusion criteria is that the employer has the ambition to launch – or develop already existent – age management strategies, and improve the working conditions for elderly employees. Managers with the authority to decide upon work arrangements such as schedules, work adaptation, task distribution and recruitment, and their HR partners, will be the target population for the intervention. It is particularly important that the HR-departments commit to the project, since they will assist the researchers in the data collection.

The intervention is based on the krAft- method[1], an action research oriented approach where the participating organisations are deeply involved in the development of new knowledge, skills and practices, based on their perceived needs and local preconditions. In this context, we will henceforth speak of ‘learning labs’. One frontline manager and one HR specialist per organization will meet together in groups of seven organizations, every six weeks for one year. All in all, there will be four groups, meeting at seven occasions each. Each group decides what topic to be raised during each session. Two researchers will attend each meeting. The role of the researchers is to facilitate the discussions, help the participants to articulate relevant topics and invite expertise to comment on these. Topics that could be raised during a learning lab are for example: what is ageing and what consequences do ageing have on work life participation? Which are the main determinants for a long and healthy work-life participation? Which strategies and methods are there for successful age management? What administrative tools can be used to support implementation of an age management strategy? What costs and benefits can be expected? Each organization should articulate clear and organization specific goals in relation to each topic, goals to be reached at the end of the program.

[1] krAft, an acronym in which: (k stands for “kompetens” (competence) r for “reflektion” (reflection), Af for “Affärsutveckling” (business development) and t for “tillväxt” (growth). Norbäck, L.E. Olsson, L.E. & P. Odenrick (2006), Homo pracademicus – om att lära om – om sig själv och sin verksamhet. Bilda förlag, Stockholm.

Method

The overall schedule for this research is shown in Figure 1. Soon after recruitment, the managers of each organisation will be interviewed. Before the intervention, an interview protocol for this purpose will be developed based on the findings of WP2 and on a review of the international literature on workplace oriented age management interventions. The aim of the interview is to scrutinize the organizations’ existing age management strategies, practices and policies, and also to explore current organizational and individual hindrances and opportunities for efficient age management. Thereto, the employers’ view on ageing workers in relation to job demands and job resources will be explored. In order to be able to proactively plan for the learning lab sessions and create a pool of expertise to be called upon, we will also invent the participants’ expectations and perceived needs before the intervention.

Additional telephone interviews will be conducted with the managers at two occasions; mid and post intervention. We are interested to see if the intervention has had any impact on the participating organizations’ work with age management issues. The informants will be asked to provide examples of changes in knowledge, attitudes and beliefs about elderly workers, as well as changes to local practices, strategies and policies concerning elderly workers. At the end of the intervention we will use the interview to evaluate whether the participating organizations have succeeded in reaching the goals they set up at the outset.

In addition to the interviews, we will collect and analyze relevant documents from each organization. These could be for example policies of recruitment and work environment issues, minutes from board meetings and action plans. Data will be collected in collaboration with the HR-partner. All learning lab sessions will be video-taped after consent from the participants. Together with the interviews, these recordings are important sources for information that the researchers can use in their analysis.

Before the intervention, a survey on working conditions, work ability, intention to stay/leave, health and well-being will be performed among all workers aged over 50 in the participating organizations. Also, the organizations’ administrative records on sick leave rates, disability benefits and retirement will be collected for the units managed by the participants. In this project, the individual level data will be aggregated to the organizational level. Together with the register data, it will provide us with a descriptive picture of the situation concerning age management outcomes in the participating organisations before the intervention. However, it is our intention to perform a long-term follow-up on these data up to 10 years after the intervention, provided adequate funding can be raised.

 

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