ANALYSIS OF HEALTH NEEDS OF A HOSPITAL STAFF

M. Muller, Ch. Vandoorne, Ph. Mairiaux

University of Liège, School of Public Health,

Occupational Health and Health Education unit

Research made possible through a grant from the government of the French community of Belgium

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Introduction

• Three university hospitals members of the Belgian French community HPH network

• Importance of involving the staff into a health promotion process

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Objectives

• Identify health needs among different categories of the staff

• Proceed to their hierarchical classification

• Compare perceptions of the employees and the managerial staff

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Material And General Methods

• Total staff : 2.200 people

• 13 occupational categories

• Group interviews for employees (19 groups)

• Individual interviews for managerial staff

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Group InterviewsDefinition of Occupational Categories

• Nursing staff in normal care units

• Nursing staff in intensive care units

• Nursing staff in operating rooms

• Stretcher operators and social workers

• Medical staff (specialists)

• Medical staff (residents)

• Policlinic staff

• Pharmacy and sterilisation staff

• Technical staff (maintenance, safety, security, data processing, ...)

• Cleaning, laundry and material handling staff

• Administrative staff in contact with patients

• Administrative staff in contact with physicians (medical secretaries)

• Other administrative staff

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Group Interviews : Methods

• Method : metaplan and some adjustments from montis' "social diagnosis" method

• Starting question and written answer

• Expression to the rest of the group

• Written expression of all experiences and their grouping in general themes

• Hierarchical classification of the themes by each participant

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Data Analysis

• In each group :– Scoring of each theme :

• Number of participants• Mean rank of priority

• On the whole population– Definition of keywords– Scoring of each keyword

• Absolute and relative frequency of quoting in priorities• Mean rank of priority

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Example of Results :Priorities in an Intensive Care Nursing Group

1

3

5

0 3 6

Number of quotings in priorities

Mea

n ra

nk o

f pr

iori

ty

Ethical attitudes of some doctors

Management of work increase and missing staff

Relationships with managerial staffShift workTroubles

about mourning

Communication between nursing units

Occupational health and safety officers' effectiveness Nursing philosophy

in the hospitalLack of skills of some physicians

Relationships with patients and families

Lack of concern in continuing education

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Results :Main Keywords Defined As Priorities

1,0

1,5

2,0

2,5

3,0

0 10 20 30 40 50 60 70

Number of quotings as priorities

Mea

n ra

nk o

f pr

iori

ty

Work load

Lack of staffRooms without daylight

Work organizing

Quality of work

Temperature

Ventilation

Relationships with patients

Inadequate equipment

Co-ordination between units

(1)(2)

(3)

(4)

Work planning

NoiseProfitabilityOdours

HumanenessExplanations to the patients

1 = Urgency in the work2 = Working schedules3 = Administrative work load4 = Team understanding

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Results : Summary

Main priorities organised along 2 axes :

• Material conditions at work inducing physical discomfort

• Factors affecting the workload– Negative factors – Positive factors or resilience factors

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Conclusions Of The Study

• Health needs are mainly in relation with daily life at work– Material factors– Psychosocial factors

• Few strictly biomedical factors

• Among priorities, consideration must be required for factors affecting workload

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Continuation

• Thinking over work load and work organization in the hospital in a participatory approach

• Validating a questionnaire about health needs of the staff built from all the opinions expressed by the participants