investing in europes health workforce of tomorrow: scope for innovation and collaboration how to...
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Investing in Europe’s health workforce of tomorrow: Scope for innovation and collaboration
How to create an attractive and supportive working environment for health professionals?
Christiane Wiskow, Tit Albreht, Carlo de Pietro
European Observatory on Health Systems and PoliciesPolicy Dialogue, Leuven, Belgium, April 2010
Why the working environment matters
• Employment: • 10 % EU employment in health sector
• Competitive labour market:• challenge to recruit and retain enough health
professionals for increasing and changing demand
• Working conditions influencing quality of care• Challenge to support effective performance
Links between work environment & quality of care
What is ‘work environment’ / ‘working conditions’?
• No agreed definition • Common aspects :
• Terms of employment • Income • Working time• Safety and health • Professional development • Work organization
What is an attractive & supportive work environment?A general job quality model
Source: adapted from Munoz de Bustillo et al, 2009
Purpose
Attractive, supportive work environment• Incentive to enter health professions and to
stay • Conditions that enable health workers to
perform effectively • Goal: Quality care
Policy options: How to create an attractive, supportive work environment
• What can be done: Examples: • Promotion of family-friendly workplace policies• Enhancing protection of health professionals’ health
• How to advance work environment issues: • Workplace assessment & certification • Intersectoral collaboration & social dialogue
Work life balancePromoting family-friendly workplace policies
Why: • General trend towards balance between work life and
non-work life Workforce is female with increasing feminization
To date, women bear major family responsibilities
What: general approach• Family-friendly workplace culture• Towards equal opportunities
Promoting family-friendly workplace policies (ctd)
• Flexible working time arrangements Reduced hours; less night shifts;
• Safe workplace • Child care facilities / arrangements
• Maternity protection• Job protection; Maternity leave; Financial compensation• Special measures
• Passage from regular to adapted workloads• Priority to less risk exposure (prohibition of certain exposures)• Parental leave• Special leave (care for sick child)• child care facilities / arrangements
Enhancing protection of health workers’ health
Why addressing safety and health ?• High exposure to risks • 32 % of HW perceive their health at risk because of their
work ⇒ may lead to premature exits / reduced work ability
• Many occupational diseases/accidents are preventable
Enhancing protection of health workers’ health
Examples of risks: • Biological risks
Infections: • new emerging (SARS, H1N1)• needlestick /sharps injuries: 1 million annually in Europe
(HBV, HCV, HIV)
• Psychosocial risksHealth sector high exposure• Stress• Violence, harassment
Policy responses: OSH
Policy responses: prevention sharp injuries
Strengthening intersectoral collaboration & social dialogue in health services
• Working conditions/work environment: Interface of labour and health policy mandates
• Multiple stakeholders to be involved• Lack of labour issues related capacity in health sector• Social dialogue: – positive correlation with positive impact on working
conditions – Lessons learnt on success factors:
– Participatory organizational culture – Mutual trust of stakeholders involved– Institutionalized dialogue & binding outcomes– Defined priorities, targets and tasks– Active commitment and competence of social partners
Workplace assessments and certification (1)The Magnet Recognition Program
14 Forces of Magnetism: • Quality of nursing leadership• Organizational structure• Management style• Personnel policies• Professional models of care• Quality of care • Quality improvement • Consultation of resources• Autonomy• Community and healthcare
organization• Nurses as teachers • Image of nurses• Interdisciplinary relationships• Professional development
Strengths: • Links work environment with quality
of care • Attract & retain nurses (magnet
effect)• Reduce burnout
Limitations: • Focus on nursing profession• USA based & hospital focused• Evidence on outcomes sometimes
weak
Workplace assessments and certification (2)The ‘Great Place To Work’ Model
Features of the Model• Workplace culture is decisive for
productivity• Employee orientation• Value-based:
o Focus on Trusto Credibility o Respect o Fairnesso Prideo Team spirit
• Germany: Benchmark survey & competition “Best employers in health sector”
Strengths: • Model easy to understand• Tools easy to use (employee
questionnaire)• Key concept of trust is important
for organizations with information asymmetries and professionals
• Assesses employee satisfaction
Limitations: • Developed and applied in
industries (private sector/ manufacturing)
• No assessment of quality of care or patient outcomes
Preliminary key messages
• Work environment important factor in recruitment & retention of health professionals
• Work environment influence quality of care• Policy responses:
multidimensional, cross-cutting & inclusive
• Solutions are contextual: priority on local /organizational level
Food for thought
• Paradox challenge: mobility and retention• Emerging new challenge: creating work
environment suiting elder health workers • Strengthen evidence on links between work
environment and quality care • Innovation/ collaboration: • Intersectoral dimension • Good place to work in the health sector: indicators? • Explore option of expanding the health sector
dimension within the European Working Conditions Observatory