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. 2023 Jun 21;23(1):667.
doi: 10.1186/s12913-023-09691-2.

Can home care work be organized to promote health among the workers while maintaining productivity? An investigation into stakeholders' perspectives on organizational work redesign concepts based on the Goldilocks Work principles

Ingeborg Frostad Liaset  1 , Marius Steiro Fimland  2   3 , Andreas Holtermann  4 , Svend Erik Mathiassen  5 , Skender Redzovic  2
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Can home care work be organized to promote health among the workers while maintaining productivity? An investigation into stakeholders' perspectives on organizational work redesign concepts based on the Goldilocks Work principles

Ingeborg Frostad Liaset et al. BMC Health Serv Res. .

Abstract

Background: Due to the aging population, the need for home care services is increasing in most Western countries, including Norway. However, the highly physical nature of this job could contribute to make recruiting and retaining qualified home care workers (HCWs) challenging. This issue may be overcome by adopting the Goldilocks Work principles, aiming at promoting workers' physical health by determining a "just right" balance between work demands and recovery periods while maintaining productivity. The aim of this study was to 1) gather suggestions from home care employees on suitable organizational (re)design concepts for promoting HCWs' physical health and 2) have researchers and managers define actionable behavioral aims for the HCWs for each proposed (re)design concept and evaluate them in the context of the Goldilocks Work principles.

Methods: HCWs, safety representatives, and operation coordinators (n = 14) from three Norwegian home care units participated in digital workshops led by a researcher. They suggested, ranked, and discussed redesign concepts aimed at promoting HCWs' health. The redesign concepts were subsequently operationalized and evaluated by three researchers and three home care managers.

Results: Workshop participants suggested five redesign concepts, namely "operation coordinators should distribute work lists with different occupational physical activity demands more evenly between HCWs", "operation coordinators should distribute transportation modes more evenly between HCWs", "Managers should facilitate correct use of ergonomic aids and techniques", "HCWs should use the stairs instead of the elevator", and "HCWs should participate in home-based exercise training with clients". Only the first two redesign concepts were considered to be aligned with the Goldilocks Work principles. A corresponding behavioral aim for a "just right" workload was defined: reduce inter-individual differences in occupational physical activity throughout a work week.

Conclusions: Operation coordinators could have a key role in health-promoting organizational work redesign based on the Goldilocks Work principles in home care. By reducing the inter-individual differences in occupational physical activity throughout a work week, HCWs' health may be improved, thus reducing absenteeism and increasing the sustainability of home care services. The two suggested redesign concepts should be considered areas for evaluation and adoption in practice by researchers and home care services in similar settings.

Keywords: Elder care; Home health care; Job redesign; Participatory approach; Workplace health promotion.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study timeline. In weeks 1 and 6, Workshop 1 and Workshop 2 were conducted, followed by a researcher evaluation. In weeks 8 and 13, the researchers arranged additional evaluations guided by the literature on work and health, with the aim of formulating behavioral aims and evaluate the concepts based on the Goldilocks Work principles, which were then discussed with managers in week 15
Fig. 2
Fig. 2
Digital workshop design. The first two steps were preparatory, focusing on creating a safe environment for idea generation, familiarizing the participants with the team collaboration software Miro, and providing the participants with relevant knowledge (e.g., regarding the Goldilocks Work principles and HCWs’ objectively measured occupational physical activity). The remaining steps included individual as well as group activities
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