Reforming for trust and professionalism in municipal healthcare services: implications for human resource management.

BACKGROUND: Many countries face an increasing demand for home-based healthcare services, and consequently experience a mismatch between expectations and available financial and human resources. It is therefore important to utilize human resources more efficiently, while at the same time offer jobs that attract the professionals they need. This article reports a study of the development and piloting of a new organizational model for home-based healthcare services in a Norwegian municipality, which addresses the need to provide efficient services and enhance trust and professionalism within healthcare services by improving work autonomy and involvement of employees. METHODS: The research project this article draws its empirical material from was commissioned by the municipality piloting the new organizational model and executed in collaboration with the municipality based on an evaluative trailing research (ETR) design. The data consists of interviews with key personnel and knowledge exchange between researchers and the involved actors in the pilot project. 20 semi-structured interviews involving a total of 34 informants were conducted. The analysis emphasises how different employee groups and management perceived and experienced various aspects of the work situation, as they were introduced to working and managing within the new organizational model. The aim is to shed light on how these employees and managers feel about it, interpret it, and respond to it. RESULTS: Overall, the results indicate that the model holds potential for realizing the benefits it aims for. However, there were also challenges that need resolving for the model to fulfil this potential. Central elements include clarification of roles and responsibilities for employees and managers, competence specification and development, and development of structures for inter-professional cross-team collaboration and information provision. CONCLUSIONS: Trust reform initiatives may be a strategy for fostering high-involvement work systems. To achieve this, sufficient attention must be paid to ensuring structures for information exchange and knowledge development in the early phases of implementation, or preferably prior to implementation. The theoretical model applied in this study could potentially be a useful managerial tool in preparing for and implementing trust reforms in healthcare services.

Exploring multiple working arrangements in Norwegian engineering, procurement, and construction industry from a middle manager and supervisor perspective: A sociotechnical system perspective.

With a scarcity of research on multiple working arrangements, the aim of the paper is to contribute empirical data from a Norwegian engineering, procurement, and construction enterprise that shed light on the challenges and benefits of a 14-21 working arrangement in itself and in relation to other working arrangements. We combine a sociotechnical system perspective with systematic content analysis using QSR NVivo, which reveals organizational complexity comprised of indirect, direct, positive, negative, and mutual interplays between various aspects of the enterprise, including processes and outcomes. We find that the 14-21 working arrangement, in combination with other factors of the work system, sets the premises for work processes and outcome factors that are both beneficial and challenging to individuals and the organization. We also find that work process factors, such as work and information flow as well as follow-up and facilitation, depend on the presence of, and dynamic coordination and communication among, individuals across the organization. This in turn requires a support network, work groups, and supervisors to be on the same working arrangement.

Knowledge management and safety compliance in a high-risk distributed organizational system.

BACKGROUND: In a safety perspective, efficient knowledge management is important for learning purposes and thus to prevent errors from occurring repeatedly. The relationship between knowledge exchange among employees and safety behavior may be of particular importance in distributed organizational systems where similar high-risk activities take place at several locations. This study develops and tests hypotheses concerning the relationship between knowledge exchange systems usage, knowledge exchange in the organizational system, and safety compliance. METHODS: The operational context of the study is petroleum drilling and well operations involving distributed high-risk activities. The hypotheses are tested by use of survey data collected from a large petroleum operator company and eight of its main contractors. RESULTS: The results show that safety compliance is influenced by use of knowledge exchange systems and degree of knowledge exchange in the organizational system, both within and between units. System usage is the most important predictor, and safety compliance seems to be more strongly related to knowledge exchange within units than knowledge exchange between units. CONCLUSION: Overall, the study shows that knowledge management is central for safety behavior.