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

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.

Exploring a career pathway for home support workers in Ireland: a systematic scoping review of the international evidence

“…More specifically, studies in the USA and Norway reveal discrepancies in assessing working conditions, scheduling and hours, pointing to the need for standardisation of assessment tools, and improved client data and organisational data collection, and communication regarding the organisation of care and the impact on occupational health outcomes ( 259 – 263 ). Planning tools and work optimisation models can help to assess care plan complexity, revealing congruencies and discrepancies in employee skills and capacity ( 264 – 266 ) and redesign work so that it supports staff recovery ( 267 ). Other research emphasises reorganisation of care and new roles for societal needs ( 268 , 269 ) as well as building in time to deliver interpersonal sensitivity ( 270 ).…”