Critical conditions for co-workership in healthcare organizations: A workplace health promotion perspective

Abstract

The workplace is well-established as one of the priority settings for promoting health in a large population. To achieve a good work environment, cooperation between managers and employees is essential. However, there is a large discrepancy between the amount of management and leadership research that has been performed and the amount of research investigating the impact of important factors of co-workership. Thus, the overall aim of this thesis was to increase knowledge about critical conditions for co-workership in healthcare organizations from the employee’s point of view. This thesis has also a practical aim of providing information that can be used and applied in establishing a holistic and sustainable health-promoting workplace. A qualitatively-driven mixed-methods approach was applied, combining different qualitative methods to gather and analyze data. Study I used data collected through observations, interviews, focus group interviews, and feedback seminars, analyzed with content analysis and descriptive statistics. Study II used data collected from twelve focus group interviews with 68 employees, analyzed with phenomenography. The results from Study I show that the communication flow and organization of the observed meetings varied in terms of physical setting, frequency, time allocated, and duration. The topics for the workplace meetings were mainly functional with a focus on clinical processes. Overall, the meetings were viewed not only as an opportunity to communicate information from the top downwards, but also as a means by which employees could influence decision-making and development at the workplace. The results from Study II show that the phenomenon of coworkership was experienced as a collective process, which included colleagues but not did explicitly include managers. Five categories emerged, representing different conceptions of co-workership: group coherence and striving toward a common goal, cooperation over professional and organizational boundaries, work experience and trusting each other’s competence, social climate and sense of community, and participation and influence. The conclusion of this thesis is that conditions such as participation and influence, social support, and communication were mostly related to the employees’ everyday work, especially the clinical work, and were not seen in relation to the overall organization. Workplace meetings seemed to be a well-functioning setting for conditions of importance for co-workership, although the outcomes of these meetings varied to a large extent. This knowledge provided in this thesis can be of importance for future strategies to develop health-promoting workplaces.