Healthy working for health - using the WEBA method
Author(s): Ellis Lourijsen, Irene Houtman, Michiel Kompier and Robert Grundemann Country: Netherlands
Is the intervention sector specific?	No
Is the intervention usable with different enterprise sizes?	Yes
Is the intervention equally applicable to both genders?	Yes
Is the intervention based on theory?	Yes
Can the intervention approach be adapted/ tailored?	Yes
Does the intervention promote CSR and how?	Yes, top management commitment was important and they were represented in the steering group. The hospital’s management team was responsible for the occupational health and safety policy.
Does the intervention promote social dialogue and how?	Yes, the programme is based on dialogue and collaboration of management, workers and other key stakeholders. A steering group is central in the process. The main responsibility of this group was overseeing and facilitating the process.
Overview (including risk assessment and law – legal requirements etc.): In the Netherlands, work stress has been an important policy issue. It was in 1990, with the enforcement of Article 3 of the Working Conditions Act that work stress became a high priority. This legislation has also promoted risk management at source. Since 1994 the legislation on Working Conditions for amended to fit the European Framework Directive (89/391/EEC), this resulted in more responsibility for employers and employees with respect to risk management and social security aspects. The shift to preventive action is considered effective by many practitioners as well many employers. Under this legislative framework, a tailor-made and step-by step strategy for risk prevention and management was implemented at in a hospital employing around 850 people in five sectors with the aim of reducing the high absenteeism rates reported. Based on the idea that a risk prevention strategy can only work if it is supported by the entire organisation, a steering committee with a broad based composition was selected to carry out the project. The ‘Healthy Working for Health’ steering committee comprised: the head of the care sector (also chair person), the head of personnel affairs, two supervisory staff members, the organisational expert, a work council member, a nurse, and an operational member of the radiology department and two consultants. The steering committee was responsible for the implementation and progress of the project programme.
Implementation: From the start, the project programme was integrated into the hospital’s normal working conditions policy. To create support for the project an initial meeting was organised with the complete workforce to explain the goals and structure of the project. To gain a general impression of the problems at work in the hospital, a limited number of staff (all levels), known as ‘key respondents’, were interviewed using existing checklists on job content and organisation of work, on working conditions, on social relations at work and on terms of employment. The interviews were followed up with an organisation wide survey (questionnaire used was based on validated instruments) to analyse stress and health problems in more details. On the basis of the survey, a number of positions were selected for further analysis using the WEBA (Dutch abbreviation for Well-being at work). This method can be used to determine job-related stress risks and learning and developing opportunities. The WEBA method complies with the provisions of Section 3 of the Dutch Working Environment Act. The results of the survey revealed that there were a number of organisation- related problems, which lead to organisation related and sector-specific health complaints. Although no direct statistical relationship and absenteeism could be demonstrated, the literature on absenteeism suggested that the organisational problems were likely to influence it. Consequently, the choice of measures was based on a ‘multi-track’ policy aimed at both the improvement of working conditions and employee’s physical and mental health, and the intensification of inspection and absentees. An approach that combines three types of measures and positively influences employees’ health and well-being in a more structured manner is an instance of integrated health promotion. Such an approach intends to go further than solely removing health hazards at the workplace. In order to arrive at a coordinated set of measures, the steering committee first examined the question whether the problems identified could be solved. The criteria used were: whether the cause of the problem was sufficiently clear, what measures could the hospital take, the cost of such measures and the expected (additional) yield. Following this examination, the committee decided to start sub-projects (interventions) to address work pressure, interior climate, physical load, provision of information, working hours and rosters, training and career opportunities, managerial style and lifestyle. The purpose of the sub-projects was to further elaborate and implement measures and solutions. The sequence of the interventions was mainly determined by the clarity of the solutions and time and manpower available to carry out the sub-projects. Each intervention was assigned a steering committee member as a coordinator. Responsibility for the implementation of each intervention was given to a single project group and the progress and coordination of the intervention was monitored by the steering committee.
Practical applications: The intervention requires external expertise to initiate the process, but the programme is flexible as it relies on in-house expertise in the form of employees and management of the organisation to design and implement the interventions. Such a programme is easily applicable in most large companies across industrial sectors.
Innovative aspects: The programme uses the WEBA method, which can be used to determine job-related stress risks and learning and developing opportunities. It complies with the local legislative provisions (in this case) Section 3 of the Dutch Working Environment Act). It also allows rules for improvement to be inferred.
Evaluation (including process issues, outcomes and sustainability): The programme was evaluated for a period of 6 months post implementation of the interventions. It involved a repetition of the survey, an analysis of the absenteeism data and cost benefit analysis. Results indicated that the employees expressed significantly fewer complaints related to aspects of job content, emotional stress and appreciation fro working environment. The survey also indicated a number of improvements in the workplace which are (possibly) associated with the measures already implemented. A significant reduction in absenteeism was also found.
Benefits (including cost effectiveness): More employees thought they were more involved in improving the work situation and were more critical of their work situation. There was a shift in the organisational culture with a move from ‘a wait-and-see attitude’ when it came to bringing about improvements, to actively engaging in bringing change. The overall programme made the employees more aware of what was going on the various departments of the hospital, which led to a better understanding of each other and a more pleasant atmosphere. A cost-benefit analysis conducted indicated an overall financial benefit. The results of the inventions were also expected to continue to bear fruit in the future.
References: Lourijsen, E., Houtman, I., Kompier, M., and Grundeman, R. (1999). The Netherlands: A hospital, ‘Healthy working for health’. In C.L. Cooper & M. KompierPreventing Stress, Improving Productivity: European Case Studies in the Workplace (pg85-120). London, UK: Routledge.
Comments: Middle management felt insufficiently involved in the project, while operational personnel in the steering group could not commit adequate time to discussions. Care must be taken that members of the steering committee represent all sections of the organisations and also are able to commit adequate time to participate in the process.