Applied Ergonomics 47 (2015) 203e210
Contents lists available at ScienceDirect
Applied Ergonomics journal homepage: www.elsevier.com/locate/apergo
Self-rostering and psychosocial work factors e A mixed methods intervention study Åse Marie Hansen a, b, *, Kirsten Nabe-Nielsen b, Karen Albertsen b, c, Annie Hogh d, Henrik Lund e, Helge Hvid e, Anne Helene Garde a a
National Research Centre for the Working Environment, Copenhagen, Denmark Department of Public Health, University of Copenhagen, Copenhagen, Denmark Team Working Life, Trekronergade 15, 1, 2500 Valby, Denmark d Department of Psychology, University of Copenhagen, Copenhagen, Denmark e The Department of Environmental, Social and Spatial Change, Roskilde University, Universitetsvej 1, P.O. Box 260, 4000 Roskilde, Denmark b c
a r t i c l e i n f o
a b s t r a c t
Article history: Received 19 March 2013 Accepted 5 October 2014 Available online
This study aims at 1) examining the effect of self-rostering on emotional demands, quantitative demands, work pace, influence, social community at work, social support from leaders and colleagues, job satisfaction, and negative acts, 2) examining whether this effect was mediated through increased influence on the scheduling of working hours, and interpreting the results in light of the different implementation processes that emerged in the study and by including qualitative data. We conducted a 12 months follow-up, quasi-experimental study of self-rostering among 28 workplaces out of which 14 served as reference workplaces. We also interviewed 26 employees and 14 managers about their expectations of introducing self-rostering. In the present study implementation of self-rostering had a positive effect on job demands and the social environment of the workplace, especially if the intervention does not comprise drastic changes of the organisation of the employees' work and private life. © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Keywords: Flexible working hours Social support
1. Introduction During the last years at least two reviews concerning the effect of work-time influence or related concepts have been published. In 2010, Joyce et al. stated that self-scheduling can have beneficial health, social and organizational effects (Joyce et al., 2010). Likewise, in 2012, Nijp et al. concluded that for theoretical and empirical reasons, work-time control is a promising tool for the maintenance of employees' workenon-work balance, health and well-being, and job-related outcomes (Nijp et al., 2012). However, there is relatively little knowledge about the mechanisms through which, work-time influence affects health and well-being. It has been suggested that work-time influence affects health through the adjustment of the working hours to the individual's needs and preferences, e.g. personal resources, demands from private life and need for restitution (Ala-Mursula et al., 2004; Garde et al., 2012). An alternative hypothesis is that the effect of work-
* Corresponding author. Department of Public Health, University of Copenhagen, Østre Farimagsgade 5, DK-1014 Copenhagen K, Denmark. Tel.: þ45 35327962; fax: þ45 35351181. E-mail addresses: [email protected], [email protected], [email protected] (Å.M. Hansen). http://dx.doi.org/10.1016/j.apergo.2014.10.006 0003-6870/© 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
time influence on health is mediated through improved psychosocial working environment. Indeed, in the previously mentioned 2010-review, Joyce et al. suggest that future research focuses on the effect of self-scheduling on psychosocial work factors, e.g. job satisfaction, worker performance, and employee morale (Joyce et al., 2010). A few previous intervention studies have investigated the effect of work-time influence and psychosocial work factors with contradictory results: When implementing an open-rota system in a Danish psychiatric hospital, job satisfaction, social support and sense of community at work increased (Pryce et al., 2006). In a Danish intervention study of the effect of work-time influence among eldercare workers, supplementary analyses showed that the degree of social support increased in the intervention group (NabeNielsen et al., 2011). Also, in Swedish retail the implementation of self-scheduling improved satisfaction with colleagues but at the same time there was a decrease in job satisfaction and in the perception of a calm and pleasant work climate (Lowden and Åkerstedt, 2000). In spite of the sparse empirical evidence it seems possible that interventions aiming at increasing employees' work-time influence, e.g. by the implementation of self-rostering, may affect both job satisfaction, the social climate (e.g. social support and social
204
Å.M. Hansen et al. / Applied Ergonomics 47 (2015) 203e210
community at work), and the intensity and demands of work (e.g. the amount to be accomplished and the speed of work). Regarding the intensity and demands of work, some self-rostering systems imply that the leader provides information about the required number of employees with specific skills on duty at different time points and thus optimizes the balance between staff demands and staff on duty. Hypothetically, such an improved balance might eliminate the efforts associated with understaffing e and thereby reduce work pace e at some time points. Alternatively, potential breaks and surplus of resources associated with overstaffing may be reduced e and thereby increase work pace. Thus, we did not have an a priori assumption about the direction of the effects of self-rostering on work pace as both a positive and negative effect could be anticipated. Furthermore, previous research showed that the work tasks, i.e. exposures in the working environment, differ between day, evening, and night shifts and it is also likely that exposure differs between weekend and weekdays. Compared to day workers, night shift workers were more exposed to low influence, low social support, and more conflicts, harassment, bullying, or violence at work (Bøggild et al., 2001; Mohren et al., 2002; Nabe-Nielsen et al., 2009). In general, night shift workers also reported lower job demands, although Bøggild et al. (2001) found that female night workers were more exposed to cognitive demands, and Mohren et al. (2002) found that night shift workers of both genders were more exposed to emotional demands. Self-rostering may provide the individual employee with the opportunity to composite a work schedule that take preferences for (or against) certain work tasks into account and that balances job demands with (fluctuating) individual resources. The consequence may be that work demands are perceived less strenuous, even if the overall demands at the workplace are unaltered. Additionally, some self-rostering systems offer the employees the possibility to see their colleagues' preferred working hours, and, thus, they have the possibility of taking their preferences for (or against) specific colleagues into account, when they schedule their own working hours. This may lead to an improved social climate at work (e.g. higher social support, higher social community at work, and fewer experiences of negative acts) for the majority but also to social exclusion of some individuals. Thus, self-rostering may have positive effects on the social climate at work, but also unintended negative effects. Indeed, in a previous paper, we showed that when employees schedule their own working hours, 36% considered the professional challenges, 26% considered the type of work tasks, 17% considered colleagues that they wanted to work together with, 7% considered colleagues that they did not want to work together with, and 6% considered the risk of violence (Nabe-Nielsen et al., 2013). Thus, although family life and leisure-time activities were among the toppriorities, employees also considered factors which eventually may lead to changes e positive as well as negative e in the psychosocial working environment. Even if work-time influence can be improved by interventions such as the implementation of self-rostering this is not always the case (Lowden and Åkerstedt, 2000; Nabe-Nielsen et al., 2011). Actually, it is likely that interventions aiming at increasing employee work-time influence e but do not succeed e will have an adverse effect on the psychosocial working environment due to disappointment and dissatisfaction. On this background, our overall aim was to investigate whether computerised self-rostering (i.e. the systematic involvement of the individual employee in the planning of his or her own work schedule by use of a computer program) has an effect on the psychosocial factors at work. More specifically, we first aimed to investigate the quantitative effect of self-rostering on job demand (i.e. emotional demands, quantitative demands, work pace),
influence, job satisfaction, and social climate (i.e. social community at work, social support from leaders and colleagues, and exposure to negative acts). Second, we investigated to which extent the effect of the intervention depended on changes in the perceived influence on the arrangement of working hours. By including qualitative data we interpreted the results in light of the different implementation processes that emerged in the study. 2. Methods 2.1. Study design and study population The present study is part of an intervention project that aimed at exploring the consequences of self-rostering on health, recovery and working hours (Albertsen et al., 2014; Garde et al., 2012). Workplaces planning to implement self-rostering were recruited through public advertising, meetings, and by personal contacts. The requirements for workplaces to participate in the study were that (part of the) employees had shift work (i.e. that they worked outside the conventional day time covering evenings/nights and/or weekends). All activities related to the interventions were planned, executed and financed by the workplaces. Data collection included questionnaires, interviews, and collection of working schedules at baseline and after 12 months follow-up. At follow-up, all interventions had been implemented for at least 9 months. In total, 28 workplaces were included. They were clusterallocated to an intervention (n ¼ 14 workplaces) or a reference group (n ¼ 14 workplaces). Allocation to the intervention or reference groups was decided by the workplace, i.e. non-randomized. 2.2. Data collection 2.2.1. Interviews Focus-group interviews and individual interviews with employees and managers were performed in each of the intervention workplaces. In total, 26 employees and 14 managers were interviewed at baseline, and 25 employees and 16 managers were interviewed at follow-up. Managers, employees responsible of the scheduling, and representatives of employees, who did not hold a central position in the implementation of self-rostering, were selected for interviews. All interviews were conducted by two researchers, one posing questions and the other taking notes. Through the qualitative interviews, we collected data about the involved companies, working conditions, and time schedules. The baseline interviews included questions about the motives for introducing self-rostering in the company. The follow-up survey included information about the change processes and attitudes to the project. In the reference group, nine leaders or other personnel responsible for the planning of working hours filled in a small questionnaire with open questions on how the working hours were planned at baseline. The questionnaire provided the basis for a half hour telephone interview. At follow-up, a summary was sent to the leaders, and they were asked to report any substantial changes that had occurred during the past 12 months (for more details on the qualitative data collection and results, see Albertsen et al. (2014)). 2.2.2. Questionnaires All employees at the workplace at the time of data collection were invited to participate. A total of 1065 participants were eligible for inclusion at baseline and 1070 at follow-up. At baseline 840 employees returned the questionnaire (response rate ¼ 78.9%) and 785 participated at follow-up (response rate ¼ 69.2%). In total, 567 responded to the questionnaire at both baseline and follow-up (follow-up response rate ¼ 63.9%). The baseline measurements
Å.M. Hansen et al. / Applied Ergonomics 47 (2015) 203e210
consisted of a questionnaire on personal background, work environment and working hours. The baseline survey and interviews took place between October 2008 and October 2009 and the follow-up took place 12 months later. At 13 out of 14 intervention workplaces, the management completed workplace questionnaires on the context of the implementations. The Danish Data Protection Agency approved the data usage (reference number: 2008-540458). 2.3. The intervention The intervention was to implement self-rostering by use of commercially available IT-software chosen by the workplace (Garde et al., 2012). The employers had to implement the software and specify the need for man-power on a running basis. Three different commercial IT-softwares were used. The three IT-softwares resembled each other and had more or less the same possibilities and training of the employees in using the IT-software prior to the implementation. Three subgroups of interventions (AeC) were made based on the workplaces' choice of IT-software, due to differences in the way they were introduced and implemented. Table 1 shows which mandatory and eligible opportunities were available and used in the three interventions. Eligible opportunities were length of shift, starting and ending times, possibility to transfer hours from one period to another (a time-bank), and a point system for distribution of unwanted hours or shifts. A work schedule for the employees was generated based on employees' preferences and their choices and the need for resources. Some workplaces included a step where the employees were invited to solve discrepancies between preferences and the need for resources by voluntarily altering their preferences (puzzle-phase). Finally, adjustments were made by the leaders, and the schedules were published. In order to be included in the study, it was mandatory that the intervention included a possibility for the employees to choose their work schedule, i.e. what days the employees wanted to work or did not want to work. Intervention A was implemented among all caregivers at 6 workplaces, mainly psychiatric and somatic hospital care settings with a need for 24/7 manning. The main aims for introducing selfrostering were to increase workers' satisfaction and wellbeing and thereby ensure possibilities for recruitment and retention. Before the intervention, working hours were planned for 4e8 weeks at a
205
time and published with at least four weeks' notice. The implementation process involved the work council and the union representatives at 80% of the workplaces. New individual work schedules were created every 1e5 weeks. Employees in intervention group A were encouraged to rethink their usual habits and attitudes towards organizing their working hours around their private life rather than their private life around the working hours, when entering their choices. After implementation 75e90 % of the employees' wishes were fulfilled. Intervention B was implemented among caregivers at 7 workplaces, mainly psychiatric care settings and intensive and somatic care units in hospitals with a need for 24/7 manning. As a rule, all employees at the workplace were obliged to use the software. However, some employees were excluded e.g. due to social or health problems. The main aims for introducing self-rostering were to increase workers' satisfaction and wellbeing and thereby ensure possibilities for recruitment and retention. Before the intervention, working hours were planned for 4e8 weeks at a time and published with at least four weeks' notice as in intervention A. After implementation working hours were planned for 4e8 weeks and 75e80 % of the employees' wishes were fulfilled. Intervention C was implemented at a call centre in the financial sector. The call centre was open from 08:00 to 20:00 on Monday to Friday and 08:00 to 16:00 during weekends. A few employees did not participate in the intervention due to either social or health problems. The main aim of intervention C was primarily to optimise resources in relation to needs of the company and secondly to improve workers' satisfaction. Before the intervention, all employees had a stable 4 weeks' roster with good possibilities to swap duties among themselves. According to the workplace questionnaire the work council had been involved to a low degree, union representatives to a high degree and employees to some degree in the implementation process of the self-rostering IT software. New individual work schedules were created every 12 weeks. It was not reported how many of the employees' wishes were fulfilled. 2.3.1. Reference group The reference group comprised psychiatric, intensive, and somatic hospital wards and a handicap home with a need for 24/7 staffing. From telephone interviews it is known that the workplaces in the reference group refrained from engaging in working hour interventions during the study period.
Table 1 Overview of mandatory and eligible requirements for the employees in the three interventions on self-rostering. Requirements
Intervention A
Intervention B
Intervention C
Mandatory requirements
Wish days to work Wish days not to work Wishes made on running basis
Yes Yes Yes
Yes Yes Yes
Yes Yes Yes
Eligible requirements
Length of shift Length between shifts Days in a row Starting and ending time Time bankd Point system Puzzle phasee
1e12 h 8e11 h 6e12 Yesa Yes from 100 to þ200 h Yes Yes
5e13 h 8e11 h 6e8 Yesb No No No
4e10 h >11 h
Contents lists available at ScienceDirect
Applied Ergonomics journal homepage: www.elsevier.com/locate/apergo
Self-rostering and psychosocial work factors e A mixed methods intervention study Åse Marie Hansen a, b, *, Kirsten Nabe-Nielsen b, Karen Albertsen b, c, Annie Hogh d, Henrik Lund e, Helge Hvid e, Anne Helene Garde a a
National Research Centre for the Working Environment, Copenhagen, Denmark Department of Public Health, University of Copenhagen, Copenhagen, Denmark Team Working Life, Trekronergade 15, 1, 2500 Valby, Denmark d Department of Psychology, University of Copenhagen, Copenhagen, Denmark e The Department of Environmental, Social and Spatial Change, Roskilde University, Universitetsvej 1, P.O. Box 260, 4000 Roskilde, Denmark b c
a r t i c l e i n f o
a b s t r a c t
Article history: Received 19 March 2013 Accepted 5 October 2014 Available online
This study aims at 1) examining the effect of self-rostering on emotional demands, quantitative demands, work pace, influence, social community at work, social support from leaders and colleagues, job satisfaction, and negative acts, 2) examining whether this effect was mediated through increased influence on the scheduling of working hours, and interpreting the results in light of the different implementation processes that emerged in the study and by including qualitative data. We conducted a 12 months follow-up, quasi-experimental study of self-rostering among 28 workplaces out of which 14 served as reference workplaces. We also interviewed 26 employees and 14 managers about their expectations of introducing self-rostering. In the present study implementation of self-rostering had a positive effect on job demands and the social environment of the workplace, especially if the intervention does not comprise drastic changes of the organisation of the employees' work and private life. © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Keywords: Flexible working hours Social support
1. Introduction During the last years at least two reviews concerning the effect of work-time influence or related concepts have been published. In 2010, Joyce et al. stated that self-scheduling can have beneficial health, social and organizational effects (Joyce et al., 2010). Likewise, in 2012, Nijp et al. concluded that for theoretical and empirical reasons, work-time control is a promising tool for the maintenance of employees' workenon-work balance, health and well-being, and job-related outcomes (Nijp et al., 2012). However, there is relatively little knowledge about the mechanisms through which, work-time influence affects health and well-being. It has been suggested that work-time influence affects health through the adjustment of the working hours to the individual's needs and preferences, e.g. personal resources, demands from private life and need for restitution (Ala-Mursula et al., 2004; Garde et al., 2012). An alternative hypothesis is that the effect of work-
* Corresponding author. Department of Public Health, University of Copenhagen, Østre Farimagsgade 5, DK-1014 Copenhagen K, Denmark. Tel.: þ45 35327962; fax: þ45 35351181. E-mail addresses: [email protected], [email protected], [email protected] (Å.M. Hansen). http://dx.doi.org/10.1016/j.apergo.2014.10.006 0003-6870/© 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
time influence on health is mediated through improved psychosocial working environment. Indeed, in the previously mentioned 2010-review, Joyce et al. suggest that future research focuses on the effect of self-scheduling on psychosocial work factors, e.g. job satisfaction, worker performance, and employee morale (Joyce et al., 2010). A few previous intervention studies have investigated the effect of work-time influence and psychosocial work factors with contradictory results: When implementing an open-rota system in a Danish psychiatric hospital, job satisfaction, social support and sense of community at work increased (Pryce et al., 2006). In a Danish intervention study of the effect of work-time influence among eldercare workers, supplementary analyses showed that the degree of social support increased in the intervention group (NabeNielsen et al., 2011). Also, in Swedish retail the implementation of self-scheduling improved satisfaction with colleagues but at the same time there was a decrease in job satisfaction and in the perception of a calm and pleasant work climate (Lowden and Åkerstedt, 2000). In spite of the sparse empirical evidence it seems possible that interventions aiming at increasing employees' work-time influence, e.g. by the implementation of self-rostering, may affect both job satisfaction, the social climate (e.g. social support and social
204
Å.M. Hansen et al. / Applied Ergonomics 47 (2015) 203e210
community at work), and the intensity and demands of work (e.g. the amount to be accomplished and the speed of work). Regarding the intensity and demands of work, some self-rostering systems imply that the leader provides information about the required number of employees with specific skills on duty at different time points and thus optimizes the balance between staff demands and staff on duty. Hypothetically, such an improved balance might eliminate the efforts associated with understaffing e and thereby reduce work pace e at some time points. Alternatively, potential breaks and surplus of resources associated with overstaffing may be reduced e and thereby increase work pace. Thus, we did not have an a priori assumption about the direction of the effects of self-rostering on work pace as both a positive and negative effect could be anticipated. Furthermore, previous research showed that the work tasks, i.e. exposures in the working environment, differ between day, evening, and night shifts and it is also likely that exposure differs between weekend and weekdays. Compared to day workers, night shift workers were more exposed to low influence, low social support, and more conflicts, harassment, bullying, or violence at work (Bøggild et al., 2001; Mohren et al., 2002; Nabe-Nielsen et al., 2009). In general, night shift workers also reported lower job demands, although Bøggild et al. (2001) found that female night workers were more exposed to cognitive demands, and Mohren et al. (2002) found that night shift workers of both genders were more exposed to emotional demands. Self-rostering may provide the individual employee with the opportunity to composite a work schedule that take preferences for (or against) certain work tasks into account and that balances job demands with (fluctuating) individual resources. The consequence may be that work demands are perceived less strenuous, even if the overall demands at the workplace are unaltered. Additionally, some self-rostering systems offer the employees the possibility to see their colleagues' preferred working hours, and, thus, they have the possibility of taking their preferences for (or against) specific colleagues into account, when they schedule their own working hours. This may lead to an improved social climate at work (e.g. higher social support, higher social community at work, and fewer experiences of negative acts) for the majority but also to social exclusion of some individuals. Thus, self-rostering may have positive effects on the social climate at work, but also unintended negative effects. Indeed, in a previous paper, we showed that when employees schedule their own working hours, 36% considered the professional challenges, 26% considered the type of work tasks, 17% considered colleagues that they wanted to work together with, 7% considered colleagues that they did not want to work together with, and 6% considered the risk of violence (Nabe-Nielsen et al., 2013). Thus, although family life and leisure-time activities were among the toppriorities, employees also considered factors which eventually may lead to changes e positive as well as negative e in the psychosocial working environment. Even if work-time influence can be improved by interventions such as the implementation of self-rostering this is not always the case (Lowden and Åkerstedt, 2000; Nabe-Nielsen et al., 2011). Actually, it is likely that interventions aiming at increasing employee work-time influence e but do not succeed e will have an adverse effect on the psychosocial working environment due to disappointment and dissatisfaction. On this background, our overall aim was to investigate whether computerised self-rostering (i.e. the systematic involvement of the individual employee in the planning of his or her own work schedule by use of a computer program) has an effect on the psychosocial factors at work. More specifically, we first aimed to investigate the quantitative effect of self-rostering on job demand (i.e. emotional demands, quantitative demands, work pace),
influence, job satisfaction, and social climate (i.e. social community at work, social support from leaders and colleagues, and exposure to negative acts). Second, we investigated to which extent the effect of the intervention depended on changes in the perceived influence on the arrangement of working hours. By including qualitative data we interpreted the results in light of the different implementation processes that emerged in the study. 2. Methods 2.1. Study design and study population The present study is part of an intervention project that aimed at exploring the consequences of self-rostering on health, recovery and working hours (Albertsen et al., 2014; Garde et al., 2012). Workplaces planning to implement self-rostering were recruited through public advertising, meetings, and by personal contacts. The requirements for workplaces to participate in the study were that (part of the) employees had shift work (i.e. that they worked outside the conventional day time covering evenings/nights and/or weekends). All activities related to the interventions were planned, executed and financed by the workplaces. Data collection included questionnaires, interviews, and collection of working schedules at baseline and after 12 months follow-up. At follow-up, all interventions had been implemented for at least 9 months. In total, 28 workplaces were included. They were clusterallocated to an intervention (n ¼ 14 workplaces) or a reference group (n ¼ 14 workplaces). Allocation to the intervention or reference groups was decided by the workplace, i.e. non-randomized. 2.2. Data collection 2.2.1. Interviews Focus-group interviews and individual interviews with employees and managers were performed in each of the intervention workplaces. In total, 26 employees and 14 managers were interviewed at baseline, and 25 employees and 16 managers were interviewed at follow-up. Managers, employees responsible of the scheduling, and representatives of employees, who did not hold a central position in the implementation of self-rostering, were selected for interviews. All interviews were conducted by two researchers, one posing questions and the other taking notes. Through the qualitative interviews, we collected data about the involved companies, working conditions, and time schedules. The baseline interviews included questions about the motives for introducing self-rostering in the company. The follow-up survey included information about the change processes and attitudes to the project. In the reference group, nine leaders or other personnel responsible for the planning of working hours filled in a small questionnaire with open questions on how the working hours were planned at baseline. The questionnaire provided the basis for a half hour telephone interview. At follow-up, a summary was sent to the leaders, and they were asked to report any substantial changes that had occurred during the past 12 months (for more details on the qualitative data collection and results, see Albertsen et al. (2014)). 2.2.2. Questionnaires All employees at the workplace at the time of data collection were invited to participate. A total of 1065 participants were eligible for inclusion at baseline and 1070 at follow-up. At baseline 840 employees returned the questionnaire (response rate ¼ 78.9%) and 785 participated at follow-up (response rate ¼ 69.2%). In total, 567 responded to the questionnaire at both baseline and follow-up (follow-up response rate ¼ 63.9%). The baseline measurements
Å.M. Hansen et al. / Applied Ergonomics 47 (2015) 203e210
consisted of a questionnaire on personal background, work environment and working hours. The baseline survey and interviews took place between October 2008 and October 2009 and the follow-up took place 12 months later. At 13 out of 14 intervention workplaces, the management completed workplace questionnaires on the context of the implementations. The Danish Data Protection Agency approved the data usage (reference number: 2008-540458). 2.3. The intervention The intervention was to implement self-rostering by use of commercially available IT-software chosen by the workplace (Garde et al., 2012). The employers had to implement the software and specify the need for man-power on a running basis. Three different commercial IT-softwares were used. The three IT-softwares resembled each other and had more or less the same possibilities and training of the employees in using the IT-software prior to the implementation. Three subgroups of interventions (AeC) were made based on the workplaces' choice of IT-software, due to differences in the way they were introduced and implemented. Table 1 shows which mandatory and eligible opportunities were available and used in the three interventions. Eligible opportunities were length of shift, starting and ending times, possibility to transfer hours from one period to another (a time-bank), and a point system for distribution of unwanted hours or shifts. A work schedule for the employees was generated based on employees' preferences and their choices and the need for resources. Some workplaces included a step where the employees were invited to solve discrepancies between preferences and the need for resources by voluntarily altering their preferences (puzzle-phase). Finally, adjustments were made by the leaders, and the schedules were published. In order to be included in the study, it was mandatory that the intervention included a possibility for the employees to choose their work schedule, i.e. what days the employees wanted to work or did not want to work. Intervention A was implemented among all caregivers at 6 workplaces, mainly psychiatric and somatic hospital care settings with a need for 24/7 manning. The main aims for introducing selfrostering were to increase workers' satisfaction and wellbeing and thereby ensure possibilities for recruitment and retention. Before the intervention, working hours were planned for 4e8 weeks at a
205
time and published with at least four weeks' notice. The implementation process involved the work council and the union representatives at 80% of the workplaces. New individual work schedules were created every 1e5 weeks. Employees in intervention group A were encouraged to rethink their usual habits and attitudes towards organizing their working hours around their private life rather than their private life around the working hours, when entering their choices. After implementation 75e90 % of the employees' wishes were fulfilled. Intervention B was implemented among caregivers at 7 workplaces, mainly psychiatric care settings and intensive and somatic care units in hospitals with a need for 24/7 manning. As a rule, all employees at the workplace were obliged to use the software. However, some employees were excluded e.g. due to social or health problems. The main aims for introducing self-rostering were to increase workers' satisfaction and wellbeing and thereby ensure possibilities for recruitment and retention. Before the intervention, working hours were planned for 4e8 weeks at a time and published with at least four weeks' notice as in intervention A. After implementation working hours were planned for 4e8 weeks and 75e80 % of the employees' wishes were fulfilled. Intervention C was implemented at a call centre in the financial sector. The call centre was open from 08:00 to 20:00 on Monday to Friday and 08:00 to 16:00 during weekends. A few employees did not participate in the intervention due to either social or health problems. The main aim of intervention C was primarily to optimise resources in relation to needs of the company and secondly to improve workers' satisfaction. Before the intervention, all employees had a stable 4 weeks' roster with good possibilities to swap duties among themselves. According to the workplace questionnaire the work council had been involved to a low degree, union representatives to a high degree and employees to some degree in the implementation process of the self-rostering IT software. New individual work schedules were created every 12 weeks. It was not reported how many of the employees' wishes were fulfilled. 2.3.1. Reference group The reference group comprised psychiatric, intensive, and somatic hospital wards and a handicap home with a need for 24/7 staffing. From telephone interviews it is known that the workplaces in the reference group refrained from engaging in working hour interventions during the study period.
Table 1 Overview of mandatory and eligible requirements for the employees in the three interventions on self-rostering. Requirements
Intervention A
Intervention B
Intervention C
Mandatory requirements
Wish days to work Wish days not to work Wishes made on running basis
Yes Yes Yes
Yes Yes Yes
Yes Yes Yes
Eligible requirements
Length of shift Length between shifts Days in a row Starting and ending time Time bankd Point system Puzzle phasee
1e12 h 8e11 h 6e12 Yesa Yes from 100 to þ200 h Yes Yes
5e13 h 8e11 h 6e8 Yesb No No No
4e10 h >11 h
