The vast majority of clinicians participating in the LAD Healthy and Safe Work project assess the organizational climate regarding psychosocial workload in their organization as inadequate. While an appropriate organizational climate is the basis for healthy and safe work.
The LAD regulates the preconditions for a healthy and safe working environment in collective labor agreements. But what if collective labor agreements come under pressure due to a high workload? Or if doctors face little participation in the organization of their work? To help doctors with this, LAD started the Healthy and Safe Work Project a few years ago. Through this project, groups of doctors in institutions are guided through a two-year process. The goal is to develop a practical, scientifically proven intervention that helps doctors improve their work culture and increase their employability sustainably. Leiden University performs all measurements and analyses, including basic measurement at the beginning of the process, interim measurements and final measurement.
Psychosocial workload
The results of the project will be delivered in 2025, but interesting results from basic measurements have already emerged. Participating physicians completed this baseline measure at baseline (526 physicians in total). This concerns medical specialists, doctors for the mentally disabled, geriatric specialists, community + health doctors, addiction doctors, general practitioners, hospital pharmacists, primary care doctors and doctors in training. One aspect that was measured was the organizational climate regarding psychosocial workload (PSA). This then relates to how much interest there is in PSA within the organization at different levels (management, supervisor and your own group). and whether action will be taken to reduce this burden or keep it at an acceptable level, in order to protect the mental health and well-being of employees (Dollard and Bakker, 2010; Bronkhorst, 2015).
Almost all physician groups fall into the “unfavorable” category.
The importance of organizational climate
It is no coincidence that organizational climate is measured. The organizational climate in relation to PSA has an important impact on work factors (workload and resources) and therefore also on the mental health and well-being of employees. Maureen Dollard, an Australian researcher and one of the most important scholars in the field, describes the organizational climate in relation to PSA as a “cause of causes” (Dollard and Packer, 2010). For example, an unfavorable organizational climate is associated with high workload (e.g. time pressure, emotional burden, bullying behavior) and lack of resources at work (e.g. autonomy, social support from manager, opportunities to rest and recover while working). These unfavorable work factors can subsequently lead to negative consequences for mental health and well-being, such as an increased risk of complaints of burnout and job dissatisfaction. On the other hand, a favorable organizational climate, where attention is paid to preventing overload and maintaining mental health, can lead to fewer complaints of overload and increased enthusiasm. Evidence for this has been provided in several longitudinal studies (Dollard and Bakker, 2010; Dollard and colleagues, 2012; Hu and colleagues, 2022).
First results of the LAD project
Twenty-eight groups of clinicians participating in the LAD project completed the baseline measurement. Based on available benchmark data (Bailey and colleagues, 2015), only a few physician groups appear to have an appropriate regulatory climate regarding PSA. Almost all physician groups fall into the “unfavorable” category. The interesting thing about the baseline measurement is that it has become clear how the organizational climate in terms of PSA, work factors (workload and resources) and indicators of sustainable employability are interconnected. For example, data suggest that an unfavorable organizational climate is associated with higher workload, particularly high time pressure, more emotional burden and more references to bullying behavior. The link to resources is even stronger: a less favorable organizational climate, for example, leads to less social support from the manager, less autonomy at work, more understaffing and poor internal communication. Finally, we see that physicians who work in an unfavorable organizational climate are less satisfied with their jobs, more often consider leaving the organization, have more complaints of burnout, and are less motivated. These results are consistent with the previous studies mentioned and confirm the importance of a good organizational climate.
Improvements
In the LAD project, doctors themselves work to improve their sustainable employability based on baseline measurement results. They address topics that interest them. Think about reduced workload, improved collaboration and work processes, clarity of roles, and enhanced position within the organization. The great thing is that physician groups have come up with targeted improvements so they can address bottlenecks. Other bottlenecks require involvement of supervisor(s) and management/board of directors to achieve better working conditions. We then see that physician groups face “systemic” factors (e.g. production standards, financial constraints, staff shortages), which means that changes are not always possible to achieve. If they enter into discussions with managers and management in such situations, we see in different physician groups that this has led to improvements in the organizational climate and in the work attitude.
Doctors must address what falls within their sphere of influence
More attention and work needed
According to LAD, it is vitally important for a healthy work environment that boards, management and senior management prioritize the organizational climate in relation to PSA, by clearly putting PSA and health and wellbeing on the agenda and anchoring it in policy. The priority now often lies with funding and production, while the person behind the doctor is not always seen enough. Doctors then feel undervalued and appear dissatisfied with the organization, making them more likely to leave. It is important for doctors to address what is within their sphere of influence, but there is also an important role for boards and management in nurturing and retaining their staff.
References:
Bailey, T. S., Dollard, M. F., and Richards, P. A. M. (2015). National Psychosocial Safety Climate (PSC) Standard: PSC 41 as a criterion for low risk of job stress and depressive symptoms. Journal of Occupational Health Psychology, 20(1), 15-26. https://doi.org/10.1037/a0038166
Bronkhorst b. (2015). Acting safely under stress: The effects of job demands, resources, and safety climate on employees' physical and psychosocial safety behavior. Journal of Safety Research, 55, 63-72. https://doi.org/10.1016/j.jsr.2015.09.002
Dollard, M. F., and Packer, A. B. (2010). Psychosocial safety climate as a precursor to conductive work environments, mental health problems, and employee engagement. Journal of Occupational and Organizational Psychology, 83(3), 579-599. https://doi.org/10.1348/096317909X470690
Dollard, M. F. (2012). Psychosocial safety climate: A key indicator of mental health and workplace engagement and a precursor to intervention success. In C. Biron, M. Karanika-Murray, & C. Cooper (Eds.), Improving organizational interventions for stress and well-being: Addressing process and context (pp. 77–101). Routledge/Taylor & Francis Group.
He, Q., Dollard, M. F., and Tarris, T. W. (2022). Organizational context matters: Psychosocial safety climate as a precursor to team and individual motivational performance. Safety Science, 145, Article 105524. https://doi.org/10.1016/j.ssci.2021.105524
