Background
OH services in Sweden
Aim
Social capital as a theoretical framework
Methods
Selection of respondents
Unit | Organizational form | Customers | Respondents from OH service provider | Respondents from employer |
---|---|---|---|---|
1 | External | Municipal | 1: Occupational physician | 1: Unit manager, elderly care |
2: Organizational consultant | 2: Unit manager, day-care centre | |||
2 | Internal | County council | 1: Occupational physician | 1: HR, elderly care administration |
3 | External | Municipal and county council | 1: Occupational physician | 1: HR, elderly care administration |
2: Ergonomist | ||||
4 | External | Municipal | 1: CEO of OH provider | 1: HR adviser |
2: Ergonomist | ||||
5 | Internal | Municipal | 1: CEO of OH provider | 1: HR specialist |
2: Rehabilitation coordinator | 2: Unit manager, disability care | |||
6 | Internal | Municipal | 1: CEO of OH provider | 1: Unit manager, social services |
2: Occupational nurse | 2: Unit manager, day-care centre | |||
3: Unit manager, elderly care | ||||
7 | Internal | Municipal | 1: Occupational physician | 1: HR strategist |
2: Occupational nurse | ||||
8 | Internal | Municipal | 1: Occupational nurse | 1: Unit manager, elderly care |
2: CEO of OH provider | ||||
9 | Internal | County council | 1: Occupational nurse | 1: Rehabilitation coordinator, hospital |
2: CEO of OH provider | ||||
10 | Internal | Municipal and county council | 1: Occupational physician | 1: HR specialist, county council |
2: Psychologist | 2: HR consultant, dental care | |||
3: Occupational nurse | ||||
11 | External | Municipal and county council | 1: Behavioural scientist | – |
2: Occupational physician | ||||
12 | External | County council | 1: Occupational nurse | 1: HR consultant, dental care |
2: Psychologist | ||||
13 | External | Municipality | – | Focus group with unit managers (n = 4) |
Focus group with unit managers (n = 6) | ||||
14 | External | Municipality | – | Focus group with unit managers (n = 4) |
Focus group with unit managers (n = 7) | ||||
15 | External | Municipality | – | Focus group with unit managers (n = 7) |
Focus group with unit managers (n = 5) | ||||
16 | External | Municipality | – | Focus group with unit managers (n = 3) |
Focus group with unit managers (n = 8) |
Data collection
Analysis
Role of the researchers and ethical considerations
Results
The organization of OH provision
Internal provision and centralized budgets facilitate the use of OH
The OH services are built into the organization, so it’s just to call them, both for employees and as a manager. There’s no limit to that.It’s not connected to any charges or anything like that?No, and that’s the beauty of it. It’s just to call them. (Employer, HR department)
Contracts influence the design of services
It constantly feels like they are trying to sell me something. A work assessment concept for 15 000 [SEK] as soon as you show them a rehabilitation case, it feels like too much business to me. (Focus group with municipal managers)
Competition between OH providers and HR departments
Today, I think that the HR department can be a threat or hindrance, since they want to take care of many things. If there’s an HR department, they like to do these things, maybe to save some money by not consulting OH services. (OH, organizational consultant)
Relation between organization of OH and perceived quality in relationships
Long-term contracts facilitate continuity and familiarity with the workplace
Of course we wanted to continue with the county council’s internal occupational health provider. In the latest procurement, it was decided that we should have two companies for occupational health services. It was a political discussion about this, where they decided to keep the internal provider in the social welfare unit, since they had been there for many years. (Employer, HR)
Honestly, I’m not sure I could say whether there is a contract or what it looks like. I know that the private companies all have different contracts, where they always need to check what they are allowed to do. But that’s not the case here. (OH, occupational physician)
Involving OH professionals in preventive work requires trust
That’s an advantage with being internal, that I participate in the management meetings where we discuss work environmental issues and rehabilitation processes. (OH, CEO)
We could be much faster in referring sick-listed employees to occupational health services. It’s all about managers knowing how to consult them and when. We could be much better at using their services. […] It’s about information, but also about relationships, that you have to gain that trust. Our provider is well on the way at getting in much earlier. (Employer, HR)
They [the OH provider] get better and better. As an employer, we don’t know so much about medicine, so they do their work on that and do not interfere with employment issues, which they used to do a lot more. Nowadays, their role is to support us in work adjustments and what we need to do. Roles are much clearer now. (Employer, HR)