The Impact of Extended Shifts on Wellbeing and Organisational Outcomes as Employees Adapt and Respond to Change

TY - GEN

T1 - The Impact of Extended Shifts on Wellbeing and Organisational Outcomes as Employees Adapt and Respond to Change

AU - Suter, Jane Elizabeth

AU - Kowalski, Tina Helen Parkin

PY - 2018/9

Y1 - 2018/9

N2 - Background: Against a backdrop of increasing demand for mental health services and severe financial pressures (UNISON, 2017), service providers have been testing new models of delivering care to reduce costs, with shift patterns and workforce planning a key focus. Evidence on the impact of extending working hours (e.g. increase from 8 to 12 hour shifts) is mixed and focuses on potential negative consequences e.g. increased accidents, fatigue, adverse effects on health and wellbeing, performance and absenteeism (Dall’Ora et al., 2015; 2016; Knauth, 2007; Smith et al., 1998). Research also highlights potential benefits to employers (fewer handovers, less overtime) and to workers (less travel time and longer periods between shift patterns) (Knauth, 2007). Few studies move beyond cross-sectional analysis and evaluate the impact on employee wellbeing after initial satisfaction of a condensed working week has passed (Smith et al, 1998, Tucker 2006). In addition, Gibbs et al., (2012) have called for quantitative research that highlights the nature and extent of stressors associated with organisational change, to be complemented by ualitative evaluations. With these issues in mind our mixed methods study evaluates the impact of extending shift hours on employee wellbeing and organisational outcomes in a large Mental Health Trust in the UK.Methods: 30 in-depth semi structured interviews were conducted from 3 layers of participants (ward managers, nurses and healthcare assistants) to evaluate employee experiences as they adapt and respond to the move from an 8 to 12 hour shift pattern. Interviews took place 6 months after the shift change with follow up interviews 6 months later. We combine this with Interrupted Time Series (ITS) modelling to identify any impact over time on outcomes such as staff turnover, absence, agency staff use, rest breaks and violence against staff.Findings: We will present the analysis of our qualitative findings and a brief overview of the ITS model results. Preliminary analysis indicates that changes to working hours are accompanied by changes to the organisation of work, workload intensification, colleague support and supervisory configuration, all of which may elicit differences in how employees adapt and respond to change, and increase stress amongst some workers. Unforeseen consequences for employees include reduced opportunity for reflection on patient care and stressful incidences, limits to employee voice, increased use of agency staff, isolation from colleagues, lower quality handovers, and disruption to patient routines and continuity of care. Yet the narrative put forward by many participants offers us insight into why previous evidence signals a preference for working longer shifts, as many coped with stress and anxiety relating to extended shifts by focussing on the trade-off of a condensed working week.Contribution:This study contributes to literature on shift work and adapting to organisational change, as one of the few that combines quantitative analysis with qualitative data to shed light on the unforeseen consequences of extended shifts and condensed work ing weeks. We add to knowledge by contextualising our evaluation with the nuances of work conditions which are often overlooked when evaluating the impact of job strain on employee wellbeing.

AB - Background: Against a backdrop of increasing demand for mental health services and severe financial pressures (UNISON, 2017), service providers have been testing new models of delivering care to reduce costs, with shift patterns and workforce planning a key focus. Evidence on the impact of extending working hours (e.g. increase from 8 to 12 hour shifts) is mixed and focuses on potential negative consequences e.g. increased accidents, fatigue, adverse effects on health and wellbeing, performance and absenteeism (Dall’Ora et al., 2015; 2016; Knauth, 2007; Smith et al., 1998). Research also highlights potential benefits to employers (fewer handovers, less overtime) and to workers (less travel time and longer periods between shift patterns) (Knauth, 2007). Few studies move beyond cross-sectional analysis and evaluate the impact on employee wellbeing after initial satisfaction of a condensed working week has passed (Smith et al, 1998, Tucker 2006). In addition, Gibbs et al., (2012) have called for quantitative research that highlights the nature and extent of stressors associated with organisational change, to be complemented by ualitative evaluations. With these issues in mind our mixed methods study evaluates the impact of extending shift hours on employee wellbeing and organisational outcomes in a large Mental Health Trust in the UK.Methods: 30 in-depth semi structured interviews were conducted from 3 layers of participants (ward managers, nurses and healthcare assistants) to evaluate employee experiences as they adapt and respond to the move from an 8 to 12 hour shift pattern. Interviews took place 6 months after the shift change with follow up interviews 6 months later. We combine this with Interrupted Time Series (ITS) modelling to identify any impact over time on outcomes such as staff turnover, absence, agency staff use, rest breaks and violence against staff.Findings: We will present the analysis of our qualitative findings and a brief overview of the ITS model results. Preliminary analysis indicates that changes to working hours are accompanied by changes to the organisation of work, workload intensification, colleague support and supervisory configuration, all of which may elicit differences in how employees adapt and respond to change, and increase stress amongst some workers. Unforeseen consequences for employees include reduced opportunity for reflection on patient care and stressful incidences, limits to employee voice, increased use of agency staff, isolation from colleagues, lower quality handovers, and disruption to patient routines and continuity of care. Yet the narrative put forward by many participants offers us insight into why previous evidence signals a preference for working longer shifts, as many coped with stress and anxiety relating to extended shifts by focussing on the trade-off of a condensed working week.Contribution:This study contributes to literature on shift work and adapting to organisational change, as one of the few that combines quantitative analysis with qualitative data to shed light on the unforeseen consequences of extended shifts and condensed work ing weeks. We add to knowledge by contextualising our evaluation with the nuances of work conditions which are often overlooked when evaluating the impact of job strain on employee wellbeing.

M3 - Conference contribution

SN - 978 - 0 - 9928786 - 4 - 1

BT - Proceedings of the 13 th European Academy of Occupational Health Psychology Conference: Adapting to rapid changes in today’s workplace

ER -