Work organization within the Swedish health service from a socio-psychological perspective. A review of research and practical work for change in county council.
The study is a full inventory. The aim was twofold: to obtain a comprehensive picture of activities and to obtain an expression of what the concept of work organization stands for within the health service. Analyses demonstrate that there is an equally strong emphasis on work organisational structure (eg. job scheduling, forms of care) and occupational content. (eg. skills development, professional role). Nevertheless, more detailed analyses demonstrated that the overall balance between structure and content does not apply to all occupational groups and at all levels within the hierarchy. The results show that occupational groups at high and intermediate levels tend to be primarily considered in terms of factors that can be regarded as involving personal development or concerned with relations with patients at a theoretical level; on the other hand, a far greater number of health care auxiliaries are treated in concrete and physical terms--in relation to work with patients and personal benefits that will accrue so long as they remain within the organization. This divergence of emphasis is paradoxical in the light of the fact that it is members of the latter group who have the more intense relations with patients and who have to bear so much of their fear and anxiety. At the same time, auxiliaries form the occupational group which, at least initially, has the lowest qualification for this task and which receives the least amount of training in what can be described as professional attitude with empathy as a central component. If a systems perspective is adopted (where the object is seen as a unified whole), the importance that the different groups are linked together via certain common conceptions becomes immediately apparent. In the light of our findings, we hold the strong belief that similar or common strategies for work organizational development should be applied to all groupings of health care staff. We also believe in the necessity of defining the role of the patient within the organization. If changes can take place along these lines, they will have a favourable impact on the organization of work within the Swedish health service.
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