Working Environment Activities in Hospitals: Expansion of Scope and Decentralization of Responsibility

Keywords: Health, Working Environment & Wellbeing, Organization & Management

Abstract

This article analyzes how two development traits in the regulatory requirements for Working Environment (WE) activities – an expansion of scope and a decentralization of responsibility – are understood and handled over time by actors responsible for WE activities in Norwegian hospitals. The expanded scope of WE activities is studied based on the requirements outlined in The Working Environment Act, public health science theory, and the WE challenges in hospitals. The decentralized responsibility for WE activities is studied based on Internal Control (IC) reform and other hospital reforms inspired by New Public Management (NPM). The final section of the article discusses the effects of the two development traits, and how these enlarge the line manager’s area of responsibility. The article is based on a qualitative, longitudinal study conducted in three Norwegian hospitals in 1998-1999 and 2013.

Author Biographies

Per-Christian Borgen, Nord University

Associate Professor, Faculty of Nursing and Health Sciences

Bente Vibecke Lunde, Nord University

Associate Professor, Faculty of Social Sciences

References

Bakken, R., Brinchmann, A., Haukelien, H., Kroken, R. and Vike, H. (2002). Maktens samvittighet [The conscience of power], Oslo: Gyldendal Akademisk.

Berg, L. N., Byrkjeflot, H. and Kvåle, G. (2010). Hybridledelse i sykehus – en gjennomgang av litteraturen [Hybrid management in hospitals – a review of the literature], Nordiske Organisasjonsstudier [Nordic Organization Studies] 12(3): 30–49.

Borgen, P. C. (2014). Systematisk HMS-arbeidet i sykehus som modernisering av offentlig sektor [Systematic health, environment and safety (HES) activities in hospitals as a modernization of the public sector], Søkelys på arbeidslivet [Norwegian Journal of Working Life Studies] 31(4):354-372.

Borgen, P. C. and Lunde, B. V. (2007). "Sykehus er en meget spesiell opplevelse". Utfordringer i HMS-arbeidet i sykehus ["The hospital is a different experience". The challenge of systematic health, environmental and safety (HES) activities in hospitals], Tidsskrift for velferdsforskning [Norwegian Journal of Welfare Research] 10(4):234-245.

Borgen, P. C. and Lunde, B. V. (2009). Arbeidslivet som arena for folkehelsearbeid. Mål og midler i HMS-arbeidet. [The workplace as an arena for public health. Means and ends in systematic health, environment and safety (HES) activities], Tidsskrift for velferdsforskning [Norwegian Journal of Welfare Research] 12(4):249-260.

Brante, T. (2005). Staten og professionerne [The state and the professions]. In: Eriksen, T. R. and Jørgensen, A. M. (eds.) Professionsidentitet i forandring [Professional identity in change], Copenhagen: Akademisk Forlag, pp. 16–36.

Bunton, R. and Macdonald, G. (eds.) (1992). Health Promotion: Disciplines and Diversity, London: Routledge.

Byrkjeflot, H. and Kragh Jespersen, P. (2014). Three conceptualizations of hybrid management in hospitals, International Journal of Public Sector Management 27(5): 441–458. doi: 10.1108/IJPSM-12-2012-0162

Dyckman, J. M. and Cutler, J. A. (2003). Scapegoats at Work: Taking the Bull’s-Eye off Your Back, Westport: Praeger.

Dyreborg, J. (2011). Safety matters have become too important for management to leave it up to the workers: The Nord OSH model between implicit and explicit frameworks, Nordic Journal of Working Life Studies 1(1): 135–160. doi: 10.19154/njwls.v1i1.2339

ENWHP (European Network for Workplace Health Promotion) (1997). Luxembourg Declaration on Workplace Health Promotion in the European Union, Luxembourg: ENWHP.

FOR-1996-12-06-1127 (1996). Forskrift om systematisk helse-, miljø- og sikkerhetsarbeid i virksomheter (Internkontrollforskriften) [Regulations relating to systematic health, environmental and safety activities in enterprises (Internal control regulations)], Oslo: Arbeids- og sosialdepartementet [Norwegian Ministry of Labor and Social Affairs].

Freidson, E. (2001). Professionalism: The Third Logic, Cambridge: Polity Press.

Graver, H. P. (1995). Sikkerhets- og miljørett [Safety and environmental law]. In: Hermansen, J. (ed.) Miljøledelse [Environmental management], Oslo: Tano, pp. 200–263.

Green, J., Tones, K., Cross, R. and Woodall, J. (2015). Health Promotion: Planning and Strategies, 3rd ed., Los Angeles: Sage Publications.

Hellevik, O. (1980). Forskningsmetode i sosiologi og statsvitenskap [Research method in sociology and political science], Oslo: Universitetsforlaget.

Hellevik, O. (2001). Diakrone data [Diachronic data]. In: Østerud, Ø., Goldmann, K. and Pedersen, M. N. (eds.) Statsvitenskapelig leksikon [Political science encyclopedia], Oslo: Universitetsforlaget, pp. 44–45.

Hippe, J. M. and Trygstad, S. C. (2012). Ti år etter: Ledelse, ansvar og samarbeid i norske sykehus [Ten years later: Management, responsibility and cooperation in Norwegian hospitals], Fafo-rapport 2012: 57, Oslo: Fafo.

Hovden, J. (1995). HMS-ledelse i bedrifter [HES management in enterprises]. In: Hermansen, J. (ed.) Miljøledelse [Environmental management], Oslo: Tano, pp. 350–364.

Iversen, H. P. and Gammelsæter, H. (2012). Reformer i utakt: Selvorganisering eller avstandsledelse i psykisk helsevern? [Reforms out of step: Self-organization or distance management in mental health care?], Nordiske Organisasjonsstudier [Nordic Organization Studies] 14(1): 28–50.

Kamp, A. (2016). Welfare professions in transition, Nordic Journal of Working Life Studies 6(S1): 1–6. doi: 10.19154/njwls.v6i1.4882

Karlsen, J. E. (2004). Ledelse av helse, miljø og sikkerhet [HES Management], Bergen: Fagbokforlaget.

Karlsen, J. E. (2010). Systematisk HMS-arbeid: Ledelse for organisatorisk bærekraft [Systematic HES work: Management for organizational sustainability], Kristiansand: Høyskoleforlaget.

Karlsen, J. E. and Lindøe, P. H. (2006). The Nordic OSH model at a turning point?, Policy and Practice in Health and Safety 4(1): 17–30. doi: 10.1080/14774003.2006.11667673

Karlsen, J. E., Nielsen, K. T. and Salomon, R. H. (2018). Working environment regulation in Norway and Denmark. In: Hvid, H. and Falkum, E. (eds.) Work and Wellbeing in the Nordic Countries, New York: Routledge, pp. 115–133. doi: 10.4324/9781351169967-9

Klausen, K. K. (2011). Fra Public Administration over New PA til NPM – en fortolkningsramme for reformer [From Public Administration over New PA to NPM – an interpretive framework for reforms]. In: Busch, T., Johnsen, E., Klausen, K. K. and Vanebo, J. O. (eds.) Modernisering av offentlig sektor: Trender, ideer og praksiser [Modernization of the public sector: Trends, ideas and practices], Oslo: Universitetsforlaget, pp. 48–61.

Knudsen, H., Busck, O. and Lind, J. (2011). Work environment quality: The role of workplace participation and democracy, Work, Employment and Society 25(3): 379–396. doi: 10.1177/0950017011407966

Krogstad, U., Hofoss, D., Veenstra, M. and Hjortdahl, P. (2006). Predictors of job satisfaction among doctors, nurses and auxiliaries in Norwegian hospitals: Relevance for micro unit culture, Human Resources for Health 4(3). doi: 10.1186/1478-4491-4-3

Kvale, S. and Brinkmann, S. (2009). Det kvalitative forskningsintervju [InterViews: Learning the craft of qualitative research interviewing], Oslo: Gyldendal Akademisk.

Lindøe, P. H. (2003). Erfaringslæring og evaluering [Learning from Experience and evaluation], Oslo: Tiden.

Lindøe, P. H., Karlsen, J. E. and Lie, T. (2001). Et nordisk grep på arbeidsmiljøregulering?: Organisering og bruk av virkemidler i de nordiske land [A Nordic approach to working environment regulation?: Organization and the use of instruments in the Nordic countries], TemaNord 2001: 535, Copenhagen: Nordisk ministerråd [Nordic Council of Ministers].

LOV-1977-02-04-4 (1977). Lov om arbeidervern og arbeidsmiljø (Arbeidsmiljøloven) [Occupational safety and working environment Act (The Working Environment Act)], Oslo: Arbeids- og sosialdepartementet [Norwegian Ministry of Labor and Social Affairs].

LOV-1999-07-02-61 (1999). Lov om spesialisthelsetjenesten m.m. (Spesialisthelsetjenesteloven) [The Specialist Health Services Act], Oslo: Helse- og omsorgsdepartementet [Norwegian Ministry of Health and Care Services].

LOV-1999-07-02-63 (1999). Lov om pasient- og brukerrettigheter (Pasient- og brukerrettighetsloven) [The Patient and User Rights Act], Oslo: Helse- og omsorgsdepartementet [Norwegian Ministry of Health and Care Services].

LOV-2005-06-17-62 (2005). Lov om arbeidsmiljø, arbeidstid og stillingsvern mv. (Arbeidsmiljøloven) [Working environment, working hours, and job security Act (The Working Environment Act)], Oslo: Arbeids- og sosialdepartementet [Norwegian Ministry of Labor and Social Affairs].

Madsen, C. U. and Hasle, P. (2017). Commitment or compliance?: Institutional logics of work environment management, Nordic Journal of Working Life Studies 7(S2): 17–38. doi: 10.18291/njwls.v7iS2.96688

Malterud, K. (2011). Kvalitative metoder i medisinsk forskning: En innføring [Qualitative methods in medical research: An introduction], 3rd ed., Oslo: Universitetsforlaget.

Mintzberg, H. (1989). Mintzberg on Management: Inside our Strange World of Organizations, New York: The Free Press.

NAV [Norwegian Labor and Welfare Administration] (2019). Arbeidsrettet rehabilitering [Occupational Rehabilitation]. Available at: https://www.nav.no/no/person/arbeid/oppfolging-og-tiltak-for-a-komme-i-jobb/tiltak-for-a-komme-i-jobb/arbeidsrettet-rehabilitering [Accessed March 31, 2019].

Norwegian Labor Inspection Authority (2016). Arbeidsmiljøarbeid i norske sykehus: Rapport om Arbeidstilsynets revisjoner i sykehus i 2014 [Working environment work in Norwegian hospitals: A report on the Norwegian Labor Inspection Authority’s audit of hospitals in 2014], Trondheim: Arbeidstilsynet. Available at: https://www.arbeidstilsynet.no/globalassets/om-oss/forskning-og-rapporter/rapporter-fra-tilsynsprosjekter/arbeidstilsynets-revisjoner-i-norske-sykehus.pdf [Accessed January 20, 2021].

Norwegian Ministry of Labor and Social Affairs (2010). Intensjonsavtale om et mer inkluderende arbeidsliv: 1.mars 2010 – 31. desember 2013 (IA-avtalen) [Letter of Intent regarding a more inclusive working life]. Available at: https://www.regjeringen.no/no/tema/arbeidsliv/arbeidsmiljo-og-sikkerhet/inkluderende_arbeidsliv/ia-tidligere-avtaleperioder/inkluderende-arbeidsliv.-avtaleperioden-2010-2013/ia-dokumenter/id621354/ [Accessed July 19, 2019].

NOU 1992: 20 [Official Norwegian Report 1992: 20] (1992). Det gode arbeidsmiljø er lønnsomt for alle [The good working environment is profitable for everyone], Oslo: Kommunaldepartementet [Ministry of Local Government].

Reay, T. and Hinings, C. R. (2009). Managing the rivalry of competing institutional logics, Organization Studies 30(6): 629–652. doi: 10.1177/0170840609104803

Skaar, S. (1994). Internkontroll i følge forskriften [Internal control according to the regulations]. In: Skaar, S. (ed.) Internkontroll: Ørkenvandring eller veien til det forjettede land? [Internal control: Wandering in the desert or road to the promised land?], Trondheim: SINTEF IFIM, pp. 37–43.

STAMI [National Institute of Occupational Health in Norway] (2002). Lillestrøm-erklæringen om helsefremmende arbeidsplasser [Lillestrøm Declaration on Workplace Health Promotion]. Available at: http://www.stamiweber.no/hefa/lillestrom_erklar.html [Accessed July 18, 2019].

STAMI [National Institute of Occupational Health in Norway] (2018). Faktabok om arbeidsmiljø og helse 2018 [Factbook on working environment and health 2018], STAMI-rapport 19/3, Oslo: Statens arbeidsmiljøinstitutt. Available at: https://stami.no/content/uploads/2018/06/Faktaboka-2018.pdf [Accessed February 19, 2020].

St. meld. nr. 37 (1992–1993) (1993). Utfordringer i helsefremmende og forebyggende arbeid. [Government White paper no. 37 (1992–93), Challenges in Health promotion and prevention], Oslo: Sosialdepartementet [Norwegian Ministry of Social Affairs].

Svensson, L. G. and Karlsson, A. (2008). Profesjoner, kontroll og ansvar [Professions, control and responsibility]. In: Molander, A. and Terum, L. I. (eds.) Profesjonsstudier [Professional studies], Oslo: Universitetsforlaget, pp. 261–278.

Thorsrud, E. and Emery, F. E. (1970). Mot en ny bedriftsorganisasjon: Eksperimenter i industrielt demokrati [Towards a new organization of enterprises: Experiments in industrial democracy], Oslo: Tanum.

Verschuren, R., de Groot, B. and Nossent, S. (1995). Working Conditions in Hospitals in the European Union, European Foundation for the Improvement of Living and Working Conditions, Luxembourg: Office for Official Publications of the European Communities.

WHO (World Health Organization) (1986). The Ottawa charter for health promotion. Available at: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/ [Accessed July 18, 2019].

Published
2021-03-23
How to Cite
Borgen, P.-C., & Lunde, B. V. (2021). Working Environment Activities in Hospitals: Expansion of Scope and Decentralization of Responsibility. Nordic Journal of Working Life Studies. https://doi.org/10.18291/njwls.125506
Section
Articles