Promoting Sustainable Work Hours Through Participatory Scheduling: A Cross-Sectional Study Employing Objective Working Time Data.

backgroundParticipatory working time scheduling (PWTS) is a form of self-scheduling involving collaboration between employees and employers. PWTS is common in Swedish health care, but its characteristics can vary substantially between workplaces. This study investigated whether the characteristics of PWTS were associated with (1) the ergonomic characteristics of the schedules that emerge from this process and (2) employee satisfaction with those schedules-two indices reflecting the sustainability of work hours.

methodsTwo hundred and forty-eight nurses, assistant nurses and care assistants (response rate 29%) from two Swedish hospitals completed a survey that asked about the respondents' experience of how the scheduling process is managed and implemented, and their own priorities when planning their schedules. Participants' realised work hours were derived from the hospitals' administrative systems. Factor analysis was used to identify composite factors of PWTS characteristics. Logistic regressions then examined associations between PWTS characteristics and (1) the prevalence of ergonomically unsound work schedule characteristics and (2) indices of employee satisfaction.

resultsSix PWTS characteristics were identified: scheduling support and personal influence (SSPI), prioritising personal motives (PPM), usability of scheduling tools (UST), scheduling as a collective process (SCP), preference for compressing hours (PCH) and bad schedule warnings (BSW). SCP and PCH predicted the frequency of long (> 40 hours) working weeks. BSW predicted the frequency of long shifts (≥ 12 h). SSPI predicted satisfaction with work hours, satisfaction with influence over work hours and frequency of thoughts about leaving the workplace.

conclusionsThe findings indicated that, for PWTS to be perceived positively, there should be open communication between employees and managers/staffing assistants, fostering individual relationships with employees and promoting employee-voice in the scheduling process such that nurses feel able to influence their work hours. However, we found only limited evidence that PWTS characteristics affected the ergonomic characteristics of the schedules that emerged from this process. IMPLICATIONS FOR NURSING MANAGEMENT: Priority should be given to allowing staff influence over their work hours while simultaneously providing those staff with support in the scheduling process. Managers need to be active in their leadership of work hours, so as to foster that communication and employee-voice. Managers should identify staff who choose to work longer work weeks and alert them to the potential risk to their own wellbeing and to patient safety. An important tool in this regard is scheduling software that warns of ergonomically unsound schedules.