Employee Wellbeing in Healthcare: The Effects of Shift Schedule Evaluation Tool with Ergonomics Recommendations

Introduction: The Finnish Institute of Occupational Health (FIOH) has issued national evidence- based ergonomic shift scheduling recommendations using a traffic light analogy. The recommendations have been integrated into the most widely utilized shift scheduling software in the public healthcare sector. We aimed to investigate whether the shift planner’s use of a shift schedule evaluation tool with ergonomic recommendations has an impact on the wellbeing of healthcare workers both at the individual and ward-level analysis.

Methods: Survey data from the Finnish Public Sector study were combined into four cohorts consisting of two consecutive waves: 1) hospital districts: in years 2015 and 2017 (n = 1943), 2) municipalities 2016 and 2018 (n = 5291), 3) hospital districts 2017 and 2019 (n = 1966), and 4) municipalities 2018 and 2020 (n = 4311). Data from the Titania® shift scheduling software were used to define the use of the shift schedule evaluation tool in the year prior to the survey wave. Multilevel mixed-effects logistic regression was used to calculate a propensity score for each participant and logistic regression was applied at the shift planning unit- level. The propensity score represented the probability of receiving an intervention, i.e., having (intervention group, IG) or not having (control group, CG) the shift schedule evaluation used by the unit’s shift planner. The regression model included several covariates such as demographic and lifestyle factors as well as working hour characteristics. The outcomes were sleep duration, sleep difficulties, psychological distress, general health, and work ability. We used a generalized linear model to obtain risk ratios with 95% confidence intervals (IC) and compare the outcomes of interest between the IG and the CG.

Results: The shift schedule evaluation tool was used for an average of 88 minutes in the municipalities and an average of nine minutes in the hospitals, covering 52% of the 8879 employees (88% females) who had complete data on the software and on the outcomes at follow-up. No association was found between the use of the tool and wellbeing at the shift planning unit -level. At the individual level, there was a reduction in psychological distress among employees in the IG (risk ratio 0.92, 95% CI 0.85–0.99).

Conclusion: Although the use of the shift schedule evaluation tool with ergonomic recommendations by shift planners was not associated with perceived wellbeing at the shift planning unit-level, an association was observed with lower psychological distress at individual level. More rigorous use of the tool may be required to achieve significant benefits for wellbeing, particularly at the unit -level. Support: The Finnish Work Environment Fund [grant number 210064] and the Finnish Institute of Occupational Health.