How effective are organizational-level interventions in improving the psychosocial work environment, health, and retention of workers? A systematic overview of systematic reviews.

OBJECTIVE: This study aimed to systematically review the effectiveness of organizational-level interventions in improving the psychosocial work environment and workers' health and retention. METHODS: We conducted an overview of systematic reviews on organizational-level interventions published between 2000 and 2020. We systematically searched academic databases, screened reference lists, and contacted experts, yielding 27 736 records. Of the 76 eligible reviews, 24 of weak quality were excluded, yielding 52 reviews of moderate (N=32) or strong (N=20) quality, covering 957 primary studies. We assessed quality of evidence based on quality of review, consistency of results, and proportion of controlled studies. RESULTS: Of the 52 reviews, 30 studied a specific intervention approach and 22 specific outcomes. Regarding intervention approaches, we found strong quality of evidence for interventions focusing on "changes in working time arrangements" and moderate quality of evidence for "influence on work tasks or work organization", "health care approach changes", and "improvements of the psychosocial work environment". Regarding outcomes, we found strong quality of evidence for interventions about "burnout" and moderate quality evidence for "various health and wellbeing outcomes". For all other types of interventions, quality of evidence was either low or inconclusive, including interventions on retention. CONCLUSIONS: This overview of reviews identified strong or moderate quality of evidence for the effectiveness of organizational-level interventions for four specific intervention approaches and two health outcomes. This suggests that the work environment and the health of employees can be improved by certain organizational-level interventions. We need more research, especially about implementation and context, to improve the evidence.

Workplace's Development of Activities and Action Plans to Prevent Violence From Clients in High-Risk Sectors.

INTRODUCTION: Interventions trying to prevent violence from clients towards employees tend to show limited effect on the risk or the frequencies of violent episodes, possibly due to a too-narrow focus on only one or a few preventive strategies. This study aimed to show what employees and line managers identify as key intervention areas for preventing violence and threats. METHODS: The study is based on data collected during a participatory intervention study aiming to improve violence prevention in Danish psychiatric units and prison and detention centers. In the intervention study, employees and line managers from 13 work units developed 293 suggestions and 92 action plans to prevent workplace violence. Through qualitative thematic analysis of the suggestions and action plans, we identified the main categories that work units viewed as important and realistic to work with to improve violence prevention. RESULTS: We identified 12 topics of violence prevention that work units considered relevant. Action plan topics used by more than half of the work units included: specific approaches to violence prevention (e.g., de-escalating techniques), communication between employees to transfer knowledge between shifts, and introduction to new employees and temporary workers. Topics used by three to five work units were: interdisciplinary corporation, communication and relational work, uniform approaches, organization of work, and staffing. Topics used rarely were: definition of violence and threats, policy and guidelines, support from colleagues and management, and engagement in violence prevention. For nine of the 12 topics, action plans were developed in both high-risk sectors. CONCLUSIONS: The violence prevention action plans developed by work units from two high-risk sectors indicate that workplaces estimate the prevention of client-induced workplace violence to require activities on many levels and cannot be solved by a single focused approach. This variety of preventive activities needs to be considered when designing violence prevention interventions.

Design of a tailored and integrated violence prevention program in psychiatric wards and prisons.

BACKGROUND: Violence and threats of violence against personnel at psychiatric wards as well as in the prison service is a major work environment problem. To date results from interventions to prevent violence and threats in these sectors have been inconclusive or of small effect. One of the reasons may be that violence and threats of violence occur as a consequence of a complex interaction between employee-level and management-level factors. OBJECTIVE: To design a tailored and theory-based intervention program directed at violence prevention in psychiatric wards and prisons that integrates the employee-level and management-level, and development of an evaluation design building on the Context, Process, and Outcome Evaluation Model. METHODS: The study follows a stepped-wedged design with 16 work units entering the intervention in four groups with differing start dates from September 2017 to January 2019. The context and process evaluation includes: calculating the implementation degree; mapping of contextual factors; interviews with unit-leaders and employees before and after the intervention. The outcome evaluation includes performing multi-level statistical analysis on data from a three-monthly questionnaire to employees at the participating workplaces. RESULTS: The first results will be available in 2020. CONCLUSIONS: The comprehensive evaluation of the intervention will give insight into the processes and effects of the intervention.