Procurement and implementation processes for Occupational Health Services in Sweden.

BACKGROUND: Employers are required to get expert advice whenever needed to ensure a safe work environment. Providers of Occupational Health Services (OHS) could be such experts, but their services are usually used to provide health-related support to individuals, not preventive Occupational Health and Safety Management (OHSM) or other group-focused interventions. OBJECTIVE: To investigate how contracts with OHS providers in Sweden are established and implemented. METHODS: Written OHS contracts were reviewed, and follow-up interviews were conducted with Human Resource (HR) managers, management, safety representatives, and OHS professionals in seven organizations. RESULTS: Generally, the HR departments drew up the contracts with the OHS providers. The contracts were not integrated with the companies' occupational health and safety management. Managers lacked knowledge on how to utilize services offered by their OHS provider. Terms and conditions of contracts were found to be inconsistent with services actually utilized. CONCLUSIONS: The procurement and implementation process promotes reactive rather than preventive interventions. Employers should include managers and safety representatives in procurement- and implementation processes and define relevant and measurable goals regarding the collaboration.

The influence of social capital on employers' use of occupational health services: a qualitative study.

BACKGROUND: Occupational health services may have a strategic role in the prevention of sickness absence, as well as in rehabilitation and return to work after sick leave, because of their medical expertise in combination with a close connection to workplaces. The purpose of this study was to explore how employers and occupational health service providers describe their business relations and the use of occupational health services in rehabilitation in relation to the organization of such services. The study uses a theoretical framework based on social capital to analyse the findings. METHODS: Interviews and focus groups with managers with Swedish public employers (n = 60), and interviews with occupational health services professionals (n = 25). RESULTS: Employers emphasized trustful relationships, local workplace knowledge, long-term contracts and dialogue about services for good relationships with occupational health providers. Occupational health providers strove to be strategic partners to employers, promoting preventive work, which was more easily achieved in situations where the services were organized in-house. Employers with outsourced occupational health services expressed less trust in their providers than employers with internal occupational health provision. CONCLUSIONS: Social capital emerges as central to understanding the conditions for cooperation and collective action in the use of occupational health services, with reference to structural (e.g. contracts), relational (e.g. trust) as well as cognitive (e.g. shared vision) dimensions. The study suggests that attention to the quality of relationships is imperative for developing purposeful occupational health service delivery in rehabilitation and return to work.

Organizational factors related to low levels of sickness absence in a representative set of Swedish companies.

OBJECTIVE: The aim of this qualitative study was to identify manageable organizational factors that could explain why some companies have low levels of sickness absence. There may be factors at company level that can be managed to influence levels of sickness absence, and promote health and a prosperous organization. PARTICIPANTS: 38 representative Swedish companies. METHODS: The study included a total of 204 semi-structured interviews at 38 representative Swedish companies. Qualitative thematic analysis was applied to the interviews, primarily with managers, to indicate the organizational factors that characterize companies with low levels of sickness absence. RESULTS: The factors that were found to characterize companies with low levels of sickness absence concerned strategies and procedures for managing leadership, employee development, communication, employee participation and involvement, corporate values and visions, and employee health. CONCLUSIONS: The results may be useful in finding strategies and procedures to reduce levels of sickness absence and promote health. There is research at individual level on the reasons for sickness absence. This study tries to elevate the issue to an organizational level. The findings suggest that explicit strategies for managing certain organizational factors can reduce sickness absence and help companies to develop more health-promoting strategies.