The Use of Worktime Planning Tools in the Finnish Public Sector. A Quasi-experimental Study (PLANTOOLS)

Summary

Participation Requirements

Description

Introduction Epidemiological studies suggest that shift work increases the risk of several major public health diseases, such as cardiovascular diseases and depression. Shift work is also associated with work-life interaction and work stress. Appropriate shift scheduling is expected to modify the he...

Introduction Epidemiological studies suggest that shift work increases the risk of several major public health diseases, such as cardiovascular diseases and depression. Shift work is also associated with work-life interaction and work stress. Appropriate shift scheduling is expected to modify the health risks of shift work but there is not sufficiently knowledge on whether it is possible to improve work time control and other health-supporting shift rotation characteristics (shift ergonomics) using different types of shift planning tools, and whether the possible changes in working hours can lead to successful and cost-saving changes in health and well-being. There is especially lack of intervention studies on the means to improve the working hours of women and older workers. Material and methods Software In the Finnish public sector, basically three separate shift scheduling software versions are currently available (Titania, CGI© Finland, Finland). The first one (Titania1), is an interactive software supporting interactive shift rostering (individual worktime control for employees) and giving guidance for health-supporting shift ergonomics both to the shift planners use the employees using the software. The second software (Titania2) is used by the shift planners only, and it gives similar guidance for health-supporting shift ergonomics than software Titania1 but does not include an option for self-rostering. The third software (Titania3) is otherwise similar shift planning software than Titania 2 (used by the shift planners only) but does not include neither the self-rostering nor the health-supporting shift ergonomics tools. The investigators will use a sampling software that has been developed earlier, to retrieve all the daily objective working hour and absence data from the employers´ records. The reliability, validity and accuracy of the used method to retrieve and analyze pay-roll data on working hours has been assessed earlier based partially on the same dataset as this study. The raw data will include data on each calendar day for shift starting and ending times, the use of shift wishes and reasons for absence. The raw data will be processed into individual level data by construction of variables within specific time frame (i.e. shift characteristics based on the length, time, recovery and social aspects of working hours per month or year). Study design Using a non-randomized quasi-experimental design, the use of a self-rostering software including also an option to evaluate shift ergonomics will be compared to the use of a shift scheduling software without self-rostering but an option for shift ergonomics evaluation and secondly, to shift scheduling software as usual (without self-rostering and shift ergonomics evaluation). Questionnaire and registry data from 2016-2019 after the intervention (T2) will be compared to baseline data from 2012 to 2015 before the intervention (T1) in the three groups. Participants The use of the three different versions of shift planning software will be studied in approximately 6 000 employees in shift planning units/departments that will be accounted as clusters in the analyses in six hospital districts of the ongoing Finnish Public Sector study. According to 3/2016 information, 2/6 hospital districts have made a managerial decision to start to use the Titania1 software during 2016 in all applicable wards, 2/6 hospital districts have decided to start to use the Titania2 software, and 2/6 organizations have decided to remain in Titania3 software. Participants are all hospital employees working in units that use the software (1-3) in the 6 hospital districts since 9/2015 for at least one year, and who have answered to a questionnaire sent to all the workers of the organizations in 2015 and 2017 or 2019. Based on earlier response rates of the cohort, the expected sample size is approximately 6000 employees, who are using at least one version of the software, and who will reply the questionnaire both in 2015 and 2017 and/or 2019. In order to minimize potential bias due to non-randomization and possible selection, the shift planning units (clusters) using Titania1, Titania2 and Titania3 will be matched for a) the amount of shift work (% of workers in each cluster having non-day shifts), b) age and c) baseline level of perceived work-time control (only for intervention 1: shift planning with shift ergonomics and self-rostering) or c) shift ergonomics (only for intervention 2: shift ergonomics). The pay-roll based daily working hour data will be retrieved from the shift scheduling program retrospectively from the beginning of 2012 and prospectively up to the end of 2019. Additional funding enables us to continue the follow-up from 2017 to 2019. In addition to comparing the overall effects of the use of Titania1 and Titania2 tools compared to Titania3, a subgroup analysis will be done based on the registry-based individual use of the Titania1 and Titania 2 software within the group the possible changes of the perceived worktime control and objective shift characteristics and individual differences (e.g. age, diurnal type, health). Thematic focus group interviews will be performed in the participating organizations to gather end-user, shift-planner and employers´ attitudes, change processes and experiences on using the Titania tools. This information will be used to further develop the Titania tools according to feedback. The guidelines of the Transparent Reporting of Evaluations with Non-randomized Designs (TREND) will be used in the reporting of the results.

Tracking Information