Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Samarbete mellan kund och företagshälsovård: Mekanismer av betydelse för förebyggande arbetsmiljöarbete
KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. IVL Svenska Miljöinstitutet. (Ergonomi)ORCID iD: 0000-0003-1723-3743
2017 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Enligt arbetsmiljölagen ska arbetsgivare när det saknas kunskap och kompetens i det systematiska arbetsmiljöarbetet (SAM) anlita en företagshälsovård (FHV) eller liknande resurs. Detta bygger på en programteori där FHV förväntas vara den externa resurs som behövs för arbetsgivare och arbetsplatser i arbetsmiljöarbetet. Samarbetet och FHVs stöd ska generera god arbetsmiljö och hälsa hos kunderna. Forskning om hur detta samarbete fungerar är begränsad.

 

Avhandlingens syfte är att utforska om FHV fungerar som stöd i kundens förebyggande arbetsmiljö-arbete och att identifiera mekanismer som har betydelse för samarbetet mellan FHV och kund. Mer precist har avhandlingen syftat till att öka kunskap och förståelse för om lagens intention uppfylls.

 

Datainsamlingen i de fyra kvalitativa fallstudierna utfördes med hjälp av semistrukturerade och tematiska intervjuer, telefonintervjuer och gruppintervjuer. Empirin samlades in i små- och stora företag samt inom den offentliga sektorn och fokuserade även på vilken betydelse avtalet har för samarbetet. Intervjuerna har genomförts med ledning, chefer och skyddsombud samt HR-personal i deltagande verksamheter samt FHV professioner i kundens FHV. Intervjuerna har analyserats med kvalitativ innehållsanalys och det sammanlagda resultatet analyserades med hjälp av realistisk utvärdering. 

 

Resultatet visar att samarbete och FHVs stöd i förebyggande SAM brister. Förändrade styrformer i offentlig sektor; New Public Management och HR transformationen identifieras som kontextuella förutsättningar som påverkar samarbetet. I den realistiska utvärderingen identifierades mekanismer som positivt eller negativt påverkar samarbetet mellan FHV och kund.

 

Mekanismer som påverkar samarbete positivt är; att det finns en fungerande samverkan och SAM hos kunden och att FHV får information och tillgång till kundens inre processer. Att FHV har en oberoende ställning med kontakter på flera nivåer i verksamheten är andra mekanismer som påverkar samarbete positivt. Att ledningen är engagerad i samarbetet med FHV och att avtalen stöder samarbetet bidrar också positivt till ett framgångsrikt samarbete. Ytterligare mekanismer som gynnsamt påverkar samarbete är att det finns kontinuerliga uppföljningar där tjänster och service kontinuerligt stäms av och anpassas efter kundens behov. En viktig mekanism som påverkar samarbetet positivt är att HR stöder samverkan och SAM i kundföretaget. 

 Identifierade mekanismer som påverkar samarbete negativt är att SAM och samverkan på arbetsplatsen mellan arbetsgivare och arbetstagare brister. Andra mekanismer som negativt påverkar är att ledningen inte är engagerad i samarbetet och att FHV inte får ta del av kundens SAM. Samarbetet påverkas även negativt när HR definierar avtalsinnehåll och är enda kontakt med FHV. En ytterligare mekanism som påverkar samarbetet negativt är att kunden upplever ett bristande förtroende; att FHV saknar kompetens.

 Ett antal mekanismer har även identifierats som påverkar samarbete negativt mellan FHV och småföretag.  Bland annat saknas samverkan mellan arbetsgivare och arbetstagare i stor utsträckning och småföretagen arbetar inte systematiskt med sin arbetsmiljö. Detta innebär att FHV inte fungerar som stöd i SAM utan de tjänster som används består framför allt av hälsoundersökningar.

 Samma mekanismer som påverkar samarbetet negativt framkommer i den offentliga sektorn; när samverkan och SAM saknas på arbetsplatsen, används FHV främst till individuella hälsofrämjande tjänster och rehabilitering. Andra mekanismer som påverkar samarbetet negativt i den offentliga sektorn är bristen på kunskap om samverkan och SAM hos både HR och skyddsombud. Det finns en otydlighet kring varandras roller som påverkar samarbetet negativt. Även kundens föreställning om FHV; att de uppfattas sakna kompetens och vara en efterhjälpande resurs, påverkar samarbetet negativt.

 Slutsatserna från avhandlingen visar att samarbetet mellan FHV och kund i stor utsträckning inte stöder förebyggande SAM. I analysen identifieras ett antal mekanismer som påverkar samarbetet mellan FHV och kund, både positivt och negativt. Framför allt kunskap om arbetsmiljö, en fungerande samverkan och SAM identifieras som viktiga mekanismer som på ett positivt sätt bidrar till att nå ett framgångsrikt samarbete.

Abstract [en]

According to the Work Environment Act, employers should, when there is lack of knowledge and competence regarding the occupational health and safety management (OHSM, employ an occupational health service (OHS) provider or comparable resource. Research on how this collaboration works is however limited. The purpose of the thesis is to investigate whether the OHS provider serves as support in the custom-er's preventive OHSM and to identify which mechanisms are important for the collaboration between the OHS provider and customer.The data collection in the four qualitative case studies was conducted using semi-structured and the-matic interviews, telephone interviews and group interviews in small and large companies as well as the public sector. The interviews were analyzed with qualitative content analysis and the overall result has been analyzed using realistic evaluation.The results show that collaboration and support from OHS providers in preventative OHSM is lacking. Contextual conditions affected collaboration, such as New Public Management and HR transformation. In the realistic evaluation, mechanisms were identified that positively or negatively affect collaboration between OHS provider and client customer. Mechanisms that affect the collaboration positively are for example; a cooperative relationship between the employers and safety representatives in OHSM at the client customer, OHS providers also need access to the client customer's internal processes. Identified mechanisms that affect the collaboration negatively are; that cooperation in the workplace between employers and employees is lacking, the OHSM does not work. Other mechanisms that negatively affect are when top management not is involved in the collaboration with the OHS provider and when the OHS provider does not get information of the client customer's OHSM.  The conclusion from the thesis is that OHS providers do not largely support the client customer's pre-ventive OHSM.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2017. , p. 42
Series
TRITA-STH : report, ISSN 1653-3836 ; 2017:10
Keywords [en]
Occupational health services, client customer, collaboration, preventive occupational health and safety management, NPM, HR, mechanism
Keywords [sv]
Företagshälsovård, kund, samarbete, förebyggande systematiskt arbetsmiljöarbete, NPM, HR, mekanism
National Category
Work Sciences
Research subject
Technology and Health
Identifiers
URN: urn:nbn:se:kth:diva-215956ISBN: 978-91-7729-535-8 (print)OAI: oai:DiVA.org:kth-215956DiVA, id: diva2:1150351
Public defence
2017-12-01, T1 Emmy Rappesalen, Hälsovägen 11 C, Huddinge, 10:00 (Swedish)
Opponent
Supervisors
Note

QC 20171019

Available from: 2017-10-19 Created: 2017-10-18 Last updated: 2017-10-23Bibliographically approved
List of papers
1. Procurement and implementation processes for Occupational Health Services in Sweden
Open this publication in new window or tab >>Procurement and implementation processes for Occupational Health Services in Sweden
Show others...
(English)In: International Archives of Occupational and Environmental Health, E-ISSN 1432-1246Article in journal (Refereed) Submitted
Abstract [en]

Purpose: This study investigates how contracts with OHS-providers in Sweden are established and implemented  to explore i) the procurement process ii) contractual terms and conditions and iii) processes for implementing and evaluating the services provided.

Methods: Review and analysis of 17 OHS contracts using both quantitative and qualitative approaches. Follow-up interviews were conducted with Human Resource managers, management, health and safety representatives and OHS professionals.

Results: Contracts with OHS providers were mainly drawn up by HR departments. First-line managers or health and safety representatives were not involved. The contracts were not integrated with the companies’ occupational health and safety management. The organisations lacked knowledge on when or why to use services from their OHS provider, which promoted reactive rather than preventive interventions. Terms and conditions of contracts were found to be quite irrelevant to what services that were actually utilised.

Conclusions: Important factors in creating conditions for a more preventive and group-oriented use of OHS expertise could be 1) the inclusion of first-line managers and health and safety representatives in needs analysis and implementation processes, 2) the definition of relevant, achievable and measurable goals regarding the collaboration and 3) the arrangement of regularly meetings with the OHS-provider.

Place, publisher, year, edition, pages
Springer
Keywords
occupational health service, purchase, contract, occupational health and safety management
National Category
Work Sciences
Identifiers
urn:nbn:se:kth:diva-215954 (URN)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareAFA Insurance
Note

QC 20171019

Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2017-10-19Bibliographically approved
2. Utilizing occupational health services in small-scale enterprises: a 10-year perspective
Open this publication in new window or tab >>Utilizing occupational health services in small-scale enterprises: a 10-year perspective
2016 (English)In: Small Enterprise Research: The Journal of SEAANZ, ISSN 1321-5906, Vol. 23, no 2, p. 101-115Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore how small-scale enterprises (SSEs) utilize occupational health services (OHS) and how the possibility of OHS providers to support occupational health and safety management (OHSM) has developed over a 10-year period. Qualitative interviews were carried out with four OHS providers and their SSE clients, with follow-up interviews being conducted with three of the four OHS providers and their clients after 10 years. The decade saw a change in market conditions for the OHS providers with each becoming larger and developing more effective marketing tools. Despite these changes, the OHS providers had not developed more collaborative or closer relationships with their small enterprise clients. Rather than increasing, the utilization of OHS had declined, with health examinations remaining the most purchased service. In addition, the three OHS providers had not improved their support for OHSM in small enterprises during the decade.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2016
Keywords
occupational health and safety management, occupational health services, small-scale enterprises, utilization of services, work environment
National Category
Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:kth:diva-198671 (URN)10.1080/13215906.2016.1221358 (DOI)000387143700001 ()
Funder
AFA Insurance
Note

QC 20170110

Available from: 2016-12-20 Created: 2016-12-20 Last updated: 2017-11-29Bibliographically approved
3. Successful collaboration between occupational health service providers and client companies: Key factors
Open this publication in new window or tab >>Successful collaboration between occupational health service providers and client companies: Key factors
2015 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 51, no 2, p. 229-237Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Occupational health services (OHS) are often described as an important resource to reduce work-related diseases and improve the workplace. OBJECTIVE: This paper identifies key factors for successful collaboration between Swedish OHS providers and their client companies. METHODS: Interviews were carried out with representatives of 15 companies and their OHS providers. The interviews were transcribed and their content analyzed. RESULTS: The results revealed that successful collaboration was highly correlated with six factors. First, the collaboration depends on both parties; "it takes two to tango". Second, the company and the OHS provider have a joint commitment to a longterm collaboration. Third, the collaboration is built on frequent contact at different organizational levels. Fourth, the company has a well-structured work environment for occupational health and safety management. Fifth, the OHS provider uses a consultative approach in its prevention and promotion activities. Finally, OHS providers seek to treat the company, not the individual. CONCLUSIONS: Our research indicates that a successful collaboration requires both occupational health and safety management (OHSM) within the company and the assistance of a competent OHS provider. A change toward more promotion and prevention services benefits the company, since the occupational health services are better tailored to the company's needs.

Place, publisher, year, edition, pages
IOS Press, 2015
Keywords
Dialogue, Trust and confidence, Work environment, Work-related illness prevention
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:kth:diva-170513 (URN)10.3233/WOR-141855 (DOI)000356065900009 ()2-s2.0-84931087129 (Scopus ID)
Note

QC 20150701

Available from: 2015-07-01 Created: 2015-07-01 Last updated: 2017-12-04Bibliographically approved
4. How can occupational health services in Sweden contribute to work ability?
Open this publication in new window or tab >>How can occupational health services in Sweden contribute to work ability?
2012 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, p. 2998-3001Article in journal (Refereed) Published
Abstract [en]

Occupational health service in Sweden is often described as an important and strategic resource to reduce work-related diseases, improve work ability and successfully assess improvement of the workplace. However, not much research has been done on how OHS contribute to reduced absence due to work-related illness or improvement of the work ability of employees. In our study, the ambition has been to describe how OHS can contribute and give effects in client companies.

Fifteen companies considered to be good examples were selected in cooperation with the social partners. Semi-structured interviews were carried out with representatives of the company and OHS. The results show that efficient collaboration depend strongly on the relationship between the OHS and the company, and were highly correlated with a continuously dialogue and contact. Good occupational safety and health management at company level was a key factor for effective use of OHS. The strategic collaborations also often led to that OHSs contribution was gradually shifted from a reactive or medical focus to a more proactive approach. Several of the interviewed OHSs also held this strategy to work more with prevention, and focusing on “treating the organization”, not the individual, leaving the executive measures to the company.

Place, publisher, year, edition, pages
IOS Press, 2012
National Category
Work Sciences
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-159740 (URN)10.3233/WOR-2012-0555-2998 (DOI)000306361803024 ()22317176 (PubMedID)2-s2.0-84859862796 (Scopus ID)
Funder
AFA Insurance
Note

QC 20150210

Available from: 2015-02-09 Created: 2015-02-09 Last updated: 2017-12-04Bibliographically approved
5. Is ownership the decisive factor in collaborations between occupational health services and client companies?
Open this publication in new window or tab >>Is ownership the decisive factor in collaborations between occupational health services and client companies?
2017 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 56, no 2, p. 309-318Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Swedish employers are required to use external resources such as Occupational Health Services ( OHS providers) if their own knowledge of occupational health and safety is insufficient. Some large employers have their own in-house OHS units but it is more common to engage the services of an external provider. However, no studies have been carried out from a critical perspective regarding how ownership of the OHS provider is related to a successful collaboration with client companies. OBJECTIVES: This study explores the extent to which the six key factors for a successful collaboration are related to ownership and seeks to identify the challenges that the different models of ownership pose. METHODS: Interviews with 15 client companies and their OHS providers were conducted in order to identify key factors in achieving a successful collaboration with an OHS provider. This study utilizes existing data to identify challenges related to ownership. RESULTS: Two key factors were identified with challenges related to ownership of the OHS provider: The importance of having a long-term perspective when building a relationship; and ensuring that collaboration extends beyond the client's HR Department to the various organisational levels of the company. CONCLUSIONS: Whatever form the ownership of an OHS provider may take, each comes with its own specific set of challenges that must be managed in order to achieve a successful collaboration with the client company.

Place, publisher, year, edition, pages
IOS Press, 2017
Keywords
Ownership, occupational health services, occupational health and safety management, work environment
National Category
Health Sciences
Identifiers
urn:nbn:se:kth:diva-204740 (URN)10.3233/WOR-172498 (DOI)000396548900015 ()28234266 (PubMedID)2-s2.0-85015398464 (Scopus ID)
Funder
AFA Insurance
Note

QC 20170601

Available from: 2017-06-01 Created: 2017-06-01 Last updated: 2017-10-18Bibliographically approved
6. Understanding the challenges facing occupational health services in the Swedish Public Sector
Open this publication in new window or tab >>Understanding the challenges facing occupational health services in the Swedish Public Sector
2017 (English)In: Nordic Journal of Working Life Studies, ISSN 2245-0157, E-ISSN 2245-0157, Vol. 7, no 3, p. 85-104Article in journal (Refereed) Published
Abstract [en]

According to Swedish Work Environmental Act, all organizations are required to implement Occupational Health and Safety Management (OHSM). In support of this and when competence within the employer’s own organization is insufficient, regulations state that the employer are required to employ external resources such as an Occupational Health Service (OHS) provider. The aim of this study was to explore how public sector organizations utilised services and support from their OHS provider in preventive OHSM. Eleven public sector organizations were studied, one hundred of respondents (politicians, managers, HR, safety representatives and OHS professionals) interviewed and the data collected qualitatively and thematically analysed. The results showed that the OHS providers do not support the public-sector organisations with preventive OHSM according to the intentions of the legislation. A significant conclusion is that the HR department has an important role in the collaboration and for the utilization of preventive services in OHSM.

Place, publisher, year, edition, pages
Roskilde, Danmark: Roskilde University, 2017
Keywords
HR department, occupational health services, occupational health and safety management, public sector, Sweden, work environment
National Category
Work Sciences
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-215953 (URN)10.18291/njwls.v7i3.97090 (DOI)000412457200006 ()2-s2.0-85029805079 (Scopus ID)
Funder
AFA Insurance, 110206Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-1563
Note

QC 20171019

Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2017-11-29Bibliographically approved

Open Access in DiVA

fulltext(752 kB)614 downloads
File information
File name FULLTEXT01.pdfFile size 752 kBChecksum SHA-512
eb1d5ede0af2d3b6841cbf59b8d629e0b051abc5fb0625c0bd4b2fdbd552a5288152b0742be47b17fdfcc3ed9c5306a85fcbf7fedb2fcd540da6dd0b109fbfd9
Type fulltextMimetype application/pdf

Search in DiVA

By author/editor
Schmidt, Lisa
By organisation
Ergonomics
Work Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 614 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 3481 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf