Master Thesis
The Requirements for Employee Assistance Programs in
Healthy Ageing at Work: a case study at the UMCG
Author:
Floris Holtland
Degree:
Dual Degree in Operations Management
Student number RUG:
2222531
Student number NUBS: 120505117
Lead supervisor:
Prof. dr. ir. Wortmann
Second supervisor:
Dr. Ying Yang
2
Contents
Abstract ... 3
1. Introduction ... 4
2. Theoretical Background ... 6
2.1 Employee Assistance Programs ... 6
2.2 Health ... 11
2.3 The relationship of EAPs with health ... 14
2.4 Critical success factors ... 17
2.5 New Product Development ... 18
3. Methodology ... 23
3.1 Concept generation... 23
3.2 Concept evaluation ... 26
4. Results ... 27
4.1 Concept generation... 27
4.2 Concept evaluation ... 33
5. Discussion ... 35
6. Conclusion ... 39
References ... 41
Appendix A – Interview Guide UMCG ... 45
3
Abstract
The Western society is ageing and the working-population is decreasing. This makes Healthy Ageing at Work become more and more important, both for employees and for employers. The relevance of these developments is reflected by the rise of Employee Assistance Programs (EAPs): workplace programs designed to assist both employers and their employees. Under the umbrella of the research program SPRINT@Work, this Master thesis project gained crucial insight in the (end)-user’s requirements for technology-based EAPs to be developed. In addition, a question of particular interest is, whether the EAP(s) should be delivered as individual stand-alone product(s) or as a suite of related products, built on a common ICT platform.
To answer these questions, 22 semi-structured interviews were held in the context of the single case study which was conducted in the healthcare sector. The main results indicate that EAPs that are to be developed should smoothly align with the current work practice. Furthermore, use of the EAPs should be in the self-interest of the workers to become widely used. Besides that, providing the staff with a
personalized health-portal is identified to be a strong desire. This portal requires connectivity and makes the use of a common ICT-platform is preferred.
The main practical implication of the project is its clarification about the critical success factors that apply to the technology-based EAPs to be developed. Besides, the project notes that managers should question whether the foundation of their current ICT-infrastructure has sufficient capacity to carry the exposure technology-based EAPs will bring in the (near) future. The theoretical novelty of the project is the exploration of the New Product Development (NPD) framework from Crawford and Di Benedetto (2008) in the unique setting of a consortium. It is concluded that the NPD-framework is of value in the setting of a consortium. However, several differences were noted compared to firms which perform the NPD-process themselves. These differences mainly relate to the enhanced intertwined complexity, which goes along with the combination of the process of NPD and the unique setting of the consortium.
Key words:
4
1. Introduction
One of the challenges the Western society has to cope with is the ageing population. The 2009 Ageing Report of the European Economy (European Commission, 2009) states that the working-population in 2060 to be reduced by 15% compared to 2007, while in the same period the share of workers aged 55-64 is expected to increase by 50%. This development makes the sustainability of health and welfare-systems is discussed.
Combined with the knowledge that investing in a culture of healthy lifestyle yields high returns (Aldana et al. 2012), the relevance to keep the workforce fit becomes straight forward. This caused the majority of the Fortune 500 companies to use Employee Assistance Programs (Sciegaj et al. 2001), for which the upcoming working definition will be used: a workplace program designed to assist both employers and their employees.
One interesting trend in society, which might inspire the development of EAPs of the future, is the Quantified Self (QS) movement. This movement seeks to promote a healthy lifestyle through a combination of technology, science and fun. Examples can be the realtime-tracking of route, speed, distance, hart-beat and altitude. Apart from QS, new technologies could form the foundation for the next generation of EAPs, which could for example focus on realtime monitoring of employees’ movements and alertness.
However, as found by Crawford and Di Benedetto (2008) “the leading cause of new product failure is the absence of a perceived need by the intended user” (p. 110). Therefore this Master thesis project attemps to answer the upcoming two research questions:
1. What requirements should new technology-based EAPs fulfill in order to be appropriate* for employers to offer to their employees? (*= promote the employees’ employability and be economically viable) 2. Given these requirements; should the concept be developed as a single EAP-product or would a suite of related products, built on a common ICT platform, be more appropriate?
The practical value of the study lies in defining the requirements that have to be taken into account during the development of technology-based EAPs. The scientific novelty is that it investigates the usefulness of the NPD framework from Crawford and Di Benedetto (2008) in the setting of a consortium, while this framework is usually used by single firms.
This consortium consists of the University Medical Center Groningen (UMCG), the University of Groningen (RUG) and several private firms. The multi-stakeholder partnership, of which the SPRINT@WORK consortium can be considered to be an example, strives to develop innovative technology based EAPs which monitor and guard employees’ welfare. The study is part of the
5
Research shows that multi-stakeholder partnerships lead to challenges which are unfamiliar to firms that carry out the NPD-process themselves (Bhaskaran and Krishnan 2009; Neba 2012; Rodriquez 2012). These challenges can be caused by mixed goals between involved firms (Rodriquez, 2012) and indistinctness about ownership, intellectual property (Neba, 2012) and costs and revenue sharing (Bhaskaran and Krishnan, 2009). Thus, this project strives to gather new insights about similarities and differences between both settings and, while doing so, mainly focuses on the effects hereof on the NPD framework from Crawford and Di Benedetto (2008).
Because the research focuses on the early stages of the NPD process, the project searched for detailed explanations and personal opinions about the end-users problems and requirements. Therefore a single case study was performed within the UMCG, which is an academic hospital in the north of the
Netherlands. Within the single case-study 8 semi-structured interviews were held within the firm. Once insights were gained about the current and (expected) future situation within the hospital, 14 IT-firms were questioned to gather concepts. In addition the semi-structured interviews with the IT-firms were designed to yield insights to answer the second research question, which focuses on whether the EAP could best be built on a common ICT platform, or as a single EAP-product. Lastly, the concepts were listed and evaluated during the concept evaluation phase. For this purpose a workshop was organized in which 8 participants took part, including most of the UMCG-interviewees that were involved in an earlier stage of the research.
6
2. Theoretical Background
In section 2 the theoretical foundation of this Master thesis project will be described. This will be done by analysing the literature on EAPs. The main search is performed in the extensive EBSCO database with academic literature. When performing the search, the following terms were used as key words or phrase: employee – wellness – workplace – EAP(s) – employee assistance – employee assistance program(s) – absenteeism – presenteeism – employee strain – health promotion – employees’ health promotion – health management – NPD partnership and NPD collaboration. Due to the size of the database a refined search has been made which merely focuses on articles which are peer reviewed, and preferably have been published recently.
With respect to the structure of this section, first a review is given about the notion of an EAP. Secondly, a review is given about the notion of Health. Thirdly, the relationship between an EAP and health is introduced. Fourthly, critical success factors are identified that can influence the success EAPs can offer. Fifth and last, an elaboration is made about the process of New Product Development. Furthermore, behind each of these subheadings a concise concluding remark is given. These remarks include the most relevant information of the section and thereby support the reader in distinguishing the essential issues from the side-issues.
2.1 Employee Assistance Programs
This section aims to deepen the understanding of EAPs. In doing so, section 2.1.1 elaborates upon the notion of an EAP. Secondly, section 2.1.2 discusses multiple motives for offering EAPs to staff. Next, section 2.1.3 explains in which contexts EAPs are used and what components can make up EAPs. In the fourth section, the relationship between EAPs and Human Resource Management is explained, after which section 2.1.5 explores the current developments in the domain of EAPs. Sixth and last a concluding remark is given.
2.1.1 The notion of an EAP
Worksite wellness programs (Edries et al. 2013), workplace disease prevention (Baicker, Cutler and Song, 2010), health promotion programs (Aldana et al. 2012) and employee health and fitness programs (Voit 2001): it is clear that a considerable amount of research has been conducted to programs which aim to safeguard and/or enhance the health of employees. Although these programs already exist for decades, no clear consistency is used in terminology (Buck Consultancy, 2010). Thus: “there is no agreed definition of what exactly constitutes an EAP” (Day et al. 2002; p.140). Due to this lack of consistency, the
definitions given to EAPs range from “an employer funded resource offered to employees and, often, to their families” (Kirk and Brown, 2003; p.138) to “any job-based program designed to identify and assist troubled employees” (Hartwell et al. 1996; p. 804).
7
would imply that the content of the EAP is specifically composed for a particular profession. Because the same EAPs might be offered to multiple groups of employees, a “job-related program” might appear to be more appropriate. Given this reflection on the notion of an EAP, the concise definition “job-related programs designed to identify and assist employees” offers more justice to the scope of. However, this definition fails to identify the exact boundaries that determine what can be considered to be an EAP. Given this indistinctness, the following extensive definition of an EAP, as used by the Journal of Employee Assistance, is more clear: an EAP is “a workplace program designed to assist: (1) work organizations in addressing productivity issues, and (2) ‘employee clients’ in identifying and resolving personal concerns, including health, marital, family, financial, alcohol, drug, legal, emotional, stress, or other personal issues that may affect job performance”1. Key in this definition, besides a more precise explanation of what can be considered to be an EAP, is the clarification of the main stakeholders that are involved in EAPs: the employee as end-user and the employer as provider. However, more stakeholders can be identified. On behalf of the employer the Human Resource Management (HRM) department can be involved, as well as the in-external occupational health service and likely allied to them, (mental) health practitioners such as psychologists. From the perspective of employees, their family can be considered to be a stakeholder, though this largely depends on the scope of the offered EAP.
All in all, the versatility in EAPs and corresponding definitions, which range from concise (Hartwell et al. 1996) to more comprehensive (Journal of Employee Assistance), make it difficult to define what exactly makes that an activity is (part of) an EAP. To prevent confusion, in this Master thesis project the
comprehensive definition from the Journal of Employee Assistance will be followed because of its more precise explanation. However, even in this more precise definition, there remains an unclear area. It could for example be argued that a small coffee chat with the supervisor could be part of an EAP. It would then depend on the content and goal of the conversation whether or not the chat can be
considered to be (part of) an EAP. This would make the border between EAP vs. no EAP to become even more grey. Furthermore,it would imply that an inexhaustible list should be developed to cover all possible options and determine whether or not something is (part of) an EAP. This is not manageable and moreover, not beneficial for anyone. Therefore, to a certain extent, gutfeeling and common sense are required to decide whether or not something is (part of) an EAP. As a result of that, there will be room for discussion.
2.1.2 Objectives of EAPs
Recent research from Buck Consultancy (2012) shows that stress is the main motive of why employers offer EAPs in Europe. Consecutively, workplace safety and physical exercise were ranked as 2nd and 3rd most important health issues that drive EAPs. With respect to the objectives of EAPs, table 1 shows that the top 3 priorities in Europe are equal to the worldwide priorities, though the sequence differs. With regard to the third objective section 2.2.3 will elaborate on the notion of presenteeism.
1 EAP-definition: Employee Assistance Professionals Association. Available at: http://www.eapassn.org [Accessed
8
Table 1: EAP employer objectives (derived from Buck Consultancy, 2012)
Objective Priority Europe Priority worldwide Improving workforce morale / engagement 1st 3rd
Reducing employee absences due to sickness or disability 2nd 2nd
Improving productivity / reducing presenteeism 3rd 1st
2.1.3 The content and context of EAPs
As can be deducted from the aforementioned EAP-definition from the Journal of Employee Assistance, EAPs can be comprehensive. While started around 1940 with the single focus on alcohol intervention programs (Sciegaj et al. 2001) and followed by a fitness focus (Shephard, 1992), EAPs over time “evolved into multiservice programs to address all types of personal problems . . . and the general personal welfare of workers” (Hartwell et al. 1996; p. 804). This is also reflected in the scientific literature about the programs, which goes back in time towards mid-20th century, while publications increased in the eighties.2 Currently, as found by Baicker et al. (2010) in a meta-analysis on 36 studies, the main focus of EAPs is weight loss and fitness (which is found in 66% of the programs), followed by a focus on smoking cessation in half of the programs.
Because a fully standardized EAP-model does not exist (Liu, 2011), several EAP-elements can be distinguished that pursue the aforementioned objectives. These elements can for example be, but are not limited to, individual counselling (Kirk and Brown, 2003), relaxation and meditation training (Jané-Llopis et al. 2011), supervised exercise classes (Edries et al. 2013) and stress management training (Liu, 2011). However, according to research from Buck Consultancy (2010), which obtained cooperation from over 1200 firms based in 47 countries, none of the aforementioned elements were ranked in the top 3. The consultancy firm found the most frequently used EAP-elements to be providing flu shots, offering discount on fitness memberships and thirdly: conducting a health risk assesment, in which elements like blood pressure, body fat and cholesterol are measured (Buck Consultancy, 2010).
2.1.4 The link with Human Resource Management
Because Human Resource (HR) departments seek to achieve a productive workforce, amongst other by maximizing the benefits that can be gained by EAPs, the aforementioned EAP-elements can all be associated with the HR-department. However, in pursuing a productive workforce several EAP-elements can add value to different HR business functions.
Firstly, EAP-elements that relate to recruitment and selection can be distinguished. This HR-task can for example embrace a screening to analyse medical conditions, develop awareness and identify risk factors.
2
9
Such screenings can either be performed before the employee is hired (such as in the army, where medical examination is part of the recruitment and selection process) or when the employee is already employed.
Secondly, with respect to HR’s absenteeism policy, the focus of an EAP can be the prevention of illness through promoting staff’s physical and/or mental health. Providing flu shots, offering a bicycle plan (which enables employees to buy a bike from the gross salary) or offering (a discount at) a gym-membership can be part of such policy. Section 2.3.1 will further elaborate on health-related aspects. Third and last, EAPs can add value to the area of training and development through, for example, the provision of coaching and supervision. Such guidance can help employees in coping with their private or work-related problems, or improve their work-life balance. Furthermore, training can enhance the employability of employees, which can be seen as the “individual's relationship with a single job” (McQuaid and Lindsay, 2005, p. 214).
2.1.5 Developments in the EAP-area
Apart from the aforementioned EAP-elements and its relationship with HRM, amongst other technological developments make that the content of EAPs changes over time. Technology-based
products or services can thereby be considered to be a new development in the area of EAPs. Web based health portals and web-based healthy lifestyle programs, the fastest growing wellness program elements according to Buck Consultancy (2010), are examples of such technology-based elements. As found by Buck Consultancy (2010) such technology-based tools“seek to deliver greater participation and results than the one-size-fits-all efforts of earlier wellness initiatives”, because they are tailored to meet the specific needs from staff (p. 4). Furthermore online tools “offer greater cost effectiveness for employers and availability to users at the time and place when they are most needed” (Buck Consultancy, 2010; p.4).
The technology-based elements Buck Consultants (2010) refer to can for example be found in Kaiser Permanente, a United States based integrated healthcare organization.Though the meaning of ‘integrated healthcare’ can be understood in multiple ways, the World Health Organization found the most commonly used meaning to be as follows: “The management and delivery of health services so that clients receive a continuum of preventive and curative services, according to their needs over time and across different levels of the health system.”3 The integrated Kaiser Permanente approach comes forth in their history which, rather than merely curing customers once ill, has a “strong tradition of prevention and innovation”.4 This can for example be seen in My health manager: a web-based health portal which can be used to make appointments with doctors, enrol in (web-based) healthy lifestyle programs, view recipes for eating well, view lab results and access a private electronic health record, comparable to the Dutch electronic patient file (EPD).
3
World Health Organization – Integrated Health Services - Available at http://www.who.int (Accessed September
23, 2013].
4
10
However, it should be noted that the healthcare system in the United States clearly differs from the system in The Netherlands. First of all, employees in the United States are often insured through their employer rather than privately. Secondly, in the Netherlands a basic healthcare insurance, which is mandatory for everyone to have, covers the general practitioner, hospital and pharmacy up to a certain standard. Though it should be noted that from 2014 onwards all Americans will be required to carry health insurance, and standards will be set by government, this is not standard at this time.5 Thirdly, the passage of the Patient Protection and Affordable Care Act “allows US-based employers to offer a health plan premium differential based on employees meeting standards such as not smoking, reaching recommended weight levels, and having normal blood pressure” (Schulte et al, 2012; p. 443). By Dutch law, such differentiation is not allowed.
However, despite these vital differences, it could also be posed that Dutch insurance firms take a more pro-active role in taking care for their customers, and therefore move towards the integrated healthcare approach. In practice, this transition can for example be seen in the insurers’ policies, which include stop-smoking programs (offered by VGZ), discount for gym-memberships (offered by Achmea) or free starting permits for running events (offered by Menzis).
Furthermore the Quantified Self (QS) development, which was shortly adressed in the introduction, can have a wider purpose then merely offering recreation. QS-related programs can for example track body movements and be used as an assesment tool. This then refers to serious gaming, in which is the game’s main purpose is other than pure entertainment. An example of serious gaming is the training of staff through the use of (e.g. driving or flight) simulators.
2.1.6 Concluding remark
As shown by the former sections, no clear consistency is used in EAP-terminology. For the sake of clarity, the comprehensive EAP-definition from the Journal of Employee Assistance is chosen for this Master thesis project. However, also this more specific definition leaves room for discussion with respect to the question what exactly makes something (part of) an EAP. Apart from that, the main health issues that drive EAPs turned out to be stress, workplace safety and physical activity/exercise (Buck Consultancy, 2010). The main objectives that employers have for EAPs are reducing absenteeism, improving productivity and improving the morale of the workforce (Buck Consultancy, 2010). The used EAP components to achieve these objectives can be very comprehensive. In addition linkages can be made with regard to how certain EAP components can contribute to particular HR business functions, such as recruitment and selection or training and development. With respect to the future of EAPs, web-based health portals, such as used within Kaiser Permanente, can be seen as sources of inspiration.
5
CNN - Most individual health insurance isn't good enough for Obamacare - Available at
11
2.2 Health
This section elaborates on the notion of health. In doing so, it first sheds light on what types of health can be distinguished, and how these relate to occupational health. Secondly, in section 2.2.1 multiple theories that relate to health are elaborated upon. Thirdly, an elaboration is made on absenteeism and presenteeism in section 2.2.3. Fourthly, numerous risk factors are identified which increase the
likelihood of suffering from a bad health. Finally, in section 2.2.5, the core of the previous sections relating to health is put forward in a concise concluding remark.
2.2.1 Types of health
As found by the World Health Organization (hereafter WHO) health is not merely the absence of disease or weakness. It is “a state of complete physical, mental and social well-being”6. As comes forth in this definition, the notion of health can be further decomposed. This refers to the distinction between physical health and mental health. The former, physical health, relates to the tangible aspect of health, as in: the limbs of the body, the heart, the lungs, the organs etc. Mental health on the other hand relates to the intangible side of health and represents the mind and intellect. It for example embraces the efficiency of learning, flexibility, elasticity when facing stress and elements of emotional intelligence, such as empathy (Jané-Llopis et al. 2011).
Alternatively, a distinction can be made between affective- and cognitive health. Cognitive health refers to the intellectual capabilities of the internal mental processes. The capability of the mind to process information is an example of a cognitive element. Affective health on the other hand refers to a person’s mood, feelings and emotional space, for which psychologists distinguish several scales. These scales can include numerous of emotional states, such as anger, anxiety, nervousness, stress, relaxed, sad, bored and depressed.7 All in all, as explained by Lawton, Connor and McEachan (2009) with regard to a smoker who knows it is unhealthy to smoke but yet continues because smoking makes him feel good, the difference between cognitive and affective “is often represented as a struggle between desire (feeling good / the affective element, author) and reason (knowing its unhealthy / the cognitive element, author)” (p. 57).
With respect to occupational health McDaid et al. (2005) found “work plays a vital part in all our lives” (p. 365). Alongside these findings Schulte et al. (2010) found “work and workplace hazards . . .
compromise the health of workers” (p. 3). Ranging from physical wear of construction personnel, repetitive strain injury affecting office-workers to high stress levels top-management might suffer from: there is no doubt that work can lead to health-problems. However, as found by Schulte et al. (2012), a majority of the injuries and diseases experienced by employees are multi-factorial. This means that, in addition to several occupational risk factors, multiple personal risk factors can be identified as well (Cancelliere et al. 2011; Jané-Llopis et al. 2011). These personal factors will be elaborated upon in section 2.2.4.
6
World Health Organization - health - Available at the WHO website {Accessed August 11, 2013].
7
12
All-in all, the complexity that comes along with these intertwined occupational- and personal risk factors, along with the insufficiently explored relationships between attitudes and behaviour (Lawton et al. 2009, p. 63), makes that no unambiguous answer can be given to the question to what extent employers should be involved in the health of their employees. However, this does not mean employers are better off doing nothing at all. Employers can analyse and reduce occupational risk factors, and at the same time explore the possibilities to offer assistance for non-work related issues. As will be elaborated upon in section 2.3 this approach can be beneficial for both employers and employees.
2.2.2 Theories relating to health
Within the context of occupational health, and closely linked to that organizational performance, several models and theories relate closely to the notion of health. The Job-Demands Resource (JD-R) model and the Conservation of Resources (COR) Theory are examples of such models and theories.
The JD-R model identifies factors which relate to emotional exhaustion and burnout by distinguishing two categories of job-aspects (Demerouti et al. 2001). Firstly, there are job demands, named hindrance stressors by Podsakoff et al. (2007). This category includes the aspects of the job which can lead to the depletion of energy through the mental and/or physical effort required. Role conflict and work-home inference are examples of such energy consuming factors (Ruysseveldt et al. 2011). On the other hand there is the job resources category, called challenge stressors by Podsakoff et al. (2007). This category includes aspects like cognitive demands and task complexity (Ruysseveldt et al. 2011).
Though both hindrance stressors and challenge stressors require energy and can cause stress,
“hindrance stressors are negatively related to workers’ well-being, while challenge stressors positively relate with job satisfaction (Podsakoff et al. 2007) and enhance workers’ well-being by promoting personal growth and development" (Ruysseveldt et al. 2011; p.218). With respect to both types of stressors Arnold Bakker, professor of Work and Organizational Psychology at the Erasmus University Rotterdam, states that enthusiastic employees excel in their work “because they maintain the balance between the energy they give and the energy they receive”.8
Bakker’s line of thought of requiring sufficient resources to handle job-related strain, is reinforced by the Conservation of Resources theory (Wright and Hobfoll, 2004). This theory focuses at the concept of stress and burnout. Though work stress can also act positively (Chan and Wan 2012), long term exposure of high levels of stress could lead to a burnout, which is a long-term response to stress associated with emotional exhaustion (Day et al. 2002). Consequently, a burnout has a severe effect on the employees’ health (De Cuyper et al. 2012) and is a significant negative predictor of both job performance and productivity (Wright and Hobfoll, 2004).
2.2.3 Absenteeism and presenteeism
With regard to monitoring the employees’ productivity, Cancelliere et al. (2011) found absenteeism and presenteeism to be the most common measures. Absenteeism can be defined as “any failure of an
8 Work engagement - Website Arnold Bakker - Available at the Arnold Bakker’s website {Accessed September 3,
13
employee to report for or to remain at work as scheduled, regardless of reason” (Cascio, 2006; p.46). In the United Kingdom, the costs related to the phenomenon have been estimated to exceed 1% of the gross domestic product (Chatterji and Tilleyt, 2013).
With respect to absenteeism personal illness can be expected to be the main reason for reporting ill. However, Cascio (2006) found that family-related issues, such as a lack of childcare alternatives and responsibilities to take care of elderly people, are the leading cause of absenteeism. However, Voit (2001) on the other hand states that “the most common reason for absence from work is
musculoskeletal disorders followed by stress and depression” (p. 279). Given these different findings, there is no unambiguous agreement about the main cause of absenteeism.
Presenteeism on the other hand is defined as being present at work “but limited in some aspect of job performance by a health problem” (Cancelliere et al. 2011; p. 1). It is defined as the flip side of
absenteeism by Chatterji and Tilleyt (2013) and often difficult to measure (Cancelliere et al. 2011). Because not attending work yields nothing to the employer and could be socially isolating for employees, attending work could be seen a positive form of presenteeism (Baker-McClearn et al. 2010). However, if sick employees turn up at work germs may get spread as well, and both the quality and quantity of work performed might suffer from not being fit (Baker-McClearn et al. 2010). Besides that, presenteeism is highly prevalent (Cancelliere et al. 2011) and, compared to absenteeism, associated with a 7.5 times greater occurrence of lost productivity and employee burnout (Dixon, 2005). It can therefore be questioned whether attending work actually supports the employees’ recovery, or if it only keeps the illness rates low (Baker-McClearn et al. 2010).
2.2.4 Personal risk factors
Related to the phenomena of absenteeism and presenteeism, several personal risk factors can be distinguished which increase the likelihood of getting ill. According to the WHO (2010) tobacco use, an unhealthy diet, insufficient physical activity and the harmful use of alcohol are the most relevant factors that increase the likelihood of getting ill. Besides that, suffering from high stress, being overweight and having poor relations with co-workers and management are potential risk factors (Cancelliere et al. 2011), as well as having certain genetics, age, gender (Schulte et al. 2012) and high salt usage (Jané-Llopis et al. 2011). According to the WHO (2010), for some diseases lifestyle related factors are even responsible for 80% of the illness.
2.2.5 Concluding remark
14
2.3 The relationship of EAPs with health
This section forms the connecting element between EAPs on the one hand and health on the other hand. Firstly, section 2.3.1 explains the role of EAPs in promoting the medical condition of employees. Secondly section 2.3.2 deepens into the economic advantages that can be gained by using EAPs. Thereafter, section 2.3.3 elaborates on the ‘soft’ advantages of EAPs. Fourth and last a concluding remark is
provided with a theoretical framework, which provides a holistic image from the main concepts and the interrelationships.
2.3.1 The health advantages
EAPs can positively impact employees and enhance mental health (Voit, 2001). The relevance of stimulating mental health is emphasized by the 2005 “Green Paper” from the European Commission, which considers mental health to be essential because it “contributes to prosperity, solidarity and social justice” in the society (p. 4). Given the time spent at work, Jané-Llopis et al. (2011) even considered the workplace to be one of the most important settings to improve mental health.
Besides promoting mental health, EAPs can also enhance physical health (Kirk & Brown 2003; Voit 2001). As found by Voit (2001), the programs can “foster healthy muscles, joints and bones” (p. 273) and lead to “decreases in body fat and weight, decreases in heart rate, and blood pressure as well as improved cardiovascular health” (p. 284). EAPs can thereby limit the employees’ exposure to risk factors such as mentioned in section 2.2.4. Apart from this positive aspects, the former president of the United States, John F. Kennedy, considered physical fitness to be “the basis of dynamic and creative intellectual activity.”9 He thereby enhanced the relevance of physical fitness and, related to that, the relevance of EAPs.
2.3.2 Financial advantages
Though some authors state that it is not yet been proven that EAPs that are provided over a longer period are more effective than once off health promotion (Edries et al. 2013), the majority of the analysed papers imply the savings gained by EAPs outweigh the program costs (Aldana et al. 2012; Brenner 2011; Cancelliere et al. 2011; Nair and Xavier 2012; Voit 2001). Moreover, in a meta-study over 36 studies, Baicker et al. (2010) found that for every Euro spent on EAPs the absenteeism costs on average fall by €2.73. These absenteeism costs can for example be costs incurred to replace or educate new workers.
Besides a reduced absenteeism, a plausible belief might be that healthier employees form a more productive workforce. Though Kirk and Brown (2003) criticized there was little evidence to conclude that such perceptions indeed had an impact on “data such as improved job satisfaction or productivity”(p. 141), Nouri (2011) found such a relation to exist. Besides that, the findings from Nouri (2011) align with earlier findings from Wright and Cropanzano (1997), who concludedthat “well-being is significantly associated with performance” (p. 368). Furthermore, the Dutchorganization for applied scientific research (TNO) showed that healthy employees are 12,5% more productive and less expensive due to a
9
15
reduced absenteeism.10 Besides that, in an absolute sense fit workers are more productive because they are less ill (von Thiele Schwarz and Hasson, 2012), and obviously absent employees are non-productive for sure.
In addition EAPs can, through the retention of employees, prevent costs with regard to the replacement of a worker. These costs include the costs to recruit a new employee, but also embrace the required training new employees have to follow. As found by Cascio (2006), the costs associated with replacing a worker should not be underestimated as these vary between 1.5 till 2.5 times the annual salary of the particular job.
2.3.3 ‘Soft’ advantages
Besides enhancing the health of employees and offering economic advantages, EAPs can positively influence an employer in a non-financial way as well (Voit 2001; Beauregard 2011; Cascio 2006). The programs can for example act as a demonstration of an employer’s commitment to its employee’s welfare. This can contribute to a positive PR-image (Voit, 2001) and significantly impact the staff’s wellbeing (Beauregard 2011).
Moreover, it is likely that it can be assumed that employees’ wellbeing in turn influences their considerations to either remain working for the firm, or alternatively, to start looking for a job elsewhere. Thus, EAPs promote employee retention. Related to this, Brenner (2011) found that
“Retaining experienced workers will become a key factor in employee benefit strategy, especially for the knowledge-economy sector” (p. 24). A good example of the battle for recruiting (the most talented) workers is seen in Silicon Valley in the United States, where technology firms like Apple and Google “vie for talent and are constantly upping the ante when it comes to providing leading-edge working
conditions”.11 To illustrate how far the battle for talent is going, Google’s company headquarters even “features a giant slide, bikes, volleyball courts and a swimming pool.”12 Though such employee benefits are uncommon to most firms and might appear redundant to some readers, Cascio (2006) found “the challenge is to create a culture that makes the best among them (referring to the employees, author) want to stay” (p. 53). This is supported by Lochbihler (2006), who found “the success or failure of the organization depends on how well an organization recruits, maintains and retains its human capital”. The employee benefits that are offeredto staff support this line of thought and make that EAPs are “an integral part of an investment in human capital.” (Brenner, 2011; p.24)
2.3.4 Concluding remark
All in all, EAPs relate positively to both mental and physical health (Kirk & Brown 2003; Voit 2001), the programs positively influence an employer in a non-financial way (Cascio 2006; Voit 2001; Beauregard
10 TNO Work Report. Available at the 10000 steps {Accessed July 24, 2013].
11
PCWorld - Google expansion in last employee perk designed to spark innovation - Available at PCWorld.com
{Accessed August 17, 2013].
12
16
2011) and can furthermore be economically attractive (Aldana et al. 2012; Baicker et al. 2010; Brenner 2011; Cancelliere et al. 2011; Nair and Xavier 2012; Voit 2001). As found by Kirk and Brown (2003) these advantages make that “EAPs are big business . . . and increasingly regarded as evidence of duty of care by employing organizations” (p. 139).
Figure 1 presents the theoretical framework. This framework provides a holistic image from the main concepts and the most relevant interrelationships. In brief, it shows that EAPs positively influence health (Voit 2001; Kirk & Brown 2003), while health holds a direct positive relationship with productivity (Nouri & Jaber 2011; von Thiele Schwarz & Hasson 2012; Baicker et al. 2010). Health also relates to productivity in an indirect way, because enjoying a better health leads to a reduced absenteeism and presenteeism (von Thiele, Schwarz and Hasson 2012; Baicker Cutler and Song2010), which on their turn lead to an increase in productivity (von Thiele Schwarz and Hasson; 2012). Lastly, a relationship between employee productivity and organizational performance seems plausible.
Besides these relationships, EAPs also relate positive with employee retention (Voit 2001; Brenner 2010). Employee retention on its turn, as found by Lochbiller (2006), relates positively with organizational performance. Please note thewide concept of organizational performance is deliberately not elaborated upon in this Master thesis project because it is beyond the scope of the research. However, for the sake of finishing the theoretical framework, it makes the other notions fall in place.
Figure 1: conceptual framework
+ (Nouri, 2011
+ (TNO, 2013)+ (TNO, 2013)
+
(Kirk and Brown,2003) + (Voit, 2001) + (Brenner, 2011)
+
(Voit, 2001) Absenteeism Presenteeism Productivity Employee retention Health + (plausible)+
(Lochbiller, 2006) - (von Thiele , Schwarzand Hasson; (2012) - (Baicker, Cutler and
Song, 2010) - (von Thiele Schwarz
and Hasson (2012)
EAPs
17
2.4 Critical success factors
This section elaborates on the main challenges and critical success factors that relate to EAPs. Firstly, section 2.4.1 elaborates upon the notion of sustainable employability. Then, the crucial element of participation is deepened at. Third and last section 2.4.3 provides a concluding remark.
2.4.1 Sustainable employability
The notion of sustainable employability is not merely a fixed given. Numerous factors can be
distinguished which influence the sustainable employability. As found by Brouwer et al. (2012) these influencing aspects can be looked at from four perspectives.
Firstly, there is the perspective of the social medicine. This perspective states that employees, in order to remain working in the period prior their retirement, should also have the abilities to do so. This
prerequisite depends on the fit between the type of work (e.g. mental or physical) and the abilities of the individual. Secondly, the legal-perspective takes the point of view from the regulations that are
applicable to work and retirement. As put to the core by Brouwer et al. (2012), this perspective emphasizes ‘the importance of giving employees the opportunity to remain working and to ensure employees are facilitated by the right conditions’ (p. 174). Thus, possible barriers such as negative financial consequences should be prevented. Thirdly, the labour psychological perspective considers age to affect the sustainable employability of employees. The line of thought behind this perspective is that each particular life-phase goes along with a changing sense of reality. These different perceptions make that pull-factors, that tempt employees to retire, and the push-factors, that act opposite and tempt employees to remain working, change over time. Fourth and last, the perspective from the business administration is identified. This point of view stresses the relevance of the context in which employees get older. More specific, the approach emphasizes the importance of the organizational culture and the availability of HR-tools such as career management and training. Related to this, the willingness to invest in sustainable employability is considered to be a key-issue.
2.4.2 Participation
No matter how magnificent an EAP might be, without participating employees, offering an EAP is
senseless and non-effective. Therefore a vital prerequisite to achieve success with EAPs, and possibly the most relevant one, is staff’s willingness to participate. As found by Voit (2001), smokers are less likely to participate in fitness programs. In addition to that, Shephard (1992) concluded that a group of 20% of the employees, which does not engage in EAP-initiatives, is mainly responsible for absenteeism. These findings note that a reactive approach of merely offering EAPs is not sufficient, and thereby emphasize the challenge for employers to stimulate employees to participate by providing them the right stimuli and conditions.
18
2.4.3 A concluding remarkAs summarized to the core by Rivilis et al. (2006), as cited in Cancelliere et al. (2011), “the most
important issue for organizations to address is not whether or not WHP programs (which are equipollent to EAPs, author) should be implemented to reduce risks and enhance productivity, but rather how such programs should be designed, implemented, and evaluated to achieve optimal results” (p. 8). Put
another way: the challenge is to persuade these individuals to enrol (Shephard, 1992), through offering a tailor-made EAP (Rivilis et al. 2006), which should address “work context, work content and individual resilience” (Jané-Llopis et al. 2011; p. 68)
.
2.5 New Product Development
This section elaborates on the process of new product development (NPD). Firstly, the NPD-phases from Crawford and Di Benedetto are explained. Secondly, section 2.5.2 makes a link with the Design Science Research model from Peffers et al. (2007), which is an alternative framework to analyse the NPD process. Thirdly, multiple crucial elements in the process of NPD are elaborated upon. Fourthly, section 2.5.4 explains the notion of a product platform. Thereafter, section five elaborates upon the concepts of open innovation and NPD-partnerships, after which section 2.5.6 elaborates upon their critical success factors. Lastly a concluding remark is made in section seven.
2.5.1 NPD phases
Within the development of new products and services Crawford and Di Benedetto (2008) distinguish five phases. These are consecutively: identifying opportunities, concept generation, concept-evaluation, the actual development and fifth and last: introduction to the market. Because technology based EAP(s) within the context of SPRINT@Work can be seen as the general area in which opportunities can be identified, the main focus of the Master thesis project will lie on the 2nd and 3rd phase: concept
generation and concept evaluation. This means the study mainly focuses at the decision point related to the concept generation, which embraces the selection from particular concepts. Besides that, a ‘go / no-go’ decision point can be noted after completing the concept evaluation phase. However, as will be explained in the methodology, the decision point related to the concept evaluation is of less value to the Master thesis research due to the setup of the study.
Because of the obscure sight of what is about to come, combined with the ‘2 steps forward, 1 step reverse’ manner of acting, the first three phases are called the ‘fuzzy front end’ of the NPD-process by Crawford and Di Benedetto (2008). Furthermore Crawford and Di Benedetto (2008) consider the
problem-based ideation approach, which starts the NPD-process from the point of view from a particular problem for which a solution is desired, to work best because it prevents the absence of a perceived need by the intended end-user, which is noted to be the leading cause of new product failure.
2.5.2 Design Science Research
19
With regard to the methodology of DSR, Peffers et al. (2007) developed a linear model. This model is displayed in figure 2 and includes six stages. The first two stages are most relevant in this Master thesis project and are therefore highlighted. In the first stage a problem needs to be identified, as well as the motivation to solve it. In this Master thesis project this first step refers to analysing the gap between current EAPs and desired technology-based EAPs. Secondly, once the gap between the current and desired situation is known, objectives have to be defined for a solution. The third step of the DSRM process model includes the actual design and development of the product. Subsequently, the fourth step is to “Demonstrate the use of the artefact to solve one or more instances of the problem” (Peffers et al. 2007; p. 55). Then, the aim of the fifth stage is to evaluate how well the developed solution(s) solve the problem(s), which can be seen as the equivalent from the concept-evaluation phase from Crawford and Di Benedetto (2008). Sixth and last, Peffers et al. (2007) state there is a need for communication. This refers to the awareness which has to be created with respect to the existence of the designed artefact and its problem-solving capabilities. This stage is comparable to Crawford and Di Benedetto’s (2008) ‘introduction to the market’ phase.
Figure 2: DSRM Process Model (derived from Peffers et al. (2007)
2.5.3 Form, technology and benefit
Despite the unclear vision on how the future will look like, several crucial elements have to be taken into account in the NPD-process. According to Crawford and Di Benedetto (2008), these crucial elements consecutively are form, technology and need/benefit. Form refers to the way in which the product is delivered, which can either be tangible (e.g. a car) or intangible, such as a service. The second element, technology, refers to the base of the innovation. This can for example be the use of new software or sensors. Lastly, need/benefit refers to the benefit the technology based EAP(s) should offer. The findings from Crawford and Di Benedetto (2008), who state that “if any of those three is missing, there cannot be product innovation” (p. 90), stress the relevance of combining all three aspects in developing
technology-based EAPs.
2.5.4 Product platform planning
20
as the costs can be spread over more models. This makes firms, for example in the car-industry, use a single chassis for multiple car models.
However, besides this supply related advantage of product platforms, another important advantages lies in the demand-side of these products. Because firms want to focus on their core processes, it is
undesirable to have incompatible systems which each have their own operating mode and platform-requirements. Thus, what firms seek for is simplicity and ease of use. Platform product can offer this, for example in having one equal interface over all products, the same technical specifications and the same method of use. A well-known example of this is the Microsoft Office suite (the platform), under whose umbrella multiple products (such as Word, Excel, PowerPoint etc.) operate in a comparable manner. In the same line of though this Master thesis project attempts to determine whether technology-based EAP(s) should be delivered as an individual stand-alone product or as a suite of related products, built on a common ICT platform.
2.5.5 Open innovation and NPD-partnerships
Within the NPD-process open innovation, which is defined as the embracement of “external ideas and knowledge in conjunction with internal R&D” (Chesbrough, 2003, p. 177) can add both risks and value. The thought behind open innovation is that currently too much knowledge is available in the world to do it all yourself. Inventions that are not used can therefore be publicly expressed, for example free of charge as a contribution to society (for example with respect to the valuable insights which can promote the development of a life-saving drug) or by using licenses. However, though open innovation can stimulate innovation because ideas can be re-used and efforts can be combined, it is not free of risk. In practice this risk refers to the fact R&D in New Product Development is likely to be expensive. It might therefore be risky for the firms (within the consortium) to share ideas because competitors, or other firms outside the borders of the consortium, might benefit from those ideas without having to invest in research.
Besides licensing inventions firms can also opt for collaboration with competitors or other firms, for example in the form of joint ventures. This type of collaboration is closely related to open innovation and involves multiple stakeholders who, as defined by Freeman (1984), can be considered to be “any group or individual who can affect or is affected by the achievement of the organization’s (consortium’s,
author) objectives” (p. 46). The SPRINT@Work partnership, in which this Master thesis project takes
place, is a good example of open innovation in which multi-stakeholders are involved.
2.5.6 Critical success factors relating to NPD-partnerships
21
Secondly and closely related to the issue of ownership, the domain of intellectual property (IP) can be noted. IP is defined as “creations of the mind, such as inventions; literary and artistic works; designs; and symbols, names and images used in commerce”.13 Within commercial enterprises IP is often reflected in the form of patents, copyrights and trademarks, which aim to protect the results from the investments made. However, despite the advantages that can be gained through securing IP, Neba (2012) found IP can also lead to conflicts and difficulties when overlooked at the start of a collaborative project. He thereby emphasized the relevance of drafting intellectual property rights which “frame the interests and concerns of participants (thereby referring to the firms involved in the partnership, author)” (p. 10). Thirdly, Rodriquez (2012) found ‘it is not easy to fit the different ways of thinking’ (p. 1), thereby pointing at the goals and timing which might differ over the organizations involved. Related to the mutually different goals, Tuunainen and Miettinen (2012) found some firms attempt to seek (financial) benefit at the expense of a partner. This behaviour could reduce trust within and hamper dedication towards the consortium (Tuunainen and Miettinen, 2012). Thus, these findings emphasize the relevance and complexity that goes along with bringing parties together and aligning the objectives.
Fourthly, as found by Rodriquez (2012), collaboration between firms can be difficult because of distrust with respect to the sharing of information. This finding is reinforced by Bunduchi (2011), who found “a key feature of collaboration in general and collaboration for innovation in particular is the existence of trust” (p. 145), and by research from Howells et al. (2008) who found that (the absence of) confidence and trust are major constraints in joined R&D initiatives. Bunduchi (2000) defined trust as “the
willingness to accept vulnerability based on positive expectations about another’s intentions or behaviours” (p. 146).
Fifthly, once the actual development is about the start, joined NPD leads to new challenges with respect to the question how the share costs and revenues of innovation. With respect to these issues Bhaskaran and Krishnan (2009) distinguished multiple options. Firstly there is investment sharing, in which firms share the cost of NPD. This could imply “one firm conducts the development work while the other agrees to bear part of the development costs.” (p. 5). Alternatively Bhaskaran and Krishan (2009) distinguish innovation sharing, in which each of the firms involved performs part of the work. However, assuming all involved parties can indeed contribute to the multiform development in another way than merely providing financial support, it seems unlikely as well that all parties will spend exactly the same amount of resources in doing so. Thus, in practice the decision on how to share costs, benefits and risks is heavily affected by the exact roles and responsibilities from the involved firms.
Sixthly, both open innovation and NPD within the setting of a consortium can contribute to a multitude of perspectives and concepts. However, though both developments might add value to the end-product, it can be debated whether open innovation in its broadest (as in: adopt ideas from anywhere) is
desirable within the setting of a consortium. This critical remark is made because a huge amount of concepts might slow down the NPD-process. Furthermore reaching consensus between all involved
13
22
parties is likely to be time-consuming as well within a consortium. Thus, it can be debated what the optimal position should be on the range of, formulated exaggeratedly, a superior product with a very long time to market on the one side, and a reasonable product that can be commercialized much faster on the other side.
2.5.7 Concluding remark
23
3. Methodology
The main aim of the research is to determine the requirements which have to be taken into account in the actual development of technology based EAPs. Furthermore, the research attempts to answer the question whether the EAP(s) should be delivered as an individual stand-alone product or as a suite of related products, built on a common ICT platform.
With regard to the method of this project, the process of New Product Development (NPD) as put forward by Crawford and Di Benedetto (2008) was followed, as elaborated upon in section 2.5. The first phase (identifying an area with opportunities) can be summarized as: technology-based EAPs within the context of the SPRINT@Work program. Therefore, the methodology of Crawford and Di Benedetto’s 2ndphase (named concept generation) and 3th phase (named concept testing) were leading in this Master thesis research.
3.1 Concept generation
Given the order of the NPD-process, it was preferred to first enhance the insight in the end-users problems and requirements, and then to explore the (technological) developments. Combined, this resulted in multiple concept statements. Following this line of thought, section 3.1.1 elaborates upon the insights in the end-users problems and requirements gathered at the UMCG, while section 3.1.2
elaborates upon the data about (technological) developments gathered at IT-firms.
For the concept generation phase, in which 22 semi-structured interviews were held, a single case study was performed within the UMCG. Because semi-structured interviews do not consist of a fixed number of closed questions, the interviews could “lead to new and creative insights . . . and have high validity with practitioners” (Voss, 2002; p. 195). Besides that, the method granted access to personal opinions which made it possible that detailed explanations could be gathered (Karlsson, 2009), which were “effective for gaining insight” (Canadian Government, 2009; p. 1).
3.1.1 UMCG
The first 8 interviews were kept within the UMCG and took 75 minutes on average. The UMCG was selected because of its expertise and affinity with the Healthy Ageing @ Work theme. Furthermore, contacts were already made because of earlier cooperation between the RUG and the UMCG. This previous acquaintance probably also contributed to the willingness of all intended interviewees to collaborate. The interviewees were selected because of their good understanding of the themes to be explored. The selection was made after consultation with an assistant professor from the UMCG, which is acquainted with the subject.
With regard to the research sample (table 2), it is vital to be aware of the focus of the concept
24
Table 2: research sample concept generation phase - UMCG
Interviewee Department Position interviewee(s)
1. Arbeid & Gezondheid* Supervisor Arbeid & Gezondheid 2. Arbeid & Gezondheid* Project leader Healthy Ageing @ Work 3. Arbeid & Gezondheid* Corporate social worker
4. HRM Head of human resource department
5. Arbeid & Gezondheid* Occupational Health physician 6. Arbeid & Gezondheid* Occupational health advisor
7. Arbeid & Gezondheid* Former supervisor Arbeid & Gezondheid
8. IT IT-manager
* Arbeid & Gezondheid is the internal occupation health service from the UMCG
To prevent that important elements are overlooked during the interviews, an interview guide was developed for the interviews that are held within the UMCG. This interview guide is attached in
Appendix A and is divided in 4 parts. The first part of the interview was aimed at gathering insight into the current and expected future problems with respect to healthy ageing in the UMCG. The goal of the second part of the interview was to explore the experiences so far and vision of the UMCG towards EAP-elements. The third section had the same purpose, though in this section the perspective off the
employee was chosen. The fourth and last part of the interview aimed to gather visions and dream-perspectives about EAP-elements of the future. To optimize the interview-protocol, a pilot interview was held beforehand.
3.1.2 IT-firms
After the interviews within the UMCG, which led to insight in the end-users problems and requirements, 15 targeted interviewees from IT-firms were approached. These IT-firms were all part of the
SPRINT@WORK consortium. The firms were selected after consulting with two professors from the RUG, which are both closely involved in the SPRINT@WORK consortium. After approaching the firms by e-mail, in which the project was introduced and the interview request was made, the firms were contacted by phone to clarify ambiguities and schedule the interview. One interviewee could not be reached. The remaining targeted interviewees were all willing to cooperate and participated in the interview (see table 3), which took 50 minutes on average.
25
To act as a guideline, an interview guide was developed (Appendix B). The first part of the interview was aimed at garnering insight into the products offered by the firms, and the relation of the product with the EAP market. Secondly, the challenges related to the EAP market were discussed, as well as the effects these challenges have on the (development of) the products. Third and last, the difficulties with respect to the commercializing of the products and the technological choices were explored.
During all interviews, both within the UMCG and with the IT-firms, all interviewees were asked for approval prior to the interview to record the interview. They all agreed. The main points of each interview were then summarized and send back to the interviewees by e-mail to verify if the
interpretation of the data reflected the words of the interviewee in a good manner. Furthermore, this verification allowed interviewees to add new insight which were not covered.
Table 3: research sample concept generation phase – IT-firms
Interviewee Firm Core-business Position interviewee
1. Smartervision Video-analysis CEO
2. KWIC Patient-safety CEO
3. Umaco Product development Project manager
4. VitalinQ Healthy lifestyle support CEO 5. Negotica System integration / domotica CEO
6. Inbiolab Electrophysiology COO
7. CGI System integration ICT architect
8. INCAS3 Research Industrial researcher
9. Tizin Mobile Mobile solutions CEO
10. PriHealth Health questionnaires Business development
11. GameAcademy Serious gaming CEO
12. aXtion Software development Manager
13. BMA Ergonomics Smart chairs Ergonomist
14. Quantified Self
26
3.2 Concept evaluation
Once the product concepts were identified, they were evaluated during the concept evaluation phase. The evaluation thereby assists in identifying the technology-based EAP with the most potency. However, rather than merely evaluating concepts, a workshop was organized which offered space to exchange ideas, and thereby raise new ideas and initiate new concepts as well. This approach aligned with the personal belief from the author that a small but thorough group discussion would be more valuable in this early, and relatively fragile, stage of the NPD-process. Furthermore it aligns with the ‘2 steps forward, 1 reverse’ manner of acting as posed by Crawford and Di Benedetto (2008). However, as a result, the concept generation and concept evaluation phases partly overlapped each other. This choice reduced the value that should be granted to the ‘go / no go’ decision point in the concept evaluation. The arguments above, combined with the desire to prevent sales pitches, made that the IT-firms from which the concepts were gained, were deliberately not invited during the concept evaluation workshop. Eight employees from the UMCG and 1 professor from the RUG were invited to participate in the workshop because of their close involvement with the subject. The targeted participants were approached by e-mail. In addition a further explanation and reminder was given during the concept-generation interviews, in which most of them were involved as well. Two targeted participants were unable to attend, which made that the following participants took part:
Table 4: research sample concept evaluation phase
Participant Department Position interviewee(s)
1. Arbeid & Gezondheid Supervisor Arbeid & Gezondheid 2. Arbeid & Gezondheid Project leader Healthy Ageing @ Work 3. Arbeid & Gezondheid Corporate social worker
4. Arbeid & Gezondheid Occupational health physician 5. Arbeid & Gezondheid Occupational health advisor 6. Faculty of Medical Sciences / UMCG Assistant Professor*
7. Faculty of Economics and Business Professor * = attended the second part of the session.
27
4. Results
This section summarizes the main results from the Master thesis project. While doing so, a distinction is made in accordance with the NPD-phases of Crawford and Di Benedetto (2008). Section 4.1 presents the results from the concept generation phase, embracing the 8 interviews kept at the UMCG and the 14 interviews held with IT-firms. Subsequently, section 4.2 presents the results from the concept evaluation phases, which were gathered during the workshop.
4.1 Concept generation
Results interviews UMCG
This part presents the results from the interviews held at the UMCG. Firstly, a sketch is provided about the current EAPs on offer. Subsequently, section 4.1.2 elaborates upon the satisfaction of these EAPs from the perspective of the staff. Thirdly, the health problems that UMCG-staff come across are
explained in section 4.1.3, after which the next section deepens at the current developments that affect these problems. Fifthly, the desires from the UMCG are summarized in section 4.1.5, after which section 4.1.6 deepens at the challenges the UMCG comes across with respect to the health ageing of its
workforce.
4.1.1 Current EAPs on offer
Multiple interviewees indicated a lot of tools are already made available to UMCG-staff. Firstly, a yearly Healthy@Work week attempts to enhance the employee’s consciousness of their own health-status and motivate them to live a healthier life. Furthermore, the UMCG-staff is given a personal budget, which is a certain percentage of their wage that can be used to promote staff’s sustainable employment. In
addition, multiple workshops are offered throughout the year and personal guidance is available all year round. This guidance can range from psychological counselling to practical guidance from an ergonomics-expert on how to improve the workplace. Besides that a hearing test, a reanimation course,
doktoehoe.nl (an informative website about health at work) and the possibility to request a PAGO (an investigation to analyse the work-related risks) are offered.
Multiple interviewees stated the services that are on offer to be spread in the organization. This was reflected in the versatility of departments which offer services, such as the Human Resource
department, Arbeid & Gezondheid, the sport medical center, a special staff shop and the Wenkebach Institute, which is the UMCG’s internal training facility. One of the interviewees called the present situation ‘fragmented’ while another interviewee added ‘the architecture is not as such that access is easy’.
4.1.2 EAP-satisfaction
28
The ‘Fitter through the night’ and ‘Grief and loss’ workshops were both mentioned multiple times in the context of succesfull initiatives. ‘Fitter through the night’ supports night-staff by giving practical hints on areas like food and lifestyle, while ‘Grief and loss’ supports managers in their dealings with employees which deal with difficult periods in their lives. With respect to EAP-elements which are perceived to be less successful, one interviewee brought forward the mindfulness-workshop for nurses. The experience with this workshop, which suffered from limited participation, was attributed to a misfit between the program and the target group.
When analysing what critical success factors made EAP-elements successful, several interviewees
indicated the investment perceived by staff should be more than compensated by the perceived benefits the EAP-element offers to the employee. With respect to this aspect, the ergonomics expert gave a striking example. She explained that staff was sometimes lifting patient out of their bed by hand. Although this behaviour is in opposition of the rules, and suboptimal for the worker’s health, the mobile lift bought for this work could be located on the other side of the department. Thus, lifting by hand could be considered to be the easiest and quickest alternative. The subsequent frequent use of the lifts, when each bed in the Intensive Care was provided with a fixed lifts, was obvious to the interviewee. Using these new lifts became the easiest option and fully aligned with the current work-habits, which made the lifts were widely used.
In addition, user friendliness was considered to be important. As put to the core by one of the interviewees, staff doesn’t like ‘complex devices which makes people feel like lab rats’. Lastly, with respect to technology-based EAPs, numerous interviewees indicated that clarity about anonymity is considered to be crucial for employees, including aspects like: what data is stored, by whom, what purpose is it used for and who is granted access to it.
4.1.3 Health problems
Analysing what specific problems certain types of professions come across turned out to be challenging. Firstly, multiple interviewees indicate that making a distinction between several categories of
professions can be done in various ways, e.g. based on the core-business of the UMCG: research, education and patient-care or, alternatively, on the base of profession-type, such as office, nurse,
specialist, maintenance, logistics, cleaning, kitchen etc. Secondly, even when a certain function group can be distinguishes, such as for example surgeons, the interviewees indicated a further distinction should be made because the working conditions could strongly differ over the particular type of surgeon (thorax, heart, cosmetic etc.). Third and last, it was indicated that, even if the focus lies on one specific type of surgeon, the difficulties the surgeons come across were also influenced by other factors such as age, personal health status etc.
Apart from specific problems, multiple general problem-areas were put forward. Virtually all
