Quality management and work environment in Swedish oral and maxillofacial surgery

Abstract: This thesis attempts to describe the opinion of the work with quality, quality management, and work environment among the employees at Oral and Maxillofacial Surgery (OMFS) clinics in Sweden. This thesis aimed to: • Analyse if the OMFS clinics in Sweden actively work with quality development and if so which systems they use. • Explore the opinion of the employees about quality work. • Describe how the employees of OMFS clinics in Sweden perceive good work, i.e. their image of the dimensions that the profession should contain to be really good work. • Investigate whether there is a discrepancy between ideal and reality for this group. • Describe how the employees of OMFS clinics in Sweden perceive their health. • Analyse how work environment influenced attitudes to and knowledge of quality among employees of OMFS clinics in Sweden. The study was based on self-report questionnaires which in 2003 were sent to all OMFS clinics in Sweden. The response rate was 86 %. • Only at two clinics did all the respondents agree on their system. • Surgeons rated intellectually stimulating work as most important, and the hazard-free work environment as least important. The nurses rated stimulating fellowship as most important, and the opportunity for career advancement as least important. • The percentage unit differences between the ideal and the reality were largest for the item the work provides opportunities to have an influence on important decisions. • There were significant differences between maxillofacial surgeons and dental nurses and assistant nurses as to muscle- and joint trouble. The differences were also significant between men and women both as to muscle- and joint troubles and somatic trouble. • Only work environment was significant for attitude towards quality work. Profession, gender, clinic size, and a factor for hard demand had significant associations to quality management system used or not. In conclusion: More than half of the respondents stated that they worked with a quality system. The dental nurses and assistant nurses had a much more positive view on the potential of quality work as a means to improve their work than had the maxillo-facial surgeons. For a majority of the dental nurses the working situation concerning the physical environment was more important than for the maxillo-facial surgeons. The employees emphasized free, influential, and intellectually stimulating work, but the dissonance between ideal and reality was rather wide concerning good work. OMFS employees are feeling unhealthy, but no worse than other high-risk-groups in human service working and better than female general practice dentists. The women of OMFS employees feel worse than the men.