On the Relationship between Sustainable Health and Quality Management : Leadership and organizational behaviours from Swedish organizations

Abstract: Sickness absence not only causes significant costs for organizations but also leads to other negative consequences for individuals and societies. Previous research has shown that working with organizational values within Quality Management affects job satisfaction and results in increased profitability and customer satisfaction. There would, in addition, seem to be great gains if managers, by working with Quality Management, can manage to establish sustainable health among co-workers.   The purpose of the research described in this thesis was to examine how Quality Management could be practised in order to support sustainable health among co-workers and what it is within Quality Management that influences sustainable co-worker health. Accordingly, the purpose was also to contribute to the understanding of the relation between sustainable health and Quality Management. To fulfil this purpose, three research questions were asked. The results are described in three parts related to the three research questions and are the product of six case studies carried out in seven different organizations.   Interviews with managers and workshops with co-workers were carried out to investigate how Quality Management can be practised within organizations in order to promote sustainable co-worker health. These investigations took place in four organizations that had received awards. Three had been awarded for their excellence in leadership, work environment and co-workership, along with improved profitability; one for its successful implementation of quality programmes. The results are descriptions of methodologies, behaviours, values and organization structure used by the organizations to support sustainable health. These are exemplified with practical examples. The methodologies, behaviours, values, and organizational structure are considered possible for other organizations to adopt and all of them are already supported in the quality, management and leadership literature. Support from the health literature is also found for most of the behaviours, methodologies, values, and organizational structure.   Surveys and focus groups interviews were carried out in five different organizations in order to find out what is of most importance when practising Quality Management in order to influence sustainable co-worker health. The results pointed to ‘Leadership Commitment’ as the most central of the values for achieving sustainable health among the co-workers. Furthermore, the values ‘Continuous Improvements’, ‘Participation of Everybody’ and ‘Customer Orientation’ were found to be related to sustainable health among the co-workers. The values ‘Leadership Commitment’ and the value ‘Participation of Everybody’ were then further elaborated to find aspects of importance for sustainable co-worker health. From the value ‘Leadership Commitment’ four aspects were extracted. These were labelled ‘Empathy’, ‘Presence and Communication’, ‘Integrity’, and ‘Continuity’. The results showed relations between the value ‘Leadership Commitment’ within Quality Management and sustainable health among the co-workers. Thus it is essential for leaders to work in accordance with that value to achieve results in the work towards sustainable co-worker health. The results indicate that this requires management and leadership that are characterized by the aspects above. The leaders have to:   • Really understand the co-workers and their work situation. • Be present and available for co-workers and communicate with them. • Act as a role model, be fair and keep their promises. • Stay in their positions long enough to build up trust and confidence.   The value ‘Participation of Everybody’ has also been shown to be related to sustainable health among the co-workers. This indicates that it is important to work in accordance with that value in the struggle to achieve sustainable health among the co-workers. The results imply that this value is characterized by the aspects ‘Development’, ‘Influence’ and ‘Being informed’. This could be done by:   • Giving the co-workers opportunities to develop their skills and develop personally. • Letting the co-workers influence their work situation and taking suggestions and proposals from them seriously. • Having good communication within the whole organization.   To manage this; the managers have to delegate more and empower the co-workers.   These results were then further elaborated within another organization in order to develop a measurement approach that can clarify the extent to which the values, ‘Leadership Commitment’ and ‘Participation of Everybody’ permeate an organization. The developed measurement approach can be used to clarify the extent to which the organization is practising the health-promoting values within Quality Management and in what areas improvement is needed to increase co-worker health. The approach can also help the organization to detect those shortcomings within the management which are important for co-worker well-being. The developed measurement approach can be used to establish and enhance co-worker health by improving their well-being, satisfaction and motivation.