Background: Only a few studies of psychosocial determinants of employee health and organizational development have been prospective, involving more than one organization and applying standardized assessment tools. This limits the ability of providing evidence-based guidance as how to carry out healthy organizational transformations. Methods: A total of 6,000 employees responded twice to a validated psychosocial-leadership questionnaire within a 2-year period. The assessment focused on changes over time in the three outcome measures – mental health, efficacy, and leadership, determined to be important indicators of a healthy organization. Changes within and between organization were assessed statistically using regular t tests and general linear modeling. Results: There were major differences between organizations in psychosocial measures, both at the baseline and over time. At the organizational level, changes between study periods in management performance feedback, participatory management, and work tempo were the most consistent predictors of improvements over time in the three outcome measures. Conclusions: Performance feedback and participatory management might be two common predictors of healthy workplaces. Some of the psychosocial determinants of healthy organizations suggested in previous research might not be universally valid. It is suggested that future research should to a larger degree make use of multiple departments and organizations in studies of psychosocial determinants of healthy organizations.

1.
Sainfort F, Karsh BT, Booske BC, Smith MJ: Applying quality improvement principles to achieve healthy work organizations. J Qual Improv 2001;27:469–483.
2.
Arnetz BB: Physicians’ view of their work environment and organisation. Psychother Psychosom 1997;66:155–162.
3.
Armstrong-Stassen M: The influence of prior commitment on the reactions of layoff survivors to organizational downsizing. J Occup Health Psychol 2004;9:46–60.
4.
Parker SK, Chmiel N, Wall TD: Work characteristics and employee well-being within a context of strategic downsizing. J Occup Health Psychol 1997;6:289–303.
5.
Aiken LH, Clarke SP, Sloane DM: Hospital staffing, organization, and quality of care: cross-national findings. Nurs Outlook 2002;50:187–194.
6.
Arnetz JE, Arnetz BB: Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers. J Adv Nurs 2000;31:668–680.
7.
Jimmieson NL, Terry DJ, Callan VJ: A longitudinal study of employee adaptation to organizational change: the role of change-related information and change-related self-efficacy. J Occup Health Psychol 2004;9:11–27.
8.
Anderzen I, Arnetz BB: The impact of a prospective survey-based workplace intervention program in employee health, biological stress markers, and organizational productivity. JOEM 2005;47:671–682.
9.
Petterson IL, Arnetz BB: Measuring psychosocial work quality and health: development of health care measures of measurement. J Occup Health Psychol 1997;2:229–241.
10.
Ustun TB: The global burden of mental disorders. Am J Public Health 1999;89:1315–1318.
11.
Kalia M: Assessing the economic impact of stress – the modern day hidden epidemic. Metabolism 2002;51(suppl 1):49–53.
12.
Thomsen S, Dallender J, Soares J, Nolan P, Arnetz B: Predictors of a healthy workplace for Swedish and English psychiatrists. Br J Psychiatry 1998;173:80–84.
13.
Arnetz JE, Arnetz BB: The development and application of a patient satisfaction measurement system for hospital-wide quality improvement. Int J Qual Health Care 1996;8:555–566.
14.
Arnetz BB: Technological stress: psychophysiological aspects of working with modern information technology. Scand J Work Environ Health 1997;23(suppl 3):97–103.
15.
Arnetz BB: Staff perception of the impact of health care transformation on quality of care. Int J Qual Health Care 1999;11:345–351.
16.
Harter JK, Schmidt FL, Hayes TL: Business-unit-level relationship between employee satisfaction, employee engagement, and business outcomes: a meta-analysis. J Applied Psychol 2002;87:268–279.
17.
Wanous JP, Reichers AE, Hudy MJ: Overall job satisfaction measures: how good are single-item measures. J Appl Psychol 1997;82:247–252.
18.
Hinshaw AS, Atwood JR: Nursing staff turnover, stress, and satisfaction: models, measures, and management. Annu Rev Nurs Res 1983:1:133–153.
19.
Price JL, Mueller CW: Handbook of Organizational Measurement. Marshfield, Pitman, 1986.
20.
Worthington AC: Frontier efficiency measurement in health care: a review of empirical techniques and selected applications. Med Care Res Rev 2004;61:135–170.
21.
Brown C, Arnetz B, Petersson O: Downsizing within a hospital: cutting care or just costs? Soc Sci Med 2003;57:1539–1546.
22.
Cohen MM, Eustis MA, Gribbins RE: Changing the culture of patient safety: leadership’s role in health care quality improvement. J Qual Saf 2003;29:329–335.
23.
Nohria N, Joyce W, Roberson B: What really works. Harv Bus Rev 2003;81:42–52.
24.
Arnetz BB: Subjective indicators as a gauge for improving organizational well-being. An attempt to apply the cognitive activation theory to organizations. Psychoneuroendocrinology 2005;30:1022–1026.
25.
Forsberg E, Axelsson R, Arnetz B: The relative importance of leadership and payment system. Effects on quality of care and work environment. Health Policy 2004;69:73–82.
26.
Petterson IL, Arnetz BB: Psychosocial stressors and well-being in health care workers. The impact of an intervention program. Soc Sci Med 1998;47:1763–1772.
27.
Thomsen S, Arnetz B, Nolan P, Soares J, Dallender J: Individual and organizational well-being in psychiatric nursing: a cross-cultural study. J Adv Nurs 1999;30:749–757.
28.
Locke EA: The nature and causes of job satisfaction; in Dunnette MD (ed): Handbook of Industrial and Organizational Psychology. Chicago, Rand McNally, 1976, pp 1297–1347.
29.
Judge TA, Thoresen CJ, Bono JE, Patton GK: The job satisfaction-job performance relationship: a qualitative and quantitative review. Psychol Bull 2001;127:376–407.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.