Researching ‘with’ not ‘on’: Engaging Foundation GNVQ students in the research process - emerging themes from the study

This paper discusses practical and methodological issues arising from ongoing case study research exploring the hopes, aspirations and learning identity of 4 cohorts of GNVQ Foundation (level 1) students in 2 English General Further Education (FE) colleges. This paper focuses on work with the student participants in the study and poses a number of questions. How can young people be engaged with a research process? How can that process be meaningful to them in the context of their lives and experiences? How can the significant ethical issues involved with working with these students be addressed? Part of the thesis for this work has been the lack of value placed on students enrolled on Foundation level programmes. Therefore, it was important to demonstrate value for them throughout this process, and one way in which this was achieved was by engaging the young people with the research process as actively as possible. Working within a Social Justice theoretical framework, and specifically considering the notion of knowledge/power relationships the paper outlines the participative approach which was taken in the development of interview questions, informed by the ‘arenas of action and centres of choice’ described by Ball et. al (2000:148). Further, it explores the practical issues and ethical tensions which arose associated with respecting the young people and facilitating their involvement in the research process whilst working within the constraints placed by their level of experience and understanding, and discusses some of the unanticipated challenges that arose from this process. The paper concludes with a discussion of the way the research has evolved in response to these issues and of the ‘added value’ to the research which has arisen from the participants’ engagement with the process

The NOVO network: A Research and Development Platform with the Vision of a Nordic Model for Sustainable Systems in Health Care

Musculoskeletal and psychological/mental disorders are major causes of sick leave, threatening the welfare of individuals and the economics of companies and societies. The prevailing research and development (R&D) of ergonomic interventions show minimal long-term effects on health and wellbeing while interventions to improve production seem to have a dominant negative effect, particularly in the health-care sector. Scientific evidence suggests that improved partnership is needed between stakeholders with different and often opposing aims, i.e., organizational productivity vs. worker wellbeing. In 2006 a Nordic R&D network, the NOVO Network, was established highlighting the need for a new approach, integrating work environment and production needs in intervention R&D. Our hypothesis is that such an integration is more readily established in the Nordic countries, largely due to their leading positions in the world in terms of social capital. Through annual symposia and other activities, the NOVO Network brings together scholars and practitioners to share knowledge and experience and to suggest and develop new areas of collaboration towards increased organizational sustainability in health care. A multicenter study conducted within the framework of the NOVO network resulted in a new, practical tool. This tool aims to facilitate partnership instead of the prevalent domination orientation, thereby combining consideration of work environment and production needs. Based on our experiences so far, this article highlights some key future challenges. As a result, we hope to see development of a stronger Nordic R&D tradition towards increased organizational sustainability in health care

Previous experiences of Value Stream Mapping (VSM) at the hospital units included in the Swedish part of the NOVO Multicenter Study

Within the county councils of Sweden (hospitals, elderly care, etc.) two waves of introduction of Lean Production (Lean) have occurred. The first occurred during the 1990s and was unsuccessful mainly due to dramatic and negative impact on the employees (Härenstam et al, 1999). The 2nd wave started after the turn of the millennium. In 2011 about 80% of the county councils were running Lean projects (SKL, 2012). Now more emphasis was put on leadership and teamwork as well as knowledge on methodology. Successful projects creating e.g. more efficient patient flows are supposed to save time. A key issue is, however, that no general agreement seems to occur on how these saved resources should be reprioritized (cf. the “50/50-basis” in Denmark). Due to this, Lean projects are often perceived as “saving projects” where staff will eventually be phased out leading to further “work intensification”. VSM is a main Lean tool used to reduce waste in production flows. Our present case studies show differences between hospitals in Lean and VSM experiences. At one hospital Lean has been developed from "below" in the organization since 2004 through successive education (SkaS-guiden 2008). In our 2 cases from this hospital the initial steps of VSM were guided by internal Lean educated stakeholders. No resistance was met from any employee. However, the writing of action plans and the following actions were integrated in parallel rationalization processes. In contrast, our 2 other cases at another hospital had only been marginally influenced by Lean. The VSM processes were guided by an external Lean educated stakeholder (one of the authors). Especially one of the cases had significant difficulties in achieving consensus on an action plan including work environment issues. The required time for the VSM analyses became considerably prolonged, partly related to lack of Lean and VSM experience. Conclusions: The duration of the VSM process seems to depend on previous Lean experiences. Problems in the assessment of an action plan, an essential part in the VSM procedure, seems partly due to employee uncertainty regarding the consequences for the individual and parallel rationalization processes

Mechanical exposure among general practice dentists in Sweden and possible implications of rationalisation

The present study investigates the dental work in terms of time distribution and mechanical exposure in value-adding work (VAW) and non-VAW. Further rationalisation of dental work would typically involve an increase in the proportion of VAW. Information on mechanical exposure within the classes of VAW and non-VAW may be used to predict possible implications of rationalisation. Sixteen dentists were investigated. Using a data logger, postures and movements were continuously recorded for each subject during the 4 h of work, which included the 45 min of video recording. Time distribution and mechanical exposure for the six different work activities identified were evaluated from the video recordings, using a loss analysis technique. VAW, which comprised 54% of the total working time, generally implied significantly more constrained mechanical exposures as compared with non-VAW. The results suggest that future rationalisation of dental work, involving a reduction of non-VAW, may increase the risk of developing musculoskeletal disorders. Statement of Relevance: The present study illustrates the potential effects of rationalisation on biomechanical exposures for dentists. The results highlight the significance of integrating ergonomic issues into the rationalisation process in dentistry in addition to ordinary workstation and tool design improvements performed by ergonomists

Ergonomic Value stream Mapping (ErgoVSM) – potential for integrating work environment issues in a Lean rationalization process at two Swedish Hospitals

Introduction: Lean is used in healthcare as a tool for business development and rationalization. Lean aims at contributing value from a holistic perspective including reduction of waste. Previous research indicates that this often creates work intensification with possible negative implications for the working environment (WE). WE considerations generally take a back seat on the rationalization process and are most often introduced later in a separate process. This paper reports findings from the Swedish part of a Nordic Multicenter Study where WE considerations have been integrated into a rationalization process based on Value Stream Mapping (VSM). ErgoVSM incorporates aspects of the physical and psychosocial WE into the VSM process. The abstract presents pros and cons for using ErgoVSM in relation to VSM at 2 wards at 2 different hospitals based on some of our preliminary data. Material and Methods: The case ward (“Ca”) used the ErgoVSM tool and the control ward (“Co”) the VSM tool. The resulting Action Plans were analyzed regarding number of suggested interventions and expected impact on performance (P) and WE. The expected WE impact was finally categorized according to impact at “Task”, “Work Content” and “Work Situation” (Westlander 1993). Two of the present researchers made these assessments independent of each other followed by a consensus procedure. Results: The Action Plan from Ca comprised 37 and Co 22 interventions. For both wards 65% of the interventions were expected to improve both P and WE. However, for Ca none of the interventions were expected to imply negative or no impact on WE, while this was 23% for Co. For Ca 16% of the interventions concerned Tasks, 46% Work Content and 38% Work Situation. The corresponding results for Co were 55%, 36% and 9% respectively. Conclusions: The Ca ward suggested more interventions, none of these with expected negative impact on WE and the suggestions were more often at a system rather than task level. The present preliminary data suggest that the ErgoVSM tool facilitate development of an Action Plan that may result in higher organizational sustainability compared with VSM

Innovation and employee injury risk in automotive disassembly operations

<p>Engineering innovations in car disassembly systems are studied for affects on system operators’ risk of repetitive strain injury (RSI). Objective instrumented measures of injury risk factors with synchronised video-based task analyses were used to examine changes in operators’ RSI risk during two cases of engineering innovation: (1) a shift in industrial model from traditional extracting saleable parts to line-based full material recovery, and (2) the prospective effects of a simulated ‘Lean’-inspired process improvement in the line system. Both cases of innovation showed significantly increased movement speeds and reduced muscular recovery opportunities, implying increased RSI risk. This case study reveals a mechanism by which innovation may increase RSI risks for operators. Managers responsible for engineering innovation should ensure their teams have the tools and mandate necessary to control injury hazards as part of the development and design process. These cases suggest how failure to manage RSI hazards in the innovation process may allow increases of injury risks that can compromise operational performance. This ‘innovation pitfall’ has implications for operator health and organisational sustainability. Alternative pathways are discussed.</p

Scientific evidence suggests a changed approach in ergonomic intervention research

Ergonomic interventions have generally been unsuccessful in improving workers’ health, with concurrent rationalization efforts negating potentially successful intervention initiatives. We propose the two aims are considered simultaneously, aiming at the joint consideration of competitive performance and work environment in a long-term perspective (“organizational sustainability”). A prerequisite is a high level of dialogue between the different groups of stakeholders, and we argue that the Nordic countries, through high levels of trust and justice (social capital), have unique opportunity to carry out such research. The present authors bring forth the vision of “a Nordic Model for development of more sustainable production systems”

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Conclusions: • Both the ErgoVSM and VSM tools seem mostly to result in intervention proposals causing improved or no change in the work environment without impaired performance. • Based on Swedish data only the use of ErgoVSM may result in some improvement of the work environment compared with VSM. Such an effect is weakly supported by the Icelandic data and not by the Danish data. Thus, only under some conditions the ErgoVSM tool may be used in favour of the VSM tool. • Most proposals were assessed to cause ergonomic improvements at system level (‘job content’ and ‘work situation’). This is in contrast to intervention proposals investigated in the ergonomic intervention literature mainly focusing task level and the individual (cf. Westgaard and Winkel, 2011)