Research led by Curtin University has found that better solutions are desperately needed for Australia’s over-stressed care workforce, with poor work relationships and unmanageable demands taking their toll.
The team from the ‘Design for Care Consortium’ surveyed 1,300 healthcare and social assistance workers over an 18-month period, to better understand whether SMART (Stimulating, Mastery, Agency, Relational, Tolerable) work design strategies could improve employee job satisfaction, mental health, and wellbeing.
The report found that 37% of workers reported they did not have enough time to do their work, 40% said their jobs were highly emotionally demanding, 22% reported high work-related burnout, and 24% said they did not spend enough time with their family.
Project lead Professor Sharon Parker, from Curtin’s Future of Work Institute, said the report highlighted the urgent need to drive innovation with work design tools across the healthcare and social assistance industry.
“Individuals with high SMART work design, compared to those with moderate or low SMART work design, report lower levels of burnout and mental ill-health, lower intention to leave, and higher job satisfaction,” Professor Parker said.
“Redesigning work involves changing systems, roles and tasks in a way that improves the wellbeing and mental health of employees. The findings from this project will help create recommendations that will be tailored for the healthcare and social assistance industry to embed SMART work design into organisations as a preventative and sustainable strategy for mental health and wellbeing.”
The report also found younger workers aged 16 to 24 were more likely to experience higher rates of poor mental health compared to all other age groups, while permanent full-time employees experienced the highest level of work demands compared to casual workers.
Client-facing workers, such as aged care workers and disability support workers, experienced less autonomy in their jobs, poorer relationships at work and higher levels of burnout.
Significantly, the Design for Care Consortium’s first report, which showed healthcare and social assistance workers were twice as likely to file a workplace compensation claim for psychological injuries, with the jobs of nurses, midwives, ambulance officers and social workers revealed as highly impacted.
“Analysis has shown that workers compensation claims are increasing for psychological injuries more than others, and this is completely generalisable,” Professor Parker said.
“And we know from the work we have done with aged care organisations here in WA that the same issues are emerging: I am confident the issues that we saw in the NSW data are also challenges that the West Australian health care workforce face.
“We see increasing levels of work pressure, increasing workloads, and people experiencing very strong emotional demands, partly due to the nature of the work but also because sometimes they feel like they are not able to deliver the quality of care that they believe they should, – which creates emotional stress such as feelings of guilt.”
Professor Parker pointed out that there was now a strong emphasis on compliance, particularly in aged care, that has emerged from the Royal Commission and other inquiries.
“And where there have been cases of poor care, the solution is often to add more layers of compliance to manage the risks,” she said.
“And while that makes logical sense, the consequence is that it is increasingly harder for people to provide care because they must engage in additional paperwork and compliance activities to meet those requirements, which also creates a lack of role clarity and internal conflict about prioritisation,” she said.
“Many of these issues, even though we often attribute them to the pandemic, were in existence well before COVID: we can go back many years in multiple sectors that see that workload has been increasing for many people: more KPIs and there’s always more and more boxes you need to tick.”
The team discovered that the experience of too many demands, too much work, and too much pressure was greatest for permanent full-time staff.
“The problem with the increasing casualisation of staff is that sometimes those people don’t know the patients and they may not know the processes, the systems… the cracks or the gaps must get filled in by those permanent full-time staff – often resulting in a great deal of extra work,” Professor Parker said.
“There’s a lot of pressure on business owners, practice managers and other healthcare providers to make sure that their business not only operates effectively, but that the workplace does not have psychosocial hazards or psychosocial risks.
“The SMART model we have developed is a simple way for small businesses and others to check in and ask those questions: what can we consider about the work itself, the quality of the work? Are we avoiding those key psychosocial risks?”
Professor Parker encouraged practice managers to look at the model and talk about it with their staff to help shift the conversation from away from the individual and back to the processes involved in the role.
An example of one of the initiatives that emerged from the research, which was suggested by front-line care staff, was the importance of a good induction process.
“If you’ve got casual people coming into the workforce because of a high number of staff absences and staff shortages, then it’s vitally important that you’ve got good ways of getting people up to speed very quickly with the people and the processes,” Professor Parker explained.
“Yet many of the organisations that we work with do not have good systems for that, which has significant consequences for the stress levels of the entire workforce. That is a very small change, but it can make a very big difference, which is what this project’s all about – uncovering those little gems that are really going to make a practical difference.”
Professor Parker highlighted that there has been a concerted focus on bringing business theory into the health sector, using approaches such as lean production systems and quality improvement.
“Yet there’s been less attention to improving the actual work of the staff themselves, but I think that is what we’re starting to see emerge now,” she said.
“And in fact, it has been partly generated by changes to work health and safety laws, which are making it crystal clear that this needs to happen. But I do not think anyone would argue that when you create work that is good for the workers, the people performing that role, then you are also going to create better quality care as a direct result.”