Uhde, Alarith
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Publication Access status: Open Access , A nurse-centered approach to computer-supported healthcare shift planning(2023)Nurse shift planning is a central work organization process in hospitals and other healthcare institutions. The shift plan provides a frame for all further healthcare activities by regulating staffing levels and group compositions at all times and on each day of the week. In addition, it fundamentally shapes each individual nurse’s life, often disturbs their circadian rhythms, and limits their ability to organize social activities. As a result, shift planning often brings challenges for nurses' physical and psychological health, and it can reduce their subjective well-being. There is a long history of research on how to improve the shift planning process, with two contrasting approaches. The first approach focuses on efficiency and full automation of the shift planning process. Its central motivation is that more efficient shift planning may free time and resources that can be used for other healthcare tasks, and that it helps to optimize staffing levels to meet the demand. A downside is that it excludes nurses from the planning process and reduces direct control of their shift plans, which creates work-life conflicts that negatively affect their well-being. The second approach gives full control of the shift plan to the nurses. This allows them to better integrate their work and private lives, but it can be inefficient and substantially increase workload for nurses, particularly in larger groups. This thesis presents the design and evaluation of an approach to shift planning that attempts to combine the best of both worlds, but with a focus on the nurses' perspective. The research followed a nurse-centered design process, focusing specifically on subjective fairness and subjective well-being from the perspective of the nurses affected by shift planning. In addition, automatic processes were included if they did not interfere with the primary goal to create a shift planning system that promotes nurses' fairness and well-being. The empirical section covers five studies. In Studies 1 and 2, we investigated nurses' subjective fairness experiences in the context of shift planning. Nurses understood fairness as equality (“everyone is treated equally”) for the general distribution of resources, such as free weekends. But in concrete planning decisions about free shifts, they understood fairness based on individual needs (“the person with a greater need gets the day off”), which has fundamental implications for how fair conflict resolution should be designed. In addition, nurses experienced involvement in the decision-making process as a central facet of fairness (i.e., procedural fairness). Study 3 covers the conceptual design of a nurse-centered shift planning system with the goal to promote subjective fairness and subjective well-being, based on interview studies with nurses and healthcare planners. Study 4 describes a nine-month appropriation study of a prototypical shift planning system that followed this conceptual design, in a ward of a retirement community. We found that some nurses used the system regularly for planning, but others did not. These differences were partially based on different lifestyles (e.g., planning months ahead vs. not planning the next week) and social considerations (e.g., preserving the reputation as a reliable and hard-working colleague). We also identified informal conflict negotiation practices (e.g., rescheduling private events, sharing shifts), informal functions of leadership (e.g., “pushing” colleagues to take time for themselves), and implications of the shift plan's release date on nurses' ability to plan for their private lives. Finally, in Study 5 we compared the informal conflict negotiation practices identified in Study 4 with an alternative, fully automated conflict resolution process. The interactive version had positive effects on fairness, well-being, and team spirit.Source Type:Doctoral Thesis5 17 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Context factors for pro-social practices in health careIn order to reduce the shortage of healthcare workers, researchers try to find ways to improve nurses’ job conditions. A lot of effort concentrates on organizing shift work in a more agreeable way by providing more autonomy to the nurses, e.g., through self scheduling. However, increased autonomy also means that nurses have to resolve scheduling conflicts within the team. To that end, a good team coherence is essential. In this brief exploratory study we present the pro-social practices of three Japanese nurses, each one working in a different setting that brings specific opportunities for pro-sociality. The findings can serve as a starting point for more focused, context-specific studies on pro-sociality in outpatient, residential, or day care.Source Type:InProceedings1 24 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Kollaborative Diensteplattform. Digitalisierung als Mittel teamorientierter Selbstorganisation"Die demografische Entwicklung, aber auch der medizinische Fortschritt haben bereits in der Vergangenheit dazu geführt, dass der Bedarf an Pflegepersonal in der Kranken- und Altenpflege gestiegen ist. Diese Entwicklung wird sich fortsetzen... Die Prognosen über die zu erwartende Versorgungslücke fallen dabei unterschiedlich aus. Dies stellt eine Herausforderung für die künftige Fachkräftesicherung dar. Sie wird verschärft durch die Tatsache, dass bereits jetzt ein bundesweiter Fachkräftemangel bei examinierten Alten- und Krankenpflegern herrscht" (Bundesagentur für Arbeit 2019, S. 5). Diese Analyse der Bundesagentur für Arbeit beschreibt ein Problem, das für viele Pflegeeinrichtungen dramatische Ausprägungen angenommen hat. Der Fachkräftemangel in der Pflege ist – in vielen Regionen Deutschlands – enorm. Zur Begründung wird in diesem Zusammenhang immer wieder auf die mangelnde Attraktivität des Pflegeberufes verwiesen. Die Attraktivität wird dabei durch unterschiedliche Faktoren eingeschränkt, zum Beispiel durch die körperlich und psychisch beanspruchende Tätigkeit, die häufig unter hohem Zeitdruck zu erbringen ist und vergleichsweise schlecht vergütet wird. Darüber hinaus ist die work-life-Balance von Pflegekräften durch Arbeit im Schichtdienst beeinträchtigt.Source Type:Book Part2 8 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Nachhaltige Motivation durch wohlbefindensorientierte GestaltungIn dem Projekt „Game of Roster“ (GamOR, siehe Kapitel 1) haben wir uns zum Ziel gesetzt, ein kollaboratives Schichtplanungssystem für Pflegekräfte zu entwickeln, das Mitarbeitende nachhaltig zur Beteiligung am Schichtplanungsprozess motivieren möchte. Das System sollte allen Mitarbeitenden ermöglichen, ihre Wünsche einzubringen, Planungskonflikte eigenständig aufzulösen und letztendlich ihre Schichtarbeit besser mit ihrem Lebensalltag zu vereinbaren. Die so entstehende Planungssicherheit und -autonomie soll nicht nur die Arbeitszufriedenheit, sondern auch das allgemeine Wohlbefinden der Pflegekräfte in ihrem angespannten Arbeitsfeld erhöhen. Die „nachhaltige Motivation” als zentrale Anforderung brachte daher das Gestaltungsziel eines als sinnvoll und freudvoll empfundenen Planungsprozesses mit sich.Source Type:Book Part3 8 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Positive work practices. Opportunities and challenges in designing meaningful work-related technologyWork is a rich source of meaning. However, beyond organizational changes, most approaches in the research field of Meaningful Work neglected the power of work-related technology to increase meaning. Using two cases as examples, this paper proposes a wellbeing-driven approach to the design of work-related technology. Despite the positive results of our cases, we argue that the use of technology as a means of increasing meaning in the workplace is still in its infancy.Source Type:Other2 15 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Stärkung von Selbstorganisation und Autonomie der Beschäftigten in der Pflege durch eine digitalisierte kollaborative DienstplanungDie Pflegebranche leidet unter einem massiven Fachkräftemangel. Der Pflegeberuf als solcher wird als wenig attraktiv wahrgenommen: physische Belastungen, Schichtdienst, vergleichsweise geringes Gehalt sind – neben weiteren Faktoren – dafür ausschlaggebend. Negative Auswirkungen von Schichtarbeit können dadurch reduziert werden, dass das Autonomieerleben der Mitarbeitenden erhöht wird. Sie haben nicht mehr das Gefühl, dass (neben ihrem Berufsleben auch) über ihr Privatleben verfügt wird, sondern sie haben selbst die Chance, die Balance herzustellen und zu gestalten. Diesen Gestaltungsspielraum adressiert das Projekt GamOR („GameofRoster“): mit Hilfe einer kollaborativen, d.h. gemeinschaftlichen, und zugleich digitalisierten Dienstplanung soll die Zufriedenheit der Pflegekräfte erhöht werden. Der Artikel beschreibt die Herangehensweise im Projekt GamOR, die im Hinblick auf digitalgestützte Veränderungsprojekte insgesamt viel Übertragungspotential bietet.Source Type:Book Part2 56 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Understanding and designing automation with peoples' wellbeing in mindNowadays, automation not only dominates industry but becomes more and more a part of our private, everyday lives. Following the notion of increased convenience and more time for the "important things in life”, automation relieves us from many daily household chores – robots vacuum floors and automated coffeemakers produce supposedly barista-quality coffee on the press of a button. In many cases these offers are embraced by people without further questioning. Of course, automation frees us from many unloved activities, but we may also lose something by delegating more and more everyday activities to automation. In a series of four studies, we explored the experiential costs of everyday automation and strategies of how to design technology to reconcile experience with the advantages of ever more powerful automation.Source Type:Other5 7
