However, few studies provide specific information on the interaction between work environment interventions and rationalization, with equal weight on documenting both processes.
Such production system interventions or rationalizations (term used in this paper) have a dominant influence on the design of organizations, production lines and workplaces, and are frequently carried out with low priority for worker health effects.
The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention.
The present study, using a historic prospective mixed-method design, documents sick leave development, here used as a work environment and health indicator, rationalization measures and work environment interventions, and their effects as perceived by the HCWs.
The results of this study confirm the initial hypothesis and thereby the assumption implicit in the study aim: on-going rationalization measures interact with work environment interventions and lessen the impact of these, highlighting the multiple processes that determine working conditions of HCWs.
Some units seem to benefit more from work environment interventions while others suffer more from rationalizations.
The authors posited that on-going rationalizations were a major cause of poor outcome of worker health interventions, and recommended that work environment concerns should be integral to the planning of rationalization efforts, which is also the theoretical basis of the present study.
The specific aim of the study is to identify critical factors in the interaction between the two processes, whereby putative positive work environment intervention effects are reduced or eliminated by rationalization.
However, the overall effect of the work environment interventions seemed small in comparison to powerful effects of the rationalization measures.
Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers.
