Original Title: Soutien à la mise en place de nouvelles formes d’organisation du travail au CIUSSS de la Capitale-Nationale

Authors' objectives: The main objective was to answer the question “How can new ways of working be implemented in the public sector and what are their effects at the organizational and professional levels?”. To this end, the following assessment questions were formulated: 1. What models for the implementation of NWW are reported in the literature? 2. What barriers and facilitators influence the implementation of NWW? 3. What are the impacts of NWW on the organization1 (structure/company/institution)? 4. What are the impacts of NWW on professionals (physical/psychological/social)?

Authors' results and conclusions: The literature search identified 1622 documents, including 1547 from the bibliographic databases and 75 documents from the grey literature. At the end of the selection process, 21 documents were retained, including 15 primary studies and 6 documents from the grey literature. The 21 documents retained were published between 2012 and 2022 and most come from the Netherlands. Only two publications relate specifically to the public sector. Eight studies are of high quality with a score above 80%, five scored between 60% and 80% and the other two scored below 60%. All but one of the documents from the grey literature have a high level of credibility. Six of the 21 documents retained report data related to the implementation of NWW in private organizations and 16 document the expected and measured impacts of NWW at the organizational and professional levels. Implementation of NWW An analysis of the different implementation models identified in the literature identified the main stages in the implementation of NWW. They include the creation of a working group dedicated specifically to the implementation of NWW, the participation of various types of consultants as well as the training and participation of both managers and employees in the change process. In all cases, the implementation of NWW is described as a lengthy process that took three to four years. Resistance to change was identified as a major impediment to the implementation of NWW, especially when it is perceived as a change imposed by the organization’s management. This perception can be modified by involving staff in the change management process, from the early stages to the adoption of NWW. Other means, such as communication, organizational openness and support, as well as making changes to the original plan in order to adjust to employees’ needs, were also identified. Impacts of NWW At the organizational level, the reduced number of hours spent in physical workplaces in favour of spatial and temporal flexibility reduces the office occupancy rate and leads to savings in per person occupancy costs. In addition, the decreased energy consumption associated with commuting to the workplace reduces the ecological footprint. At the professional level, the main variables addressed in the documents retained are: employee commitment, satisfaction and performance. The expected impacts, according to the statistical models generated from outcomes assessed at a single point in time, show that NWW are associated with these variables. These impacts are thought to be mediated and moderated by various factors according to the studies. However, the impacts measured over time did not show any significant effects. Other variables, such as autonomy, health and well-being, work demands and support from colleagues or supervisors, were each addressed in three studies but the outcomes for each of these variables are inconsistent. Since the constituent practices of NWW are not the same in the different studies and the same outcome of interest is not measured in the same way in the studies relating to them, it was not possible to group the outcomes for the same variable Despite the limitations mentioned, the implementation of NWW remains an interesting and innovative option in the public sector. The results of this assessment of technologies and methods of intervention will support decision making in the reorganization of work toward the implementation of NWW in certain directorates of the CIUSSS de la Capitale-Nationale. Measurements over time of the expected effects of NWW will have to be carried out in order to document the actual impacts of NWW at the organizational and professional levels.

Authors' recommendations: 1. NWW are comprised of a set of simultaneous practices (≥ 2 practices) in addition to the use of ICT, which is essential, in particular, to make work in different places and access to organizational knowledge possible. 2. NWW practices can vary from place to place, whether in terms of the reconfiguration of physical spaces, policies or organizational structures. 3. It takes several years (≥ 3 years) to implement NWW fully. 4. According to the documents retained, the implementation of NWW involves: • Creating working groups/projects specifically dedicated to the transformation process; • The participation of consultants (ICT, design, human resources, change management); • The participation and training of managers and employees in order to introduce the changes. 5. Organizations that have implemented NWW point to resistance to change as a significant barrier that can be exacerbated by the perception that the change is being imposed by management. 6. Most of the documents retained use a statistical model to predict the impacts of NWW, while few longitudinal studies have measured the actual effects of NWW. 7. The impacts measured do not always correspond to the expected impacts. 8. The variety of combinations of the constituent practices of NWW means that the impacts measured cannot be attributed to a specific practice. 9. The variability in definitions, measures and tools used does not allow for the grouping of studies on the same variable or the assessment of the level of evidence of outcomes of interest. 10. More longitudinal studies using standardized tools are needed to measure the actual impact of NWW on both employees and the organization.

Authors' methods: A systematic review of the literature was carried out. A search strategy was defined in collaboration with a librarian to query the bibliographic databases PsycInfo (PsycNET) and CINHAL. A search of the grey literature was also carried out in March 2022. The relevant studies published from January 2010 to September 2022 were selected from the CIMO typology (Denyer et al., 2008). The quality of the studies and the credibility of the documents from the grey literature were assessed using the QualSyst tool (Kmet, Lee and Cook, 2004) and the AACODS tool for the evaluation and critical appraisal of grey literature (Tyndall, 2010). Two professionals split up the tasks after making sure they had a common understanding of the selection and quality assessment criteria. Data extracted using a structured checklist were synthesized and analyzed based on the assessment questions.

Project Status: Completed

URL for project: https://www.ciusss-capitalenationale.gouv.qc.ca/sites/d8/files/docs/MissionUniversitaire/ETMISSS/etmiss_sommaire-executif-NFOT_ANG.pdf

Year Published: 2023

URL for published report: https://www.ciusss-capitalenationale.gouv.qc.ca/sites/d8/files/docs/MissionUniversitaire/ETMISSS/ETMI-ABREGEE-SOUTIEN-ORGANISATION-TRAVAIL.pdf

English language abstract: There is no English language summary available

Publication Type: Full HTA

Country: Canada

Province: Quebec

Organisation Name: Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale

Contact Address: 525, boulevard Wilfrid-Hamel, bureau A-122

Contact Name: Sylvie St-Jacques

Contact Email: uetmisss.deau.ciussscn@ssss.gouv.qc.ca