Organizational Support for Safety and Work Ability in Healthcare Workers: A Longitudinal Study

Maintaining healthcare worker (HCW) work ability and continuing employment are critical issues. We examined the association of work ability with the previously unexamined work-environment factors of organizational support for safety (OSS) and surface-acting emotional labor (SaEL).

A self-administered survey covering work-environment features recruited employees of five U.S. public-sector healthcare facilities in 2018-2019 and 2021. Linear regression on the outcome of work ability, both cross-sectionally and longitudinally, focused on OSS and SaEL with additional independent variables.

A total of 1,059 and 1,553 surveys were collected from predominantly female HCWs; 425 answered both questionnaires. Almost two thirds of the HCWs were either non-direct care or unlicensed HCWs. Work ability scores were lower in direct-care workers versus non-direct-care workers. In multivariable regression models, OSS was positively associated with work ability, and SaEL was negatively associated, cross-sectionally at baseline and follow-up. Job strain, back pain, and safety hazards were also negatively associated with work in both cross-sectional and longitudinal analyses, while social support and civility norms (combined) were positively associated. In the longitudinal analysis, only OSS positively predicted work ability, while SaEL had a borderline negative effect.

The finding that OSS predicts work ability is novel. Despite high turnover, there has been little examination of risk factors for low work ability among HCWs. The importance of this organizational predictor justifies organization-level interventions to improve workplace safety. Such actions could simultaneously address and mitigate the additional risk factors of SaEL, job strain, and back pain in order to improve work ability for all groups of HCWs.