How does a new working method in the Norwegian Labour and Welfare Organization (NAV) succeed in reducing sick leave rates?

摘要

Background : In Norway, reducing workplace absenteeism due to illness is a government priority. The results of ongoing efforts to reduce the rates, however, remain limited. Under bureaucratic procedures, the Norwegian Labour and Welfare Organization (NAV) initially determines whether sickness benefits are to be paid out, based on a certificate from a physician. If a sick leave is prolonged, the NAV office in the municipality where the employee lives meets with the employee and the employer before decision-making. A pilot project for a new model of organizing NAV’s follow up of employees on sick leave was introduced in 2016. New teams of NAV advisors were established to follow up the employee based on workplace rather than residence, as in ordinary procedures. The model, known as the workplace-centered team, enabled an ongoing relationship between an employee’s workplace and the NAV team following up on the employee during the sick leave. During 2017, NAV succeeded in achieving its project goal of a 20 percent reduction in the sick leave rate. It thus appears that the new model of the workplace-centered team can remedy challenges of absenteeism in the workplace. Methods : This paper presents findings from a study of the NAV workplace-centered team pilot project in ?stfold County. We analysed sick leave statistics and data from 13 semi-structured focus group interviews with NAV advisors from the central NAV Workplace Centre and at local levels and employers in five urban municipalities. The analysis focused on the effects of the workplace-centered team and the workplace-centered team as an organizational concept. Discussion : We found that each workplace-centered team was organized around a specific workplace and met with the employee and the employer early in the sick leave period. Participants in the meetings could be the employee, the employer and the NAV advisor acquainted with the workplace. If necessary, additional resources e.g. the employee’s doctor or from the occupational health service unit also joined the team. This established an arena where different experts could discuss solutions that would enable the employee to return to work. It also ensured that each member of the team could gain knowledge of conditions at the workplace affecting the employee on sick leave. Indeed, the dominant causes of doctor-certified sick leaves in Norway are psychological ailments and muscular-skeletal pains. Such diagnoses can be complex and unclear and related to challenges at the workplace (wicked problems). Hence, the establishment of the workplace-centered team served to establish meeting places for collaboration and development of individual solutions that were better adapted to addressing the existence of such wicked problems. Results and Lessons learned : The pilot holds promising results and the model of the workplace-centered team, by providing opportunities to solve challenges of absenteeism in the workplace, represents an alternative to the hierarchical bureaucratic model that currently characterize NAV. Limitations and suggestions for future research : This research has assessed the new organizational model through interviews with NAV personnel and employers. More extensive research is needed, including interviews with employees themselves and other involved professionals, such as physicians.