Healthcare digitalisation and its association with quality and employee health, a mixed-methods study

• Date: 04 December 2023
• Pages: 1-20
• DOI: https://doi.org/10.1108/IJWHM-03-2022-0045
• Published date: 04 December 2023
• Subject Matter: Health & social care,Healthcare management,HR & organizational behaviour,Human resource policy,Employee welfare
• Author: Maria Qvarfordt,Stefan Lagrosen

Healthcare digitalisation and its

association with quality

and employee health,

a mixed-methods study

Maria Qvarfordt and Stefan Lagrosen

Linnaeus University, Kalmar, Sweden

Abstract

Purpose –Previous research has identified associations between quality management and employee health.

This study’s purpose was to (1) examine those associations in a public healthcare organisation and (2) explore

and describe the association between digitalisation and employee health.

Design/methodolog y/approach –An online qu estionnaire includi ng indices to measure qua lity

management values, employee health and digitalisation was answered by 118 managers in Swedish public

healthcare. Correlation analysis was used to analyse the data. Based on the survey results, 12 qualitative, in-

depth interviews were conducted with healthcare managers.

Findings –The findings show that employeehealth is associated with quality management and digitalisation.

Categories were defined to describe the managers’views of the relationship between digitalisation and health.

Research limitations/implications –Causality was not explicitly tested and cannot be assumed. However,

the results strengthen the body of research showing that quality management is related to employee health,

and associations between health and digitalisation were identified.

Practical implications –The findings and model should be helpful for healthcare managers in a digitalising

environment who aim to preserve or enhance employee health whilst ensuring high service quality.

Originality/value –The results were used to create an integrated conceptual model depicting the association

between quality, digitalisation and health. This association has not previously been studied.

Keywords Quality working life, Health and safety, Healthcare, Quality management, Digitalisation, Values

Paper type Research paper

Introduction

Workplace health is not as good as it should be with issues affecting job performance,

depression and a lack of work–life balance (Jones et al., 2022;Wang et al., 2010). The most

common reason for problems is work overload, often due to downsizing and increasing

demands (Brenner et al., 2014). However, there may also be a connection to digitalisation

(Zeike et al., 2019) as part of the digital transformation. The term digitalisation is recurrently

associated to the term digital transformation when discussing organisational change in

healthcare (Parviainen et al., 2017). Thus, digital transformation is prompted by

organisational change that in turn is triggered and influenced by digitalisation (Hanelt

et al., 2021). Despite contention about the consequences implied by digitalisation, its

influences on work-related health have not yet been studied thoroughly. In particular, there is

Healthcare

digitalisation

and employee

health

1

© Maria Qvarfordt and Stefan Lagrosen. Published by Emerald Publishing Limited. This article is

published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce,

distribute, translate and create derivative works of this article (for both commercial and non-commercial

purposes), subject to full attribution to the original publication and authors. The full terms of this licence

may be seen at http://creativecommons.org/licences/by/4.0/legalcode

The authors wish to acknowledge The Kamprad Family Foundation for Entrepreneurship, Research

and Charity for its valuable funding. The authors would like to thank Editage (www.editage.com) for

English language editing.

The current issue and full text archive of this journal is available on Emerald Insight at:

https://www.emerald.com/insight/1753-8351.htm

Received 20 March 2022

Revised 2 September 2022

10 February 2023

8 May 2023

Accepted 7 November 2023

InternationalJournal of Workplace

Health Management

Vol. 17 No. 1, 2024

pp. 1-20

Emerald Publishing Limited

1753-8351

DOI 10.1108/IJWHM-03-2022-0045

a research gap concerning the digital transformation’s potential impact on managers’health

(Zeike et al., 2019).

Quality management is a central element in healthcare organisations, with a primary

objective to optimise patient care and outcomes (Aggarwal et al., 2019). Previous research has

found associations between quality management and employee health in multiple industries

(B€

ackstr€

om et al., 2014;Lagrosen et al., 2007;Lagrosen and Lagrosen, 2014,2020). Thus, it

seems reasonable to conclude that quality management positively affects workplace health.

The connection between digitalisation and health is, however, less researched. Associations

between digitalisation and workplace health is a topic that has been previously examined, e.g.

within the industry sector (Diebig et al., 2020). Nevertheless, little is known about the extent to

which organisations have adopted digitalisation and how this occurrence has changed the

nature of workplace health, in particular regarding the healthcare sector (Pillinger, 2016).

Introducing digital applications can lead to so-called “techno-stress”, which may affect health.

Techno-stress has been found in healthcare organisations, for instance, affecting nurses’

workplace health (Mahdian et al., 2017). Techno-stress is defined as stress experienced by

users in organisations as a result of information and communications technology usage

(Ragu-Nathan et al., 2008). As organisations worldwide are increasingly digitalising, not least

healthcare organisations, exploring the association between digitalisation and health should

be valuable. Therefore, this study’s purpose is to explore and describe the association

between digitalisation and workplace health. In addition, the connection between quality

management and health will be examined in a public health context to further verify it.

Theoretical concepts and relationships

Health science

The health sciencesresearch field aims to develop knowledge to maintain andimprove health

at the individualand population levels(Stucki et al., 2016). Healthsciences research focusseson

the prevalence of andmotives behind illness, the usefulnessand efficiency of techniques and

treatmenteffectiveness (Polgar andThomas, 2019). Health sciencesemphasise the significance

of public health initiatives at the societal and policy level, targeting health concerns within

society (White, 2015). Adopting a multidisciplinary frame of reference by combining

biomedical, psychosocial, organisational and societal factors, health sciences aim to improve

individuals’health, including from a workplace perspective (Bachrach and Abeles, 2004).

Investing in health at the societal level requires a common view of health responsibilities,

investments in health processes, sustainable partnerships and health infrastructures

(Fawcett et al., 2010), preferably from a multidisciplinary perspective (Weller et al., 2014).

Moreover, health sciences research aims to provide professionals who are active in the health

field with findings that contribute to evidence-based healthcare (Polgar and Thomas, 2019).

Quality management

Quality management can be seen as a system comprising various components (Hellsten and

Klefsj€

o, 2000) and is a crucial element in the healthcare sector (Aggarwal et al., 2019). Three

levels of quality management with increasing depth have been proposed (Lagrosen and

Lagrosen, 2003) (see Figure 1).

The most superficial level consists of techniques and tools. On a deeper level, there are

models or systems, such as the standards and award models. Finally, the most profound level

includes the fundamental values of quality management. An extensive literature search

reveals the following six values as the most common (Lagrosen, 2006):

(1) Continuous improvement: organisations should always strive to improve their

processes and products; tolerance levels should be shunned.

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