Timo Sinervo, Laura Hietapakka, Soile Juujärvi, Salla Lehtoaro, Tarja Heponiemi, 11th EPH conference, Ljubljana Slovenia

1. New competencies and care integration in future
health and social care
Timo Sinervo1, Laura Hietapakka1, Soile Juujärvi2, Salla Lehtoaro1,,
Tarja Heponiemi1
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2. Changes in the working life and competence
needed are in focus
13.12.2018
Competence workforce for the future
Project manager: research professor
Ilmo Keskimäki. THL

3. Introduction
• Finnish health and social care under large reform
– New legistlation (proposal in parliament) and organisational
changes
– Despite legistlation changes have been taken place already
• Key changes:
– In future larger areas (18 counties) in responsibility of all health
and social services (now 300 municipalities),
– Care integration, social and health, primary and secondary
– Service production from municipalities to multiple providers
• Competition, easy access into market (private, county, third sector)
13.12.2018 Competence workforce for the future

4. Care integration
• Care integration is related to efficiency and quality of care (Coleman et al. 2009)
• Integration has positive effects on worker collaboration, decrease of job
demands (Boumans et. al 2008) and worker satisfaction (Boyd et al 2009)
• Integration a constant problem: workers don’t know whom to contact,
necessary information not available (Jolanki ym. 2017)
• Inside organization silos (Ham 2011), Most important to make changes at
client level work
• What does integration require, competences, management?
– Multiprofessional team work, management of networks, trust, interaction,
shared goals (West et al.)
– Distributed knowledge (Salomon ym. 1993), workers need to know enough of
each others work
13.12.2018 Competence workforce for the future

5. Study question
• What effects has well-functioning integration?
– Which competencies are needed more in future?
– Does care integration explain worker stress and job satisfaction?
• Participators: Federations of Municipalities: Siun sote , Eksote, Hyvinkää
hospital District and City of Hyvinkää
• In this paper:
– Personnel survey to all organizations, N=1914
– Questions in this paper: how well information flow and co-operation is
working in case of clients with multiple service needs
– Time pressure, job satisfaction, psychological well-being (GHQ)
• The project financed by Strategic Research Council 2016–August 2019
13.12.2018 Competence workforce for the future

6. 0
5
10
15
20
25
30
35
40
45
Advice clients in
using electronic
services
Guiding clients via
electronic services
Multiprofessional
work in care
planning,
evaluation and
service
Take into account
client service
perspective in all
situtations
Using structured
documenting in
patient records
Encouraging clients
to do changes for
health promotion
Making sure that
information is
flowing in care path
No changes
Some
increase
Much
increase
Ehealth Care path
Competence needs in future…
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Multiprofessional

7. Information flow and co-operation in relation to
time pressure,t-values (working sector and superiority
adjusted)
Time pressure Job satisfaction Psychological well-
being GHQ
Information flow
and co-operation
-5,50*** 6,39*** -4,41**
Working sector
and superiority
adjusted
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The better the information flow and co-operation
between sectors the less stress and the better well-
being and job satisfactio

8. Information flow and co-operation in relation to
time pressure in health centers (correlations)
Health
center
Specialized
care
Mental health
and substance
abuse care
Elderly
care
Social
work
Social
services
13.12.2018 Competence workforce for the future
R=0,36***
R=0,02
R=0,14
R=0,23*
R=0,15
If co-operation
Works with
specialized
care and
Social work
Time pressure
Lower in
Health centers

9. Information flow and co-operation in relation to
time pressure in elderly care (correlations)
Elderly
care
Specialized
care
Mental health
and substance
abuse care
Health
center
Social
work
Social
services
13.12.2018 Competence workforce for the future
R=0,19***
R=0,19***
R=0,26***
R=0,22***
R=0,19***
In elderly care
co-operation
with all
sectors
Is related
To time
pressure

10. In conclusion
• Competence in multiprofessional work, ehealth and care path
needed in future
• Co-operation and information flow are related to worker well-
being
• In health centers and elderly care co-operation and
information flow with other sectors important stress factor
• Differences between sectors
13.12.2018 Competence workforce for the future

11. More information
Dr. Research manager Timo Sinervo
firstname.lastname@thl.fi
National Institute for Health and Welfare (THL)
Service Systems Research Unit
www.stncope.fi
Twitter: @stncope
13.12.2018 Competence workforce for the future