1 Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Empowering for health promoting leadership in hospitals and nursing homes Christina Dietscher, Peter Nowak With support from Thomas Stidl 19th May 2005, Dublin, 13th International Conference on Health Promoting Hospitals (HPH)

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 2 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Overview Context Background Intervention areas and design Results Suggestions for practice

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 3 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Context The Vienna Information Network „Health Promotion in Hospitals and Nursing Homes“ (funded in 2000) is the first regional HPH network in Austria. Aims of the information network: –Information, motivation and empowerment of experts and executive personnel –Development and dissemination of knowledge (specific guidelines, fact sheets, www) –General information for staff in hospitals and nursing homes (web- site and newsletters, project database) –Exchange with other HPH networks –Support activities in specific topic areas, e.g. cooperation with task force on HP for children and adolescents –Building strategic alliances with relevant stakeholders

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 4 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Background 1 Discussions in the Information Network and scientific back ground pointed to: –Specific demand and acceptability in Vienna for HP for staff –Executive personnel as a strategic entry point for implementation Why should executive personnel be specifically empowered for health promotion? –They are an important target group (25% suffer from burnout) –They have major health impact on staff –They have a key position for strategic orientation

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 5 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Intervention areas Identification of 3 HP intervention areas for executive personnel on the basis of a literature review: –Health promoting self management –Health promoting working conditions for and cooperation with staff –Health promoting strategic and organisational development Development of a factsheet on –Problems and solutions for all 3 areas

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 6 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Background 2 But executive personnel –Have no time –Have to deal with an overflow on information –Are used to self-exploitation –Are more interested in economic or technical aspects of their organisation –... and are therefore difficult to reach with and for HP How then to interest and involve executive personnel in HP?

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 7 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Design of intervention Aims : –To reach a relevant part of executive personell from a maximum proportion of all organizations in Vienna –to create an adequate learning environment for a huge number of people –to take into account the expert status of executive personnel –to take into account health promotion principles (Rootman et.al.) Interventions –Broad invitation addressing top and middle management –One day workshop (short and long enough) –Social design adapted from „Open space“ (Harrison Owen) –Publication of results on the network’s website

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 8 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 „Open space“ (after Harrison Owen) Facilitator sets the frame Open thematic agenda – topics raised by participants No major pre-prepared inputs Discussion in self-organised groups led by initiators of topics Strong self-responsibility of participants Final presentation of results and feed back in the plenary

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 9 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Results (all) directors and top managers of Viennese hospitals and nursing homes were invited 150 actually attended very open and positive working atmosphere enthusiastic feedback, specifically on the possibilities to address the own personal health needs 80 percent of participants wanted to increase health promoting activities within their organisation in the future

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 10 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Results 2 17 health promotion topics were raised, discussed, and documented, e.g.: Self management: –Burnout –Work satisfaction –Overcoming loneliness in the leadership role Working conditions for and interaction with staff –Communication, feedback and appreciation culture –Mobilising positive energy at work –Health promotion for older staff –Health promoting material setting, e.g. smoke-free environment Strategic orientation –Error culture – from “blaming” to learning from mistakes –Promoting the health of staff means also to promote patient health

Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie 11 WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Suggestions for practice If you want to engage major stakeholders in health promotion in your organisation: Show them first how they can use HP to improve their own personal situation Apply HP principles in the social design of your intervention, especially: equity, participation, empowerment, holistic approach to health Create an open learning environment to support adoption of health promotion Work with large groups in order to mobilize a lot of energy and provide transparency

12 Ludwig Boltzmann- Institut für Medizin- und Gesundheits- soziologie WHO - Kooperations- zentrum für Gesundheits- förderung in Krankenhaus und Gesund- heitswesen © Dietscher, Nowak 2005 Thank you for your attention!