Strategies at Health Care Facilities to Improve Working Environment for Japanese Nursing Staff: Multiple Case Study

Abstract

Working hours and environment must be improved to increase Work-Life Balance for nurses, thus increasing the number of the medium- to long-term nurses. This study aimed to identify specific issues and strategies for medical facilities to implement, using the perspectives of nursing managers, to improve nurses' working hours and environments. From November 2019 to March 2020, we conducted interviews with the nursing managers of five medical facilities in Japan, including acute and chronic care hospitals, who consented to participate in this study. The data were qualitatively analyzed for each facility regarding their workplace issues and specific strategies utilized, as well as changes in staff and organizational structures in accordance with each facility's background and resources, with the commonalities between each one being extracted. Common issues were identified, such as the increasing number of workers in specific shifts, taking days off and overtime work, employees raising children while continuing to work, and the increasing number of nursing assistants aimed at reducing nurses' overall workload. Based on the results of our study, specific strategies such as changing the number of staff assigned to each work shift, reviewing each organization's recruitment plans, appropriately managing personnel based on the available data, actively operating the Work-Life Balance system, providing a workplace that encourages employee motivation, promoting nursing managers' attitudes, and fostering an organizational culture that seeks to improve the workplace environment are all crucial for improving issues related to nurses' working hours and their environments.