Itseohjautuvuus ikäihmisten palveluissa

Recent years have seen examples of self-organizing organizations. Preliminary experience with these suggests that at least some of the self-organizing organizations have been successful in terms of operational effectiveness, job satisfaction, and customer satisfaction. Experience has shown that self-organizing organizations release individuals' energy and help to target it more wisely and accurately for the benefit of the organization.
The general goal of this project was to develop Finnish home care in different areas. The purpose was to find out how the self-organizing team work management model fits into Finnish home care practices. The aim was to develop home care so that the teams are self-organizing and empower the staff, the work atmosphere is open and positive and there is trust in the teams. In addition to increased work ability and well-being at work, we believed that the model would be cost-effective and professionally develop the staff. The research questions were as follows: does the self-organizing care model work in Finland, does the model promote work ability, well-being at work and customer satisfaction, what is the cost-effectiveness of the model and is the model applicable to different types and sizes of care organizations.
In order to obtain answers to these research questions, individual and group interviews as well as a customer and staff survey were conducted. The material was collected at the beginning and end of the project by conducting interviews in two municipalities, ie small and medium-sized municipalities, at the beginning and end of the project. In addition, an occupational well-being survey was conducted at the beginning of the project in a small and medium-sized municipality and at the end of the project in the above-mentioned and later large municipalities (not only home care but also service housing). Between the research periods, coaching for staff and teams was provided in small and medium-sized municipalities. The purpose of the coaching was to create an understanding of self-direction and to encourage participating personnel to develop their activities towards self-direction.
Based on the results of the project, the self-direction of the teams also seems to have positive results in the Finnish service system, although mainly only in service housing and only to a small extent in home care. According to the results of the personnel survey, self-organizing teamwork would seem to have connections to the influence of teams, teamwork functional experience, management fairness, access to skills at work, and workload in terms of hurry and solitary work. In addition, self-direction was also related to well-being at work, especially in terms of job satisfaction and willingness to change jobs, as well as the quality of care perceived to be better.
The results of the interviews showed that when the team members themselves had been able to influence the organization of their own work, they were also more satisfied with their work and teamwork. These results were confirmed in interviews in which, in the first phase, interviewees in both municipalities highlighted feelings of abundance, inadequacy, and stress in the work. In a small municipality, these were associated with a small number of staff and a genuine desire to do good customer work.
Service housing teams differ from home care teams in that they are almost always in constant interaction with colleagues, while in home care staff have less opportunities for interaction and joint development.
Teams that had developed self-direction reported that they had gained more influence in a number of areas, particularly in the planning of shifts and holidays, the division of labor and working methods. Based on both the interviews and the surveys, it seems that the home care teams where self-organizingness was developed were clearly different: for example, in the small municipality team, the results were perceived as positive, moderately neutral. In the small municipality, the staff had developed self-direction together with the strong support of the management. In this study, we found no positive cost changes during the first year. After two years, however, we noticed a positive trend. From this, we can conclude that it can take a long time before changes in team behavior affect costs. Development does not take place in an unchanged state, but at the same time various changes are taking place, such as staff changes, changes of supervisors or a corona pandemic.

Keywords: self-direction, home care, staff, clients, well-being at work,