Insight into management in the "zone of uncertainty".

An average of 6.5 days per year - that's how long employees in Switzerland miss from work due to illness or accident. According to a projection by the State Secretariat for Economic Affairs (SECO), work-related health problems affect 1.1 million employees in Switzerland. The Job Stress Index of Health Promotion Switzerland shows a mismatch between resources and stressful work factors in almost 25 percent of the working population - a mismatch that has been proven to increase the risk of psychosocial impairments such as stress or burnout. According to SECO, health problems in the workplace cost more than CHF 20 billion a year. Managers of Swiss companies cannot ignore such figures. But how exactly does one approach the challenge of "health management", not least if the mental stress of employees in particular is to be reduced?

Health management = a matter for the boss?

In collaboration with the Swiss Society for Organization and Management, the Lucerne University of Applied Sciences and Arts conducted an in-depth interview study of 29 top executives in this regard. The study "Occupational health management is a matter for the boss!?" (www.hslu.ch/bgmchefsache) shows how this management task is dealt with in Swiss companies, non-profit and administrative organisations. The answers of the interviewees were very different. Nevertheless, commonalities emerged:

For the respondents, health management means "management in the zone of uncertainty". This describes the area of action in which all managers - regardless of their sector or management style - largely see themselves as being on their own.

Managing health also means crossing borders, for which, however, the respondents still have little competence and know-how: In most cases, health is seen as a "matter" to which formal management cannot devote itself, or only to a very limited extent. The resulting uncertainty about action and decision-making reinforces resistance and reservations about systematic health measures.

As shown in the chart on the following page, the health of employees is not a problem in the perception of the respondents if health is clearly given or illness can be clearly identified. Ideally, employees are either healthy and employer and employee meet in a formally defined performance contract: remuneration is paid for work performed. Or the employee's illness is obvious, for example because the arm is broken or a professional opinion (e.g. doctor's certificate) is available. In such situations, loss of benefits and follow-up costs are dealt with via institutionalised processes (e.g. IV offices or case management).

The topic of health only becomes a problem when neither health nor illness can be clearly determined. Between the two poles of "healthy" and "ill", the "uncertainty zone" of health management arises, in which the interviewees hardly have any orientation for action.

The three aspects of the "zone of uncertainty

In terms of content, the "zone of uncertainty" consists of three aspects: the handling of intimacy in the management relationship, the delimitation of privacy and work, and the conflict between employee health and economic performance.

1. intimacy in the leadership relationship:

According to the interviewees, intimacy refers to the state of closeness and familiarity that is of central importance for employee management in certain situations and problem situations. For example, it can be important for a manager to be close enough to employees to find out whether, in addition to the workload, there are also personal stresses at home that could affect their health and performance. This requires a form of closeness and mutual trust, which must be carefully and attentively shaped when dealing with health issues. Creating such intimacy is usually unfamiliar to the managers interviewed and therefore a major challenge. This is especially true when it comes to psychological complaints.

2. privacy and work:

"Privacy" refers to a personal aspect of the zone of insecurity: health is considered private in the workplace, and addressing it is often understood as an intrusion into employees' privacy. While most managers find it relatively easy to address an obvious alcohol problem of a subordinate, this becomes more difficult in the case of behaviour such as excessive smoking, unusual weight gain or loss or signs of exhaustion. Managers thus need a great deal of tact. If the conversation is not sought out for fear of an invasion of privacy, there is a danger that, for example, employee overloads will only be recognised when there is already a loss of working hours and corresponding costs are incurred.

3. accept conflicts of values:

Finally, the "uncertainty zone" is characterized by conflicts of values. At the core of this conflict is the economic provision of services on the one hand and employee health on the other. From the point of view of the interviewees, the topic of health is often still attributed a quasi-religious or dogmatic connotation, from which they must consciously distance themselves in order not to be perceived as "health apostles". Against this background, health management also becomes a corporate policy issue that must be carefully addressed between the various interest groups (e.g. employees, members of management, human resources, etc.).

Qualified self-responsibility

In the course of the aspects of the "zone of insecurity" described above, it is necessary to find a way to take up intimate and private topics and make them addressable. Managers can learn this in leadership courses, for example. At the same time, it is essential that not only managers but also employees take responsibility for health in the company: In the context of team as well as cultural development, everyone can discuss and define common values together. This leads to an increased assumption of responsibility for health by the employees. At the same time, this also means a change in the leadership role. This focuses more on mediating between the different perspectives, on sustainable development opportunities for individual employees and on creating spaces for exchange (e.g. quality circles or weekly team meetings), which promote qualified self-responsibility on the part of the employees.

Today and in the future, work no longer takes place only in the traditional workplace, but is shifting into the various spheres of people's lives. Health management is likely to remain an important field of action in this development.