Solving care labor shortages through employee-driven experiments: A multiple case study

Abstract This study examines the second application of the BTS model in Finland - a development process aimed at fostering employee-driven innovation to improve working conditions and enhance workforce integration in the social and health care sector. It is thought that using systematic methods of development and participatory work-oriented development, effective solutions can be found to solve labor shortages, turnover rates, and demanding working conditions of the sector. The study case in focus is a 10-month training and coaching program, which included three in-person workshops and between-workshop assignments. During the program, development teams designed, tested, and evaluated new practices within their own organizations. Using a process-oriented, multiple qualitative case study approach, we followed six development cases from the initial goals set by participants through to the practical experiments carried out in their workplaces. Our data includes audio-recorded workshop discussions, associated documents, and assignments, as well as follow-up interviews conducted after the training. The solutions developed addressed multiple dimensions of employee attraction and retention, including onboarding, leadership practices, and the organization and division of labor. However, the process was challenged by the interplay between two distinct development logics: standardization and measurement on one hand, and iteration and open-endedness on the other. While the working method was experienced as demanding, participants reported an increased sense of developmental agency and a strengthened belief in their ability to influence everyday work practices. As a conclusion, we suggest that the success of employee-driven workplace development does not rest solely on the solutions created or the working methods employed, but also on the participants’ evolving sense of their authority to shape new workplace practices and contribute to broader organizational development.