Implementing work ability management: a mixed-methods study from supervisors’ perspectives in public social and health care organizations

Effective Work Ability Management (WAM) is crucial given high rates of mental health- and musculoskeletal-related sickness absence, an aging workforce, and financial pressures in public social and health care organizations. The gap between knowledge and practice indicates inefficient WAM implementation. This study applied the COM-B model for behavior change to examine WAM implementation, focusing on supervisors as key implementers within the health services system. The study aimed to (1) identify facilitators and barriers to WAM implementation and (2) develop a checklist and recommendations to support implementation in public social and health care organizations. The study used a mixed-methods design combining qualitative and quantitative data, including two surveys, focus group interviews, and co-development workshops. The study identified key facilitators and barriers to WAM implementation, reflecting supervisors’ capability, opportunity, and motivation to implement WAM across five themes: knowledge-based management, models and practices, collaboration and support, information flow, and organizational culture. These themes were operationalized and mapped to the COM-B model, yielding 24 co-developed checklist statements and 10 recommendations outlining responsibilities, actions, and monitoring needs. Together, they aim to help organizations assess WAM’s current state from supervisors’ perspective and plan targeted development actions. The five identified themes influence successful WAM implementation. Supervisors’ self-evaluation of motivation and capabilities facilitated, whereas organizational structures that influence implementation opportunities were viewed as barriers. Strengthening communication and collaboration structures is essential. Enhancing supervisors’ capabilities, improving implementation opportunities by strengthening knowledge-based management practices, ensuring support, and establishing clear objectives and feedback are crucial. Considering contextual variation across large social and health care organizations could help ensure consistent implementation of the checklist and recommendations across these organizations. Further research is needed to validate the checklist, examine its applicability across different organizations, identify potential modification requirements, and assess its impact on organizational outcomes.