Enhancing employee experience and workplace well-being in oncology: a bottom-up co-construction approach in healthcare institutions in Québec

Background: The commitment of health personnel in initiatives for improving their working conditions is recognised as a key condition for the success and the sustainability of such initiatives. Healthcare organisations are faced with the challenge of deploying strategies needed to mobilise this commitment. The objective of this article is to present the results of a qualitative evaluation of a bottom-up co-construction project aimed at engaging oncology staff at four Québec healthcare organisations in improving their work experience. Methods: As part of our constructivist approach, we utilised a qualitative method, which involved conducting one-on-one interviews and gathering documentary data, including survey results, to assess the development and implementation of an intervention across four oncology units. We conducted one-on-one interviews from January 26, 2023 to March 5, 2023 with 17 workers from different categories. We collected documentary data that cover the pre-implementation activities, the co-construction workshops, and the intervention implementation. All collected data were coded and analysed using QDA Miner 6.0, and our findings were validated iteratively throughout the project, involving regular interaction with participants. Results: Fourteen areas of vulnerability emerged across the four dimensions studied, and six were targeted by workers as priorities: emotional exhaustion; role conflict; ability to learn; leadership; team cohesion; and communication. Interventions developed to address the prioritised areas included: co-development workshops; training sessions aimed at enhancing workers' control over their working environment; team connectivity through professional and social activities; staffing and workload reviews; support from a psychosocial professional; and coaching. According to workers, most improvements occurred in two targeted areas, team cohesion and communication, even in the units where these issues were not prioritised at first. Participants pinpointed some factors that facilitated the implementation of the intervention and its impact (engagement, organisational support, the bottom-up approach) and others that created constraints (staff shortages, conflicting priorities, level of commitment). Conclusions: This exploratory work offers insightful perspectives on how a bottom-up co-construction approach can serve as a lever to engage workers to improve their work experience. It may inspire other healthcare organisations, both in oncology and in other fields of activity.