Associations between lean maturity in primary care and musculoskeletal complaints among staff: a longitudinal study

• Published in: BMJ open Vol. 13; no. 2; p. e067753
• Main Authors: Kaltenbrunner, Monica, Mathiassen, Svend Erik, Bengtsson, Lars, Högberg, Hans, Engström, Maria
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 22.02.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Caring Science; Cross-Sectional Studies; Data collection; Health & safety; Health Services Research; Health-Promoting Work; Human resource management; Humans; Hälsofrämjande arbete; Lean in Health care Questionnaire (LiHcQ); Lean manufacturing; Longitudinal Studies; Musculoskeletal Diseases - epidemiology; Musculoskeletal disorders; musculoskeletal disorders (MSD); Nordic Musculoskeletal Questionnaire (NMQ); Nurses; Occupational Diseases - epidemiology; Organisational development; Pain; Philosophy; Prevalence; PRIMARY CARE; Primary Health Care; Problem solving; Questionnaires; Response rates; Retrospective Studies; Risk factors; Surveys and Questionnaires; Vårdvetenskap; Working conditions; Sweden; Musculoskeletal disorders; Health & safety; Human resource management; PRIMARY CARE; Organisational development
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-067753

ObjectiveThis study had two aims: (1) to determine the prevalence of musculoskeletal complaints among staff in primary care and (2) to determine to what extent lean maturity of the primary care unit can predict musculoskeletal complaints 1 year later.DesignDescriptive, correlational and longitudinal design.SettingPrimary care units in mid-Sweden.ParticipantsIn 2015, staff members responded to a web survey addressing lean maturity and musculoskeletal complaints. The survey was completed by 481 staff members (response rate 46%) at 48 units; 260 staff members at 46 units also completed the survey in 2016.Outcome measuresAssociations with musculoskeletal complaints were determined both for lean maturity in total and for four Lean domains entered separately in a multivariate model, that is, philosophy, processes, people and partners, and problem solving.ResultsThe shoulders (12-month prevalence: 58%), neck (54%) and low back (50%) were the most common sites of 12-month retrospective musculoskeletal complaints at baseline. Shoulders, neck and low back also showed the most complaints for the preceding 7 days (37%, 33% and 25%, respectively). The prevalence of complaints was similar at the 1-year follow-up. Total lean maturity in 2015 was not associated with musculoskeletal complaints, neither cross-sectionally nor 1 year later, for shoulders (1 year β: −0.002, 95% CI −0.03 to 0.02), neck (β: 0.006, 95% CI −0.01 to 0.03), low back (β: 0.004, 95% CI −0.02 to 0.03) and upper back (β: 0.002, 95% CI −0.02 to 0.02).ConclusionThe prevalence of musculoskeletal complaints among primary care staff was high and did not change within a year. The extent of lean maturity at the care unit was not associated with complaints among staff, neither in cross-sectional analyses nor in a 1-year predictive analysis.