The flexibilisation of working hours is currently being discussed across all sectors. The four-day week has been launched in Germany in 2024 as a pilot project with 50 companies from various sectors, as announced by the Tagesschau news programme.
Work-life balance in the healthcare sector is a buzzword that appears in every job application and has also reached hospital benefits. The medical journal Ärzteblatt reported on burnout among junior staff back in 2019, and the coronavirus pandemic has exacerbated conditions and made them more visible.
Doctors are also striking against poor pay and no longer want to work at the limit. The 40-hour week with five working days plus overtime seems to be being called into question by various symptoms of exhaustion.
A four-day week in the healthcare sector is therefore in line with the quality of time and could offer new opportunities to improve the quality of work. However, a number of points need to be considered, which are outlined here as examples.
Shortage of skilled labour and workload in hospitals
The shortage of skilled labour in the healthcare sector is a cause for concern. This seems to contradict the desire to reduce working hours. However, because the shortage of staff increases the general workload, solutions must be found.
Innovative duty rota models can help to increase the attractiveness of the nursing profession and at the same time continue to improve patient care by increasing employee satisfaction. Hospitals already offer various models for flexibilising working hours in nursing.
Models of the 4-day week in pilot projects
On the one hand, working hours can be reduced for a four-day week, with full or adjusted wage compensation. On the other hand, the full number of hours can also be worked on 4 days. This is very strenuous, especially in nursing, but has been successfully tested since autumn 2023.
The Bielefeld Clinical Centre has even been able to record an increase in staff with a pilot project for the 4-day week. This way of working therefore promises to be an incentive for applicants.
The idea is to complete the collectively agreed working hours in 4 days. Shifts are therefore 9 hours long with a half or three-quarter hour break after 6 hours. The big advantage for the hospital and the patients is that the overlap time is 2 hours. During this time, an above-average number of staff are present and complex procedures can be carried out together. There is more peace and quiet on the ward and the patients also notice that the nursing staff are more balanced and attentive, explains Henrik van Gellekom, Head of Nursing.
He explains the principles and benefits of the concept in a Podcast and in television programmes. Staff also need to be informed, as it means a change to their usual working rhythm.
In fact, 10% more staff are needed, but the benefits for employees are so great that the number of applicants in Bielefeld has risen. This is because the majority of days off are interesting for recreation, leisure and family as well as mobility times. If employees have to travel long distances to their workplace, they can save travelling costs and time with a 4-day week. Sick days are also reduced if the week only has 4 days.
The new rota must always be agreed with the works council and the legally agreed break times must be adhered to. The model is therefore mathematically complex, but remains in the collective labour agreement. In this tv contribution, Henrik van Gellekom speaks of a "game changer in the healthcare sector" that makes the nursing profession attractive (again).
A clinic in Soest has already followed this approach and the Fürth Hospital has tested the four-day week for the op area in 2023. The advantage is that the already long working hours during operations can be done without overtime and staff can recover more quickly. Critics criticise the fact that the day off could be cancelled out by "filling in" for sick colleagues.
However, the four-day week in nursing is being successfully tried and expanded. And the Hochtaunus-Kliniken have also offered doctors the opportunity to switch to the four-day week in a pilot project. This is possible in a hospital.
Difficulties with the four-day week for doctors in private practice
However, a four-day week appears to be more complicated for doctors in private practice. However, the idea is being discussed for practices, as the Ärzteblatt writes. As doctors in private practice have a very high additional administrative workload, the Virchowbund suggested that Wednesdays should only be used for bureaucratic work.
Health insurance companies don't think much of a four-day week for doctors' surgeries, headlines the MDR and also quotes critical voices from the medical profession. This is because the number of patients would of course not be reduced. Rather, it would be spread over the remaining days and would exhaust both doctors and waiting patients. In rural areas in particular, where medical care is not guaranteed across the board, this could lead to sick people going to hospital emergency departments. However, emergency departments are also known to be overloaded. And so the necessary care would continue to shift.
Flexibility in implementation and alternative models
Apparently, the 4-day week is not (yet) a panacea, but the current situation calls for more flexible working hours. After all, long working hours, chronic staff shortages and a high workload for all employees are not only a burden on staff, but also impair patient care.
With FLEX4UKW, the University Hospital of Würzburg has created a different but equally innovative working time model to retain employees. In this model, employees decide how much they want to work and are then assigned to a specific area. This means that nursing staff who have already retired or those who are still looking after daycare children can be recruited again. This is also interesting for junior staff because the areas can be changed just as flexibly and different fields can be tried out.
In any case, the implementation requires a willingness to change from everyone involved. Familiar working hours have to be reorganised, duty rosters have to be redrawn and employees have to adjust to longer shifts while the weekly hours remain the same. A changeover therefore requires careful planning, securing personnel resources, communication with employees and regular evaluation.
This is made easier if companies engage in open management. Because communication with employees creates an atmosphere of appreciation and participation, which is particularly important for Generation Z (Intergenerational teamwork in the life sciences sector). The generation currently entering the labour market.
The same goes for a good work-life balance. Talking about this with employees will greatly motivate future candidates.
Conclusion
The introduction of a four-day week in the healthcare sector therefore offers a promising opportunity to improve working conditions and thus increase the quality of patient care. By creating a better work-life balance, reducing stress, fatigue and increasing productivity, the four-day week can help address the challenges in healthcare and create a positive working environment for existing and future employees. Careful planning, training and support should ensure that the transition goes smoothly and achieves the desired results. Open communication is a great advantage here and another sign of an organisation's innovative mindset.
The four-day week is on the rise in the healthcare sector and should definitely be considered in order to remain attractive and innovative for future applicants.
