Defining a positive work environment for hospital healthcare professionals: A Delphi study

The work environment of healthcare professionals is important for good patient care and is receiving increasing attention in scientific research. A clear and unambiguous understanding of a positive work environment, as perceived by healthcare professionals, is crucial for gaining systematic objective insights into the work environment. The aim of this study was to gain consensus on the concept of a positive work environment in the hospital. This was a three-round Delphi study to establish consensus on what defines a positive work environment. A literature review and 17 semi-structured interviews with experts (transcribed and analyzed by open and thematic coding) were used to generate items for the Delphi study. The literature review revealed 228 aspects that were clustered into 48 work environment elements, 38 of which were mentioned in the interviews also. After three Delphi rounds, 36 elements were regarded as belonging to a positive work environment in the hospital. The work environment is a broad concept with several perspectives. Although all 36 elements are considered important for a positive work environment, they have different perspectives. Mapping the included elements revealed that no one work environment measurement tool includes all the elements. We identified 36 elements that are important for a positive work environment. This knowledge can be used to select the right measurement tool or to develop interventions for improving the work environment. However, the different perspectives of the work environment should be considered.