Workplace flexibility increases productivity throughout presenteeism: A conceptual framework

Introduction

In the last few decades of research, the concept of presenteeism or attendance at work while sick has mainly been conceptualized as a variable with negative implications (e.g., productivity losses) (Aronsson & Gustafsson, 2005). Despite the advances in recent years, the presenteeism literature is still not conceptually grounded in a strong theory (Lohaus & Habermann, 2019). For example, some literature suggests that there is a lack of conceptual clarity around the topic of presenteeism in the current policy debate about workplace flexibility and productivity (Irvine, 2011). The relationship between workplace flexibility and presenteeism seems to be under studied. Therefore, this chapter draws upon the conceptual framework of positive presenteeism (Karanika-Murray & Biron, 2019; Karanika-Murray & Cooper, 2018), with the emphasis on those schools of thought on presenteeism that are more interested in studying reduced productivity losses associated with sickness presence (Turpin et al., 2004) and the consequences of these behaviours (Gosselin, Lemyre & Corneil, 2013; Lopes et al., 2018). These theoretical contributions have tried to conceptualize presenteeism as an adaptive behaviour (Karanika-Murray & Biron, 2019; Karanika-Murray & Cooper, 2018). Karanika-Murray and Biron developed a model where presenteeism is represented as a dynamic, balanced process of adaptation between health constraints and performance demands, depending on the availability of internal capacities and flexible work resources (Karanika-Murray & Biron, 2019). And, focusing on the positive side of presenteeism, these authors proposed a 2{x}2 presenteeism framework, built upon the axes of health and performance. For example, an optimal adjustment to health constraints and performance demands is related with functional presenteeism (e.g., being highly engaged with work to forget psychological and/or physical problems), and in contrast, poor health and poor performance are associated with dysfunctional presenteeism (Karanika-Murray & Biron, 2019).

Previous studies define organizational flexibility as the organizational capacity to adapt the internal structure of the company to the external environment (Broekaert, Andries & Debackere, 2016). Within the big umbrella of organizational flexibility, we will adopt the concept of workplace flexibility where flexible work arrangements are important measures to promote the employees’ capacity to deal with their health problems, increased job demands and possible work-family conflicts (Butler et al., 2009). Examples of job arrangements include job crafting, flexible task management, schedule flexibility (e.g., flexitime) and location flexibility (e.g., the employee can choose the best physical location to work, such as telework or remote work through Internet).

The fast growth of the gig economy raises questions about the quality of jobs that are currently being created. Gig economy is generally characterized by temporary positions and short-term engagements among employers, workers and customers (Kalleberg & Dunn, 2016). However, gig economy is also seen as promoting jobs that offer considerable levels of flexibility, autonomy and work-life balance (Kalleberg & Dunn, 2016).With this in mind, we proposed an explanatory model that may provide guidance for managers and academicians and considers the role of individual productivity despite presenteeism and the contextual factors of flexibility. These factors, when embedded in strong climates of presenteeism (i.e., pressures to go to work while ill) may lead to different employee profiles and varying levels of productivity conditioned by environments with asymmetrical patterns of flexibility and presenteeism climates.

Based on these assumptions, we aim: i) to provide a clear picture of the constructs and to increase the debate around the topics of flexibility on presenteeism; ii) to develop individualized and contextualized profiles where presenteeism can be adaptive and functional (Karanika-Murray & Biron, 2019); and iii) to explain potential antecedents (e.g., presenteeism climate, bureaucracy) that may lead to each of the studied profiles.

Presenteeism and productivity

In the presenteeism literature, the construct can be operationalized solely as an attendance behaviour (e.g., Aronsson, Gustafsson & Dallner, 2000; McGregor, 2017), or as behaviour and consequent outcome (Ferreira et al., 2019; Hemp, 2004). In the latter approach, productivity loss is the consequence of sickness presence at work (Turpin et al., 2004). It is important to note that productivity will be considered only at an individual level, referring to the employee efficiency in the performance of tasks and functions at work (Gosselin et al., 2013). Since productivity loss due to absenteeism can be more easily calculated than productivity loss due to presenteeism (Hemp, 2004), researchers are striving to understand productivity losses attributed to presenteeism, and to develop better instruments to measure this. Moreover, there is a need for improved and, therefore, better models to evaluate the true impact of health on productivity costs. For example, what are the dynamics of individual sickness on team performance (McGregor, 2017)? Previous measures have only focused on the productivity outcomes of specific health conditions, such as chronic diseases (e.g., Stanford Presenteeism Scale [SPS-6] developed by Koopman et al., 2002), or confuse psychological and physical health problems (e.g., World Health Organization Health and Work Performance Questionnaire [HPQ] developed by Kessler et al., 2003).

Several studies provide evidences of weak psychometric properties (Ospina et al., 2015), suggesting that measures are merely evaluating financial metrics (Schultz, Chen & Edington, 2009), or were not specifically designed to measure productivity loss attributable to physical or psychological problems (Grawitch et al.. 2017).

Our proposed presenteeism model describes the dynamic nature of presenteeism and focuses on how the dynamic process between productivity and flexibility can delineate different types of presenteeism behaviours. These presenteeism behaviours can be influenced by structural and contextual aspects of the organizations (their presenteeism climate) and individuals’ own health status. To illustrate, the dynamic nature of presenteeism can depend if the sickness conditions employees are dealing with are temporary and ‘unpredictable’ conditions (e.g. epilepsy, vertigo attacks) and/or chronic (e.g., types of cancer, allergies) and also from the availability of organizational resources to protect workers’ health and performance (e.g., high vs. low support from supervisors and peers).

Presenteeism behaviours can occur due to numerous reasons. For example, they can occur in employees who feel job insecurity, pressure by their peers or fear of being judged or criticized by their team/colleagues (Johns, 2011). Notwithstanding, increased workloads may also cause presenteeism, leading individuals to feel that they cannot afford to take sick leave regardless of their health status. Herewith, non-flexible work arrangements can lead to barriers in how workers manage their own health (Roelen & Groothoff, 2010).

With this in mind and following recommendations from Karanika-Murray and Biron (2019), our conceptual model can bring theoretical clarity to bear on the dynamic nature of presenteeism behaviour, with specific focus on the different levels of productivity losses a worker can present when they decide to go to work sick.