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CONCILIAR+ Project – Implementation of Portuguese Standard 4552-2022: Conciliation of Professional, Personal and Family Life

Received Golden Case recognition at the CAF Users Event 2025 in Warsaw

CAF Best Practice
Date of publication: September 2025

Executive summary

Effective CAF User recognition was the impetus for the development of 3 main organizational areas:

  • Management and Monitoring,
  • Provision of Services to Users and
  • Community Involvement and

Considering the staff feedback and identification of a generation gap on expectations and life style of younger professionals, the Board of Directors decided to launch the CONCILIAR+, a project in order to get an organizational diagnosis and identify measures to improve staff satisfaction and weelbeing. The ULSRA was the 2nd healthcare organization to achieve this certification in Portugal.

About the organisation

The CAF project was primarily developed on the Centro Hospitalar do Baixo Vouga, EPE, a general hospital centre with 3 hospitals in the Region of Aveiro. The organization till the 31st December 2023 delivers care to a population of 315.000 citizens with 2.100 staff members and 33 medical specialities.

On the 1st of January 2024 primary care and public health of the Aveiro Region were integrated with hospital care to serve a population of 340.000 citizens supported by 3.100 staff members and the integration of 46 functional primary care units and public health services. This integration was a result of a national health reform of the National Health Service (NHS) led by Government.

Quality improvement aspects

Main objectives of the CONCILIAR+ Project:

  • To create an internal quality improvement culture,
  • To empower support services on hospital settings (initiated with CAF project),
  • To get a diagnosis of staff expectations and answers to promote professional satisfaction,
  • To improve conciliation of professional life and quality of life,
  • To promote interaction between professionals,
  • To reduce
  • Not all objectives were quantified however was possible to achieve results on these broad areas:
  • Disease absenteeism level with a reduction of 15% from 2022 to 2023
  • Interaction of professionals within 5 workshops (ex: make-up, cooking and financial literacy).
  • Healthy Workplaces Award (May 2024) – Portuguese Psychologist

Stakeholders and communication

The Board of Administration, mainly the Chair of the Board, launched the idea of the project and supported participating and monitoring its steps.

The internal Quality Service mas responsible for managing both processes, CAF and CONCILIAR+, with the support of a multidisciplinary team. It was also facilitated external consultancy.

The communication of the process was accomplished thru the weekly newsletter, leaflets, and messages in the organization intranet as well several information sessions.

The way to seek staff participation and involvement was through questionnaires, workshops, free participation and free suggestions. The project team was always open to suggestions from colleagues and several suggestions were collected and added to the project measures.

It was also possible to seek opinions from users and staff families through patient satisfaction questionnaires and thru workshops with main stakeholders.

It was provided external consultancy to support the CAF process and in the implementation of NP 4552 certification.

Implementation process/approach

The project was implemented based on the following steps:
  1. Development, diagnosis and assessment of psychosocial risks for all employees of the institution
  2. Implementation of Standard NP4552;
  3. Preparation of the Conciliation

The process was based on these steps, which were initiated by the Team appointed by the Board of Administration, from March 2022 to the present date, as it is a dynamic and continuous improvement process.

The activities developed in the 3 phases were as follows:
  1. Development, diagnosis and assessment of psychosocial risks for all employees of the institution:
  • Development and application of a validated questionnaire to all employees to diagnose psychosocial risks, integrating the assessment of fatigue at work and the reconciliation of professional, personal and family life;
  • Conducting interview panels with representative groups (6 panels) (Service/Department Directors, Hospital Administrators, Support Services Directors, Chief Nurses, etc)
  • Preparation of the Final Report with a summary of the results obtained, identification of the measures to implement and dissemination to professionals.
2.      Implementation of Standard NP4552
  • Project development in accordance with the requirements of NP 4552:2016/NP 4552:2022;
  • A Context Analysis was carried out to identify relevant internal and external factors;
  • Stakeholders were identified;
  • The Principles and Values that guide the Institution in terms of Conciliation were identified/reviewed;
  • The Institution’s Conciliation Policy was defined;
  • Actions for addressing the Risks and Opportunities from the SWOT analysis, associated with the Conciliation Management System, were identified;
  • The Implementation Plan was drawn up, which was operationalized and is monitored over time;
  • Internal and external audits were carried out by independent elements of the implementation process;
  • Improvement and/or corrective actions were identified and
3.      Preparation of the Conciliation Program

The Program was developed based on suggestions from professionals at the institutional level, and the opinions of families were considered and integrated.

The activities focused on the three aspects of the Standard:

  • Good Labor Practices;
  • Professional Support and Personal Development;
  • Services and Benefits (in this area, partnerships were established with external entities).

Several strategies were used, namely: Focus group; Brainstorming; Questionnaires and Clarification Sessions, were the way to get better results on staff participation.

In the initial phase, the project has got support from an External Consulting Company, in order to know and facilitate compliance with the legal requirements of the NP 4552. Members of staff constituted the local project team. The costs of the Consulting Company as well as the Certifying Company were supported by a European funding – “Compete 2020” and SAMA.

The gains obtained were reflected mainly in the well-being of professionals and their families, with more advantageous prices in some areas, promotion of a good working environment, contribution to the reduction of absenteeism with proactive measures from the Occupational Medicine and Occupational Health Service.

The main challenge is the project enlargement to all primary care units, mainly due to its geographic dispersion. To overcome these difficulties, we held project presentation sessions in the different Units, listening to professionals and incorporating their feedback into the Conciliation Program Measures, actions that aimed to meet the expectations and needs of these professionals.

Success Measurement. Main results with regards to the focus area

Some of the project outputs to be considered and with impact on the staff wellbeing:
  • N.º of outpatients consultations after risk identification of burnout ( 96 in 2023 and 2024)
  • N.º of external partnerships:
    • Insurance company – 65 simulation requests and 12 formalized.
    • Activities for children: Wise man’s hat; living Science; Sun Tribe; Pedagogical Farm;
    • Gymnasiums.
  • N.º of workshops: 5 (Make up; Cooking and Financial Literacy.
  • N.º of art expositions from authorship of professionals – 11

 

Staff satisfaction level
  • 4.4% very satisfied;
  • 41,5% satisfied;
  • 26,9% indifferent;
  • 21% dissatisfied;
  • 2% very dissatisfied.

Level of Absenteeism – Decreased 15% from 2022 year to 2023. 

The CONCLIAR+ foresees continuous monitoring of measures like staff satisfaction and absenteeism and developing new partnerships and other social and leisure facilities for professionals.

The replication of the psychosocial risk questionnaire will give new information on the impact of measures. 

The essence of the innovation and the transferability of the solutions introduced

The project CONCILIAR+ ended with an award of certification that is a good practice to all kind and size of organizations.

The organization acknowledges that the highlight on the personal and family life needs to be promoted specially to younger members of staff.

Covid-19 pandemic has left burnout, moral distress and Long Covid on many members of staff facing fatigue and lack of enthusiasm. Junior doctors didn´t have preparation and experience to face the pandemic and we are facing an intergenerational shift about life perspectives. Nurses and other health care professionals also feel work loaded.

The process reinforced the importance of the wellbeing of professionals and motivation. The pandemic also stressed all environment revealing existing fractures not yet addressed. Mental health support was reinforced during and after the pandemic with a direct access to consultations and psychological support.

We acknowledge that in healthcare we share the same problems and challenges, and the workforce is one of the most challenging situations nowadays, namely in the way to retain professionals and to create and sustain a positive work environment.

We are happy to say that standard certification by NP 4552-2022 – Conciliation Management between professional, personal and familiar life is a good practice and a continuous improvement process that can be used after a stressful situation as Covid19 or as a regular tool to improve quality of human resources management in healthcare organizations focusing on their wellbeing and satisfaction.

Lessons learnt

As lessons that we have learned from the CONCILIAR+ implementation and management we choose to refer these ones:

  • To look and understand that these certification processes are a continuous improvement tool and not a single process ending with the award.
  • Staff participation is crucial; the process has been a way to reinforce participation and trust, setting professional´s wellbeing as a priority in the institutional agenda,
  • Top and explicit management support is also essential to achieve success.

Read the
complete study

About the author(s)

Margarida França & Maria Jose Oliveira
Unidade Local de Saúde da Região de Aveiro, EPE (ULSRA)
Portugal

Other best practices

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Portugal
Written by: Margarida França & Maria Jose Oliveira
of Unidade Local de Saúde da Região de Aveiro, EPE (ULSRA)

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