A recent study by Kelly et al.1 aimed to understand how different factors within community-based opiate-prescribing services affect the overall work environment. The study examines how clear each organisation’s goals are, how well the team works together, how much freedom staff have, and how open each organisation is to change. The goal was to identify what makes a good work environment in these services and how to improve it.

The mixed-methods study was conducted across 12 publicly funded community-based opiate-prescribing services in Ireland. Data were collected simultaneously through surveys and interviews with frontline staff. The surveys gathered information about the work environment from 132 staff members, while in-depth interviews were conducted with 12 participants in order to explore the issues in greater detail.

The authors analysed the survey data using statistical methods (multivariate linear regression modelling) in order to see how different factors were related, and they investigated the interview data using an abductive approach in order to explore the reasons behind these relationships.

Key findings
The study found that the organisational climate in community-based opiate-prescribing services is influenced by a complex interplay of factors, including the following:

• Resources were identified as crucial for a positive organisational climate. Adequate physical infrastructure, training, staffing, and opportunities for professional growth were associated with better outcomes. However, programmes with higher patient needs often had poorer organisational climates.
• Organisational factors such as leadership, supervision, staff relationships, and collective training were also important for a positive organisational climate and were often impacted by resource availability.
• Programme practices and how resources are utilised within organisations played a significant role in shaping the overall work environment, both positively and negatively.
• Other challenges such as rigid hierarchies, bureaucratic processes, differing philosophical views on addiction, and high staff turnover negatively impacted on organisational climate, and were often linked to resource shortages.

The authors highlight that effective opiate-prescribing services depend on a variety of factors, many of which can be improved without additional resources. The authors also highlight that a comprehensive approach is needed in order to address the complex challenges faced by these services, focusing on both client recovery and staff well-being within a supportive system. The authors note that understanding staff perspectives is crucial for service enhancement, and a combined approach of quantitative and qualitative research can provide valuable insights into addressing organisational challenges and implementing sustainable improvements.

1    Kelly P, Searby A, Goodwin J. An exploration of organizational climate in community-based opiate prescribing services; a mixed methods study. J Subst Use Addict Treat. 2024;162:209362. Available from: https://www.drugsandalcohol.ie/40901/