Benefits and Challenges of Teleworking for a Sustainable Future: Knowledge Gained through Experience in the Era of COVID-19

Abstract

Since the outbreak of COVID-19, working from home has become the norm for millions of workers worldwide. The purpose of this research was to analyze the benefits and challenges of teleworking in the administrative sectors (except Telehealth Services) of Greek healthcare units with a view to harnessing the knowledge gained through experience, in order to create a frame for sustainable behaviors. Complex and dynamic changes, from both a technical and behavioral aspect, are required to implement teleworking. Therefore, a systematic literature review (SLR) as well as primary quantitative research were used as research methods. The purpose of the SLR was to identify the existing scientific literature. Then, combined with the results of the quantitative research, the data were analyzed, described, and interpreted, and then summarized in the conclusion. In addition, the research was conducted to identify the relationships between telecommuting and organizational behavior, in order to achieve sustainable development in businesses. Moreover, an important positive aspect of telework that emerged from this literature review is the creation of opportunities for potential direct or indirect linkages between telework and many sustainable development goals (SDGs), based on the fact that telework appears to be a community-friendly form of work. In summary, this research strongly suggests that leaders facilitate telecommuters to adopt green practices and volunteerism that can consequently contribute to the SDGs. However, in order to meet the challenges arising from unprecedented times, the leaders of the organizations should redesign their policies, while governments should focus on guaranteeing the rights and freedoms of the workers.

1. Introduction

Since the term telecommuting was first coined in the 1970s, scholars and practitioners have debated the merits of working away from the office, as it represents a fundamental shift in the way organizations have historically operated [1].

The year 2020 was an unplanned milestone in the progress of digital transformation. Due to the social distancing required due to COVID-19, many workers have been led to telecommute and take advantage of new technologies even in administrative areas of hospitals. In the aftermath of the global health crisis, the world has finally begun to open its doors again and now faces the new realities of a new era. As telework and hybrid work continue to increase [2,3], it is crucial to investigate the long-term sustainability impact of these options.

At the same time, businesses and organizations were given the opportunity to adapt their business models to the requirements of the new era. In this context, questions such as the following arise:

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What are the implications of these rapid digitalization technological changes in terms of teleworking?

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Could telecommuting have a future as a good practice for achieving sustainability?

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What is the role of leadership and organizational behavior management in the post-COVID-19 era?

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Through which mechanism can teleworking have positive results from the perspective of the individual, the organization, and society?

The purpose of this research was to examine the advantages and challenges related to teleworking within the administrative sectors of Greek healthcare units. By leveraging the insights acquired from this analysis, the aim is to establish a framework for fostering sustainable practices in the future. Furthermore, this paper intends to investigate the challenges and perspectives of leadership in the era of digital transition through the case study of telecommuting among employees in administrative positions in Greek healthcare units during the COVID-19 era. However, it should be emphasized that the survey does not concern Telehealth Services administrators. In particular, complex and dynamic changes from technical and behavioral aspects are required to implement teleworking. Therefore, this study analyzes the changes in question that permeate all areas of life, pushing companies and organizations to undertake extensive transformation processes, and focuses on the development of new leadership skills in the new era.

While conducting the literature survey, it was also found that studies on the connection between telecommuting and sustainability have increased significantly in recent years. However, the final sample from the relevant literature was still relatively small. For this reason, a systematic review was also carried out to identify the relationships between teleworking and organizational culture, with the aim of achieving sustainable growth in companies.

Many authors consider that research in this direction makes a significant contribution to the academic body of knowledge in an area that intersects a wide range of economic, social, and environmental interests. It is further intended that this paper will contribute to informing practitioners, leaders and policymakers who seek to better understand the wider implications of long-term telework and help them to mitigate any negative consequences, while at the same time it is reasonable to promote the positive aspects of teleworking. In any case, the hybrid model that is expected to prevail requires a rethinking of the way work is performed, coordinated, and regulated at both corporate and societal levels [4].

In any case, the importance of the study lies in validating telecommuting as a viable option for promoting sustainable behavior, as it can be adapted into a community-friendly form of work for a larger workforce. In all instances, the objective is to enhance human well-being and improve both human and environmental health. In essence, telework encompasses numerous facets and implications, making it essential to thoroughly investigate this subject for the improvement of aspects that concern employees, organizations, and the community at large. Research findings indicate that telecommuting yields substantial effects on the labor market, bringing forth economic and social advantages. Consequently, its impact is multiple and affects many aspects of society and the SDGs.

In summary, the aim of this study was to investigate the attitudes and behaviors of employees working in teleworking areas within Greek health care units during the period of COVID-19 lockdowns and how these data relate to SDGs. To achieve this aim, the research design focused on examining the following research hypotheses:

Hypothesis 1.

The perception of difficulties during COVID-19 that led to the implementation of teleworking were heterogeneous by sociodemographic characteristics (e.g., gender, age and education level).

Hypothesis 2.

The educational level of employees affects their intention and attitude toward teleworking.

Hypothesis 3.

The educational level of workers affects having the necessary equipment and space at home, as well as the required technological support for the implementation of teleworking.

Hypothesis 4.

There are factors of organizational stress that can predict the acceptance of sustainable development through telework.

Hypothesis 5.

The impact of telecommuting during the COVID-19 crisis is perceived through various aspects (social, economic, environmental) of the lives and careers of hospital workers.

Hypothesis 6.

Employees’ intention to telework during times of crisis in order to support the needs of hospital administrative departments is not influenced by sociodemographic factors.

Finally, this research makes two contributions. First, it involves gathering and analyzing literature review data concerning the SDGs. Second, it validates the relevant research hypotheses through primary quantitative research using a survey of Greek hospital administrators. Overall, the study’s added value lies in its focus on enhancing human well-being and promoting human and environmental health.

2. Impact of Teleworking

Remote work is a type of flexible working arrangement that allows an employee to work from a remote location outside of corporate offices. There are several different terms used to define this concept. Telework and telecommuting are used interchangeably along with other terms such as work-from-home (WFH), e-work, flexible work, home office, home-based telecommuting, mobile work and virtual workplace.

Remote working exploded in the year 2020, with estimates suggesting that almost 40% of people employed in the EU started teleworking full-time as a result of COVID-19, according to The European Commission [5]. In other words, this year changed the world economy and the world of work in an unprecedented way. In addition, the mass adoption of telecommuting has been a vital business shift since the virus outbreak. The sudden demand for working from home has given significant impetus to the digital transformation of the workforce [6].

Beňo [7] provides more positive than negative evidence, as more than half of the studies cited flexibility, productivity, efficiency, and satisfaction as advantages. Nevertheless, in many studies the results are contradictory, and many implications remain unknown regarding how it affects the employee experience, which can be considered one of the paradoxes of telecommuting [8]. In any case, this way of working is not for everyone, as the perception of difficulties leading to the implementation of teleworking was influenced by socio-demographic characteristics [9,10,11].

Moreover, the impact of telecommuting can be multifaceted [12,13]:

• Individual;
• Organizational;
• Social.

New data, technological developments and a globally connected world make it clear that telecommuting will play a critical role in the future of the workplace.

Based on this context, the following hypotheses were established.

Hypothesis 1. The perception of difficulties during COVID-19 that led to the implementation of teleworking were heterogeneous by sociodemographic characteristics (e.g., gender, age and education level).

Hypothesis 2. The educational level of employees affects their intention and attitude toward teleworking.

2.1. Challenges to the Implementation of Telework

Teleworking during the pandemic poses additional challenges. New homeworkers are probably not used to being isolated from their co-workers and may not have a home office or work-friendly area. In addition, getting virtual meeting technology to work well is not always easy. It seems like another chore, which, however, is necessary for social distancing. With other family members potentially also at home, including children or a partner, avoiding distractions and interruptions can be nearly impossible. This challenge concerns especially women due to parenting [14].

Teleworkers may not have a home office or work-friendly area. To find privacy, employees might find themselves in the awkward situation of conducting meetings and their duties from their bedrooms or kitchens. Getting virtual meeting technology to work well is not always easy. All these changes can originate anxiety, fear of job loss, anger, sadness, or frustration [15,16].

Based on this context, the following hypotheses were established.

Hypothesis 3. The educational level of workers affects having the necessary equipment and space at home, as well as the required technological support for the implementation of teleworking.

Hypothesis 4. There are factors of organizational stress that can predict the acceptance of sustainable development through telework.

The potential factors associated with teleworking in the COVID-19 era are categorized as follows [15]:

• Environmental: the economic uncertainty that accompanies the health crisis is a stressful factor, due to the fear of losing a job. Simultaneously, a technological change is taking place;
• Organizational: with the assumption of responsibilities, the work role of teleworkers is overloaded, while there is a lack of social support, space problems and distraction;
• Personal: this is the case of conflict of family-professional responsibilities.

As a consequence of work stress, the following symptoms are observed, which impede efficiency and productivity:

• Physiological: e.g., headaches, high blood pressure, chronic diseases;
• Psychological: e.g., job dissatisfaction, depression, uncertainty about prospects due to a pandemic, insufficient conditions for well-being;
• Behavioral: e.g., nervousness, absenteeism.

The responses to job dissatisfaction of the teleworker can be categorized as follows [17]:

• Exit;
• Voice;
• Loyalty;
• Neglect.

The above-mentioned conditions may have a negative impact on business from the following aspects:

• Decreased productivity: as a result of low performance and deviant behavior at work due to lack of job satisfaction;
• Low degree of internal business communication/cooperation: given the work inclusion experienced in teleworking conditions, there is a high possibility of misunderstandings within the company and time delays;
• Poor services/product quality: as a consequence of the above problems, such as low morale and an increase in the number of errors, the project provided may not meet the specifications of the company [18].

The organizational measures proposed for managing the stress of the teleworker, in our case, are the following:

• Training: training in the form of seminars can help support and improve self-efficacy;
• Employee involvement: the employee must be involved in matters related to his/her job performance (e.g., making decisions or submitting proposals for improvements);
• Organizational communication: due to the isolation of the individual it would be useful to increase the formal organizational communication in order to properly manage issues and reduce stress;
• Leave and wellness programs: for exhausted employees, it is important to take leave for their rejuvenation and to have access to psychological support programs.

At the least, sustainable development is inextricably linked to employee participation, giving particular importance to determining attitudes and behavior in the workplace. For this reason, it must be emphasized that employee engagement practices are, in their purest form, exercises in innovation, but also commitment at the same time. Therefore, to attract employees and benefit from it, the organization must invest not only in meeting the needs of employees but also in engagement practices in order to drive and sustain growth [19].

2.2. Telework and Sustainable Development

The Global Goals and the 2030 Agenda for Sustainable Development is a chain of reflections, commitments, and concerted actions that seek to end poverty and hunger, realize the human rights of all, achieve gender equality and empower all women and girls, and ensure the sustainable protection of the planet and its natural resources [20]. Sustainable development is a dynamic and constantly evolving concept and refers to meeting the needs of the current generation without jeopardizing the future of the next [21,22].

More specifically, social sustainability is about the quality of an organization’s relationships with its stakeholders. In this context, teleworking can be seen as a way of working that can be used to propose organizational transformations aimed at the seventeen sustainable development and social sustainability goals set by the United Nations. The specific social, economic, and environmental objectives aim to improve human well-being and environmental health [23,24].

In particular, the positive aspects of telecommuting include aspects related to the long-term impacts on sustainable development issues. The scoping review of Moglia et al. [25] identified the link between telecommuting and sustainability outcomes from many previous academic studies. In particular, there seems to be a connection with the following nine SDGs [26]:

• No 3. Ensure healthy lives and promote well-being for all at all ages;
• No 4. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all;
• No 5. Achieve gender equality and empower all women and girls;
• No 8. Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all;
• No 9. Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation;
• No 10. Reduce inequality within and among countries;
• No 11. Make cities and human settlements inclusive, safe, resilient and sustainable;
• No 12. Ensure sustainable consumption and production patterns;
• No 13. Take urgent action to combat climate change and its impacts.

More specifically, diverse impacts and research opportunities were identified across a range of areas on the impacts of the SDGs with a greater impact on goals No 9-3-8-11-13 and relatively smaller impacts on goals No 5-4-12-10, in line with the above literature review. The increased rates of teleworking may therefore contribute positively to the SDGs related to e.g., good health and well-being, gender equality, reducing social inequalities, mitigating the effects of environmental issues, as well as challenges for the future in sustainable cities and resilient communities [25].

Based on this context, the following hypothesis was established.

Hypothesis 5. The impact of telecommuting during the COVID-19 crisis is perceived through various aspects (social, economic, environmental) of the lives and careers of hospital workers.

2.3. Telework and the Frame for Sustainable Behaviors

Notably, there is another positive aspect of telework, which appears to create opportunities for potential linkages between telework and other additional SDG areas. According to Kamerade and Burchell [27] telecommuting appears to be a community-friendly form of work, as a counterbalance to the position that it leads to social distancing. The results show that telecommuters tend to report involvement in both volunteer/philanthropic and political/union activities more than non-telecommuters, after controlling for demographic and labor market variables.

More specifically, the specific study [27] shows that telecommuting can make volunteering possible, since working from home and avoiding a commute gives professionals time to give back to their communities. Therefore, volunteering related to telecommuting can, for example, contribute either to the fight against poverty, ensuring food for the hungry, or to caring for the homeless, adopting abandoned pets, participating in solving environmental problems.

Similarly, the contribution of volunteering to the successful management even of phenomena such as an energy transition can be mentioned, given that such changes require the acceptance and support of citizens. Active participation in the community and the local energy system is therefore important. For instance, rather than participating as simple consumers of energy, community members can now take on a number of different roles within the energy system, as they are able to influence the ways and extent to which energy is produced. Moreover, the importance of civil society groups for transformations towards an environmentally friendly energy system has been emphasized in countries such as the UK, Germany, and the USA [28,29].

In this way, telecommuting can act as a framework for promoting sustainable behaviors among citizens-teleworkers, who offer voluntary work to solve social problems. Therefore, since volunteering is an inherently multidimensional phenomenon [30,31], it can be said that teleworking can be directly or indirectly linked to solving problems related to the remaining 8 areas of the SDGs, which are the following [26]:

• No 1. End poverty in all its forms everywhere;
• No 2. End hunger, achieve food security and improved nutrition and promote sustainable agriculture;
• No 6. Ensure availability and sustainable management of water and sanitation for all;
• No 7. Ensure access to affordable, reliable, sustainable and modern energy for all;
• No 14. Conserve and sustainably use the oceans, seas and marine resources for sustainable development;
• No 15. Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss;
• No 16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels;
• No 17. Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development.

At the same time, according to Jones (2010) [32] employees could respond to the socially responsible business practices of their company. These hypotheses derive from organizational identity and social exchange theories and refer to company volunteering programs, through which employees could spend volunteer time during their paid work hours. The effects of these socially responsible business practices appear to be linked to the benefit of companies and their employees. In other words, telecommuting could potentially act as an opportunity for volunteering for the employee (e.g., contributing to sociality and well-being [33], while simultaneously there could be a benefit for the image of the company, as a corporate social responsibility that aims to achieve the SDGs.

In short, teleworking as a framework of sustainable behaviors may potentially contribute significantly in a direct (as suggested in the literature review of Moglia et al. [25]) or in an indirect way (as mentioned by Kamerade and Burchell [27] to the achievement of all of the United Nations SDGs, for the benefit of humanity.

Therefore, the framework of sustainable behaviors could concern most workers in teleworkable sectors. After all, during the COVID-19 crisis, the majority of them showed a willingness to cooperate for the common good, regardless of socio-demographic factors. A human characteristic could be considered the intention to cooperate, help each other and show compassion in catastrophe (in other words to show understanding and extend pro-sociality under crisis [34]), even at a personal cost [35] (e.g., sacrificing free time for volunteering).

Based on this context, the following hypothesis was established.

Hypothesis 6. Employees’ intention to telework during times of crisis in order to support the needs of hospital administrative departments is not influenced by sociodemographic factors.

2.4. The Role of Leaders in Remote Work

The sudden need for teleworking is driving digital transformation of the workforce and the evolution of the work environment at unprecedented speed [6]. Furthermore, it is leading to radical changes in business models, organizations, and work design. For managers, this means that they increasingly must relinquish power in favor of more democratic models of leadership [36,37,38].

This fact goes hand in hand with the empowerment of their employees for self-action and responsibility, through a behavior-oriented towards human relations, mentoring and networking. In addition, digitization leads to changes in the skills required for management tasks, such as agility, willingness to change and remote leadership. Digitization also means that employee performance is more transparent to managers and that presence in the workplace can be used less as a means to measure performance today, since interest in exploiting digital workplaces is growing. Therefore, result orientation plays a key role, while the right implementation of smart technologies in the workplace is required so that the business benefits of digital workplaces bring positive results [39]. Additionally, to prevent workers from being hindered in their productivity by increasing pressure in the context of digitization, leadership should focus on the health and well-being of teleworkers [40].

Moreover, a proposed type of leadership of the new era is that of transformational leadership, thanks to the various advantages of its application so far. As a trust-building concept, it can successfully shape change processes, creating commitment from employees. On the contrary, obstacles to the implementation of transformational leadership must be pointed out, such as leadership distance, which increases with digitalization. Since the digitization of the world of work puts new skill demands on managers, the established model needs to be re-evaluated and supplemented in a different background. The addition of the model leads to a focus on future sustainability and the SDGs, and can ideally minimize some of the problem areas [40,41].

In addition, from the managers’ point of view, it is of prime importance to promote ICT (information and communications technology) and lifelong learning (as it relates to telework and digitization) to keep up with the latest developments since they can act as one of the most important factors in achieving the SDGs in 2030. It is noteworthy, however, that while in developed countries, regulation of telework is a common practice, this is not the case in some Asian countries (e.g., Indonesia, China), where long leadership distance emphasizes increased supervision and punishment among many workers and often is a preferred management style. Nevertheless, the existence of socio-cultural barriers in these countries can hinder the utilization of the advantages of teleworking [42,43].

3. Literature Review and Conceptual Framework

As various studies have attempted to determine whether telecommuting is ultimately a positive or a negative thing for many years, the findings are often contradictory and much remains unknown about how it affects the employee experience [8]. In fact, some researchers have labelled this “gray zone” as the “telework paradox of mutually incompatible consequences for employees” [44,45]. If telecommuting enhances perceived autonomy and reduces workfamily conflict, this, in turn, will have a positive impact on work attitudes, performance, and stress. At the same time, if telecommuting harms relationships with colleagues and supervisors, this would mean that the positive effects mentioned above come at the expense of social bonds [44,45] and, by extension, the achievement of SDGs. Therefore, the different perspectives of the individual, the organization and society will then be presented in the form of a literature review (see

Table 1. Advantages (+) and Disadvantages (-) of Telework.

Part 1: The individual/teleworkers’ perspectives
+ Autonomy/independence [30]. + Flexible working hours [26,30,46]. + Improving time management and professional flexibility [30]. + Saving time and travel expenses [30,33,47]. + Flexibility in organizing care for family members/relatives [4,30,48,49]. + Job satisfaction [8,13,50] + Personalised workspace and chosen silence: it concerns workers with their workplace, which promotes well-being, concentration and few distractions. It allows you to work from anywhere [51,52]. + Reduced stress from arriving late for work-Less travel time will reduce travel stress [4,48,53]. + Teleworkers were able to develop greater social support relationships with certain colleagues, especially other teleworkers, while simultaneously allowing them to distance themselves from negative work relationships [54].	- Reduced sense of belonging [30]. - Professional and social isolation, lack of face to face, in person interactions and emotional support from colleagues, negative effects on co-worker relationships, less visibility, observation [30,44,52,55,56]. - Hyperavailability Syndrome-Work-life imbalance-Employees struggle to separate work and home life [4,30,55,57]. - Need for self-discipline and motivation [30,55]. - Lack of professional support [30,58]. - Performance Control, loss of data security and equipment accountability [42,55]. - The increased use of electronic monitoring and surveillance methods by employers can increase employee anxiety and stress levels and increase the invasion of teleworkers’ privacy [52,59,60]. - Legal issues, loss of legal rights (e.g., teleworkers’ right to log off, unpaid overtime hours [25,61]. - Reduced employment opportunities-Teleworking negatively affects career aspirations due to inadequate managerial assessments [26,30,53,62]. - Lack of skills-Inadequate training [4,47]. - Technostress, digital exhaust, technology dependence and sedentary life as impacts on workers’ mental and physical health and safety [52,63,64,65]. - Long working hours and a lack of adequate work space and ergonomically adapted equipment and furniture at home can also increase risks to teleworkers’ physical health [52,63,65].
Part 2: The organizational perspectives
+ Increase in productivity [55,66]. + Secure retention, strengthen organizational commitment and improve performance within the organization [66]. + Increased supply of human resources [30,55]. + Significant reduction in absenteeism and delays [30,55]. + Savings on direct costs [30,55]. + Increased motivation and satisfaction [30,40]. + Creation of a positive corporate image [30]. + Reductions in office space requirements, capital. + Retention of rare skills and talents [40,55].	- Implementation difficulties for centrally managed organizations [30,40]. - Investments in training and new methods of supervision [30,40]. - Challenges for managers [30,40]. - Potential damage to engagement and identification with the organization due to complex communication [30,40]. - Changes in working methods [30,40]. - Costs associated with moving to telework [30]. - Legal issues [30,55]. - Internal HR Policies-If these policies are not designed and implemented, employees will only depend on management support [13,67]. - Difficulties in selecting suitable work activities and people. - Teleworking may apply to some employees [30,48,49]. - Loss of data security and equipment accountability [55].
Part 3: The societal and SDG perspectives
+ Reduction of environmental damage [24,30,55,68]. + Reduce traffic/congestion [24,30,55,68]. + Solutions for population groups with special needs or health problems [30]. + Reduces discrimination (i.g. gender, sexual orientation, religion, skin color or nationality). Perceived discrimination may be reduced since telecommuting, by definition, reduces physical, face-to-face interaction [53,68,69]. + Saving of infrastructure and energy [24,55,70]. + Regeneration for rural or marginal areas. Through Internet access and the trend of digital nomads, a town could get an economic boost [52,71,72]. + Benefits for the family. Parents can prioritize family and have more time for their children or themselves [4,48,49,59]. + Health living (i.e., lessens fast food consumption) [73,74]. + Telecommuting appears to be a community-friendly form of work, because telecommuters tend to report involvement in both volunteer and political/union activities [27]. + Benefits the military spouse population, which is an underutilized and underemployed group of educated or experienced professionals. Due to their frequent movements and need for flexibility, many remain unemployed [55,75]. + Extends career beyond retirement. It also allows retirees to maintain their savings while remaining professionally and physically active in giving back to their communities and families [4,26]. + Improves Public Health as it can help keep people healthy (e.g., during COVID-19) [8,65].	- Social distancing [30]. - The existence of socio-cultural barriers (e.g., particularly in autocraticasian societies) may hinder the utilization of the benefits of teleworking [42]. - Home energy consumption patterns may offset the benefits of teleworking [25,52,76,77]. - Dependency on technology [52]. - Effects on the mental and physical health and safety of workers may have an impact on society [3,25,42,52]. - Women who telecommute from home also face increased risks of digital harassment and domestic violence [52]. - Degradation of labor rights [25]. - It can lead to further urban sprawl and gentrification that would undermine environmental benefits [25]. - Fragmentation of the workforce, individualization of employment relationships and the emergence of new inequalities in the labor market between those who can work remotely and those who cannot (e.g., because not everyone has access to broadband or the necessary equipment and space at home). These inequalities are closely related to socio-economic inequalities [52].

).

3.1. Individual/Teleworkers’ Perspectives on Telecommuting

Many studies have sought to profile and distinguish the motivations of the teleworker, taking into account demographic characteristics and aspects such as gender, age, education, parental status, number of children, commuting time, disability status, health, and occupation [4,21,25]. However, the effect of gender as a determinant of telecommuting preference remains undefined. In general, this option is chosen or appears to benefit female workers more often, since women in multiple roles (e.g., mother, wife, worker, homemaker) are usually absent from work more often than men. In addition, during telecommuting, fewer conflicts were observed between employees, as due to time flexibility they are rarely absent. They added that due to solving problems related to family obligations, they show more satisfaction about, and loyalty towards, their organization [78]. Furthermore, telecommuting seems to be preferred by certain age groups. For young workers who can easily use information and communication technologies (ICT), telecommuting has become a natural part of work, while for older workers it has become a form of postponing or staying after retirement [4,26] (see Table 1—Part 1).

In opposition, the following can be considered as important negative aspects:: isolation, technostress, technology dependence and sedentary life as impacts on workers’ mental and physical health and safety; Hyperavailability Syndrome; work-life imbalance [4,30,52,55,57,63,64,65].

3.2. Organizational Perspective of Telework

Factors such as improved productivity, improved monitoring of employee performance through digitization, reduced maintenance and operation costs in the workplace, and better employee attraction and retention are some of the benefits of telecommuting from the point of view of organizations.

On the contrary, various challenges for organizations are reported in research, such as the negative impact on the organization regarding the culture and the weakening of team spirit, lack of coordination and feedback between office workers and telecommuters, as well as the loss of time due to extended online meetings [4,79,80]. Therefore, organizational changes are required to implement telework, a step that was not taken in numerous cases due to the sudden implementation of telework forced by COVID-19, as in the case of our study. These changes include issues such as training employees, providing equipment and support technologies to accelerate telecommuting, implementing a telecommuting program aligned with organizational culture, investing in security measures, implementing GDPR, and evaluating the features of work [33,67,80]. In addition, the support of teleworkers (as they are the most important factor) at all levels (e.g., psychological, emotional, physical, technological), and the strengthening of trust in order to develop capabilities is crucial for the successful implementation of a telework project e.g., through the promotion of autonomy, self-motivation and self-organization of work for the employee [4,31,80]. (see Table 1—Part 2).

3.3. Societal and SDG Perspectives of Telework

In the literature, there are many reports on the positive effects of telework on society and in particular as an action for the Sustainable Development Goals (SDGs). These challenges are related to issues such as global warming, travel or traffic times, natural disasters, or the energy crisis, but also issues related to the possibility of teleworking for socially vulnerable groups of citizens (e.g., disabled, long-term patients, pregnant women) [49]. In particular, it is considered that the above challenges can have a more positive development thanks to the possibilities offered by teleworking since digital transformation is increasing [81]. Furthermore, telecommuting is related to the transformation taking place in the form of the workplace due to the growth of jobs in various industries. These are related to ICT, education, art, design, utilities, scientific and technical services, as well as financial services, in which sectors telework seems to be easier to implement or are more affected by telework. The pandemic has shown how important the application of telecommuting is to the management of crises, epidemics, natural and man-made mass disasters [4,25,57,82].

On the negative side, we should highlight the view that energy consumption patterns at home may offset the benefits of telecommuting. For example, telecommuting and the associated energy use at home (e.g., for heating, cooking and lighting) may not reduce the energy used in the office (e.g., offices may continue to be heated and lit for as long as before) [42]. Finally, telecommuting can also lead to greater (or more intense) use of digital technologies, which can, in turn, increase greenhouse gas emissions–currently, data center and network infrastructure use accounts for 2% of global greenhouse gas emissions [76]. Other important negative aspects could be: the dependency on technology [52]; the fact that effects on the mental and physical health and safety of workers may have an impact on society [3,25,42,52]; women teleworkers might face increased risks of digital harassment and domestic violence [52].

Important issues are also the degradation of labor rights [25] and the existence of socio-cultural barriers (e.g., particularly in authoritarian societies, where increased supervision and punishment among workers is observed) [42], which can prevent the benefits of telecommuting from being exploited. Therefore, our case study is of interest as it concerns workers in healthcare administration who were forced to work remotely under the COVID-19 lockdown (see Table 1—Part 3).

4. Materials and Methods

4.1. Research Questions

Quantitative research was chosen by using a questionnaire to conduct the research. The reason why this methodology was adopted is the advantage of easy and fast data collection. In contrast to qualitative research, quantitative research is an important and frequently used means of data collection, which allows for the examination of the relationship between variables, as well as the collection of a large amount of data [83]. Moreover, it was supposed that the use of electronic media would facilitate the distribution and collection of questionnaires during lockdowns. Additionally, since our survey targeted individuals who had telecommuted, participants would be familiar with digital media.

The general objective of the research was to investigate the attitude and behavior of employees in teleworkable sectors of Greek healthcare units during the COVID-19 confinement period. Based on the purpose of the research, the research design focused on the following research hypotheses, which are also illustrated in the following research model (see Figure 1).

4.2. Research Tool and Data Collection

The questionnaire was created in proportion to the objectives of the research, and it was basedb on the previous research efforts of Baert et al. [69], Raišienė et al. [78] and Schuster et al. [84]. The types of closed questions mainly used are double choice, multiple choice, Likert scale and importance scale. The majority of the answers to the questions are given on a 5-point Likert scale, so that the respondents can indicate the level that best represents them.

The questionnaires were distributed online to hospital administrators in Greece, at a time when teleworking was still very common due to the measures against the spread of COVID-19. The research took place in September and October 2021. Participation was voluntary and anonymous.

The questionnaire includes 23 questions (see

Table 2. Structure of the Questionnaire.

(1) Demographic characteristics:

1.1. Gender 1.2. Age 1.3. Education Level 1.4. Years of service 2. In which department do you work?

(2) The circumstances that led to telecommuting and the intention for this choice:

3. Have there been management difficulties in your hospital service during the time of COVID-19 that led to the implementation of telework? 4. Before COVID-19 did you work remotely? 5. Would you like to work remotely? 6. During the time of COVID-19 did you work remotely?

(3) The possible positive aspects of telecommuting and the impact on individual, organizational and societal level:

7. Telecommuting can improve my job satisfaction and commitment to the hospital where I work. 8. Telecommuting can improve my work performance. 9. Telecommuting could reduce stress e.g., due to flexible working hours or reducing the spread of the virus. 10. Telecommuting could reduce burnout e.g., because of the time savings due to not commuting. 11. Telecommuting could reduce my days away from work (e.g., for special leave for parents and vulnerable social groups) because of the flexibility it offers. 12. Would you work remotely during a lockdown if you were given the option to support the needs of your department?

(4) Demographic characteristics: The potential challenges of telecommuting and the impact on individual, organizational and societal level:

13. Telecommuting can lead to social and professional isolation from the hospital where I work. 14. Telecommuting gives reduced opportunities to share information. 15. Telecommuting presents difficulties in separating the boundaries between work and personal time. 16. Telecommuting can force telecommuters to work overtime to prove their worth and lead to burnout. 17. The operation of technologies and virtual meetings is not always an easy task. 18. As a telecommuter, do you have an office or co-working space in your home? 19. As a telecommuter, did you receive the required technology support from your hospital?

) that are classified into 4 different groups, according to the purposes of the research, its objectives, and the research hypotheses. The groups concerned the following:

(1)

Demographic data (Questions No. 1.1–1.4 and No. 2). The data of questions No. 1.1 to No. 1.4 are categorical (nominal data) and concern the following: gender, age, education, and years of service. While question 2 is open-ended and concerns the employment department in order to note the range of departments in which teleworking can be implemented in a hospital;

(2)

Questions about the circumstances that led to telecommuting and the intention for this choice (questions No. 3–6);

(3)

Questions about the possible positive aspects of telecommuting and the impact on individual, organizational and societal levels (questions No. 7–12);

(4)

Questions about the potential challenges of telecommuting and the impact on individual, organizational and societal levels (questions No. 13–19).

4.3. Sampling and Participants

Sample selection refers to the taking of a number of respondents from the wider community [83]. In particular, the research population is the total of possible respondents that can be selected during the research process [83]. In the present survey, the target population is the teleworkable/administrative sectors of Greek health and welfare units, with the final sample of the survey being 125 respondents. The selection of the respondents was made randomly from a sampling frame of healthcare worker social networking groups.

Table 3. Demographic characteristics.

Distribution of Answers Regarding the Sample (N = 125):
1.1. Gender
	Frequency	Percent	Valid Percent	Cumulative Percent
Female	109	87.2	87.2	87.2
Male	16	12.8	12.8	100
Total	125	100	100
1.2. Age
18–24	2	1.6	1.6	1.6
25–30	8	6.4	6.4	8
31–40	14	11.2	11.2	19.2
41–55	94	75.2	75.2	94.4
55+	7	5.6	5.6	100
Total	125	100	100
1.3. Education Level
Secondary education	24	19.2	19.2	19.2
Higher education	54	43.2	43.2	62.4
Master’s degree holder	42	33.6	33.6	96
Holder of a Ph.D	5	4	4	100
Total	125	100	100
1.4. Years of service: Median = 17.00. Interquartile Range: 11.00

shows the answers of the respondents regarding their demographic characteristics. Specifically, 87.2% were women, 12.8% were men. Regarding their age, it is observed that 5.6% were 55+ years old, 75.2% were 41–55 years old, 11.2% were 31–40 years old and 6.4% were 25–30 years old and 1.6% reported being 18–24 years old.

4.4. Limitations of the Research

Limitations of the study were mainly related to the refusal of potential study participants due to the absence of subject knowledge. Furthermore, people who did not know Greek could not answer, since the questionnaire was in Greek. Also, the male-to-female ratio of respondents was disproportionate, as many men did not show willingness to take the time to complete the questionnaire. Finally, the survey was conducted entirely online. However, we believe that high participation in research allows the conclusions to be extrapolated to the population with considerably increased safety.

5. Results

5.1. Results of Descriptive Statistics

First, the results obtained using descriptive statistics will be presented. Thus, for the categorical variables, the absolute and relative frequency for each of their categories will be presented. For the ordinal variables, in addition to the absolute and relative frequencies, the median value and the interquartile range will also be presented, two statistics suitable for describing Likert-type variables.

5.1.1. Demographic Characteristics

A total of 125 people took part in this research, of which 87.2% were women, and 12.8% were men (Table 3). Regarding their age, 5.6% were 55+ years old, 75.2% were 41–55 years old, 11.2% were 31–40 years old and 6.4% were 25–30 years old and 1.6% reported being 18–24 years old.

Also shown is the distribution of the participants’ responses regarding their education. More specifically, 43.2% of participants were graduates of higher education, 33.6% were holders of postgraduate degrees, 19.2% were graduates of secondary education and 4% were holders of Ph.D.

For years of service, from the Table 3 below, the median was 17 years, with an interquartile range of 11 years.

Regarding the employment section of the sample,

Table 4. Distribution of responses to the following question (N = 125): In which department do you work?

	Frequency	Percent	Valid Percent	Cumulative Percent
Citizen service office	1	0.8	0.8	0.8
Call center	1	0.8	0.8	1.6
Surgery warehouse	1	0.8	0.8	2.4
Secretariat	40	32	32	34.4
Office of Education	1	0.8	0.8	35.2
Program management office	1	0.8	0.8	36
Patient movement office	5	4	4	40
Supply office	3	2.4	2.4	42.4
Telemedicine design and development office	1	0.8	0.8	43.2
Dietetics department	2	1.6	1.6	44.8
Human resources management	1	0.8	0.8	45.6
Material Management Department	1	0.8	0.8	46.4
Hospital director	3	2.4	2.4	48.8
Quality control department	1	0.8	0.8	49.6
Medical service	1	0.8	0.8	50.4
Social service	1	0.8	0.8	51.2
Accounting department	30	24	24	75.2
Payroll	1	0.8	0.8	76
Nursing department	2	1.6	1.6	77.6
Economics Department	4	3.2	3.2	80.8
Pathological clinic	1	0.8	0.8	81.6
Order Office	1	0.8	0.8	82.4
Nursing service	1	0.8	0.8	83.2
Department of receipt of sanitary material	1	0.8	0.8	84
Information technology department	6	4.8	4.8	88.8
Protocol Department	2	1.6	1.6	90.4
Human resources Department	8	6.4	6.4	96.8
Quality control service	1	0.8	0.8	97.6
Pharmacy	1	0.8	0.8	98.4
Psychiatric clinic	2	1.6	1.6	100
Total	125	100	100

shows that the majority of participants were administrative employees of many different hospital departments (32.8%). The departments with the highest percentage were secretarial (32%) and accounting employees (24%), while HR department (6.4%) and IT employees (4.8%) also had comparatively high rates of telecommuting.

From the demographic characteristics it is concluded that women participants are the majority compared to men. Although in our survey an attempt was made to send questionnaires to an equal number of men and women, the number of female responses received was overwhelmingly higher. This fact can be a limitation of our research and may mean that most of the men who did not participate in the survey have never worked remotely. Therefore, it could be assumed that telecommuting in our research serves women more, possibly because of their role as mothers and home carers. However, further investigation of the matter is suggested to confirm the assumption.

5.1.2. Descriptions for the Main Research Part

Participants were then asked a number of questions (

Table 5. Distribution of responses to the following question (N = 125): Have there been management difficulties in your hospital service during the time of COVID-19 that led to the implementation of telework?

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	2	1.6	1.6	1.6
Disagree	3	2.4	2.4	4
I neither agree nor disagree	18	14.4	14.4	18.4
Agree	50	40	40	58.4
Strongly Agree	52	41.6	41.6	100
Total	125	100	100
Median = 4. Interquartile Range = 1

) related to employment in Greek healthcare units and hospitals during the COVID-19 lockdown and telecommuting. The following tables show the frequencies and percentages, while they include the median and the interquartile range. For nominal variables, only frequencies and percentages are given.

From the comparison of the results of

Table 6. Distribution of responses to the following question (N = 125): Before COVID-19 did you work remotely?

	Frequency	Percent	Valid Percent	Cumulative Percent
No	109	87.2	87.2	87.2
Yes	16	12.8	12.8	100.0
Total	125	100.0	100.0

,

Table 7. Distribution of responses to the following question (N = 125): Would you like to work remotely?

	Frequency	Percent	Valid Percent	Cumulative Percent
Νο	47	37.6	37.6	37.6
Yes	78	62.4	62.4	100.0
Total	125	100.0	100.0

and

Table 8. Distribution of responses to the following question (N = 125): During the time of COVID-19 did you work remotely?

	Frequency	Percent	Valid Percent	Cumulative Percent
Νο	44	35.2	35.2	35.2
Yes	81	64.8	64.8	100.0
Total	125	100.0	100.0

it can be concluded that before the pandemic, a small percentage of 12.8% of the workers in the Greek health and welfare units worked remotely (see

Table 9. Distribution of responses to the following question (N = 125): Telecommuting can improve my job satisfaction and commitment to the hospital where I work.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	13	10.4	10.4	10.4
Disagree	14	11.2	11.2	21.6
I neither agree nor disagree	43	34.4	34.4	56.0
Agree	32	25.6	25.6	81.6
Strongly Agree	23	18.4	18.4	100.0
Total	125	100.0	100.0
Median = 3. Interquartile Range = 4

), whereas since the COVID-19 pandemic, 64.8% of employees worked remotely (see Table 7). Telecommuting seems to be viewed positively by 62.4% of employees (see Table 8).

Furthermore, research proposed that teleworking could improve employees’ job satisfaction and commitment to an organization and even their job performance (see Table 9 and

Table 10. Distribution of responses to the following question (N = 125): Telecommuting can improve my work performance.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	14	11.2	11.2	11.2
Disagree	22	17.6	17.6	28.8
I neither agree nor disagree	34	27.2	27.2	56.0
Agree	29	23.2	23.2	79.2
Strongly Agree	26	20.8	20.8	100.0
Total	125	100.0	100.0
Median = 3. Interquartile Range = 2

). Teleworking could also reduce work-related burnout and stress, due to reduced commuting or more flexible hours (see

Table 11. Distribution of responses to the following question (N = 125): Telecommuting could reduce stress e.g., due to flexible working hours or reducing the spread of the virus.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	4	3.2	3.2	3.2
Disagree	5	4.0	4.0	7.2
I neither agree nor disagree	28	22.4	22.4	29.6
Agree	45	36.0	36.0	65.6
Strongly Agree	43	34.4	34.4	100.0
Total	125	100.0	100.0
Median = 4. Interquartile Range = 2

and

Table 12. Distribution of responses to the following question (N = 125): Telecommuting could reduce burnout e.g., because of the time savings due to not commuting.

		Frequency	Percent	Valid Percent	Cumulative Percent
Valid	I absolutely disagree	4	3.2	3.2	3.2
	Disagree	12	9.6	9.6	12.8
	I neither agree nor disagree	17	13.6	13.6	26.4
	Agree	47	37.6	37.6	64.0
	Strongly Agree	45	36.0	36.0	100.0
	Total	125	100.0	100.0
	Median = 4. Interquartile Range = 2

). Other profits include reduced commuting costs and flexibility to work from anywhere (see Table 12 and

Table 13. Distribution of responses to the following question (N = 125): Telecommuting could reduce my days away from work (e.g., for special leave for parents and vulnerable social groups) because of the flexibility it offers.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	6	4.8	4.8	4.8
Disagree	6	4.8	4.8	9.6
I neither agree nor disagree	19	15.2	15.2	24.8
Agree	46	36.8	36.8	61.6
Strongly Agree	48	38.4	38.4	100.0
Total	125	100.0	100.0
Median = 4. Interquartile Range = 2

). In addition, thanks to remote work, the health and welfare units can thus continue without interruption the operation of their administrative services by supporting effectively and dynamically all the other health and welfare services (see

Table 14. Distribution of responses to the following question (N = 125): Would you work remotely during a lockdown/quarantine if you were given the option to support the needs of your department?

	Frequency	Percent	Valid Percent	Cumulative Percent
Νο	6	4.8	4.8	4.8
Yes	119	95.2	95.2	100.0
Total	125	100.0	100.0

).

However, telecommuting is confirmed by our case study to have disadvantages, such as social and professional isolation, reduced opportunities for information sharing, and difficulties in separating work and personal time (see

Table 15. Distribution of responses to the following question (N = 125): Telecommuting can lead to social and professional isolation from the hospital where I work.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	3	2.4	2.4	2.4
Disagree	16	12.8	12.8	15.2
I neither agree nor disagree	43	34.4	34.4	49.6
Agree	33	26.4	26.4	76.0
Strongly Agree	30	24.0	24.0	100.0
Total	125	100.0	100.0
Median = 4. Interquartile Range = 1

,

Table 16. Distribution of responses to the following question (N = 125): Telecommuting gives reduced opportunities to share information.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	5	4.0	4.0	4.0
Disagree	17	13.6	13.6	17.6
I neither agree nor disagree	34	27.2	27.2	44.8
Agree	46	36.8	36.8	81.6
Strongly Agree	23	18.4	18.4	100.0
Total	125	100.0	100.0
Median = 4. Interquartile Range = 1

and

Table 17. Distribution of responses to the following question (N = 125): Telecommuting presents difficulties in separating the boundaries between work and personal time.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	4	3.2	3.2	3.2
Disagree	12	9.6	9.6	12.8
I neither agree nor disagree	28	22.4	22.4	35.2
Agree	39	31.2	31.2	66.4
Strongly Agree	42	33.6	33.6	100.0
Total	125	100.0	100.0
Median = 4. Interquartile Range = 2

). The lack of physical separation between these two worlds can create problems, such as family responsibilities extending into work and professional obligations encroaching on family time. This can cause telecommuters to work overtime to prove themselves, leading to burnout. The ability to be constantly connected to work through a variety of technologies (e.g., Zoom, Slack) can also make workers feel like they cannot unplug at the end of the day (see

Table 18. Distribution of responses to the following question (N = 125): Telecommuting can force telecommuters to work overtime to prove their worth and lead to burnout.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	10	8.0	8.0	8.0
Disagree	20	16.0	16.0	24.0
I neither agree nor disagree	31	24.8	24.8	48.8
Agree	34	27.2	27.2	76.0
Strongly Agree	30	24.0	24.0	100.0
Total	125	100.0	100.0
Median = 4. Interquartile Range = 1

and

Table 19. Distribution of responses to the following question (N = 125): The operation of technologies and virtual meetings is not always an easy task.

	Frequency	Percent	Valid Percent	Cumulative Percent
I absolutely disagree	4	3.2	3.2	3.2
Disagree	12	9.6	9.6	12.8
I neither agree nor disagree	35	28.0	28.0	40.8
Agree	48	38.4	38.4	79.2
Strongly Agree	26	20.8	20.8	100.0
Total	125	100.0	100.0
Median = 4. Interquartile Range = 1

).

It is also noteworthy that many employees (40.8%, see

Table 20. Distribution of responses to the following question (N = 125): As a telecommuter, do you have an office or co-working space in your home?

	Frequency	Percent	Valid Percent	Cumulative Percent
Νο	51	40.8	40.8	40.8
Yes	74	59.2	59.2	100.0
Total	125	100.0	100.0

) do not have a suitable space for teleworking, while the vast majority (76.18%, see

Table 21. Distribution of responses to the following question (N = 125): As a telecommuter, did you receive the required technology support from your hospital?

		Frequency	Percent	Valid Percent	Cumulative Percent
Valid	Νο	96	76.8	76.8	76.8
	Yes	29	23.2	23.2	100.0
	Total	125	100.0	100.0

) lack technological support during the performance of their work duties.

5.2. Results of Inductive Statistics

The relationships between the examined variables were studied in the second part of the analysis of the results obtained from the present research.

5.2.1. Relationship between Main Research Part Questions and Age

Because the dependent variables were ordinal and age had two levels, we used the Mann–Whitney test to examine possible differences in their responses by age.

We found only one statistically significant relationship, which concerns responses to the question “Have there been management difficulties in your hospital service during the time of COVID-19 that led to the implementation of telework” and age (U = 776.5. p = 0.003). Looking at the mean ranks, we conclude that participants who were 41 years of age or older expressed a higher degree of agreement with the proposition that there were ‘management difficulties in their hospital service during the time of COVID-19 that led to the implementation of telework’ than those who were under 41 years. Therefore, participants who were 41 years of age or older appear to have struggled more than participants who were under 41 years of age (

Table 22. Differences in responses by age.

Questions	Age	N	Mean Rank	Sum of Ranks
(1) Have there been management difficulties in your hospital service during the time of COVID-19 that led to the implementation of telework?	<41 years old	24	44.85	1076.50
	41 years and older	101	67.31	6798.50
	U = 776.5 p = 0.003
(2) Telecommuting can improve my job satisfaction and commitment to the hospital where I work.	<41 years old	24	67.65	1623.50
	41 years and older	101	61.90	6251.50
	U = 1100.5 p = 0.47
(3) Telecommuting can improve my work performance.	<41 years old	24	69.92	1678.00
	41 years and older	101	61.36	6197.00
	U = 1046.0 p = 0.286
(4) Telecommuting could reduce stress e.g., due to flexible working hours or reducing the spread of the virus.	<41 years old	24	69.48	1667.50
	41 years and older	101	61.46	6207.50
	U = 1056.5 p = 0.305
(5) Telecommuting could reduce burnout e.g., because of the time savings due to not commuting.	<41 years old	24	69.52	1668.50
	41 years and older	101	61.45	6206.50
	U = 1055.5 p = 0.300
(6) Telecommuting could reduce my days away from work because of the flexibility it offers.	<41 years old	24	58.04	1393.00
	41 years and older	101	64.18	6482.00
	U = 1093.0 p = 0.429
(7) Telecommuting can lead to social and professional isolation from the hospital where I work.	<41 years old	24	63.40	1521.50
	41 years and older	101	62.91	6353.50
	U = 1202.5 p = 0.951
(8) Telecommuting gives reduced opportunities to share information.	<41 years old	24	60.08	1442.00
	41 years and older	101	63.69	6433.00
	U = 1142.0 p = 0.648
(9) Telecommuting presents difficulties in separating the boundaries between work and personal time.	<41 years old	24	61.31	1471.50
	41 years and older	101	63.40	6403.50
	U = 1171.5 p = 0.791
(10) Telecommuting can force telecommuters to work overtime to prove their worth and lead to burnout.	<41 years old	24	53.46	1283.00
	41 years and older	101	65.27	6592.00
	U = 983.0 p = 0.140
(11) The operation of technologies and virtual meetings is not always an easy task	<41 years old	24	59.75	1434.00
	41 years and older	101	63.77	6441.00
	U = 1134.0 p = 0.609

).

In the

Table 23. Anx² independence test to a series of nominal variables (Yes/No answers) and an ordinal one (age).

Variables	Categories	Age		x2 (1)	p
		<41 Years Old	41+ Years Old
		n (%)	n (%)
(1) Before COVID-19. did you work remotely?	Νο	19	90	1.72	0.190
		79.2%	89.1%
	Yes	5	11
		20.8%	10.9%
(2) Would you like to work remotely?	Νο	7	40	0.90	0.343
		29.2%	39.6%
	Yes	17	61
		70.8%	60.4%
(3) During the time of COVID-19, did you work remotely?	Νο	8	36	0.045	0.831
		33.3%	35.6%
	Yes	16	65
		66.7%	64.4%
(4) As a telecommuter, do you have an office or co-working space in your home?	Νο	10	41	0.009	0.923
		41.7%	40.6%
	Yes	14	60
		58.3%	59.4%
(5) As a telecommuter, did you receive the required technology support from your hospital?	Νο	21	75	1.909	0.167
		87.5%	74.3%
	Yes	3	26
		12.5%	25.7%

anx² independence test was applied, because we had a series of nominal variables (Yes/No answers) and an ordinal one (age). From the results that follow, no statistically significant relationship is found.

5.2.2. Relationship between Main Research Part Questions and Educational Level

Because the dependent variables were ordinal and educational level was categorized into three levels (secondary education, higher education, Master’s/PhD holder), the Kruskal–Wallis test was used to examine possible differences in their responses according to their educational level.

Only one statistically significant relationship was found, which concerned responses to the question “Were there any management difficulties in your hospital service during the COVID-19 era that led to the implementation of telework?” and educational level (x²(2) = 7.796, p = 0.020).

Also, in

Table 24. Τhe mean rank per age category and the corresponding values of x²(2) and p.

Questions	Education level	N	Mean Rank
(1) Were there any management difficulties in your hospital service during the COVID-19 era that led to the implementation of telework?	Secondary education	24	64.08
	Higher education	54	54.05
	Master’s/PhD holder	47	72.73
	x2(2) = 7.796 p = 0.020
(2) Telecommuting can improve my job satisfaction and commitment to the hospital where I work.	Secondary education	24	49.31
	Higher education	54	64.21
	Master’s/PhD holder	47	68.60
	x2(2) = 4.934 p = 0.085
(3) Telecommuting can improve my work performance.	Secondary education	24	52.06
	Higher education	54	64.16
	Master’s/PhD holder	47	67.26
	x2(2) = 3.038 p = 0.219
(4) Telecommuting could reduce stress e.g., due to flexible working hours or reducing the spread of the virus.	Secondary education	24	60.10
	Higher education	54	60.28
	Master’s/PhD holder	47	67.61
	x2(2) = 1.351 p = 0.509
(5) Telecommuting could reduce burnout e.g., because of the time savings due to not commuting.	Secondary education	24	56.27
	Higher education	54	63.56
	Master’s/PhD holder	47	65.79
	x2(2) = 1.248 p = 0.536
(6) Telecommuting could reduce my days away from work (e.g., for special leave for parents and vulnerable social groups) because of the flexibility it offers.	Secondary education	24	57.44
	Higher education	54	57.64
	Master’s/PhD holder	47	72.00
	x2(2) = 5.224 p = 0.073
(7) Telecommuting can lead to social and professional isolation from the hospital where I work.	Secondary education	24	67.92
	Higher education	54	65.36
	Master’s/PhD holder	47	57.78
	x2(2) = 1.782 p = 0.410
(8) Telecommuting gives reduced opportunities to share information.	Secondary education	24	70.31
	Higher education	54	62.61
	Master’s/PhD holder	47	59.71
	x2(2) = 1.488 p = 0.475
(9) Telecommuting presents difficulties in separating the boundaries between work and personal time.	Secondary education	24	61.54
	Higher education	54	65.47
	Master’s/PhD holder	47	60.90
	x2(2) = 0.487 p = 0.784
(10) Telecommuting can force telecommuters to work overtime to prove their worth and lead to burnout.	Secondary education	24	60.38
	Higher education	54	61.76
	Master’s/PhD holder	47	65.77
	x2(2) = 0.490 p = 0.783
(11) The operation of technologies and virtual meetings is not always an easy task.	Secondary education	24	64.19
	Higher education	54	66.73
	Master’s/PhD holder	47	58.11
	x2(2) = 1.597 p = 0.450

, the mean rank per age category is presented, as well as the corresponding values of x²(2) and p.

To determine between which categories of educational level there are differences on the variable “Were there managerial difficulties in your service of your hospital during the time of COVID-19 that led to the implementation of telework”, we performed paired Mann–Whitney tests. From the results that follow, we conclude that the participants who were holders of a master’s/doctorate showed a higher degree of agreement with the proposition in question, compared to those who had a higher education (U = 882.5 p = 0.004). Therefore, participants who held a master’s/doctoral seem to have had more difficulty than participants who had a higher education.

Also, in

Table 25. The mean rank per education level category and the corresponding values of U and p.

	Education Level	Mean Rank	U	p
Have there been management difficulties in your hospital service…?	Secondary education	43.54
	Higher education	37.70
			551.000	0.264
	Secondary education	33.04
	Master’s/PhD holder	37.51
			493.000	0.341
	Higher education	43.84
	Master’s/PhD holder	59.22
			882.500	0.004

the mean rank per education level category is presented.as well as the corresponding values of U and p.

Finally, because there were a number of nominal variables (yes/no responses) and one ordinal (educational level), the anx² independence test was applied (see

Table 26. Anx² independence test, on nominal variables (yes/no responses) and an ordinal (educational level).

			Education Level
			Secondary Education	Higher Education	Master’s/PhD Holder
(1) Before COVID-19, did you work remotely?	Νο	Count	20	49	40	109
		% within the Education level	83.3%	90.7%	85.1%	87.2%
	Yes	Count	4	5	7	16
		% within the Education level	16.7%	9.3%	14.9%	12.8%
x2(2) = 1.113, p = 0.573
(2) Would you like to work remotely?	Νο	Count	15	19	13	47
		% within the Education level	62.5%	35.2%	27.7%	37.6%
	Yes	Count	9	35	34	78
		% within the Education level	37.5%	64.8%	72.3%	62.4%
x2(2) = 8.46, p = 0.015)
(3) During the time of COVID-19, did you work remotely?	Νο	Count	12	21	11	44
		% within the Education level	50.0%	38.9%	23.4%	35.2%
	Yes	Count	12	33	36	81
		% within the Education level	50.0%	61.1%	76.6%	64.8%
x2(2) = 5.494. p = 0.064
(4) As a telecommuter. do you have an office or co-working space in your home?	Νο	Count	16	22	13	51
		% within the Education level	66.7%	40.7%	27.7%	40.8%
	Yes	Count	8	32	34	74
		% within the Education level	33.3%	59.3%	72.3%	59.2%
x2(2) = 10.01, p = 0.007
(5) As a telecommuter. did you receive the required technology support from your hospital?	Νο	Count	22	39	35	96
		% within the Education level	91.7%	72.2%	74.5%	76.8%
	Yes	Count	2	15	12	29
		% within the Education level	8.3%	27.8%	25.5%	23.2%
x2(2) = 3.756, p = 0.153

). From the results that follow, two statistically significant relationships were identified:

–

A statistically significant relationship is found between educational level and the variable “Would you like to work remotely?” x²(2) = 8.46. p = 0.015). In particular, the majority of participants who held a master’s degree/doctorate (72.3%) wished to work remotely, as did the majority of participants who were graduates of higher education (64.8%). However, the majority of participants who were secondary school graduates did not wish to work remotely (62.5%);

–

A statistically significant relationship is found between educational level and the variable “As teleworkers, did you receive the required technological support from your hospital?” x²(2) = 10.01. p = 0.007). In particular, the majority of participants who held a Master’s/PhD (72.3%) stated that they had an office or friendly workspace at home. as did the majority of participants who were graduates of higher education (59.3%). However, the majority of participants who were secondary school graduates stated that they did not have an office or a friendly workspace at home (66.7%).

6. Discussion

The effects of telecommuting have been widely discussed in the last decade and especially since the emergence of COVID-19, during which many people were forced to telecommute due to lockdowns. This issue has been discussed both in the relevant literature and in official government documents at an international level. Although the effects are rarely seen in isolation, they have been divided into different categories based on the changes they cause. The adoption of telecommuting measures has been shown to have economic, equity and environmental benefits for organizations, workers, and local governments. Furthermore, the effects can be at a personal, organizational, or societal level and by extension affect the achievement of the SDGs. Moreover, the importance and benefits of telework organizations have been widely recognized by organizations, governments and academics around the world [1,24,68].

First, it was observed that employees’ socio-demographic characteristics can potentially influence the perception of the difficulties that led to the adoption of teleworking during the crisis period as it happened with Greek healthcare administrators during COVID-19 (Hypothesis 1, confirmed), since participants who were 41 years of age or older seem to have struggled more than participants who were under 41 years of age. Additionally, the educational level of employees affects their intention to telework and is related to their positive or negative attitude to work from home (Hypothesis 2, confirmed). In particular, the majority of participants with a master’s/Ph.D. desired to work remotely, as did the majority of higher education graduates, in contrast to secondary education graduates. Those findings are supported by previous studies, such as those of Moens et al. [69], Beňo [7] and Gajendran and Harrison [44].

Furthermore, the educational level (and possibly the income of the employees since in Greek healthcare units the employees are paid according to their educational level) affects the existence of the necessary equipment and space at home, as well as the required technological support for the implementation of telework (Hypothesis 3, confirmed). More specifically, the majority of university graduate participants (of all levels) stated that they had an office or friendly workspace at home but also received the required technological support from the hospital, in contrast to the participants who were secondary school graduates. Those findings are supported by previous studies, such as those of Cuerdo-Vilches et al. [51] and Campbell and Gavett [14]. Finally, it should be underlined that from Hypotheses 2 and 3 it may be concluded that the possibility for the adoption of telework is linked to the educational level and economic status of the employee, which creates social inequalities in access to telework. This element was previously mentioned in research by Martins and Sobral [52].

In addition, supporting the findings of Boell et al. [8] and Cuerdo-Vilches et al. [51], the research outcomes suggest that telecommuting could improve the job satisfaction and commitment [13,50,85] of employees in an organization and even their work performance. These positives could be offset by the negatives associated with organizational stress in order to predict acceptance of sustainable development through telework (Hypothesis 4, confirmed). At the same time, the assumption on the part of telecommuters, as it emerged from the survey, that telecommuting could reduce burnout and stress, due to reduced commuting or more flexible hours, may contribute to the same goal [30,33,47].

Moreover, supporting the findings of Green et al. [12] and Lebopo et al. [13] the research outcomes suggest that the impact of telecommuting during the COVID-19 crisis is perceived through various aspects (social, economic, environmental) of hospital workers’ lives and careers (Hypothesis 5, confirmed). This is also related to the fact that the impact of telecommuting may be even higher since the adoption of telecommuting can reduce commuting costs (for all parties, e.g., individuals, organisations and the environment), increasing the flexibility to work from anywhere, as it emerged in our case study [4,30,48,49].

It could also be implicitly concluded that higher acceptance of telecommuting (and by extension the sustainable development it entails) can be achieved when there are higher levels of positive economic and social impact. Finally, it is confirmed that employees’ intention to telework in times of crisis to support the needs of the hospital’s administrative departments is not influenced by socio-demographic factors (Hypothesis 6, confirmed), since the vast majority (95.2%) of the participants stated that they would work from distance during a lockdown/quarantine if given the option in order to support the needs of their department. Those findings are supported by previous studies, such as those by Moglia et al. [25] and Karia and Asaari [9].

From the above, it follows that there is an interconnection between the variables, as well as the multiple effects of telework on sustainable development in the teleworkable sectors of Greek healthcare units.

6.1. Theoretical and Practical Implications of the Findings

6.1.1. Theoretical Implications

○

The preference for remote work among higher education graduates compared to secondary education graduates may be related to their exposure to more digital technologies and remote learning during their academic journey. This finding suggests that educational experiences can influence individuals’ attitudes and preferences towards remote work;

○

The presence of an office or friendly workspace at home, along with technological support from the hospital, may have a positive impact on employees’ work-life balance and overall job satisfaction. This implies that providing adequate remote work infrastructure can potentially lead to higher retention rates and reduced turnover for organizations;

○

The technological support provided by the hospital indicates the importance of IT infrastructure in facilitating remote work arrangements. This finding highlights the significance of investing in technology and training to ensure seamless remote work experiences for employees.

○

The positive association between telecommuting and job satisfaction suggests that the flexibility and autonomy afforded by remote work can lead to higher levels of job satisfaction among employees. This finding aligns with theories such as the job characteristics model which posits that autonomy and task significance can enhance job satisfaction [86];

○

The link between telecommuting and increased work commitment supports the idea that employees who are allowed to work remotely may feel more loyal and dedicated to their organization. This finding is consistent with the psychological contract theory, which suggests that employees reciprocate perceived organizational support with increased commitment [87];

○

The perceived impact of telecommuting on various aspects of hospital workers’ lives and careers during the COVID-19 crisis may have implications for research related to work-life balance, job adaptability, and organizational resilience during times of crisis;

○

The examination of social, economic, and environmental aspects of telecommuting sheds light on the interconnectedness of remote work and its broader implications beyond individual job satisfaction and performance. This finding may contribute to theories and discussions about the changing nature of work and its consequences on society and the environment;

○

The willingness of the vast majority of respondents to work remotely during a lockdown or quarantine highlights the adaptability of employees in the face of challenging circumstances. This finding may contribute to research on organizational resilience and employee behavior during crises;

○

The preference for remote work during lockdowns indicates that individuals value the continuity of their work and departmental support over the physical workspace. This finding challenges traditional notions of office-based work and may contribute to discussions on the future of work and workplace flexibility.

6.1.2. Practical Implications

▪

Employers should consider the educational background of their workforce when developing remote work policies. Tailoring remote work opportunities to suit the preferences of higher education graduates may lead to higher job satisfaction and better retention rates among this group;

▪

Organizations should recognize the importance of providing a conducive remote work environment for employees. Supporting employees in setting up home offices or providing access to co-working spaces can positively impact their productivity and well-being;

▪

Hospitals and other organizations should prioritize investments in technology and IT infrastructure to enable effective remote work. Providing employees with the necessary tools and training for remote work can lead to increased efficiency and job performance;

▪

Organizations should consider implementing telecommuting options as part of their employee retention and engagement strategies. Allowing employees to work remotely, at least part of the time, can foster a sense of trust and loyalty, leading to higher commitment levels;

▪

Managers should focus on clear communication and goal-setting for remote employees. When employees are not physically present in the office, it becomes crucial to establish transparent expectations and performance metrics to ensure work quality and accountability;

▪

Hospitals and organizations should recognize the multifaceted effects of telecommuting during crisis situations. Understanding the social, economic, and environmental impacts can inform more comprehensive crisis management strategies and remote work policies;

▪

Policymakers and organizations should consider the lessons learned from the COVID-19 crisis and explore ways to integrate telecommuting into their long-term strategies for emergency preparedness and business continuity;

▪

Organizations should be prepared to offer remote work options during times of crisis, such as lockdowns and quarantines, to support their employees and maintain operations. Having a flexible remote work policy in place can help to ensure business continuity during challenging times;

▪

Hospital administrators and managers should communicate the availability of remote work options to employees and provide the necessary resources to facilitate remote work. This could include providing remote access to hospital systems, ensuring data security, and offering training on remote work best practices.

6.2. Recommendations for Future Research

The present study only focused on one area, which can be characterized as a weakness, as the results cannot be compared to other regions or countries. However, this could be an opportunity for future research to be extended to other areas to provide an opportunity to compare and contrast other studies, both locally and internationally. This could lead to the inclusion of other variables, such as the association of telework with volunteering and teleworkers’ intention to contribute to society and the achievement of the SDGs. In other words, the analysis can be further developed to expand the areas of focus and broaden our understanding of how the SDGs intersect with the volunteering that has resulted from telecommuting. Therefore, the aim is to confirm telecommuting as an option for sustainable behavior since it can be transformed into a community-friendly form of work for more workers. In each case, the aim is to improve human well-being and enhance human and environmental health.

Then, it would be recommended to further research the topic in order to investigate the extent to which contemporary leaders possess the characteristics of digital leadership 4.0 linked to telework and digital transformation, as well as to future sustainability and the SDGs. This research could make a significant contribution to humanity’s future crises. In this context, further research should also be done on ways to assess the quality of work in person or from home.

Finally, a mixed research design approach that adds qualitative aspects in the form of interviews with both teleworkers and managers, as well as policymakers could provide additional data on the research topic and in particular on promoting sustainable behaviors and acceptance of sustainable development through teleworking.

7. Conclusions

The significance of telework spans various dimensions, making it crucial to explore this subject for the betterment of employees, organizations, and the community at large. Studies reveal that telecommuting substantially influences the labor market, yielding economic and social advantages. As a result, its multi-faceted impact reverberates across society and aligns with the Sustainable Development Goals (SDGs). Understanding these implications is essential to harness the full potential of telework for the benefit of all stakeholders involved.

In particular, implementing telecommuting entails intricate and ever-evolving adjustments in both technical and behavioral domains. However, limited research delves into the organizational behavioral aspect crucial for a successful transition to telework or hybrid work arrangements. To bridge this gap, our study presents a theoretical framework that outlines the essential elements for effectively transitioning to sustainable telecommuting practices, alongside the necessary telework leadership within organizations. By employing this framework, organizations can work towards achieving sustainable development while optimizing the benefits of telecommuting for all stakeholders involved.

The concept of telecommuting has garnered significant interest from researchers and the general public alike, owing to its potential to yield widespread benefits at the individual, organizational, and societal levels. Nevertheless, it is important to acknowledge that there are also potential drawbacks associated with telework. This article offers a comprehensive review of the existing telework literature, presenting a critical synthesis that embraces both its advantages and disadvantages. By adopting an interdisciplinary approach and gaining an integrated understanding of these aspects, we can better shape and inform organizational practices and public policies related to telecommuting, ensuring its optimal utilization and positive impact on various stakeholders.

Moreover, a significant and positive aspect of telework, highlighted in the current literature review, is its potential to foster linkages with other Sustainable Development Goal (SDG) areas. This stems from the observation that telework tends to be a community-friendly form of work. Notably, Kamerade and Burchell [27], found that many teleworkers engage in giving and volunteering, countering the notion that telework results in social distancing and suggesting its potential to promote sustainable behaviors. In light of these findings, this research strongly advocates for leaders to facilitate telecommuters in adopting green practices and encouraging volunteerism, as these actions can substantially contribute to achieving the SDGs.

The findings of this study strongly indicate that implementing a telecommuting program can significantly contribute to cultivating a positive work environment, leading to enhanced employee satisfaction. Such a work arrangement effectively addresses the fundamental psychological needs of employees, thereby fostering greater job satisfaction. This conclusion serves as compelling evidence for organizations seeking to formulate strategies for attracting and retaining talented staff. These results support the notion that well-designed management practices can mitigate any perceived detrimental effects, risks, or social inequalities associated with telework.

In conclusion, in response to the unique challenges posed by unprecedented times, leaders must re-evaluate their policies, while governments should prioritize safeguarding workers’ rights and freedoms. Recognizing the paramount importance of the employees themselves, the successful implementation of telework necessitates a thorough evaluation for the benefit of all stakeholders involved-employees, organizations, and society at large. By doing so, we can strive towards achieving social, environmental, and organizational sustainability, ensuring a positive outcome for everyone involved.