Sample records for care workforce effects

  1. The emerging primary care workforce: preliminary observations from the primary care team: learning from effective ambulatory practices project.

    Ladden, Maryjoan D; Bodenheimer, Thomas; Fishman, Nancy W; Flinter, Margaret; Hsu, Clarissa; Parchman, Michael; Wagner, Edward H


    Many primary care practices are changing the roles played by the members of their health care teams. The purpose of this article is to describe some of these new roles, using the authors' preliminary observations from 25 site visits to high-performing primary care practices across the United States in 2012-2013. These sites visits, to practices using their workforce creatively, were part of the Robert Wood Johnson Foundation-funded initiative, The Primary Care Team: Learning From Effective Ambulatory Practices.Examples of these new roles that the authors observed on their site visits include medical assistants reviewing patient records before visits to identify care gaps, ordering and administering immunizations using protocols, making outreach calls to patients, leading team huddles, and coaching patients to set self-management goals. The registered nurse role has evolved from an emphasis on triage to a focus on uncomplicated acute care, chronic care management, and hospital-to-home transitions. Behavioral health providers (licensed clinical social workers, psychologists, or licensed counselors) were colocated and integrated within practices and were readily available for immediate consults and brief interventions. Physicians have shifted from lone to shared responsibility for patient panels, with other team members empowered to provide significant portions of chronic and preventive care.An innovative team-based primary care workforce is emerging. Spreading and sustaining these changes will require training both health professionals and nonprofessionals in new ways. Without clinical experiences that model this new team-based care and role models who practice it, trainees will not be prepared to practice as a team. PMID:24128622

  2. The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: design of a cluster randomised controlled trial

    Jeon, Yun-Hee; Simpson, Judy M; Chenoweth, Lynn; Cunich, Michelle; Kendig, Hal


    Background A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care − CLiAC) was developed to improve managers’ leadership capacities to support the delivery of quality care in Australi...

  3. Health Care Reform and the Primary Care Workforce Bottleneck

    Schwartz, Mark D


    To establish and sustain the high-performing health care system envisioned in the Affordable Care Act (ACA), current provisions in the law to strengthen the primary care workforce must be funded, implemented, and tested. However, the United States is heading towards a severe primary care workforce bottleneck due to ballooning demand and vanishing supply. Demand will be fueled by the “silver tsunami” of 80 million Americans retiring over the next 20 years and the expanded insurance coverage fo...

  4. Effects of decentralisation and health system reform on health workforce and quality-of-care in Indonesia, 1993-2007.

    Diana, Aly; Hollingworth, Samantha A; Marks, Geoffrey C


    The impact of decentralisation, socioeconomic changes and healthcare reforms in Indonesia on type and distribution of healthcare providers and quality-of-care has been unclear. We examined workforce trends for healthcare facilities from 1993 to 2007 using the Indonesian Family Life Surveys. Each included a sample of public and private healthcare facilities, used standardised interviews for numbers and composition of staffing, and quality-of-care vignettes. There was an increase in multiprovider facilities and shift in profile of solo providers-increasing proportions of midwives and drop in doctors in rural areas (including facilities with doctors) and nurses in urban areas. Quality-of-care scores were low, particularly for nurses as solo providers. Despite increased numbers of healthcare workers and growth of the private sector, outer Java-Bali and rural areas continued to be disadvantaged in workforce capacity and quality-of-care. The results have implications for accreditation and in-service training requirements, the legal status of nurses and private sector regulation. PMID:24825032

  5. Economic Cost and Health Care Workforce Effects of School Closures in the U.S.

    Lempel, Howard; Epstein, Joshua M.; Hammond, Ross A


    School closure is an important component of U.S. pandemic flu mitigation strategy, but has important costs. We give estimates of both the direct economic and health care impacts for school closure durations of 2, 4, 6, and 12 weeks under a range of assumptions. We find that closing all schools in the U.S. for four weeks could cost between $10 and $47 billion dollars (0.1-0.3% of GDP) and lead to a reduction of 6% to 19% in key health care personnel.

  6. Evaluation of a support worker role, within a nurse delegation and supervision model, for provision of medicines support for older people living at home: the Workforce Innovation for Safe and Effective (WISE) Medicines Care study

    Lee, Cik Yin; Beanland, Christine; Goeman, Dianne; Johnson, Ann; Thorn, Juliet; Koch, Susan; Elliott, Rohan A


    Background Support with managing medicines at home is a common reason for older people to receive community nursing services. With population ageing and projected nurse shortages, reliance on nurses may not be sustainable. We developed and tested a new workforce model: ‘Workforce Innovation for Safe and Effective (WISE) Medicines Care’, which enabled nurses to delegate medicines support home visits for low-risk clients to support workers (known as community care aides [CCAs]). Primary study a...

  7. 75 FR 25259 - National Health Care Workforce Commission


    ...: Nominations can be submitted by either of the following: E- mail: . Mail: GAO Health Care... OFFICE National Health Care Workforce Commission AGENCY: Government Accountability Office (GAO). ACTION... Comptroller General of the United States responsibility for appointing 15 members to the National Health...

  8. Primary care workforce development in Europe.

    Groenewegen, P.; Heinemann, S.; Gress, S.; Schäfer, W.


    Background: There is a large variation in the organization of primary care in Europe. In some health care systems, primary care is the gatekeeper to more specialized care, whilst in others patients have the choice between a wide range of providers. Primary care has increasingly become teamwork. Meth

  9. Development of an interactive model for planning the care workforce for Alberta: case study

    Bloom Judy


    Full Text Available Abstract Introduction In common with other jurisdictions, Alberta faces challenges in ensuring a balance in health worker supply and demand. As the provider organization with province-wide responsibility, Alberta Health Services needed to develop a forecasting tool to inform its position on key workforce parameters, in the first instance focused on modeling the situation for Registered Nurses, Licensed Practical Nurses and health care aides. This case study describes the development of the model, highlighting the choices involved in model development. Case description A workforce planning model was developed to test the effect of different assumptions (for instance about vacancy rates or retirement and different policy choices (for example about the size of intakes into universities and colleges, different composition of the workforce. This case study describes the choices involved in designing the model. The workforce planning model was used as part of a consultation process and to develop six scenarios (based on different policy choices. Discussion and evaluation The model outputs highlighted the problems with continuation of current workforce strategies and the impact of key policy choices on workforce parameters. Conclusions Models which allow for transparency of the underlying assumptions, and the ability to assess the sensitivity of assumptions and the impact of policy choices are required for effective workforce planning.

  10. Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply

    Henrickson Michael


    Full Text Available Abstract The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career

  11. Growing ambulatory care nurse leaders in a multigenerational workforce.

    Moye, Janet P; Swan, Beth Ann


    Ambulatory care faces challenges in sustaining a nursing workforce in the future as newly licensed nurses are heavily recruited to inpatient settings and retirements will impact ambulatory care sooner than other areas. Building a diverse team by recruiting nurses of different ages (generations) and skills may result in a more successful and robust organization. Knowledge about generational characteristics and preferences will aid nurse leaders and recruiters in attracting high-quality, talented nurses. Nurses of Generations X and Y can increase their likelihood of success in ambulatory care by better understanding intergenerational issues. PMID:20050492

  12. Changing workforce demographics necessitates succession planning in health care.

    Collins, Sandra K; Collins, Kevin S


    Health care organizations continue to be plagued by labor shortage issues. Further complicating the already existing workforce challenges is an aging population poised to retire en masse within the next few years. With fewer cohorts in the age group of 25 to 44 years (Vital Speeches Day. 2004:71:23-27), a more mobile workforce (Grow Your Own Leaders: How to Identify, Develop, and Retain Leadership Talent, 2002), and an overall reduction in the number of individuals seeking employment in the health care field (J Healthc Manag. 2003:48:6-11), the industry could be faced with an unmanageable number of vacant positions throughout the organization. Bracing for the potential impact of these issues is crucial to the ongoing business continuity of health care organization. Many health care organizations have embraced succession planning to combat the potential labor famine. However, the health care industry as a whole seems to lag behind other industries in terms of succession planning efforts (Healthc Financ Manage. 2005;59:64-67). This article seeks to provide health care managers with a framework for improving the systematic preparation of the next generation of managers by analyzing the succession planning process. The proposition of these models is to initiate and simplify the gap reduction between theoretical concepts and future organizational application. PMID:17992105

  13. Societal Change, Care Need and Long-Term Care Workforce in Selected European Countries

    Schulz, Erika; Geyer, Johannes


    This paper aims to show the impact of societal change on the demand and supply of long-term care workforce. As age is the major driver of the need for care the growth in the number of elderly and oldest old will increase the demand for long-term care workforce. Caregiving to the elderly is predominantly the task of the family in almost all European countries. However, the majority of European countries provide some kind of formal care either in institutions, at home or as cash benefits. The a...

  14. Effective Training Skills. Workforce 2000 Partnership.

    Enterprise State Junior Coll., AL.

    This curriculum package on effective training skills for hourly textile employees has been developed by the Workforce 2000 Partnership, a network of industries and educational institutions that provides training in communication, computation, and creative thinking to employees and supervisors in textile, apparel, and carpet industries at 15 plants…

  15. Ageing, Care Need and Long-Term Care Workforce in Germany

    Schulz, Erika


    This paper aims to show the impact of population ageing on the demand and supply of long-term care workforce. As age is the major driver of the need for care the growth in the number of elderly and oldest old will increase the demand for long-term care services. Since 1995 formal care services in institutions and at home as well as cash benefits for informal home care financed by the long-term care insurance system are available, but only for people with at least substantial impairments in ac...

  16. Issues facing the future health care workforce: the importance of demand modelling.

    Segal, Leonie; Bolton, Tom


    This article examines issues facing the future health care workforce in Australia in light of factors such as population ageing. It has been argued that population ageing in Australia is affecting the supply of health care professionals as the health workforce ages and at the same time increasing the demand for health care services and the health care workforce.However, the picture is not that simple. The health workforce market in Australia is influenced by a wide range of factors; on the demand side by increasing levels of income and wealth, emergence of new technologies, changing disease profiles, changing public health priorities and a focus on the prevention of chronic disease. While a strong correlation is observed between age and use of health care services (and thus health care workforce), this is mediated through illness, as typified by the consistent finding of higher health care costs in the months preceding death.On the supply side, the health workforce is highly influenced by policy drivers; both national policies (eg funded education and training places) and local policies (eg work place-based retention policies). Population ageing and ageing of the health workforce is not a dominant influence. In recent years, the Australian health care workforce has grown in excess of overall workforce growth, despite an ageing health workforce. We also note that current levels of workforce supply compare favourably with many OECD countries. The future of the health workforce will be shaped by a number of complex interacting factors.Market failure, a key feature of the market for health care services which is also observed in the health care labour market - means that imbalances between demand and supply can develop and persist, and suggests a role for health workforce planning to improve efficiency in the health services sector. Current approaches to health workforce planning, especially on the demand side, tend to be highly simplistic. These include historical

  17. To effectively adapt and renew workforce competences

    Full text: Most of French operating nuclear plants were constructed within a small time window. Few new plants have come on line within the last decade. As a result, most operating plants today have an ageing workforce that is going to retire in large numbers. In the next ten years, 40% of EDF nuclear workforce is going to retire, in average 600 people per year. At the same time, potential restructurings are opportunities to provide internal personnel for Nuclear Power Plants. The first generation of nuclear industry workers was hired during nuclear plant starting and testing. That was an opportunity to for training in the field without nuclear hazard. In addition, the NPP requirements increased dramatically through the last twenty years. This situation led to start a project to effectively adapt and renew workforce competences in the 19 EDF NPP in France. This Paper describes three steps to successfully ensure this transition to the new generation of nuclear industry workers. Acting in the field from their initial training, recruits are earlier ready to perform: 1. A Nuclear Job Academy in each French region based on Team Building and Sister Plants association, new training techniques and field training regarding behaviour and craft. All the new comers in Nuclear Power Station are led by an experienced technical mentor and trained by managers and experienced staff. 2. Flow loop maintenance simulator in each plant.On line training and test for periodic training.Step by Step qualification process. Internal workforce moving and rotation become a consistent, safe and successful opportunity to renew competences: EDF Group promotes the mobility of human resources by improving skills management (training programs, encouraging profession mobility, and reorientation towards priority jobs). To ensure that each nuclear new comer from internal workforce meets the nuclear requirements (as hired people), we build strong process witch guaranty internal people recruitment with

  18. Effectively training the hospice and palliative medicine physician workforce for improved end-of-life health care in the United States.

    Bui, Thomas


    The widening gap between the demand for palliative care services and the supply of trained palliative care professionals has resulted in considerable end-of-life distress for patients. Without formal training in palliative medicine and end-of-life symptom management, physicians in the United States are less equipped to competently address seriously ill and dying patients' medical, emotional, and spiritual needs. Recent attempts within graduate medical education training deliberately seek to prepare a critical mass of physicians as the new hospice and palliative medicine workforce in the United States. In addition, healthcare reform proposals may re-define the National Health Service Corps (NHSC) post-graduate training over the next five years and the Hospice Medicare Benefit altogether. Healthcare policy options include steady changes at multiple levels of medical training -namely, medical school curriculum mandates, requiring all graduate physician residency training to foster patient-centered communication skills and discussions about advanced directives, and instituting palliative medicine proficiency Continuing Medical Education (CME) requirements for all states' medical licensing boards. Attracting qualified physicians to serve patients at the end of life, innovative medical school loan repayment programs and scholarships will also foster excellence in the field of hospice and palliative medicine. Correcting our current paucity of formal training in palliative medicine better utilizes hospice and restores patients' dignity at the end of life. PMID:22174315

  19. Impact of Ageing on Long-Term Care Workforce in Denmark

    Schulz, Erika


    This paper aims to show the impact of societal change on the demand and supply of long-term care workforce. As age is the major driver of the need for care the growth in the numberof elderly and oldest old will increase the demand for long-term care workforce. Caregiving to the elderly is predominantly the task of the family in almost all European countries. However, the majority of European countries provide some kind of formal care either in institutions, at home or as cash benefits. The am...

  20. Dynamic simulation for effective workforce management in new product development

    M. Mutingi


    Full Text Available Effective planning and management of workforce for new product development (NPD projects is a great challenge to many organisations, especially in the presence of engineering changes during the product development process. The management objective in effective workforce management is to recruit, develop and deploy the right people at the right place at the right time so as to fulfill organizational objectives. In this paper, we propose a dynamic simulation model to address the workforce management problem in a typical NPD project consisting of design, prototyping, and production phases. We assume that workforce demand is a function of project work remaining and the current available skill pool. System dynamics simulation concepts are used to capture the causality relationships and feedback loops in the workforce system from a systems thinking. The evaluation of system dynamics simulation reveals the dynamic behaviour in NPD workforce management systems and shows how adaptive dynamic recruitment and training decisions can effectively balance the workforce system during the NPD process.

  1. Availability of Child Care in Rural Communities: Implications for Workforce Recruitment and Retention.

    Henning-Smith, Carrie; Kozhimannil, Katy B


    The objective of this study was to identify differences in child care availability by rural-urban location for all counties in Wisconsin, and describe implications for recruitment and retention of health care workforce. We used data on licensed child care slots for young children (age poverty and higher unemployment than micropolitan and metropolitan counties. The association between geographic location and child care availability remained, even after adjusting for household structure and labor force participation. The number of hours men worked and the percentage of men not working were both negatively associated with available child care slots, whereas there was not a significant relationship between women's labor force participation and child care availability. Rural areas face health care workforce shortages. Recruitment strategies to overcome shortages must move beyond individual-level incentives to focus on community context and family support, including availability of child care in rural counties. PMID:26596864

  2. A Dual-Driver Model of Retention and Turnover in the Direct Care Workforce

    Mittal, Vikas; Rosen, Jules; Leana, Carrie


    Purpose: The purpose of this study was to understand the factors associated with turnover and retention of direct care workers. We hypothesize that a dual-driver model that includes individual factors, on-the-job factors, off-the-job factors, and contextual factors can be used to distinguish between reasons for direct care workforces (DCWs)…

  3. Understanding and improving communication processes in an increasingly multicultural aged care workforce.

    Nichols, Pam; Horner, Barbara; Fyfe, Katrina


    This study explored how culture shapes relationships in aged care and the extent to which the residential aged care sector supports a cohesive multicultural workforce. An exploratory methodology utilising semi-structured questionnaires collected data from 58 participants comprising: staff who provide direct care to residents; managers; and family members from six residential care facilities in Perth, Western Australia. Communication issues emerged as an over-arching theme, and included interpersonal communication, the effect of cultural norms on communication and the impact of informal and formal workplace policies relating to spoken and written language. Sixty percent of participants from a culturally and linguistically diverse (CaLD) background had experienced negative reactions from residents with dementia, linked to visible cultural difference. They used a range of coping strategies including ignoring, resilience and avoidance in such situations. CaLD participants also reported prejudicial treatment from non-CaLD staff. The findings highlight the need for organisations to incorporate explicit processes which address the multiple layers of influence on cross cultural communication: internalised beliefs and values; moderating effects of education, experience and social circumstance; and factors external to the individuals, including workplace culture and the broader political economy, to develop a cohesive multicultural workplace. PMID:25661853

  4. Forecasting the nursing workforce in a dynamic health care market.

    Dumpe, M L; Herman, J; Young, S W


    The ability to discern the interacting factors that affect supply and demand for nurses could help nurse educators and nurse leaders allocate resources to meet these needs. Forecasting models must take into account the interactions of three crucial groups of health care providers--physicians, nurse practitioners, and physician's assistants. Buerhaus has noted that market size, wages, preferences for nursing services, and availability of substitutes influence the demand for nursing services. Changes in nurse supply resulting from Medicare reimbursement for nursing services have not been studied, though it could safely be projected that such reimbursement will increase nurse supply. Nurses with baccalaureate degrees and advanced practice preparation will be in the greatest demand in ambulatory care, managed care, public health, and home care settings, raising concerns again that the educational mix is in need of adjustment upwards. PMID:9748982

  5. Strengthening organizational commitment. Understanding the concept as a basis for creating effective workforce retention strategies.

    Manion, Jo


    One of the most significant challenges facing any health care leader today is that of building commitment among followers. The last decade, with its tumultuous changes in our organizations, left many employees emotionally detached from their workplace. Mistrust, increasing cynicism, escalating financial pressures, and continuing challenges adversely impact our workforce's organizational commitment. The author explores the concept of commitment, which can serve as a basis for developing practical effective retention strategies. PMID:15192998

  6. The Impacts of Electronic Health Record Implementation on the Health Care Workforce.

    Zeng, Xiaoming


    Health care organizations at various levels are transitioning into the new electronic era by implementing and adopting electronic health record systems. New job roles will be needed for this transition, and some current job roles will inevitably become obsolete due to the change. In addition to training new personnel to fill these new roles, the focus should also be on equipping the current health care workforce with knowledge and skills in health information technology and health informatics that will support their work and improve quality of care. PMID:26961833

  7. Selecting tomorrow's physicians: the key to the future health care workforce.

    Mahon, Kelly E; Henderson, Mackenzie K; Kirch, Darrell G


    Recent U.S. health care reform efforts have focused on three main goals: improving health care for individuals, improving population health, and lowering costs. Physicians, who traditionally have practiced with considerable autonomy, will be required to become members of the team-based patient care models necessary to achieve these goals. In this perspective, the authors assert that medical school admissions, the selection of the future physician workforce, is a key component of health care reform. They review the historical context for medical school admission processes, which have placed a premium on grades and standardized test scores, and examine how admission practices are undergoing fundamental changes in order to select physicians with both the academic and interpersonal and intrapersonal competencies necessary to operate in the health care system of the future. The authors describe how new techniques, such as holistic review and multiple mini-interviews, are contributing to the shift toward competency-based medical education. Innovations underway at the Association of American Medical Colleges to transform medical school admissions also are explored. The authors conclude by arguing that although the admission process has great potential to transform the future health care workforce, major overhauls of the health care payment and delivery systems must be achieved alongside innovations in health professions education to truly transform the U.S. health care system. PMID:24128626

  8. Workforce matters: exploring a new flexible role in health care

    Bridges, Jaqueline


    This thesis describes an action research study that took place in the context of increasing intervention by UK central government in the shaping and delivery of health services, and broadening expectations about who could deliver services. The study was aimed at exploring the issues arising from the development of the interprofessional care co-ordinator (IPCC) role in an acute in-patient setting. The role was new, introduced with an inherent flexibility that enabled IPCCs to speed patients ...

  9. Listening to the Voices of Children in Foster Care: Youths Speak out about Child Welfare Workforce Turnover and Selection

    Strolin-Goltzman, Jessica; Kollar, Sharon; Trinkle, Joanne


    Child welfare workforce turnover rates across private and public child welfare agencies are concerning. Although research about the causes of child welfare workforce turnover has been plentiful, empirical studies on the effects of turnover on child outcomes are sparse. Furthermore, the voices and experiences of youths within the system have been…

  10. Effective leadership, teamwork and mentoring--essential elements in promoting generational cohesion in the nursing workforce and retaining nurses.

    Nelsey, Lorraine; Brownie, Sonya


    Despite recent increases in nurse recruitment in Australia, the current nursing workforce is still below the predicted numbers for the future demands. The combination of an ageing workforce, high nursing staff turnover and an inability to attract and retain nurses is eroding the capacity of the health care sector to appropriately respond to the care needs of the community. Currently, the nursing workforce may have as many as four generations working together. Differences in employment needs and values, work ethics, attitudes towards authority, and professional aspirations, contribute to some of the cross-generational problems that emerge and the turnover of nursing staff. Strategies to improve the retention rates of nurses need to focus on building a cohesive workforce by utilising the strengths and skill sets that characterise different generations of nurses, and creating the conditions in which nurses across all generations feel supported and valued. The aim of this article is to explain how effective leadership, teamwork and mentoring can assist efforts to promote generational cohesion and address the decline in the number of nurses in the workforce. PMID:23362605

  11. Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?

    Freund, T.; Everett, C.; Griffiths, P.; Hudon, C.; Naccarella, L.; Laurant, M.G.H.


    World-wide, shortages of primary care physicians and an increased demand for services have provided the impetus for delivering team-based primary care. The diversity of the primary care workforce is increasing to include a wider range of health professionals such as nurse practitioners, registered n

  12. Workforce Characteristics of Infant and Toddler Caregivers in Centers, Family Child Care Homes and Early Head Start Programs: A Massachusetts Capacity Study Research Brief

    Dennehy, Julie; Marshall, Nancy L.


    This research brief is part of the Massachusetts Capacity Study and focuses on the characteristics of the workforce caring for infants and toddlers in licensed or regulated early care and education in Massachusetts. The brief reviews the latest information on workforce education, staff-child ratios, group size, teacher tenure and turnover, and…

  13. Using Resources Effectively: An Overview of Funding Resources for Workforce Development Initiatives

    Gruber, David


    One model for effective workforce development--long-term, comprehensive career pathways combining post-secondary education, customized training and paid work experience--is an expensive one, frequently difficult for workforce agencies or postsecondary institutions employing traditional policies and practices to implement. But, by rethinking the…

  14. A Statewide Train-the-Trainer Model for Effective Entrepreneurship and Workforce Readiness Programming

    Fields, Nia Imani; Brown, Mananmi; Piechocinski, Alganesh; Wells, Kendra


    A statewide youth and adult train-the-trainer model that integrates workforce readiness and entrepreneurship can have a profound effect on young people's academic performance, interest in college, and overall youth development. Participants in workforce and entrepreneurship programs develop personal resources that have value in school, in the…

  15. Next generation workforce.

    Swenson, Cathy


    The health care industry has become a very complex business. CQsts are rising and resources such as funding and human capital are diminishing. Human capital resources are about to reach true crisis proportions. The vital workforce we have counted on is expected to begin thinning as large numbers of Boomers retire. Not only does this deplete the workforce from a pure numbers perspective, but it also affects intellectual capital and institutional memory. Generational trends and characteristics have affected the workforce environment and will continue to do so as another generation continues to enter the workforce. Generation Y, also tagged Nexter, offers core values that can bring positive changes to the health care workforce. Technology continues to change at lightning speed. Embracing new technology and using it to refine the way we do business will help deliver success. Meaningful strategic plans are needed to change the model of business delivery and employee care in our future workforce. PMID:18389847

  16. The HIV Primary Care Workforce of Tomorrow: The UCSF Integrated HIV/AIDS Primary Care Capacity Nurse Practitioner Program.

    Portillo, Carmen J; Stringari-Murray, Suzan; Fox, Christopher B; Monasterio, Erica; Rose, Carol Dawson


    The increasing demand for primary care services and the current health care workforce shortage is predicted to cause drastic reductions in the number of clinicians who are competent to provide HIV care. For the past decade, the University of California, San Francisco (UCSF) School of Nursing has provided HIV specialty education for Advanced Practice Nursing students in the Master's curriculum. In 2013, UCSF was funded by the Health Resources Services Administration to establish a nurse practitioner (NP) HIV primary care education program to expand the number of NPs prepared to provide culturally appropriate comprehensive HIV primary care. To this end, UCSF faculty have developed and validated a set of HIV Primary Care entry-level NP competencies, integrated general HIV knowledge into the NP curriculum, and enhanced our current HIV Specialty curriculum and clinical training. Described herein is UCSF's Integrated HIV/AIDS Primary Care Capacity Nurse Practitioner Program. PMID:27086186

  17. France panel discussion 'education and training for industry'. To effectively adapt and renew workforce competences

    EDF Operation and Engineering Company is the World's leading Nuclear Operator with the most important Nuclear fleet in Europe. Most of French operating nuclear plants were constructed within a small time window. Few new plants have come on line within the last decade. As a result, most operating plants today have an ageing workforce that is going to retire in large numbers. In the next ten years, 40% of EDF nuclear workforce is going to retire, in average 600 people per year and 1000 people at the peak. At the same time, EDF Company potential restructuring are opportunities to provide internal personnel for Nuclear Power Plants. The first generation of nuclear industry workforce was hired during nuclear plant starting and testing. That was an opportunity for training in the field without nuclear hazard. In addition, the NPP requirements increased dramatically through the last twenty years. This situation led to start a project to effectively adapt and renew workforce competences in the 19 EDF NPP in France. The presentation will focused on two main ways to achieve this goal. - A consistent program developed in 2007 to adapt our non-technical internal workforce for nuclear competences and skills needed. - A reliable Nuclear Educational and Training Program called 'Nuclear Academy' created for nuclear hired workforce based on team building, sister plants association, Senior workers and management presentations, and field training. (author)

  18. Health workforce development planning in the Sultanate of Oman: a case study

    Ghosh Basu


    Full Text Available Abstract Introduction Oman's recent experience in health workforce development may be viewed against the backdrop of the situation just three or four decades ago, when it had just a few physicians and nurses (mostly expatriate. All workforce categories in Oman have grown substantially over the last two decades. Increased self-reliance was achieved despite substantial growth in workforce stocks. Stocks of physicians and nurses grew significantly during 1985–2007. This development was the outcome of well-considered national policies and plans. This case outlines how Oman is continuing to turn around its excessive dependence on expatriate workforce through strategic workforce development planning. Case description The Sultanate's early development initiatives focused on building a strong health care infrastructure by importing workforce. However, the policy-makers stressed national workforce development for a sustainable future. Beginning with the formulation of a strategic health workforce development plan in 1991, the stage was set for adopting workforce planning as an essential strategy for sustainable health development and workforce self-reliance. Oman continued to develop its educational infrastructure, and began to produce as much workforce as possible, in order to meet health care demands and achieve workforce self-reliance. Other policy initiatives with a beneficial impact on Oman's workforce development scenario were: regionalization of nursing institutes, active collaboration with universities and overseas specialty boards, qualitative improvement of the education system, development of a strong continuing professional development system, efforts to improve workforce management, planned change management and needs-based micro/macro-level studies. Strong political will and bold policy initiatives, dedicated workforce planning and educational endeavours have all contributed to help Oman to develop its health workforce stocks and gain

  19. Workforce and Leader Development: Learning From the Baldrige Winners in Health Care.

    Arnold, Edwin W; Goodson, Jane R; Duarte, Neville T


    It is ironic that perhaps the only constant in health care organizations today is change. To compete successfully in health care and position an organization for high performance amid continuous change, it is very important for managers to have knowledge of the best learning and development practices of high-performing organizations in their industry. The rapid increases in the rate of technological change and geometric increases in knowledge make it virtually imperative that human resources are developed effectively. This article discusses the best learning and development practices among the Malcolm Baldrige National Quality Award winners in the health care industry since 2002 when the industry had its first award-winning organization. PMID:26217991




    Full Text Available It is generally recognized that there is diversity in the workforce of any enterprise, be it business, government, or civil society. This study therefore seeks to find out the impact of workforce diversity on organizational effectiveness using a Nigerian bank for the study. We used the Blau’s1977 index of heterogeneity to measure the diversity index. While asset growth for the year 2008 and 2009, using 2007 and 2008 as base year was used to measure the growth strategy. To determine group diversity and performance outcomes moderated by workgroup context, a series of hierarchical regression analysis were conducted. The study finds significant correlation between some of the diversity variables as well as individual diversity variables with the measures of organizational effectiveness. Also it reveals that gender and ethnicity are negatively related to both employee productivity and performance bonus. In addition the study find that gender, age and tenure diversities are positively correlated and are significantly related. It is recommended that company executives use good strategies to effectively manage workforce diversity and collaborative research efforts should be done to ascertain the contextual variables that moderate workforce diversity to produce positive performance outcomes.

  1. Critical cultural competence for culturally diverse workforces: toward equitable and peaceful health care.

    Almutairi, Adel F; Rondney, Patricia


    In this article, we argue that attaining equity, and therefore peace in health care delivery, necessitates that nursing and other health care professions more carefully attend to the sociocultural context in which health care is delivered. That sociocultural context includes culturally diverse patients, families, and communities, as well as health care providers who are themselves culturally diverse. We draw on findings from Almutairi's doctoral research with health care providers in Saudi Arabia to argue for what he has identified as critical cultural competence for health care providers. In so doing, we explicate the complexity of cultural and linguistic issues and power relations induced by race, class, and gender that can contribute to vulnerabilities for health care providers and recipients alike. PMID:23907302

  2. Economics of Caring Labor: Improving Compensation in the Early Childhood Workforce. Summary. Working Paper Series.

    Ripple, Carol

    Improving compensation in early care and education (ECE) has been and will continue to be an extremely difficult policy issue. The Mailman Family Foundation and the Foundation for Child Development convened a group of 18 representatives of diverse disciplines concerned about child- and elder-care compensation. This report details the issues…

  3. Effect of Prior Health-Related Employment on the Registered Nurse Workforce Supply.

    Yoo, Byung-kwan; Lin, Tzu-chun; Kim, Minchul; Sasaki, Tomoko; Spetz, Joanne


    Registered nurses (RN) who held prior health-related employment in occupations other than licensed practical or vocational nursing (LPN/LVN) are reported to have increased rapidly in the past decades. Researchers examined whether prior health-related employment affects RN workforce supply. A cross-sectional bivariate probit model using the 2008 National Sample Survey of Registered Nurses was esti- mated. Prior health-related employment in relatively lower-wage occupations, such as allied health, clerk, or nursing aide, was positively associated with working s an RN. ~>Prior health-related employ- ment in relatively higher-wage categories, such as a health care manager or LPN/LVN, was positively associated with working full-time as an RN. Policy implications are to promote an expanded career ladder program and a nursing school admission policy that targets non-RN health care workers with an interest in becoming RNs. PMID:27055308

  4. Timely and Effective Care - State

    U.S. Department of Health & Human Services — Timely and Effective Care measures - state data. This data set includes state-level data for measures of heart attack care, heart failure care, pneumonia care,...

  5. Transforming primary care: vision and reality: a whole systems approach to developing the workforce

    Jackson, C; Manley, K.


    Assumptions underpinning presentation – whole systems approaches and the skills required for culture change. Developing a shared purpose for primary care. Drawing on: - Whole systems approach to urgent and emergency care - Implementing shared values - Developing shared purposes across organisations: EKHUFT/Community Trust/Mental Health Trust - Developing the skills sets to be leaders: - Aspiring Consultant Programme - CLP programmes across the multi-disciplinary team ...

  6. Piecewise Linear Model for Multiskilled Workforce Scheduling Problems considering Learning Effect and Project Quality

    Shujin Qin


    Full Text Available Workforce scheduling is an important and common task for projects with high labour intensities. It becomes particularly complex when employees have multiple skills and the employees’ productivity changes along with their learning of knowledge according to the tasks they are assigned to. Till now, in this context, only little work has considered the minimum quality limit of tasks and the quality learning effect. In this research, the workforce scheduling model is developed for assigning tasks to multiskilled workforce by considering learning of knowledge and requirements of project quality. By using piecewise linearization to learning curve, the mixed 0-1 nonlinear programming model (MNLP is transformed into a mixed 0-1 linear programming model (MLP. After that, the MLP model is further improved by taking account of the upper bound of employees’ experiences accumulation, and the stable performance of mature employees. Computational experiments are provided using randomly generated instances based on the investigation of a software company. The results demonstrate that the proposed MLPs can precisely approach the original MNLP model but can be calculated in much less time.

  7. Trends over ten years in the primary care and community nurse workforce in England

    Drennan, Vari; Davis, Kathy


    This report gives a new analysis of the trends in the numbers, demographics and turnover of nursing and support to nursing staff employed in primary care and community nursing. The analysis provides new insights for commissioners and providers of services and education at a time when government policy is focusing on increased provision of health services outside of hospitals. The analysis adds to current knowledge on the statistics published by the Department of Health because it considers bo...

  8. The future dental workforce?

    Gallagher, J E; Wilson, N H F


    The Editor-in-Chief of the BDJ has previously raised important questions about dental workforce planning and the implications for dental graduates of recent changes and pressures. It is now time to revisit this issue. Much has changed since the last workforce review in England and Wales, and the rate of change is in all probability set to increase. First, at the time of writing this paper the momentous step of including dental care professionals (DCPs) on General Dental Council (GDC) registers in the United Kingdom has recently been completed. Second, the Scope of Practice of all dental professionals has been under consultation by the General Dental Council, and research evidence suggests that greater use should be made of skill-mix in the dental team. Third, within England, Lord Darzi has just published the 'Final Report of the NHS Next Stage Review', which emphasises 'quality care' and 'team-working' as key features of healthcare; this report was accompanied by an important document entitled 'A High Quality Workforce', in which plans for local workforce planning within the NHS are outlined, placing responsibilities at national, local and regional levels. Fourth, policy makers across the UK are wrestling with addressing oral health needs, promoting health and facilitating access to dental care, all of which have implications for the nature and shape of the dental workforce. Fifth, with the impact of globalisation and European policies we are net gainers of dentists as well as having more in training. Sixth, although there have been reviews and policy initiatives by regulatory, professional and other bodies in support of shaping the dental workforce, there has been little serious consideration of skill-mix and funding mechanisms to encourage team-working. Together, these events demand that we enter a fresh debate on the future dental workforce which should extend beyond professional and national boundaries and inform workforce planning. This debate is of great

  9. Converging values: matures, boomers, xers, and nexters in the health care workforce.

    Parsons, Lynn C


    The successful leader will try several strategies to bridge the generational gap and use the expertise of each cohort group to facilitate patient care. The energy, technoliteracy, and commitment to a balance between work and personal time by the Generation X and Nexters will complement the wisdom and nursing experience of the Mature and Baby Boomer generations. Time must be taken to understand the differences between the generations. Recognizing differences and appreciating the expertise that everyone brings to the workplace will create an environment that embraces generational diversity. Celebrating individual differences comes from taking time to learn about coworkers and will enhance a healthy work environment. PMID:12510502

  10. Towards building the oral health care workforce: who are the new dental therapists?

    Blue, Christine M; Lopez, Naty


    In 2009, Minnesota Governor Pawlenty signed into law a bill approving the creation of a new dental team member: the dental therapist. The intent of this legislation was to address oral health disparities by creating a dental professional who would expand access to dental care in Minnesota. This study aimed to describe the characteristics of the first class of dental therapy students at the University of Minnesota and to ascertain the values and motivations that led them to choose a career in dental therapy. Four surveys were used to create the composite profile of the ten students in this first dental therapy class: 1) the California Critical Thinking Skills Test, 2) the Learning Type Measure, 3) the Attitudes Toward Healthcare Survey, and 4) a values and motivation survey that included demographic data. The results of the surveys revealed interacting influences of the students' background, personal self-concept, and environment leading to a career decision to pursue dental therapy. PMID:21205726

  11. Timely and Effective Care - National

    U.S. Department of Health & Human Services — Timely and Effective Care measures - national data. This data set includes national-level data for measures of heart attack care, heart failure care, pneumonia...

  12. Timely and Effective Care - Hospital

    U.S. Department of Health & Human Services — Timely and Effective Care measures - provider data. This data set includes provider-level data for measures of heart attack care, heart failure care, pneumonia...

  13. Surviving managed care: the effect on job satisfaction in hospital-based nursing.

    Buiser, M


    Major changes brought about by managed care have redefined the nursing profession. Current trends such as case management, downsizing, restructuring of the workforce, and changes in the patient profile have had numerous effects, particularly on job satisfaction among hospital-based nurses. Strategies to improve job satisfaction during this era of increased managed care penetration include enhanced communication mechanisms, support from hospital administration, implementation of care models that promote professional nursing practice, adequate staffing, and competitive salaries and benefits. PMID:11033702

  14. Whistle-blowing and workplace culture in older peoples' care: qualitative insights from the healthcare and social care workforce.

    Jones, Aled; Kelly, Daniel


    Inquiries in the UK into mistreatment of older people by healthcare employees over the last 30 years have focused on introducing or supporting employee whistle-blowing. Although whistle-blowers have made an important contribution to patient safety it remains a controversial activity. The fate of whistle-blowers is bleak, often resulting in personal and professional sacrifices. Here we draw on the views of healthcare and social care employees working with older people to explore perceptions of whistle-blowing as well as alternative strategies that may be used to raise concerns about the mistreatment of patients by co-workers. Whistle-blowing was perceived as a negative term. Managers said they promoted open cultures underpinned by regular team meetings and an open-door ethos. Others described workplace norms that were somewhat at odds with these open culture ideals. Whistle-blowing was considered risky, and this led to staff creating informal channels through which to raise concerns. Those who witnessed wrongdoing were aware that support was available from external agencies but preferred local solutions and drew upon personal ethics rather than regulatory edicts to shape their responses. We argue that the importance of workplace relationships and informal channels for raising concerns should be better understood to help prevent the mistreatment of vulnerable groups. PMID:24717014

  15. Cause and effect relationship between post-merger operating performance changes and workforce adjustments

    Kuvandikov, A.


    Prior empirical research provides substantial evidence showing that mergers and acquisitions lead to operating performance decline (Ghosh, 2001). At the same time such transactions involve workforce reductions, as reported in the public media. However, systematic empirical evidence on the association between operating performance and workforce adjustments is inconclusive. On the one hand workforce reductions may be undertaken to improve efficiency and firm profitability (Cascio et al., 1997) ...

  16. Workforce deployment--a critical organizational competency.

    Harms, Roxanne


    Staff scheduling has historically been embedded within hospital operations, often defined by each new manager of a unit or program, and notably absent from the organization's practice and standards infrastructure and accountabilities of the executive team. Silvestro and Silvestro contend that "there is a need to recognize that hospital performance relies critically on the competence and effectiveness of roster planning activities, and that these activities are therefore of strategic importance." This article highlights the importance of including staff scheduling--or workforce deployment--in health care organizations' long-term strategic solutions to cope with the deepening workforce shortage (which is likely to hit harder than ever as the economy begins to recover). Viewing workforce deployment as a key organizational competency is a critical success factor for health care in the next decade, and the Workforce Deployment Maturity Model is discussed as a framework to enable organizations to measure their current capabilities, identify priorities and set goals for increasing organizational competency using a methodical and deliberate approach. PMID:19999370

  17. Workforce strategies to improve children's oral health.

    Goodwin, Kristine


    (1) Tooth decay is the most common chronic disease for children. (2) As millions receive dental coverage under the Affordable Care Act, the demand for dental services is expected to strain the current workforce's ability to meet their needs. (3) States have adopted various workforce approaches to improve access to dental care for underserved populations. PMID:25556260

  18. Role of AYUSH workforce, therapeutics, and principles in health care delivery with special reference to National Rural Health Mission

    Samal, Janmejaya


    Decades back AYUSH systems of medicine were limited to their own field with few exceptions in some states as health in India is a state issue. This took a reverse turn after the initiation of National Rural Health Mission (NRHM) in 2005 which brought the concept of “Mainstreaming of AYUSH and Revitalization of Local Health Traditions” utilizing the untapped AYUSH workforces, therapeutics and principles for the management of community health problems. As on 31/03/2012 AYUSH facilities were co-...

  19. Health Care Evolution Is Driving Staffing Industry Transformation.

    Faller, Marcia; Gogek, Jim


    The powerful transformation in the health care industry is reshaping not only patient care delivery and the business of health care but also demanding new strategies from vendors who support the health care system. These new strategies may be most evident in workforce solutions and health care staffing services. Consolidation of the health care industry has created increased demand for these types of services. Accommodating a changing workforce and related pressures resulting from health care industry transformation has produced major change within the workforce solutions and staffing services sector. The effect of the growth strategy of mergers, acquisitions, and organic development has revealed organizational opportunities such as expanding capacity for placing physicians, nurses, and allied professionals, among other workforce solutions. This article shares insights into workforce challenges and solutions throughout the health care industry. PMID:27584892

  20. Professionalization of the U.S. Defense Acquisition Workforce: Progress, Problems and Future Directions

    Rendon, Rene G.


    This paper provides a discussion on the professionalization of the U.S. defense acquisition workforce. Recent legislation and its impact on education, training, and experience requirements are first discussed. Problems in professionalizing the workforce are identified, such as accurately defining the workforce, developing and accessing workforce data, and effectively recruiting and retaining the workforce. The current challenges to managing the acquisition workforce include ...

  1. The global nephrology workforce: emerging threats and potential solutions!

    Sharif, Muhammad U; Elsayed, Mohamed E; Stack, Austin G


    Amidst the rising tide of chronic kidney disease (CKD) burden, the global nephrology workforce has failed to expand in order to meet the growing healthcare needs of this vulnerable patient population. In truth, this shortage of nephrologists is seen in many parts of the world, including North America, Europe, Australia, New Zealand, Asia and the African continent. Moreover, expert groups on workforce planning as well as national and international professional organizations predict further reductions in the nephrology workforce over the next decade, with potentially serious implications. Although the full impact of this has not been clearly articulated, what is clear is that the delivery of care to patients with CKD may be threatened in many parts of the world unless effective country-specific workforce strategies are put in place and implemented. Multiple factors are responsible for this apparent shortage in the nephrology workforce and the underpinning reasons may vary across health systems and countries. Potential contributors include the increasing burden of CKD, aging workforce, declining interest in nephrology among trainees, lack of exposure to nephrology among students and residents, rising cost of medical education and specialist training, increasing cultural and ethnic disparities between patients and care providers, increasing reliance on foreign medical graduates, inflexible work schedules, erosion of nephrology practice scope by other specialists, inadequate training, reduced focus on scholarship and research funds, increased demand to meet quality of care standards and the development of new care delivery models. It is apparent from this list that the solution is not simple and that a comprehensive evaluation is required. Consequently, there is an urgent need for all countries to develop a policy framework for the provision of kidney disease services within their health systems, a framework that is based on accurate projections of disease burden, a

  2. Exponential growth of dental schools in Chile: effects on academic, economic and workforce issues

    Ricardo Andres Cartes-Velasquez


    Full Text Available In the last 30 years, Chile has undergone noteworthy economic development and an exponential growth in the access of its population to higher education. The aim of this paper was to review the changes in academic, economic and workforce issues that occurred as a consequence of the growth in supply of undergraduate dental vacancies between 1997 and 2011. Data collected from the Consejo de Educación Superior - CES, Comisión Nacional de Acreditación - CNA, and Instituto Nacional de Estadísticas de Chile - INE included these variables: number of dental schools, school type (private or traditional, see explanation below, city where the school is located, entry vacancies, total student enrollment, admission scores, percentile rank of dentistry as a university career, tuition fees, accreditation status, and number of inhabitants. There was an exponential increase in dental schools in Chile (5 to 34 that occurred in association with the rise in tuition fees (US$ 3900 to US$ 9800, a deterioration in the academic level of dental students (650 to 550 points in admission scores and a predicted 77.5% oversupply of dentists by 2025, according to WHO criteria. The exponential increase in dental schools in Chile brought about negative consequences, such as increasing career costs, deterioration in the academic level of dental students, and an oversupply of dentists, associated with lower incomes and possibly leading to unemployment. Additional research should be conducted to determine whether an increase in the number of dentists can improve the population's access to dental care and reduce the oral disease burden.

  3. Health effects of low-level radiation: ethical issues for patients and workforces

    In the light of recent media-driven furores concerning the sensitive matter of patient consent, and the new legislation that impinges upon this issue, the nature of ethical practices for epidemiological research needs to be looked at anew. This paper considers the present landscape, with particular reference to the nuclear workforce and BNFL's current practice in this regard. (author)

  4. Health policy thoughtleaders' views of the health workforce in an era of health reform.

    Donelan, Karen; Buerhaus, Peter I; DesRoches, Catherine; Burke, Sheila P


    Although registered nurses rank similarly with physicians in the public's esteem, physicians are more visible than nurses in media coverage, public policy, and political spheres. Thus, nursing workforce issues are overshadowed by those of other health priorities, including Medicare and health reform. The purpose of this research was to understand the visibility and salience of the health workforce in general, gain an understanding about the effectiveness of messages concerning the nursing workforce in particular, and to understand why nursing workforce issues do not appear to have gained more traction in national health care policymaking. The National Survey of Thoughtleaders about the Health Workforce was administered via mail, telephone and online to health workforce and policy thoughtleaders from August 2009-October 2009. Of 301 thoughtleaders contacted, 123 completed questionnaires for a response rate of 41%. Thoughtleaders agree that nurses are critical to the quality and safety of our healthcare system, that there are current nursing shortages, and that nursing shortages will be intensified by health reform. Thoughtleaders reported that while they do hear about nursing issues frequently, they do not view most sources of information as proposing effective policy solutions. This study highlights a critical gap in effective policy advocacy and leadership to advance nurse workforce issues higher on the national health agenda. PMID:20637930

  5. Challenging the Feminisation of the Workforce: Rethinking the Mind-Body Dualism in Early Childhood Education and Care

    Van Laere, Katrien; Vandenbroeck, Michel; Roets, Griet; Peeters, Jan


    Despite the political and academic debate on the demands for more male workers in Early Childhood Education and Care (ECEC), no European country has reached the benchmark set for 2006 to have 20% male early childhood workers. This has predominantly been countered by challenging the idea that care for the youngest implies an activity "that…

  6. An Innovative Program in the Science of Health Care Delivery: Workforce Diversity in the Business of Health.

    Essary, Alison C; Wade, Nathaniel L


    According to the most recent statistics from the National Center for Education Statistics, disparities in enrollment in undergraduate and graduate education are significant and not improving commensurate with the national population. Similarly, only 12% of graduating medical students and 13% of graduating physician assistant students are from underrepresented racial and ethnic groups. Established in 2012 to promote health care transformation at the organization and system levels, the School for the Science of Health Care Delivery is aligned with the university and college missions to create innovative, interdisciplinary curricula that meet the needs of our diverse patient and community populations. Three-year enrollment trends in the program exceed most national benchmarks, particularly among students who identify as Hispanic and American Indian/Alaska Native. The Science of Health Care Delivery program provides students a seamless learning experience that prepares them to be solutions-oriented leaders proficient in the business of health care, change management, innovation, and data-driven decision making. Defined as the study and design of systems, processes, leadership and management used to optimize health care delivery and health for all, the Science of Health Care Delivery will prepare the next generation of creative, diverse, pioneering leaders in health care. PMID:27262477

  7. The Heterogeneous Effects of Workforce Diversity on Productivity, Wages and Profits

    Garnero, Andrea; Kampelmann, Stephan; Rycx, François


    We estimate the impact of workforce diversity on productivity, wages and productivity-wage gaps (i.e. profits) using detailed Belgian linked employer-employee panel data. Findings show that educational (age) diversity is beneficial (harmful) for firm productivity and wages. While gender diversity is found to generate significant gains in high-tech/knowledge intensive sectors, the opposite result is obtained in more traditional industries. Estimates neither vary substantially with firm size no...

  8. Reviewing The Benefits of Health Workforce Stability

    Buchan James


    Full Text Available Abstract This paper examines the issue of workforce stability and turnover in the context of policy attempts to improve retention of health workers. The paper argues that there are significant benefits to supporting policy makers and managers to develop a broader perspective of workforce stability and methods of monitoring it. The objective of the paper is to contribute to developing a better understanding of workforce stability as a major aspect of the overall policy goal of improved retention of health workers. The paper examines some of the limited research on the complex interaction between staff turnover and organisational performance or quality of care in the health sector, provides details and examples of the measurement of staff turnover and stability, and illustrates an approach to costing staff turnover. The paper concludes by advocating that these types of assessment can be valuable to managers and policy makers as they examine which policies may be effective in improving stability and retention, by reducing turnover. They can also be used as part of advocacy for the use of new retention measures. The very action of setting up a local working group to assess the costs of turnover can in itself give managers and staff a greater insight into the negative impacts of turnover, and can encourage them to work together to identify and implement stability measures.

  9. Strengthening the Math-Related Teaching Practices of the Early Care and Education Workforce: Insights from Experts. Policy Report

    Ryan, Sharon; Whitebook, Marcy; Cassidy, Deborah


    As a growing body of evidence links school success and early mathematical experiences, there is increasing interest in offering young children opportunities to bridge their informal understanding of mathematics with more formal concepts and processes. At the same time, many teachers and caregivers in the early care and education (ECE) field may…

  10. Maintaining a Sufficient and Quality Physician Workforce: The Role of For-profit Medical Schools.

    Babcock, Jessica M; Babcock, Blake D; Schwartz, Marshall Z


    Currently, in the United States there is a significant physician workforce shortage. This problem is likely to persist as there is no quick solution. The nature of this shortage is complex and involves factors such as an absolute physician shortage, as well as physician shortages in primary care and certain specialty care areas. In addition, there is a misdistribution of physicians to medically underserved areas and populations. The medical education system trains medical school graduates that eventually feed the physician workforce. However, several factors are in place which ultimately limits the effectiveness of this system in providing an appropriate workforce to meet the population demands. For-profit medical schools have been in existence in and around the continental US for many years and some authors have suggested that they may be a major contributor to the physician workforce shortage. There is currently one for-profit medical school in the US, however the majority exist in the Caribbean. The enrollment in and number of these schools have grown to partially meet the ever-growing demand for an increase in medical school graduates and they continue to provide a large number of graduates who return to the US for postgraduate medical training and, ultimately, increase the physician workforce. The question is whether this source will benefit the workforce quality and quantity needs of our growing and aging population. PMID:25114564

  11. Expanding the primary health care workforce through contracting with nongovernmental entities: the cases of Bahia and Rio de Janeiro

    Ireland, Megan; Cavalini, Luciana; Girardi, Sabado; Araujo, Edson C.; Lindelow, Magnus


    Background Brazil has experienced difficulties in attracting health professionals (especially doctors and nurses) to practice at the primary health care (PHC) level and in rural and remote areas. This study presents two case studies, each a current initiative in contracting for primary health services in Brazil: one for the state of Bahia and the other for the city of Rio de Janeiro. The two models differ considerably in context, needs, modalities, and outcomes. This article does not attempt ...

  12. First Annual LGBT Health Workforce Conference: Empowering Our Health Workforce to Better Serve LGBT Communities.

    Sánchez, Nelson F; Sánchez, John Paul; Lunn, Mitchell R; Yehia, Baligh R; Callahan, Edward J


    The Institute of Medicine has identified significant health disparities and barriers to health care experienced by lesbian, gay, bisexual, and transgender (LGBT) populations. By lowering financial barriers to care, recent legislation and judicial decisions have created a remarkable opportunity for reducing disparities by making health care available to those who previously lacked access. However, the current health-care workforce lacks sufficient training on LGBT-specific health-care issues and delivery of culturally competent care to sexual orientation and gender identity minorities. The LGBT Healthcare Workforce Conference was developed to provide a yearly forum to address these deficiencies through the sharing of best practices in LGBT health-care delivery, creating LGBT-inclusive institutional environments, supporting LGBT personal and professional development, and peer-to-peer mentoring, with an emphasis on students and early career professionals in the health-care fields. This report summarizes the findings of the first annual LGBT Health Workforce Conference. PMID:26789511

  13. The effects of patient care: A cross-sectional study of job stress, emotional exhaustion and job satisfaction among hospital employees

    Uteng, Karoline


    A great deal of the Norwegian healthcare workforce is employed in hospitals. Their well-being is important not only for the hospital employees themselves, but also for their patients. The current study wished to investigate the effect of patient care on hospital employees' perceived amount of job stress, emotional exhaustion and job satisfaction. It was hypothesized that patient care would elevate levels of the two first outcome variables as patient care can be stressful and bring psychologic...

  14. Bureau of Health Workforce

    ... address shortages, and develop ongoing strategies to monitor, forecast and meet long‐term health workforce needs. Scholarship, ... and low-interest loans available to students with financial need Shortage Designation The Bureau of Health Workforce ...

  15. The crisis in human resources for health care and the potential of a 'retired' workforce: case study of the independent midwifery sector in Tanzania.

    Rolfe, Ben; Leshabari, Sebalda; Rutta, Fredrik; Murray, Susan F


    The human resource crisis in health care is an important obstacle to attainment of the health-related targets for the Millennium Development Goals. One suggested strategy to alleviate the strain upon government services is to encourage new forms of non-government provision. Detail on implementation and consequences is often lacking, however. This article examines one new element of non-government provision in Tanzania: small-scale independent midwifery practices. A multiple case study analysis over nine districts explored their characteristics, and the drivers and inhibitors acting upon their development since permitted by legislative change. Private midwifery practices were found concentrated in a 'new' workforce of 'later life entrepreneurs': retired, or approaching retirement, government-employed nursing officers. Provision was entirely facility-based due to regulatory requirements, with approximately 60 'maternity homes' located mainly in rural or peri-urban areas. Motivational drivers included fear of poverty, desire to maintain professional status, and an ethos of community service. However, inhibitors to success were multiple. Start-up loans were scarce, business training lacking and registration processes bureaucratic. Cost of set-up and maintenance were prohibitively high, registration required levels of construction and equipping similar to government sector dispensaries. Communities were reluctant to pay for services that they expected from government. Thus, despite offering a quality of basic maternity care comparable to that in government facilities, often in poorly-served areas, most private maternity homes were under-utilized and struggling for sustainability. Because of their location and emphasis on personalized care, small-scale independent practices run by retired midwives could potentially increase rates of skilled attendance at delivery at peripheral level. The model also extends the working life of members of a professional group at a time of

  16. Civil Service Workforce Market Supply and the Effect on Cost Estimating Relationship (CERS) that May Effect the Productivity Factors for Future NASA Missions

    Sterk, Steve; Chesley, Stephan


    The upcoming retirement of the Baby Boomers will leave a workforce age gap between the younger generation (the future NASA decision makers) and the gray beards. This paper will reflect on the average age of the workforce across NASA Centers, the Aerospace Industry and other Government Agencies, like DoD. This paper will dig into Productivity and Realization Factors and how they get applied to bi-monthly (payroll) data for true full-time equivalent (FTE) calculations that could be used at each of the NASA Centers and other business systems that are on the forefront in being implemented. This paper offers some comparative costs analysis/solutions, from simple FTE cost-estimating relationships (CERs) versus CERs for monthly time-phasing activities for small research projects that start and get completed within a government fiscal year. This paper will present the results of a parametric study investigating the cost-effectiveness of alternative performance-based CERs and how they get applied into the Center's forward pricing rate proposals (FPRP). True CERs based on the relationship of a younger aged workforce will have some effects on labor rates used in both commercial cost models and other internal home-grown cost models which may impact the productivity factors for future NASA missions.

  17. Experiential Training for Empowerment of the Workforce.

    Cook, John A.

    As downsizing of government and business organizations has become widespread, many managers are seeking to increase productivity by empowering the workforce. When effectively and appropriately implemented, empowered workforce structures can cut costs and improve quality and safety. Yet resistance to such changes arises from a patriarchal…

  18. Building effective critical care teams

    Manthous, Constantine; Nembhard, Ingrid M; Hollingshead, Andrea B


    Critical care is formulated and delivered by a team. Accordingly, behavioral scientific principles relevant to teams, namely psychological safety, transactive memory and leadership, apply to critical care teams. Two experts in behavioral sciences review the impact of psychological safety, transactive memory and leadership on medical team outcomes. A clinician then applies those principles to two routine critical care paradigms: daily rounds and resuscitations. Since critical care is a team en...

  19. Building effective workforce management practices through shared governance and technology systems integration.

    Krive, Jacob


    In integrated delivery networks (IDNs) with complex management structures, shared governance in nursing is a proven model for health care delivery. After Advocate Health Care, the largest IDN in Illinois, implemented shared governance in its nursing, clinical, and non-clinical departments and restructured the organization's technology use, it benefited greatly from a new, shared decision-making process. After listening to business consultants, clinical professionals, and information technology experts, hospitals should take the blended, or comprehensive, approach to new projects. They can succeed by promoting communication supported by an integrated computer platform that helps nursing and business executives reach a consensus. Traditional modes of operation, in which individual administrative, clinical, and technology departments separately introduce innovation, do not deliver an advantage. However, models that incorporate open communication, integration, and knowledge sharing will help large IDNs and other complex health care organizations make the best possible use of their resources and investments. PMID:24294648

  20. Israeli registered nurse workforce

    Glazer Greer


    Abstract This commentary on the article by Nirel, Riba, Reicher and Toren, "Registered nurses in Israel - workforce employment characteristics and projected supply", describes major findings from this important Israeli study and links findings to other nursing workforce studies worldwide. Israeli projections include a 25% decrease in RNs in the workforce by 2028; the greater likelihood of leaving the progression of young nurses compared to older nurses, and the greater likelihood of leaving t...

  1. Building effective critical care teams.

    Manthous, Constantine; Nembhard, Ingrid M; Hollingshead, Andrea B


    Critical care is formulated and delivered by a team. Accordingly, behavioral scientific principles relevant to teams, namely psychological safety, transactive memory and leadership, apply to critical care teams. Two experts in behavioral sciences review the impact of psychological safety, transactive memory and leadership on medical team outcomes. A clinician then applies those principles to two routine critical care paradigms: daily rounds and resuscitations. Since critical care is a team endeavor, methods to maximize teamwork should be learned and mastered by critical care team members, and especially leaders. PMID:21884639

  2. Children's workforce strategy.


    The Green Paper, Every child matters, recognised the crucial importance of the children's workforce to improving outcomes for children and young people. The Children's Workforce Strategy sets out the government's vision of a world-class children's workforce which is increasingly competent and confident, inspiring trust and respect from parents and carers as well as from children and young people themselves. The document sets out four major strategic challenges: to recruit more high quality staff into the children's workforce; to retain people in the workforce including by offering better development and career progression; to strengthen interagency and multi-disciplinary working; and to promote stronger leadership and management. The strategy builds on work already in hand and on existing good practice. It puts forward proposals to tackle each of the strategic challenges with action nationally and locally. PMID:16114715

  3. Civil Service Workforce Market Supply and the Effect on the Cost Estimating Relationships (CERs) that may effect the Productivity Factors for Future NASA Missions

    Sterk, Steve; Chesley, Stephen


    The upcoming retirement of the Baby Boomers on the horizon will leave a performance gap between younger generation (the future NASA decision makers) and the gray beards. This paper will reflect on the average age of workforce across NASA Centers, the Aerospace Industry and other Government Agencies, like DoD. This papers will dig into Productivity and Realization Factors and how they get applied to bimonthly (payroll data) for true FTE calculations that could be used at each of the NASA Centers and other business systems that are on the forefront in being implemented. This paper offers some comparative costs solutions, from simple - full time equivalent (FTE) cost estimating relationships CERs, to complex - CERs for monthly time-phasing activities for small research projects that start and get completed within a government fiscal year. This paper will present the results of a parametric study investigating the cost-effectiveness of different alternatives performance based cost estimating relationships (CERs) and how they get applied into the Center s forward pricing rate proposals (FPRP). True CERs based on the relationship of a younger aged workforce will have some effects on labor rates used in both commercial cost models and internal home-grown cost models which may impact the productivity factors for future NASA missions.

  4. The status of adolescent medicine: building a global adolescent workforce.

    Lee, Lana; Upadhya, Krishna K; Matson, Pamela A; Adger, Hoover; Trent, Maria E


    Remarkable public health achievements to reduce infant and child mortality as well as improve the health and well-being of children worldwide have successfully resulted in increased survival and a growing population of young people aged 10-24 years. Population trends indicate that the current generation of 1.8 billion young people is the largest in history. However, there is a scarcity of dedicated resources available to effectively meet the health needs of adolescents and young adults worldwide. Growing recognition of the pivotal roles young people play in the cultures, societies, and countries in which they live has spurred an expanding global movement to address the needs of this special population. Building an effective global workforce of highly-skilled adolescent health professionals who understand the unique biological, psychological, behavioral, social, and environmental factors that affect the health of adolescents is a critical step in addressing the health needs of the growing cohort of young people. In this review, we aim to: 1) define a global assessment of the health needs for adolescents around the world; 2) describe examples of current training programs and requirements in adolescent medicine; 3) identify existing gaps and barriers to develop an effective adolescent health workforce; and 4) develop a call for targeted actions to build capacity of the adolescent health workforce, broaden culturally relevant research and evidence-based intervention strategies, and reinforce existing interdisciplinary global networks of youth advocates and adolescent health professionals to maximize the opportunities for training, research, and care delivery. PMID:26167974

  5. MS PHD'S: Effective Pathways to Mentoring for Increasing Diversity in the Geoscience Workforce - What have we done? What can we still do?

    Ricciardi, L.; Johnson, A.; Williamson Whitney, V.; Ithier-Guzman, W.; Johnson, A.; Braxton, L.


    In 2003 a young, African-American geoscientist and professor discovered significant gaps in the recruitment and retention of minority students within the post-secondary educational community and a subsequent correlation of underrepresentation within the geosciences workforce. From this research, a unique concept was born: The Minorities Striving and Pursuing Higher Degrees of Success in Earth System Science Professional Development Program (MS PHD'S PDP). This program was founded upon a vision that minorities can and should play a role in facilitating a network to attract, retain and increase minority representation in the geosciences workforce. In 2003, the pilot MS PHD'S program focused on a simple grass roots concept of effective mentoring and professional development administered by and for minorities through professional development activities. Today the program has grown to an impressive number of alumni who, in addition to establishing careers in the ESS professional workforce, also return to mentor the next generation of upcoming minority geoscientists. Alumni, mentors and current participants not only experience what has grown into a three-phase program but also enjoy enhanced benefits of ongoing interaction through social media, list-servs and webinars. While keeping its feet firmly planted in its grass-roots philosophy of effective mentoring and professional development by and for minorities, the MS PHD'S program looks to the future, by asking the question, "What can we do next to ensure the future of maintaining and growing diverse representation in the geosciences workforce?" Looking ahead, future goals for the program include increasing its pilot representation motto of "by and for minorities", exploring new technologies and digital tools, and expanding its supportive network of distinguished academicians, scientific organizations, industry partners, alumni, peers, and representatives of non-science disciplines.

  6. Geographic Analysis of the Radiation Oncology Workforce

    Purpose: To evaluate trends in the geographic distribution of the radiation oncology (RO) workforce. Methods and Materials: We used the 1995 and 2007 versions of the Area Resource File to map the ratio of RO to the population aged 65 years or older (ROR) within different health service areas (HSA) within the United States. We used regression analysis to find associations between population variables and 2007 ROR. We calculated Gini coefficients for ROR to assess the evenness of RO distribution and compared that with primary care physicians and total physicians. Results: There was a 24% increase in the RO workforce from 1995 to 2007. The overall growth in the RO workforce was less than that of primary care or the overall physician workforce. The mean ROR among HSAs increased by more than one radiation oncologist per 100,000 people aged 65 years or older, from 5.08 per 100,000 to 6.16 per 100,000. However, there remained consistent geographic variability concerning RO distribution, specifically affecting the non-metropolitan HSAs. Regression analysis found higher ROR in HSAs that possessed higher education (p = 0.001), higher income (p < 0.001), lower unemployment rates (p < 0.001), and higher minority population (p = 0.022). Gini coefficients showed RO distribution less even than for both primary care physicians and total physicians (0.326 compared with 0.196 and 0.292, respectively). Conclusions: Despite a modest growth in the RO workforce, there exists persistent geographic maldistribution of radiation oncologists allocated along socioeconomic and racial lines. To solve problems surrounding the RO workforce, issues concerning both gross numbers and geographic distribution must be addressed.

  7. Geographic Analysis of the Radiation Oncology Workforce

    Aneja, Sanjay [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States); Smith, Benjamin D. [University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Gross, Cary P. [Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States); Department of General Internal Medicine, Yale University School of Medicine, New Haven, CT (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Haffty, Bruce G. [Cancer Institute of New Jersey, New Brunswick, NJ (United States); Roberts, Kenneth [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Yu, James B., E-mail: [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States)


    Purpose: To evaluate trends in the geographic distribution of the radiation oncology (RO) workforce. Methods and Materials: We used the 1995 and 2007 versions of the Area Resource File to map the ratio of RO to the population aged 65 years or older (ROR) within different health service areas (HSA) within the United States. We used regression analysis to find associations between population variables and 2007 ROR. We calculated Gini coefficients for ROR to assess the evenness of RO distribution and compared that with primary care physicians and total physicians. Results: There was a 24% increase in the RO workforce from 1995 to 2007. The overall growth in the RO workforce was less than that of primary care or the overall physician workforce. The mean ROR among HSAs increased by more than one radiation oncologist per 100,000 people aged 65 years or older, from 5.08 per 100,000 to 6.16 per 100,000. However, there remained consistent geographic variability concerning RO distribution, specifically affecting the non-metropolitan HSAs. Regression analysis found higher ROR in HSAs that possessed higher education (p = 0.001), higher income (p < 0.001), lower unemployment rates (p < 0.001), and higher minority population (p = 0.022). Gini coefficients showed RO distribution less even than for both primary care physicians and total physicians (0.326 compared with 0.196 and 0.292, respectively). Conclusions: Despite a modest growth in the RO workforce, there exists persistent geographic maldistribution of radiation oncologists allocated along socioeconomic and racial lines. To solve problems surrounding the RO workforce, issues concerning both gross numbers and geographic distribution must be addressed.

  8. Improvement, trust, and the healthcare workforce

    Berwick, D


    Although major defects in the performance of healthcare systems are well documented, progress toward remedy remains slow. Accelerating improvement will require large shifts in attitudes toward and strategies for developing the healthcare workforce. At present, prevailing strategies rely largely on outmoded theories of control and standardisation of work. More modern, and much more effective, theories of production seek to harness the imagination and participation of the workforce in reinventi...

  9. Exploring Leadership within the Modern Organization: Understanding the Dynamics of Effective Leadership of a Virtual, Multigenerational Workforce

    Schultz, Roger W.


    This study examined a relatively new but growing set of leadership challenges that the leader of the modern organization faces more frequently due to the dynamics of the workplace. The new challenges involve leading a workforce virtually, in that more frequently workers are physically dispersed away from the leader and fellow workers. The second…

  10. Effects of Family of Origin on Women’s and Men’s Workforce Involvement

    Evans, M. D. R.; Jonathan Kelley


    This report investigates the effects of family background on men’s and women’s labour force participation and on the number of hours that they work. It uses the largest dataset ever brought to bear on this topic in Australia, the combined set of 13 IsssA surveys conducted between 1984-2001 (IsssA-Pool) with over 26,000 cases.) Logistic regression and OLS models allow us to estimate the separate effects of a variety of aspects of family background. Parental education encourage participation of...

  11. Effects of government spending on research workforce development: evidence from biomedical postdoctoral researchers.

    Hyungjo Hur

    Full Text Available We examine effects of government spending on postdoctoral researchers' (postdocs productivity in biomedical sciences, the largest population of postdocs in the US. We analyze changes in the productivity of postdocs before and after the US government's 1997 decision to increase NIH funding. In the first round of analysis, we find that more government spending has resulted in longer postdoc careers. We see no significant changes in researchers' productivity in terms of publication and conference presentations. However, when the population is segmented by citizenship, we find that the effects are heterogeneous; US citizens stay longer in postdoc positions with no change in publications and, in contrast, international permanent residents (green card holders produce more conference papers and publications without significant changes in postdoc duration. Possible explanations and policy implications of the analysis are discussed.

  12. Workforce shortages are a global issue.

    Christmas, Kate; Hart, Karen A


    A consortium of international organizations convened a first-ever Global Health Care Workforce Conference to discuss the worldwide shortages of health care workers and the migration patterns of health care workers from developing nations to the first world. Over 300 participants from 47 countries, including one-third from developing countries, discussed a variety of critical issues ranging from global immigration, recruitment, economics, to partnerships. Results, recommendations, and actionable items generated from the conference, as well as ways to put these ideas into practice, will be critical for sustaining and improving world health and the plight and numbers of health care providers. PMID:17803002

  13. Effect of Primary Health Care Orientation on Chronic Care Management

    Schmittdiel, Julie A.; Shortell, Stephen M.; Rundall, Thomas G; Bodenheimer, Thomas; SELBY, Joe V.


    PURPOSE It has been suggested that the best way to improve chronic illness care is through a redesign of primary care emphasizing comprehensive, coordinated care as espoused by the Chronic Care Model (CCM). This study examined the relationship between primary care orientation and the implementation of the CCM in physician organizations.

  14. Challenges confronting the health workforce in sub-Saharan Africa.

    Habte, Demissie; Dussault, Gilles; Dovlo, Delanyo


    Sub-Saharan Africa and the international health community face a daunting challenge to deal with an extraordinary disease burden and improve the health status of Africans. Despite decades of effort to provide effective, equitable and affordable health care services, the health indices of Africans have stagnated and in some instances have deteriorated. Africa is the only continent that has not fully benefited from recent advances in biomedical sciences that brought health tools and technologies to tackle most of the disease burden. The emergence of the HIV/AIDS epidemic has confounded the health scene and posed further challenges. Several factors are responsible for this state of affairs: macro factors, that represent the broader socio-cultural environment that impact on health, and micro factors, which are largely health sector specific. There is increasing recognition that the major limiting factor to improved health outcomes is not lack of financial resources or health technologies but the lack of implementation capacity which depends on the presence of a functional health system. The drivers and architects of this are health workers, 'the most important of the health system's input'. The Commission on Macroeconomics and Health advocates a greatly increased investment in health rising in low income countries to a per capita expenditure of US $34 per year and states that the problem in implementing this recommendation is not difficulty in raising funds but the capacity of the health sector itself to absorb the increased flow. Yet, until fairly recently sufficient attention has not been directed to the role of the health workforce. The failure to develop and deploy an appropriate and motivated health workforce, and the environment necessary for the workforce to perform optimally is clearly a critical determinant of the health status of Africans. This paper summarizes key issues facing the workforce and outlines a framework to develop strategies to address them

  15. Transportability of tertiary qualifications and CPD: A continuing challenge for the global health workforce

    Saltman Deborah C


    Full Text Available Abstract Background In workforces that are traditionally mobile and have long lead times for new supply, such as health, effective global indicators of tertiary education are increasingly essential. Difficulties with transportability of qualifications and cross-accreditation are now recognised as key barriers to meeting the rapidly shifting international demands for health care providers. The plethora of mixed education and service arrangements poses challenges for employers and regulators, let alone patients; in determining equivalence of training and competency between individuals, institutions and geographical locations. Discussion This paper outlines the shortfall of the current indicators in assisting the process of global certification and competency recognition in the health care workforce. Using Organisation for Economic Cooperation and Development (OECD data we highlight how International standardisation in the tertiary education sector is problematic for the global health workforce. Through a series of case studies, we then describe a model which enables institutions to compare themselves internally and with others internationally using bespoke or prioritised parameters rather than standards. Summary The mobility of the global health workforce means that transportability of qualifications is an increasing area of concern. Valid qualifications based on workplace learning and assessment requires at least some variables to be benchmarked in order to judge performance.

  16. Engaging the Workforce - 12347

    Likert, Covey, and a number of others studying and researching highly effective organizations have found that performing functions such as problem-solving, decision-making, safety analysis, planning, and continuous improvement as close to the working floor level as possible results in greater buy-in, feelings of ownership by the workers, and more effective use of resources. Empowering the workforce does several things: 1) people put more effort and thought into work for which they feel ownership, 2) the information they use for planning, analysis, problem-solving,and decision-making is more accurate, 3) these functions are performed in a more timely manner, and 4) the results of these functions have more credibility with those who must implement them. This act of delegation and empowerment also allows management more time to perform functions they are uniquely trained and qualified to perform, such as strategic planning, staff development, succession planning, and organizational improvement. To achieve this state in an organization, however, requires a very open, transparent culture in which accurate, timely, relevant, candid, and inoffensive communication flourishes, a situation that does not currently exist in a majority of organizations. (authors)

  17. Engaging the Workforce - 12347

    Gaden, Michael D. [Transuranic Waste Processing Center, Lenoir City, TN 37771 (United States); Wastren Advantage Inc. (United States)


    Likert, Covey, and a number of others studying and researching highly effective organizations have found that performing functions such as problem-solving, decision-making, safety analysis, planning, and continuous improvement as close to the working floor level as possible results in greater buy-in, feelings of ownership by the workers, and more effective use of resources. Empowering the workforce does several things: 1) people put more effort and thought into work for which they feel ownership, 2) the information they use for planning, analysis, problem-solving,and decision-making is more accurate, 3) these functions are performed in a more timely manner, and 4) the results of these functions have more credibility with those who must implement them. This act of delegation and empowerment also allows management more time to perform functions they are uniquely trained and qualified to perform, such as strategic planning, staff development, succession planning, and organizational improvement. To achieve this state in an organization, however, requires a very open, transparent culture in which accurate, timely, relevant, candid, and inoffensive communication flourishes, a situation that does not currently exist in a majority of organizations. (authors)

  18. Study of the effect of humanistic nursing care model wards in Children Caring Ward School on the nurses' caring ability

    Jiao He; De-Ying Hu; Yi-Lan Liu; Li-Fen Wu; Lian Liu


    Objective: To understand the effect of humanistic nursing care model wards in Children Caring Ward School (CCWS) on the nurses' caring ability. Methods: Questionnaire 25 nurses of humanistic nursing care model wards in CCWS using the Nkongho Caring Ability Inventory (CAI) before and after implement the humanistic nursing care model, including reform the systems of nursing care, introduce humanistic care model, implement the humanistic care, to measure the nurses' caring ability. Results: The nurses' caring ability had significantly developed on total, cognition dimension, courage dimension and patience dimension after all measures considered (p Conclusions: The humanistic nursing care model wards in CCWS has a positive effect on the nurses' caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients' satisfaction.

  19. Effective Perioperative Communication to Enhance Patient Care.

    Garrett, J Hudson


    Breakdowns in health care communication are a significant cause of sentinel events and associated patient morbidity and mortality. Effective communication is a necessary component of a patient safety program, which enables all members of the interdisciplinary health care team to effectively manage their individual roles and responsibilities in the perioperative setting; set expectations for safe, high-reliability care; and measure and assess outcomes. To sustain a culture of safety, effective communication should be standardized, complete, clear, brief, and timely. Executive leadership and support helps remove institutional barriers and address challenges to support the engagement of patients in health care communication, which has been shown to improve outcomes, reduce costs, and improve the patient experience. PMID:27472971

  20. Leaders, leadership and future primary care clinical research

    Qureshi Nadeem; Mitchell Caroline; Magin Parker; McCowan Colin; Lasserson Daniel; Kadam Umesh; Hanratty Barbara; Del Mar Chris; Cleland Jennifer; Furler John; Rait Greta; Steel Nick; van Driel Mieke; Ward Alison


    Abstract Background A strong and self confident primary care workforce can deliver the highest quality care and outcomes equitably and cost effectively. To meet the increasing demands being made of it, primary care needs its own thriving research culture and knowledge base. Methods Review of recent developments supporting primary care clinical research. Results Primary care research has benefited from a small group of passionate leaders and significant investment in recent decades in some cou...

  1. Primary care nurses: effects on secondary care referrals for diabetes?

    Dijk, C.E. van; Verheij, R.A.; Hansen, J.; Velden, L. van der; Nijpels, G.; Groenewegen, P.P.; Bakker, D.H. de


    BACKGROUND: Primary care nurses play an important role in diabetes care, and were introduced in GP-practice partly to shift care from hospital to primary care. The aim of this study was to assess whether the referral rate for hospital treatment for diabetes type II (T2DM) patients has changed with t

  2. Development and Implementation of a Child Welfare Workforce Strategy to Build a Trauma-Informed System of Support for Foster Care.

    Kerns, Suzanne E U; Pullmann, Michael D; Negrete, Andrea; Uomoto, Jacqueline A; Berliner, Lucy; Shogren, Dae; Silverman, Ellen; Putnam, Barbara


    Effective strategies that increase the extent to which child welfare professionals engage in trauma-informed case planning are needed. This study evaluated two approaches to increase trauma symptom identification and use of screening results to inform case planning. The first study evaluated the impact of training on trauma-informed screening tools for 44 child welfare professionals who screen all children upon placement into foster care. The second study evaluated a two-stage approach to training child welfare workers on case planning for children's mental health. Participants included (a) 71 newly hired child welfare professionals who received a 3-hr training and (b) 55 child welfare professionals who participated in a full-day training. Results from the first study indicate that training effectively increased knowledge and skills in administering screening tools, though there was variability in comfort with screening. In the second study, participants self-reported significant gains in their competency in identifying mental health needs (including traumatic stress) and linking children with evidence-based services. These findings provide preliminary evidence for the viability of this approach to increase the extent to which child welfare professionals are trauma informed, aware of symptoms, and able to link children and youth with effective services designed to meet their specific needs. PMID:26928411

  3. The Changing Global Context of Virtual Workforce

    James A. Ejiwale


    Full Text Available The technological revolution occurring in today’s market place has made it possible for many companies to be innovative about the way and where work is done. To get the job done, due to digital revolution, companies have turned to virtual workforce to harness the benefits of connectivity and effective information sharing among stakeholders to get the job done. More important, the success of coordinating work among a virtual workforce for profitability in a rapidly changing global environment depends on “effective indirect communication” between the leadership and the virtual workforce. This article will address the importance of effective communication as a necessary tool for the success of e-leadership, productivity improvement in virtual work environment.

  4. Improving oral healthcare delivery systems through workforce innovations: an introduction

    Mertz, Elizabeth A.; Finocchio, Len


    The objective of this paper is to describe the purpose, rationale and key elements of the special issue, Improving Oral Healthcare Delivery Systems through Workforce Innovations. The purpose of the special issue is to further develop ideas presented at the 2009 Institute of Medicine (IOM) workshop, Sufficiency of the U.S. Oral Health Workforce in the Coming Decade. Using the IOM discussions as their starting point, the authors evaluate oral health care delivery system performance for specific...

  5. Attrition from nursing and midwifery workforce: analysis of 'young' leavers

    DIMITROVA, Margarita


    The current work examines some of the main factors which possibly influence the number of ‘young’ leavers from the nursing and midwifery workforce. Two main reasons justify the significance of this research. Firstly, the education and training of health care staff requires a significant financial and time investment. Secondly, there is a relationship between the size of the available workforce and patient outcomes. The research was conducted in two stages. The first is a qualitative resear...

  6. Effective access to health care in Mexico

    Gutiérrez, Juan Pablo; García-Saisó, Sebastián; Dolci, Germán Fajardo; Ávila, Mauricio Hernández


    Background Effective access measures are intended to reflect progress toward universal health coverage. This study proposes an operative approach to measuring effective access: in addition to the lack of financial protection, the willingness to make out-of-pocket payments for health care signifies a lack of effective access to pre-paid services. Methods Using data from a nationally representative health survey in Mexico, effective access at the individual level was determined by combining fin...

  7. Dental workforce planning in Sri Lanka

    De Silva, Maduwage


    Sri Lanka is a developing South Asian country which provides free education and healthcare for all its citizens. This thesis presents a policy-oriented study, partly empirical and partly modelling, whose aim was to understand dental care provision and workforce planning, at a time where Sri Lanka?s dental health policies appear to have failed to achieve their intended results, leading to a mismatch between supply and demand, i.e. “underemployment and unemployment” of trained dental surgeons, ...

  8. Securing the Workforce

    Clausen, Lisbeth; Kruuse, Mikkel


    Japan is world renowned for its quality production and efficient management, lean. However, economic stagnation - and a bottom score in the OECD statistics on women participation in the workforce - has forced the Japanese government to focus on the economic benefits of diversity in Corporate Japa...

  9. Solomon Islands : Workforce Development

    World Bank


    Solomon Islands has undertaken a comprehensive assessment of the strength of its workforce development (WfD) policies and institutions to support these initiatives and enhance evidence based dialogue on their implementation. This assessment has been based on the World Bank s Systems Approach for Better Education Results (SABER) systems benchmarking initiative, under which a suite of analyt...

  10. The Pedagogy of Leadership and Educating a Global Workforce

    Davis, Dannielle Joy


    No Child Left Behind illustrates policy that stifles pedagogy and the effective training of a global workforce. In an effort to enhance the educational outcomes of students, critical pedagogy and Gardner's Five Minds for the Future are presented as tools for the cultivation of a more innovative workforce. The pedagogical strategies and…

  11. Managing a scarce resource: addressing critical health workforce challenges.

    Giepmans. P.; Dussault, G.; Batenburg, R.; Frich, J.; Olivers, R.; Sermeus, W.


    With health care services significantly changing, the challenge is to initiate innovative, situational and integrated workforce forecasting and planning. Many health systems require a shift in mindset to move to the planning of skill mixes for health care professionals. This implies great challenges

  12. Primary Care: Medicine's Gordian Knot.

    Oddone, Eugene Z; Boulware, L Ebony


    Primary care is the cornerstone of effective and efficient healthcare systems. Patients prefer a trusted primary care provider to serve as the first contact for all of their healthcare questions, to help them make important health decisions, to help guide them through an expanding amount of medical information and to help coordinate their care with all other providers. Patients also prefer to establish an ongoing, continuous relationship with their primary care provider. However, fewer and fewer physicians are choosing primary care as a career, threatening the foundation of the health system. We explore the central challenges of primary care defined by work-force controversies about who can best deliver primary care. We also explore the current challenging reimbursement model for primary care that often results in fragmenting care for patients and providers. Finally, we explore new models of primary care health delivery that may serve as partial solutions to the current challenges. PMID:26802754

  13. Palliative care teams: effective through moral reflection.

    Hermsen, M.A.; Have, H.A.M.J. ten


    Working as a multidisciplinary or interdisciplinary team is an essential condition to provide good palliative care. This widespread assumption is based on the idea that teamwork makes it possible to address the various needs of the patient and family more effectively. This article is about teamwork

  14. Integrated Care and the Evolution of the Multidisciplinary Team.

    Dobbins, Mary Iftner; Thomas, Sheila A; Melton, Stacy L Stokes; Lee, Stacy


    The primary care medical home continues to adapt by applying new research to population health approaches to care. With the discovery that life experiences trigger a chain of biologic events linked to chronic illnesses, the role of patient-centered multidisciplinary care teams becomes of paramount importance. Subsequently, mental health professionals are being incorporated into the primary care setting, using their skills in nontraditional models to customize care for each patient. This "integration" of primary care and unique mental health services engenders opportunity for enhanced clinical care, professional workforce development and support, more effective population health initiatives, and informed health care policy. PMID:27262000

  15. Forum on Workforce Development

    Hoffman, Edward


    APPEL Mission: To support NASA's mission by promoting individual, team, and organizational excellence in program/project management and engineering through the application of learning strategies, methods, models, and tools. Goals: a) Provide a common frame of reference for NASA s technical workforce. b) Provide and enhance critical job skills. c) Support engineering, program and project teams. d) Promote organizational learning across the agency. e) Supplement formal educational programs.

  16. CAM practitioners in the Australian health workforce: an underutilized resource

    Grace Sandra


    Full Text Available Abstract Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health

  17. Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives.

    Morris, Joanne; Grimmer, Karen; Gilmore, Lisa; Perera, Chandima; Waddington, Gordon; Kyle, Greg; Ashman, Bryan; Murphy, Karen


    Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. PMID:25018637

  18. American Psychiatric Nurses Association-Transitions in Practice Certificate Program: Bridging the Knowledge Gap in Caring for Psychiatric Patients Within the General Nursing Workforce.

    Adams, Susie M; Black, Patricia


    The purpose of this article is to publicize an important new Web-based educational program. Recognizing the growing gap in psychiatric-mental health knowledge and the need to better prepare new graduates and nurses transitioning from other service lines into psychiatric inpatient nursing settings, the American Psychiatric Nurses Association developed a 15-hour, modularized curriculum to provide foundational psychiatric-mental health knowledge. This modularized curriculum, called American Psychiatric Nurses Association Transitions in Practice (ATP) focuses on the knowledge and skills to insure the success of nurses new to psychiatric-mental health nursing settings and to improve the overall care for persons with mental health and substance use disorders. The ATP program is also proving to be useful content for nurses in emergency departments, hospitals, and other health settings to improve their care of patients with psychiatric and mental health needs. A summary of the program modules and a toolkit with suggested measures for nurses, patients, and agency outcomes is described. Feedback from participants completing the ATP program within the first 6 months is overwhelmingly positive and holds promise for widespread application across a variety of health care settings. PMID:27259126

  19. Matching residency numbers to the workforce needs.

    Khan, S; Johnston, L; Faimali, M; Gikas, P; Briggs, T W


    Matching the number of surgeons to the demands for orthopedic services has been notoriously difficult. Not only does one need to evaluate current trends in the supply and provision of services but anticipate the impact of future reforms on these variables. The British Orthopaedic Association has aspired to provide consultant to population ratio of 1:15,000 by 2020. Currently, the orthopedic community is tasked with providing care for an aging population with soaring levels of obesity; with both of these factors set to grow and also with an overall decline in productivity. Orthopedic surgeons must brace themselves for an explosion in demand. At the same time, a paradigm shift has occurred in the delivery of services with the creation of specialist centers. We are amidst a generational shift in the demographics and psychology of the orthopedic workforce. The orthopedic community must be aware of the effects of these far-reaching changes when tailoring the supply of surgeons for the future needs. PMID:24706153

  20. Geoscience and the 21st Century Workforce

    Manduca, C. A.; Bralower, T. J.; Blockstein, D.; Keane, C. M.; Kirk, K. B.; Schejbal, D.; Wilson, C. E.


    Geoscience knowledge and skills play new roles in the workforce as our society addresses the challenges of living safely and sustainably on Earth. As a result, we expect a wider range of future career opportunities for students with education in the geosciences and related fields. A workshop offered by the InTeGrate STEP Center on 'Geoscience and the 21st Century Workforce' brought together representatives from 24 programs with a substantial geoscience component, representatives from different employment sectors, and workforce scholars to explore the intersections between geoscience education and employment. As has been reported elsewhere, employment in energy, environmental and extractive sectors for geoscientists with core geology, quantitative and communication skills is expected to be robust over the next decade as demand for resources grow and a significant part of the current workforce retires. Relatively little is known about employment opportunities in emerging areas such as green energy or sustainability consulting. Employers at the workshop from all sectors are seeking the combination of strong technical, quantitative, communication, time management, and critical thinking skills. The specific technical skills are highly specific to the employer and employment needs. Thus there is not a single answer to the question 'What skills make a student employable?'. Employers at this workshop emphasized the value of data analysis, quantitative, and problem solving skills over broad awareness of policy issues. Employers value the ability to articulate an appropriate, effective, creative solution to problems. Employers are also very interested in enthusiasm and drive. Participants felt that the learning outcomes that their programs have in place were in line with the needs expressed by employers. Preparing students for the workforce requires attention to professional skills, as well as to the skills needed to identify career pathways and land a job. This critical

  1. Redistributive effects of Swedish health care finance.

    Gerdtham, U G; Sundberg, G


    This paper investigates the redistributive effects of the Swedish health care financing system in 1980 and 1990 for four different financial sources: county council taxes, payroll taxes, direct payments and state grants. The redistributive effects are decomposed into vertical, horizontal and 'reranking' segments for each of the four financial sources. The data used are based on probability samples of the Swedish population, from the Level of Living Survey (LNU) from 1981 and 1991. The paper concludes that the Swedish health care financing system is weakly progressive, although direct payments are regressive. There is some horizontal inequity and 'reranking', which mainly comes from the county council taxes, since those tax rates vary for each county council. The implication is that, to some extent, people with equal incomes are treated unequally. PMID:10346051

  2. Characteristics of effective health care managers.

    Johnson, Sherryl W


    This article provides an overview of traditional and contemporary management theories. Concerns, characteristics, and skills of effective managers are also presented. Further, a self-assessment (survey) of 7 highly effective health care managers in a South Georgia community was conducted to determine their ratings on 6 management indices. The assessment or Scale of Transformational Leadership uses a Likert-type scale to allow for the evaluation of managers. The scale contains 6 management elements for assessment: attention, meaning, trust, self, vision, and feeling. Individual ratings and group summary skills rating are presented. Findings revealed the order of managerial importance of the elements as follows (from highest to lowest): Management of Trust, Management of Attention, Management of Self, Management of Feeling, Management of Meaning, and Management of Risk. As a second tier, the final ratings are corroborated by health care management interns. PMID:15923923

  3. Understanding effective care management implementation in primary care: a macrocognition perspective analysis

    Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A.


    Background Care management in primary care can be effective in helping patients with chronic disease improve their health status. Primary care practices, however, are often challenged with its implementation. Incorporating care management involves more than a simple physical process redesign to existing clinical care routines. It involves changes to who is working with patients, and consequently such things as who is making decisions, who is sharing patient information, and how. Studying the ...

  4. Effect of Organizational Culture on Patient Access, Care Continuity, and Experience of Primary Care.

    Hung, Dorothy; Chung, Sukyung; Martinez, Meghan; Tai-Seale, Ming


    This study examined relationships between organizational culture and patient-centered outcomes in primary care. Generalized least squares regression was used to analyze patient access, care continuity, and reported experiences of care among 357 physicians in 41 primary care departments. Compared with a "Group-oriented" culture, a "Rational" culture type was associated with longer appointment wait times, and both "Hierarchical" and "Developmental" culture types were associated with less care continuity, but better patient experiences with care. Understanding the unique effects of organizational culture can enhance the delivery of more patient-centered care. PMID:27232685

  5. Impending challenges in the hematopoietic stem cell transplantation physician workforce.

    Gajewski, James L; LeMaistre, C Frederick; Silver, Samuel M; Lill, Michael C; Selby, George B; Horowitz, Mary M; Rizzo, J Douglas; Heslop, Helen E; Anasetti, Claudio; Maziarz, Richard T


    With increasing use of high dose chemotherapy with autologous and allogeneic transplants the need for the transplant physician workforce requires reassessment. The types of transplants and patients are also shifting toward transplants being done in patients with more comorbidities and more commonly these types of patients require more work effort per patient from the transplant physician. Additionally, HSCT survivors often require ongoing care at the transplant center due to the inability of the primary care workforce or the hematology/oncology workforce to absorb caring for post complex post transplant patients. The adult transplant workforce has had very few physicians join under age 40. Nearly 50% of adult transplant physicians are over age 50 whereas only 28% of pediatric transplant physicians are over age 50. By 2020, it is projected that we will need 1,264 new adult transplant physicians and 94 pediatric transplant physicians. Training time for a physician is approximately 15 years. The capping of both medical school slots and residency slots since the early '80s is now having a very big impact on supply, but other factors are also affecting supplies such as generational differences, lifestyle expectations, and the change of the medical workforce from being mostly men. Workforce shortages are being reported for many specialities. Workforce problems are also present for nurses, pharmacists and medical technologists. So increasing use of general internists and mid-level providers may not exist as a solution. Transplant physicians must be actively engaged in the medical education process to show young medical students and residents who are not committed to another sub specialty career the excitement and challenges of a career in bone marrow transplantation, so that our field will have providers for the future. PMID:19781658

  6. People matter: tomorrow's workforce for tomorrow's world.

    Easmon, Charles


    The focus of any health service, now and into the future, should be people delivering safe, quality care to people; care that covers not just diagnosis and treatment, but the whole experience that patients and their carers have of the service. Workforce development, the process by which the current and future workforce is planned and trained, must be related to current and future patterns of service delivery and take account of financial reality. It cannot exist in isolation. Despite employing 1.3 million people, upon whom up to 70% of its budget is spent, the NHS has been curiously relaxed about the workforce development of both its staff in training and of those trained staff who, with the impact of demographic change and the increasing speed of technological progress, will need to adapt to new ways of working and learn new skills. Given that the NHS has been repeatedly criticised by the Health Select Committee for its failure to link workforce planning and development with service and financial planning, and that inadequate staffing has been a feature of a number of recent organizational failures, how is this to be achieved? Some NHS organisations have been shown to be poor employers with a culture of bullying and fear and the use of suspensions and financial settlements bound to gagging clauses to remove whistleblowers. Gender and ethnic discrimination is an issue not yet fully resolved. Furthermore with the demographic changes around the increasing needs of an elderly population, the introduction of new technology and the increasing interdependency of health and social care, there is a need for a clear vision as to how the future NHS will be structured and developed. Fewer large specialist centres are likely, combined with local, community oriented integrated services with appropriate specialist support. Decisions need to be taken about this in time to give workforce development processes time to plan the best skill mix combinations and to develop clinicians

  7. Finnish SMEs’ perspectives on workforce diversity

    Doan, Duong


    Workforce diversity has been gaining popularity in the US since the 1960s. Giant companies worldwide have realized the benefits of workforce diversity despite having to deal with the challenges it brings. This study examines the workforce diversity situation in Finland through exploiting the perspectives of Finnish SMEs on workforce diversity. The focus will be on their experiences of a diverse workforce, benefits a diverse workforce brings and what challenges the SMEs are facing in relation ...

  8. Using competences and competence tools in workforce development.

    Green, Tess; Dickerson, Claire; Blass, Eddie

    The NHS Knowledge and Skills Framework (KSF) has been a driving force in the move to competence-based workforce development in the NHS. Skills for Health has developed national workforce competences that aim to improve behavioural performance, and in turn increase productivity. This article describes five projects established to test Skills for Health national workforce competences, electronic tools and products in different settings in the NHS. Competences and competence tools were used to redesign services, develop job roles, identify skills gaps and develop learning programmes. Reported benefits of the projects included increased clarity and a structured, consistent and standardized approach to workforce development. Findings from the evaluation of the tools were positive in terms of their overall usefulness and provision of related training/support. Reported constraints of using the competences and tools included issues relating to their availability, content and organization. It is recognized that a highly skilled and flexible workforce is important to the delivery of high-quality health care. These projects suggest that Skills for Health competences can be used as a 'common currency' in workforce development in the UK health sector. This would support the need to adapt rapidly to changing service needs. PMID:21072016

  9. Training Tomorrow's Nuclear Workforce

    Training tomorrow's Nuclear Workforce Start with the children. That is the message Brian Molloy, a human resources expert in the IAEA's Nuclear Power Engineering Section, wants to convey to any country considering launching or expanding a nuclear power programme. Mathematics and science curricular and extra-curricular activities at secondary and even primary schools are of crucial importance to future recruiting efforts at nuclear power plants, he says:''You need to interest children in science and physics and engineering. The teaching needs to be robust enough to teach them, but it must also gain their interest.'' Recruiting high-calibre engineers needed for the operation of nuclear power plants is a growing challenge, even for existing nuclear power programmes, because of a wave of retirements combined with increasing global demand. But essential as engineers are, they are only a component of the staff at any nuclear power plant. In fact, most employees at nuclear power plants are not university graduates - they are skilled technicians, electricians, welders, fitters, riggers and people in similar trades. Molloy argues that this part of the workforce needs more focus. ''It's about getting a balance between focusing on the academic and the skilled vocational'', he says, adding that countries considering nuclear power programmes often initially place undue focus on nuclear engineers.

  10. Workforce planning and knowledge management for new nuclear programmes

    The authors discusses the report Milestones in the Development of a National Infrastructure for Nuclear Power produced by the IAEA to provide guidance on the use of integrated workforce planning as a tool to effectively develop these resources. The report describes three distinct phases in the development of a national infrastructure. It shows how to elaborate a workforce plan for implementing a national nuclear power program. The authors emphasize that the nuclear power field, comprising industry, government authorities, regulators, R and D organizations and educational institutions, relies for its continued success on a specialized, highly trained and motivated workforce. The role of knowledge management in nuclear power is underlined

  11. Effects of Co-Worker and Supervisor Support on Job Stress and Presenteeism in an Aging Workforce: A Structural Equation Modelling Approach

    Tianan Yang


    Full Text Available We examined the effects of co-worker and supervisor support on job stress and presenteeism in an aging workforce. Structural equation modelling was used to evaluate data from the 2010 wave of the Health and Retirement Survey in the United States (n = 1649. The level of presenteeism was low and the level of job stress was moderate among aging US workers. SEM revealed that co-worker support and supervisor support were strongly correlated (β = 0.67; p < 0.001. Job stress had a significant direct positive effect on presenteeism (β = 0.30; p < 0.001. Co-worker support had a significant direct negative effect on job stress (β = −0.10; p < 0.001 and presenteeism (β = −0.11; p < 0.001. Supervisor support had a significant direct negative effect on job stress (β = −0.40; p < 0.001 but not presenteeism. The findings suggest that presenteeism is reduced by increased respect and concern for employee stress at the workplace, by necessary support at work from colleagues and employers, and by the presence of comfortable interpersonal relationships among colleagues and between employers and employees.

  12. The Patient-Centered Medical Home: Preparation of the Workforce, More Questions than Answers.

    Reynolds, P Preston; Klink, Kathleen; Gilman, Stuart; Green, Larry A; Phillips, Russell S; Shipman, Scott; Keahey, David; Rugen, Kathryn; Davis, Molly


    As American medicine continues to undergo significant transformation, the patient-centered medical home (PCMH) is emerging as an interprofessional primary care model designed to deliver the right care for patients, by the right professional, at the right time, in the right setting, for the right cost. A review of local, state, regional and national initiatives to train professionals in delivering care within the PCMH model reveals some successes, but substantial challenges. Workforce policy recommendations designed to improve PCMH effectiveness and efficiency include 1) adoption of an expanded definition of primary care, 2) fundamental redesign of health professions education, 3) payment reform, 4) responsiveness to local needs assessments, and 5) systems improvement to emphasize quality, population health, and health disparities. PMID:25707941

  13. Ethnic diversity in the nurse workforce: a literature review.

    Otto, Laureen A; Gurney, Cindy


    In the 2000-2003 New York State Nurses Association Strategic Plan, the Board of Directors called for an assessment of the progress made toward achieving an ethnically diverse nursing workforce as reflected in the literature. In this paper the authors have responded to that request and offer a snapshot of progress as well as standstills in the journey toward diversity. Although the literature has tended to focus on cultural competency of the healthcare worker, and includes numerous calls for action to diversify the nurse workforce, very little scholarly work has been conducted that rigorously evaluates such diversification activities. The purpose of this literature review is to explore existing scholarly work in ethnic diversity at three levels: in the general workforce, the healthcare workforce, and the nursing workforce. The authors explored the literature as it addresses two aspects: academic and career factors influencing diversity; and recruitment, retention, and other strategies employed to diversify the workforce. By exploring the existing research, gaps can be identified in order to either direct further research, or target funding to recruitment strategies to effectively enhance a more ethnically diverse nurse workforce. PMID:17665538

  14. The effects of integrated care on professionals: a systematic review

    Janse, B.; Fabbricotti, I.N.; Huijsman, R.


    Background and aim Traditional care is increasingly being replaced by integrated care models, which often implies changes for health professionals involved. However, although literature on integrated care is abundant, the primary focus is rarely on professionals. Consequently, it is not clear if and how they are affected by integrated care interventions. The aim of this study, therefore, is to provide a systematic review of the literature on the effect of integrated care on professionals. Met...

  15. Integrating palliative care into comprehensive cancer care.

    Abrahm, Janet L


    While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care. PMID:23054873

  16. Corruption in health-care systems and its effect on cancer care in Africa.

    Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan


    At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients. PMID:26248847

  17. Housing the Workforce Following the Canterbury Earthquakes in New Zealand

    Chang-Richards, Yan; Wilkinson, Suzanne J; Seville, Erica; Brundson, David


    Temporary housing following a large-scale disaster has a positive effect on household welfare and community recovery. Following the 2010 and 2011 Canterbury earthquakes, a shortage of temporary accommodation created barriers for the outside construction workforce to engage in repairs and rebuild in Christchurch. This study investigates the impacts of housing shortages for the overall recovery and the strategies adopted by both households and the workforce in the building industry. Findings su...

  18. Addressing the workforce pipeline challenge

    A secure and affordable energy supply is essential for achieving U.S. national security, in continuing U.S. prosperity and in laying the foundations to enable future economic growth. To meet this goal the next generation energy workforce in the U.S., in particular those needed to support instrumentation, controls and advanced operations and maintenance, is a critical element. The workforce is aging and a new workforce pipeline, to support both current generation and new build has yet to be established. The paper reviews the challenges and some actions being taken to address this need. (authors)

  19. Addressing the workforce pipeline challenge

    Leonard Bond; Kevin Kostelnik; Richard Holman


    A secure and affordable energy supply is essential for achieving U.S. national security, in continuing U.S. prosperity and in laying the foundations to enable future economic growth. To meet this goal the next generation energy workforce in the U.S., in particular those needed to support instrumentation, controls and advanced operations and maintenance, is a critical element. The workforce is aging and a new workforce pipeline, to support both current generation and new build has yet to be established. The paper reviews the challenges and some actions being taken to address this need.

  20. The effect of managed care on hospitals' provision of uncompensated care.

    McKay, Niccie L; Meng, Xiaoxian


    This study examines the effect of managed care on hospitals' provision of uncompensated care, using a new measure of managed care that is hospital-specific, rather than measured for the area as a whole, and which includes payment by preferred provider organizations (PPOs) as well as by health maintenance organizations (HMOs). Based on data for Florida hospitals in the period 1998-2002, the results indicate that a higher percentage of private managed care patient-days was associated with a decrease in uncompensated care as a percentage of total operating expenses, holding net profit margin and other factors constant. The results suggest that spillover effects on uncompensated care should be taken into account when considering increases in managed care payment. PMID:17583265

  1. Family matters? The effect of kinship care on foster care disruption rates.

    Andersen, Signe Hald; Fallesen, Peter


    Compared with other types of out-of-home care, kinship care is cheap, and offers the child a more familiar environment. However, little is known about the causal effect of kinship care on important outcomes. This study is the first to estimate causal effects of kinship care on placement stability, using full-sample administrative data (N=13,157) and instrumental variables methods. Results show that, in a sample of children of age 0-17 years, kinship care is as stable as other types of care, and only when the kin caregiver is particularly empathic and dutiful does this type of care prove more stable. Thus, in terms of stability, most children do not benefit additionally from being placed with kin. PMID:26195029

  2. Effects and side-effects of integrating care: the case of mental health care in the Netherlands

    Hutschemaekers, Giel J.M.; Tiemens, Bea G.; Winter, M. de


    Purpose Description and analysis of the effects and side-effects of integrated mental health care in the Netherlands. Context of case Due to a number of large-scale mergers, Dutch mental health care has become an illustration of integration and coherence of care services. This process of integrati

  3. Can a single question effectively screen for burnout in Australian cancer care workers?

    Girgis Afaf


    Full Text Available Abstract Background Burnout has important clinical and professional implications among health care workers, with high levels of burnout documented in oncology staff. The aim of this study was to ascertain how well a brief single-item measure could be used to screen for burnout in the Australian oncology workforce. Methods During 2007, 1322 members of the Clinical Oncological Society of Australia were invited to participate in a cross-sectional nationwide survey; 740 (56% of eligible members consented and completed the survey. Data from the 638 consenting members who reported that their work involved direct patient contact were included in the secondary analyses reported in this paper. Burnout was assessed using the MBI Human Services Survey Emotional Exhaustion sub-scale and a single-item self-defined burnout scale. Results Emotional exhaustion was "high" in 33% of the sample when assessed by the psychometrically validated MBI. The single-item burnout measure identified 28% of the sample who classified themselves as "definitely burning out", "having persistent symptoms of burnout", or "completely burned out". MBI Emotional Exhaustion was significantly correlated with the single-item burnout measure (r = 0.68, p 2 of 0.5 (p Conclusions The moderate to high correlation between the single-item self-defined burnout measure and the emotional exhaustion component of burnout suggest that this single item can effectively screen for burnout in health care settings which are time-poor for assessing burnout more comprehensively.

  4. The effects of patient care in health care work: The effects of patient care on job stress, emotional exhaustion, and job satifaction among health care workers in Norway

    Granbo, Sanna Mari Dyrkorn


    Previous research has indicated that patient care is a source of job stress and emotional exhaustion, but at the same time a source of job satisfaction. The present study examined the effects of hours spent in patient care on job stress, emotional exhaustion, and job satisfaction, and investigated the relationship between hardiness, job control and work-related support and the three dependent variables. A questionnaire survey, consisting of Cooper’s Job Stress Questionnaire, the Emotional Exh...

  5. Six principles to enhance health workforce flexibility

    Nancarrow, Susan A


    Abstract This paper proposes approaches to break down the boundaries that reduce the ability of the health workforce to respond to population needs, or workforce flexibility. Accessible health services require sufficient numbers and types of skilled workers to meet population needs. However, there are several reasons that the health workforce cannot or does not meet population needs. These primarily stem from workforce shortages. However, the health workforce can also be prevented from respon...

  6. Workforce Information Cubes for NASA

    National Aeronautics and Space Administration — Workforce Information Cubes for NASA, sourced from NASA's personnel/payroll system, gives data about who is working where and on what. Includes records for every...

  7. Effective Marketing of Quality Child Care.

    Caldwell, Bettye M.; Boyd, Harper W., Jr.


    Identifies negative public and professional attitudes that lie beneath the contemporary negative image of quality child care. Argues that concepts and principles of marketing are appropriate for influencing parents to choose high quality services and helping ensure that supplementary care is of sufficient quality to enhance, not inhibit, the…

  8. Expanding clinical roles for nurses to realign the global health workforce with population needs: a commentary.

    Maier, Claudia B; Aiken, Linda H


    Many countries, including Israel, face health workforce challenges to meet the needs of their citizens, as chronic conditions increase. Provider shortages and geographical maldistribution are common. Increasing the contribution of nurse practitioners and other advanced practice nursing roles through task-shifting and expansion of scope-of-practice can improve access to care and result in greater workforce efficiency. Israel and many other countries are introducing reforms to expand nurses' scope-of-practice. Recent international research offers three policy lessons for how countries just beginning to implement reforms could bypass policy barriers to implementation. First, there is substantial evidence on the equivalence in quality of care, patient safety and high consumer acceptance which should move policy debates from if to how to effectively implement new roles in practice. Second, regulatory and finance policies as well as accessible advanced education are essential to facilitate realignment of roles. Third, country experience suggests that advanced practice roles for nurses improve the attractiveness of nursing as a career thus contributing to solving nursing shortages rather than exacerbating them. Designing enabling policy environments and removing barriers will gain in relevance in the future as the demand for high-quality, patient-centered care is increasing. PMID:27280014

  9. Trends in the nursing workforce in New South Wales, CHERE Research Report 23

    Denise Doiron; Glenn Jones


    Administrative panel data on NSW nurses covering the 90s are used to address several trends in the nursing workforce: the attrition and ageing of nurses, the hours of work in nursing, the allocation of the nursing workforce across job premises in particular across the public and private sectors, and the effects of personal, job and other characteristics on retention in nursing. Findings include: evidence of ageing of the nursing workforce due to a slower entry and an increase in retention; a ...

  10. Effectiveness the pharmaceutical care in diabetic patients*

    Jorge E Machado -Alba


    Full Text Available Objective: To determine the effectiveness of pharmaceutical care to improve control of type-2 diabetes mellitus. Methods: We carried out pharmacotherapeutical intervention during 19 months on patients with type-2 diabetes mellitus who were affiliate members of the contributive regime of the General System for Healthcare and Social Security in  Bogotá and Cartagena. Through an interview and evaluation of medical records, we obtained information about antidiabetic medications used, doses, other medications, along with Hemoglobin A1c level, arterial pressure, serum low-density lipoprotein cholesterol level, nephropathy screening, retinal screening, foot exams in the last year and problems associated with medication use by means of the DADER method Negative Outcomes Associated with Medication (NOM. Results: The study had a sample of 143 patients (64 intervened and 79 controls with female predominance (67.1% and 53.1%, respectively, mean age of 63.9±11.2 years. The patients in both groups were taking an average of 6.0±2.7 medications. Initial HbA1c mean was 7.7% and 7.8%, without improvement by the end of the study (7.4% for those intervened and 7.8% for the control group. Hypertension (81.1% and dyslipidemia (62.9% were the most important comorbidities. About 50.4% of NOM were of effectiveness, follows 31.3% of necessity. The mean cost per patient in controls was 1.4 greater than for the intervened group. Conclusions: Increased effectiveness of the antidiabetic therapy was not demonstrated in patients intervened with pharmacotherapeutical monitoring, but we did obtain a reduction in healthcare costs.

  11. Effectiveness the pharmaceutical care in diabetic patients

    Jorge E. Machado-Alba


    Full Text Available Objective: To determine the effectiveness of pharmaceutical care to improve control of type-2 diabetes mellitus.Methods: We carried out pharmacotherapeutical intervention during 19 months on patients with type-2 diabetes mellitus who were affiliate members of the contributive regime of the General System for Healthcare and Social Security in Bogotá and Cartagena. Through an interview and evaluation of medical records, we obtained information about antidiabetic medications used, doses, other medications, along with Hemoglobin A1c level, arterial pressure, serum low-density lipoprotein cholesterol level, nephropathy screening, retinal screening, foot exams in the last year and problems associated with medication use by means of the DADER method Negative Outcomes Associated with Medication (NOM.Results: The study had a sample of 143 patients (64 intervened and 79 controls with female predominance (67.1% and 53.1%, respectively, mean age of 63.9±11.2 years. The patients in both groups were taking an average of 6.0±2.7 medications. Initial HbA1c mean was 7.7% and 7.8%, without improvement by the end of the study (7.4% for those intervened and 7.8% for the control group. Hypertension (81.1% and dyslipidemia (62.9% were the most important comorbidities. About 50.4% of NOM were of effectiveness, follows 31.3% of necessity. The mean cost per patient in controls was 1.4 greater than for the intervened group.Conclusions: Increased effectiveness of the antidiabetic therapy was not demonstrated in patients intervened with pharmacotherapeutical monitoring, but we did obtain a reduction in healthcare costs.

  12. CAD/CAM at a Distance: Assessing the Effectiveness of Web-Based Instruction To Meet Workforce Development Needs. AIR 2000 Annual Forum Paper.

    Wilkerson, Joyce A.; Elkins, Susan A.

    This qualitative case study assessed web-based instruction in a computer-aided design/computer-assisted manufacturing (CAD/CAM) course designed for workforce development. The study examined students' and instructors' experience in a CAD/CAM course delivered exclusively on the Internet, evaluating course content and delivery, clarity of…

  13. Effects of decentralized health care financing on maternal care in Indonesia

    R. Hartwig (Renate); R.A. Sparrow (Robert); S. Budiyati (Sri); A. Yumna (Athia); N. Warda (Nila); A. Suryahadi (Asep); A.S. Bedi (Arjun Singh)


    textabstractWe exploit variation in the design of sub-national health care financing initiatives in Indonesian districts to assess the effects of these local schemes on maternal care from 2004 to 2010. The analysis is based on a district pseudo-panel, combining data from a unique survey among Distri

  14. The healthy migrant effect in primary care

    Gimeno-Feliu, Luis A.; Amaia Calderón-Larrañaga; Esperanza Diaz; Beatriz Poblador-Plou; Rosa Macipe-Costa; Alexandra Prados-Torres


    Objective: To compare the morbidity burden of immigrants and natives residing in Aragón, Spain, based on patient registries in primary care, which represents individuals’ first contact with the health system. Methods: A retrospective observational study was carried out, based on linking electronic primary care medical records to patients’ health insurance cards. The study population consisted of the entire population assigned to general practices in Aragón, Spain (1,251,540 individuals, of...

  15. The global pharmacy workforce: a systematic review of the literature

    Anderson Claire


    , complexity of medication therapy and increased prescriptions. To maintain and expand the future pharmacy workforce, increases in recruitment and retention will be essential, as will decreases in attrition, where possible. However, scaling up the global pharmacy workforce is a complex, multifactorial responsibility that requires coordinated action. Further research by means of prospective and comparative methods, not only surveys, is needed into feminization; decreasing demand for postgraduate training; graduate trends; job satisfaction and the impact of pharmacy technicians; and how effective existing interventions are at expanding the pharmacy workforce. More coordinated monitoring and modelling of the pharmacy workforce worldwide (particularly in developing countries is required.

  16. Effectiveness of the Smart Care Service for Diabetes Management

    Chung, Young-Soon; Kim, Yongsuk; Lee, Chang Hee


    Objectives The aim of this study was to assess the effectiveness of the Smart Care service for the diabetes management. Methods Fifty-six patients with diabetes mellitus were recruited in Daegu, Korea. All participants completed a diabetes management education course (diet, exercise, and complications) for their self-care and received access to a care management website through a netbook and smartphone. The website accepts uploads of glucose level, body weight, HbA1c, low-density lipoprotein ...

  17. Cohort effects on the need for health care and implications for health care planning in Canada.

    Whittaker, William; Birch, Stephen; MacKenzie, Adrian; Murphy, Gail Tomblin


    The sustainability of publicly funded health care systems is an issue for governments around the world. The economic climate limits governments' fiscal capacity to continue to devote an increasing share of public funds to health care. Meanwhile the demands for health care within populations continue to increase. Planning the future requirements for health care is typically based on applying current levels of health service use by age to demographic projections of the population. But changes in age-specific levels of health over time would undermine this 'constant use by age' assumption. We use representative Canadian survey data (Canadian Community Health Survey) covering the period 2001-2012, to identify the separate trends in demography (population ageing) and epidemiology (population health) on self-reported health. We propose an approach to estimating future health care requirements that incorporates cohort trends in health. Overall health care requirements for the population increase as the size and mean age of the population increase, but these effects are mitigated by cohort trends in health-we find the estimated need for health care is lower when models account for cohort effects in addition to age effects. PMID:26586614

  18. Building Workforce Strength: Creating Value through Workforce and Career Development

    Elsdon, Ron


    This book explores the perspectives of experienced practitioners, sharing ideas about building and sustaining organizational strength through workforce development practices and systems. As the saying goes, a company's greatest resource is its people. When managers really believe that and work to develop organizational capabilities, productivity,…

  19. Managing a national radiation oncologist workforce: A workforce planning model

    Purpose: The specialty of radiation oncology has experienced significant workforce planning challenges in many countries. Our purpose was to develop and validate a workforce-planning model that would forecast the balance between supply of, and demand for, radiation oncologists in Canada over a minimum 10-year time frame, to identify the model parameters that most influenced this balance, and to suggest how this model may be applicable to other countries. Methods: A forward calculation model was created and populated with data obtained from national sources. Validation was confirmed using a historical prospective approach. Results: Under baseline assumptions, the model predicts a short-term surplus of RO trainees followed by a projected deficit in 2020. Sensitivity analyses showed that access to radiotherapy (proportion of incident cases referred), individual RO workload, average age of retirement and resident training intake most influenced balance of supply and demand. Within plausible ranges of these parameters, substantial shortages or excess of graduates is possible, underscoring the need for ongoing monitoring. Conclusions: Workforce planning in radiation oncology is possible using a projection calculation model based on current system characteristics and modifiable parameters that influence projections. The workload projections should inform policy decision making regarding growth of the specialty and training program resident intake required to meet oncology health services needs. The methods used are applicable to workforce planning for radiation oncology in other countries and for other comparable medical specialties.

  20. Responding to financial pressures. The effect of managed care on hospitals' provision of charity care.

    Mas, Núria


    Healthcare financing and insurance is changing everywhere. We want to understand the impact that financial pressures can have for the uninsured in advanced economies. To do so we focus on analyzing the effect of the introduction in the US of managed care and the big rise in financial pressures that it implied. Traditionally, in the US safety net hospitals have financed their provision of unfunded care through a complex system of cross-subsidies. Our hypothesis is that financial pressures undermine the ability of a hospital to cross-subsidize and challenges their survival. We focus on the impact of price pressures and cost-controlling mechanisms imposed by managed care. We find that financial pressures imposed by managed care disproportionately affect the closure of safety net hospitals. Moreover, amongst those hospitals that remain open, in areas where managed care penetration increases the most, they react by closing the health services most commonly used by the uninsured. PMID:23389814

  1. Effect of intermediate care on mortality following emergency abdominal surgery. The InCare trial

    Vester-Andersen, Morten; Waldau, Tina; Wetterslev, Jørn;


    . The aim of the present trial is to evaluate the effect of postoperative intermediate care following emergency major abdominal surgery in high-risk patients.Methods and design: The InCare trial is a randomised, parallel-group, non-blinded clinical trial with 1:1 allocation. Patients undergoing...... emergency laparotomy or laparoscopic surgery with a perioperative Acute Physiology and Chronic Health Evaluation II score of 10 or above, who are ready to be transferred to the surgical ward within 24 h of surgery are allocated to either intermediate care for 48 h, or surgical ward care. The primary outcome...... measure is all-cause 30-day mortality. We aim to enrol 400 patients in seven Danish hospitals. The sample size allows us to detect or refute a 34% relative risk reduction of mortality with 80% power. DISCUSSION: This trial evaluates the benefits and possible harm of intermediate care. The results may...

  2. Embedding effective depression care: using theory for primary care organisational and systems change

    Gunn Jane M


    Full Text Available Abstract Background Depression and related disorders represent a significant part of general practitioners (GPs daily work. Implementing the evidence about what works for depression care into routine practice presents a challenge for researchers and service designers. The emerging consensus is that the transfer of efficacious interventions into routine practice is strongly linked to how well the interventions are based upon theory and take into account the contextual factors of the setting into which they are to be transferred. We set out to develop a conceptual framework to guide change and the implementation of best practice depression care in the primary care setting. Methods We used a mixed method, observational approach to gather data about routine depression care in a range of primary care settings via: audit of electronic health records; observation of routine clinical care; and structured, facilitated whole of organisation meetings. Audit data were summarised using simple descriptive statistics. Observational data were collected using field notes. Organisational meetings were audio taped and transcribed. All the data sets were grouped, by organisation, and considered as a whole case. Normalisation Process Theory (NPT was identified as an analytical theory to guide the conceptual framework development. Results Five privately owned primary care organisations (general practices and one community health centre took part over the course of 18 months. We successfully developed a conceptual framework for implementing an effective model of depression care based on the four constructs of NPT: coherence, which proposes that depression work requires the conceptualisation of boundaries of who is depressed and who is not depressed and techniques for dealing with diffuseness; cognitive participation, which proposes that depression work requires engagement with a shared set of techniques that deal with depression as a health problem; collective action

  3. Determining the effectiveness of the Delphi method for quantifying the drivers of demand for health and social care

    Yang, He


    This paper focuses on research of the Delphi method used in the Centre for Workforce Intelligence (CfWI). In the CfWI, the Delphi method is applied to quantify the uncertainties for the future workforce demand and supply modelling in health and social care. The objective of this research is to review and assess the strengths and weaknesses of the Delphi method as applied to recent CfWI projects, and to make recommendations for improving this method. The Strategic Options Development and Analy...

  4. Effects of Enhanced Depression Treatment on Diabetes Self-Care

    Lin, Elizabeth H. B.; Katon, Wayne; Rutter, Carolyn; Simon, Greg E.; Ludman, Evette J; Von Korff, Michael; Young, Bessie; Oliver, Malia; Ciechanowski, Paul C.; Kinder, Leslie; Walker, Edward


    PURPOSE Among patients with diabetes, major depression is associated with more diabetic complications, lower medication adherence, and poorer self-care of diabetes. We reported earlier that enhanced depression care reduces depression symptoms but not hemoglobin A1c level. This study examined effects of depression interventions on self-management among depressed diabetic patients.

  5. Effects of Quality Improvement System for Child Care Centers

    Ma, Xin; Shen, Jianping; Kavanaugh, Amy; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Till, Lance; Watson, Grace


    Using multiple years of data collected from about 100 child care centers in Palm Beach County, Florida, the authors studied whether the Quality Improvement System (QIS) made a significant impact on quality of child care centers. Based on a pre- and postresearch design spanning a period of 13 months, QIS appeared to be effective in improving…

  6. Cost-Effectiveness of Collaborative Care for the Treatment of Depressive Disorders in Primary Care: A Systematic Review

    Grochtdreis, Thomas; Brettschneider, Christian; Wegener, Annemarie; Watzke, Birgit; Riedel-Heller, Steffi; Härter, Martin; König, Hans-Helmut


    BACKGROUND: For the treatment of depressive disorders, the framework of collaborative care has been recommended, which showed improved outcomes in the primary care sector. Yet, an earlier literature review did not find sufficient evidence to draw robust conclusions on the cost-effectiveness of collaborative care. PURPOSE: To systematically review studies on the cost-effectiveness of collaborative care, compared with usual care for the treatment of patients with depressive disorders in prim...

  7. Integration of the ageing workforce

    Krenn, M.; Oehlke, P.; Kees, H.; Leonard, L.; Wendelen, E.; Linkola, P.; Neubauer, G.; Vries, S. de; O'Kelly, K.P.


    The age structure in Europe and other industrialized countries is changing as a result of declining birth rates and continuous rise in life expectancy. This report shows the facts and figures of an ageing workforce. It also describes the predjudices, personnel policies and problems connected to the

  8. Health workforce governance in Italy.

    Vicarelli, Giovanna; Pavolini, Emmanuele


    More precise health workforce governance has become a prominent issue in healthcare systems. This issue is particularly important in Italy, given its strongly doctor-centered healthcare system and the dramatic aging of its physicians' labor force. Using different sources of information (statistical data, official planning documents and interviews with key informants), the article attempts to answer two questions. Why has the Italian healthcare systems found itself in the situation of a potential drastic reduction in the amount of doctors in the medium term without a rebalancing through a different mix of skills and professionals? How good is the capacity of the Italian healthcare system to plan healthcare workforce needs? The widespread presence of 'older' physicians is the result of the strong entry of doctors into the Italian healthcare system in the 1970s and 1980s. Institutional fragmentation, difficulties in drafting broad healthcare reforms, political instability and austerity measures explain why Italian health workforce forecasting and planning are still unsatisfactory, although recent developments indicate that changes are under way. In order to tackle these problems it is necessary to foster closer cooperation among a wide range of stakeholders, to move from uni-professional to multi-professional health workforce planning, and to partially re-centralise decision making. PMID:26470643

  9. Identification and Development of Critical Workforce Skills in the Chattanooga Region

    Dorris, John Peter


    The purpose of this quantitative study was to identify the workforce skills perceived to be critical in the Chattanooga region, and to explore how colleges and businesses can partner to effectively develop those skills. Data from a June 2011 survey of workforce stakeholders in the Chattanooga region were analyzed. The 78 survey respondents…

  10. Terminal care: evaluation of effects on surviving family of care before and after bereavement.

    Cameron, J; Parkes, C. M.


    To evaluate the effects on the family of a comprehensive programme of terminal cancer care, 20 close relatives of patients who had died in a Palliative Care Unit (PCU) were compared with a matched group of 20 relatives of patients who had died of cancer in other wards of the same teaching hospital. Interviewed by telephone 1 year and 2 weeks after bereavement, relatives of PCU patients report significantly fewer psychological symptoms and less lasting grief and anger than relatives of patient...

  11. Towards Effective Ponseti Clubfoot Care: The Uganda Sustainable Clubfoot Care Project

    Pirani, Shafique; Naddumba, Edward; Mathias, Richard; Konde-Lule, Joseph; Penny, J. Norgrove; Beyeza, Titus; Mbonye, Ben; Amone, Jackson; Franceschi, Fulvio


    Neglected clubfoot is common, disabling, and contributes to poverty in developing nations. The Ponseti clubfoot treatment has high efficacy in correcting the clubfoot deformity in ideal conditions but is demanding on parents and on developing nations’ healthcare systems. Its effectiveness and the best method of care delivery remain unknown in this context. The 6-year Uganda Sustainable Clubfoot Care Project (USCCP) aims to build the Ugandan healthcare system’s capacity to treat children with ...

  12. Status of the National Security Workforce



    This report documents the status of the national security workforce as part of the National Security Preparedness Project, being performed by the Arrowhead Center of New Mexico State University under a DOE/NNSA grant. This report includes an assessment of the current workforce situation. The national security workforce is an important component of national security for our country. With the increase of global threats of terrorism, this workforce is being called upon more frequently. This has resulted in the need for an increasing number of national security personnel. It is imperative to attract and retain a skilled and competitive national security workforce.

  13. The Relevance of the Affordable Care Act for Improving Mental Health Care.

    Mechanic, David; Olfson, Mark


    Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce. PMID:26666969

  14. Effective factors in providing holistic care: A qualitative study

    Vahid Zamanzadeh


    Full Text Available Background: Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses′ provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. Materials and Methods: A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis software. Results: Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Conclusion: Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

  15. How Much for Whom? Lessons from an Efficacy Study of Modest Professional Development for Child Care Providers

    Gerde, Hope K.; Duke, Nell K.; Moses, Annie M.; Spybrook, Jessaca; Shedd, Meagan K.


    Research Findings: Examining the effects of professional development of the early childhood workforce that fit within the constraints of government policy is crucial for identifying types and amounts of effective training and informing child care policy. The present study used a cluster-randomized trial to evaluate the effects of a professional…

  16. Treatment of late-life mental disorders in primary care: we can do a better job.

    Moak, Gary S


    Health care services provided to older adults today are not as effective as they should be. The quality of care for late-life mental disorders often falls short of desired standards. The growth of the elderly population makes it imperative for the health care system to address late-life mental disorders more effectively. Intervention strategies based in primary care settings show the most promise, but effectiveness will depend on solving the geriatric psychiatry workforce crisis. Collaborative care is one promising model for improving geriatric mental health care delivery in primary care. Diffusion of collaborative care into the health care system and integrating geriatric psychiatry into other models such as geriatric medical homes will require redesign of the organization and financing of primary care and psychiatry to overcome current barriers. Public policy should reflect the essential role of psychiatry in geriatrics and promote the integration of geriatric psychiatry with primary care. PMID:21740202

  17. Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians

    Agra Yolanda


    Full Text Available Abstract Background The Spanish Palliative Care Strategy recommends an intermediate level of training for primary care physicians in order to provide them with knowledge and skills. Most of the training involves face-to-face courses but increasing pressures on physicians have resulted in fewer opportunities for provision of and attendance to this type of training. The effectiveness of on-line continuing medical education in terms of its impact on clinical practice has been scarcely studied. Its effect in relation to palliative care for primary care physicians is currently unknown, in terms of improvement in patient's quality of life and main caregiver's satisfaction. There is uncertainty too in terms of any potential benefits of asynchronous communication and interaction among on-line education participants, as well as of the effect of the learning process. The authors have developed an on-line educational model for palliative care which has been applied to primary care physicians in order to measure its effectiveness regarding knowledge, attitude towards palliative care, and physician's satisfaction in comparison with a control group. The effectiveness evaluation at 18 months and the impact on the quality of life of patients managed by the physicians, and the main caregiver's satisfaction will be addressed in a different paper. Methods Randomized controlled educational trial to compared, on a first stage, the knowledge and attitude of primary care physicians regarding palliative care for advanced cancer patients, as well as satisfaction in those who followed an on-line palliative care training program with tutorship, using a Moodle Platform vs. traditional education. Results 169 physicians were included, 85 in the intervention group and 84 in the control group, of which five were excluded. Finally 82 participants per group were analyzed. There were significant differences in favor of the intervention group, in terms of knowledge (mean 4.6; CI

  18. Effects of an implemented care policy on patient and personnel experiences of care.

    Lövgren, Gunvor; Eriksson, S; Sandman, P-O


    A care policy was implemented within health care in the county of Västerbotten, Sweden. A questionnaire was administered before and after the implementation of the care policy to assess its effects. Patients within hospital care and primary health care described their experiences in a base-line study (n=3950) in 1994 and a follow-up study (n=2941) in 1996. On the same occasions personnel (n=2362 and 2310, respectively) answered the same questionnaire assessing what they thought their patients experienced. No significant positive effects of the implementation were seen by the patients. Fewer patients felt that they were understood when they talked about their problems, dared to express criticism or denied they were treated nonchalantly in the follow-up study. The experiences of the personnel were in line with those of the patients concerning nonchalant treatment in the follow-up study. Furthermore, fewer staff members thought that their patients felt they had adequate help with hygiene whilst more thought that their patients felt they were responded to in a loving way. One interpretation of the negative outcome is that organizational changes, strained resources and cuts in staffing during the 90s may have reduced the possibility of integrating the care policy in spite of an ambitious and extensive intervention. PMID:11985743

  19. Challenging the Cost Effectiveness of Medi-Cal Managed Care

    Riner, R. Myles


    Full Text Available Some researchers and consulting groups have promoted managed care as a way to provide cost-effective quality care to Medicaid patients, based on assertions that are often poorly substantiated. Unfortunately, politicians and policy makers in California and other states have adopted the presumption of the cost-effectiveness of Medicaid Managed Care as a rationale for expanding the use of managed care programs to include a larger share of more Medicaid eligible enrollees, and expand coverage and services to the currently uninsured. This paper challenges the assertion that Medi-Cal Managed Care is cost effective, by demonstrating that the unique and idiosyncratic manner in which Medi-Cal managed care has been implemented in California (and other states creates perverse incentives leading to cost-shifting and selective enrollment and dis-enrollment of costly beneficiaries. This places an unfair burden on fee-for-service Medi-Cal providers, who are expected to provide more services for less reimbursement. Administrators of Medicaid Managed Care programs need to consider risk adjusted rates for beneficiaries enrolled in plans in order to align incentives with program objectives. [WestJEM. 2009;10:124-129.

  20. Strategies for Managing a Multigenerational Workforce

    Iden, Ronald

    The multigenerational workforce presents a critical challenge for business managers, and each generation has different expectations. A human resource management study of organizations with more than 500 employees reported 58% of the managers experiencing conflict between younger and older workers. The purpose of this single case study was to explore the multigenerational strategies used by 3 managers from a Franklin County, Ohio manufacturing facility with a population size of 6 participants. The conceptual framework for this study was built upon generational theory and cohort group theory. The data were collected through face-to-face semistructured interviews, company documents, and a reflexive journal. Member checking was completed to strengthen the credibility and trustworthiness of the interpretation of participants' responses. A modified van Kaam method enabled separation of themes following the coding of data. Four themes emerged from the data: (a) required multigenerational managerial skills, (b) generational cohort differences, (c) most effective multigenerational management strategies, and (d) least effective multigenerational management strategies. Findings from this study may contribute to social change through better understanding, acceptance, and appreciation of the primary generations in the workforce, and, in turn, improve community relationships.

  1. Patient attributes warranting consideration in clinical practice guidelines, health workforce planning and policy

    Segal Leonie


    Full Text Available Abstract Background In order for clinical practice guidelines (CPGs to meet their broad objective of enhancing the quality of care and supporting improved patient outcomes, they must address the needs of diverse patient populations. We set out to explore the patient attributes that are likely to demand a unique approach to the management of chronic disease, and which are crucial if evidence or services planning is to reflect clinic populations. These were incorporated into a new conceptual framework; using diabetes mellitus as an exemplar. Methods The patient attributes that informed the framework were identified from CPGs, the diabetes literature, an expert academic panel, and two cross-disciplinary panels; and agreed upon using a modified nominal group technique. Results Full consensus was reached on twenty-four attributes. These factors fell into one of three themes: (1 type/stage of disease, (2 morbid events, and (3 factors impacting on capacity to self-care. These three themes were incorporated in a convenient way in the workforce evidence-based (WEB model. Conclusions While biomedical factors are frequently recognised in published clinical practice guidelines, little attention is given to attributes influencing a person's capacity to self-care. Paying explicit attention to predictable threats to effective self-care in clinical practice guidelines, by drawing on the WEB model, may assist in refinements that would address observed disparities in health outcomes across socio-economic groups. The WEB model also provides a framework to inform clinical training, and health services and workforce planning and research; including the assessment of healthcare needs, and the allocation of healthcare resources.

  2. The Effects of Day Care: A Literature Review.

    Heist, Michele E.

    This paper reviews research reported in the last 10 years on the effects of day care on children and their families. The review is organized around the following areas: attachment and emotional development; psycho-social development; intellectual and cognitive development; health and nutritional effects; the effect of caregiver stability; the…

  3. Case managers optimize patient safety by facilitating effective care transitions.

    Carr, Dana Deravin


    In this new era of patient safety, the case manager, as an advocate and facilitator of care, has a pivotal role on the front line of healthcare delivery. Effective communication and collaboration between disciplines is key to the promotion of patient safety, and ultimately the avoidance of life-threatening medical errors. Across the healthcare continuum and within hospitals in particular, patients are routinely transferred from one service to another, from one level of care to another, or from one provider to another. As patients are stabilized and transitioned through the hospital system, there are multiple hand-offs of care or care transitions that can often expose the patient to fragmented service and increase the risk of communication breakdown. Ineffective hand-offs can result in a disruption of continuity between one level of care and the next. In a culture that places a strong emphasis on patient safety, case managers can facilitate opportunities that ease care transitions whereby a change in venue is no longer perceived as a disruption in the flow of care but rather is viewed as a coordinated changeover where cautious and comprehensive communication sets the tone for the continued delivery of safe and effective healthcare. PMID:17413671

  4. Invigorating Entrepreneurial Spirit among Workforce



    With the key intent of stimulating entrepreneurial spirit among the workforce, this paper identifies the diverse entrepreneurial qualities required to propel the entrepreneurial spirit unremittingly. These relevant personal skills and strategies of New Venture Creation further aid in the successful creation and subsequent maintenance of an entrepreneur business. Prior to application of the identified skills, this paper vividly demonstrates the importance of such skills to any entrepreneurial ...

  5. The Changing Workforce And Marketplace

    Terry L. Howard


    Full Text Available The makeup of the labor force has changed dramatically in the last 25 years and will continue to change at an even faster pace. Businesses and/or organizations will achieve many benefits from including the ageing population and people with disabilities in both the workforce and marketplace.  Viewing the ageing population and people with disabilities as strategic business partners will achieve a strong, competitive advantage.

  6. LMBE Strategic Workforce Succession Planning

    Foo, Ginny Gin Siew


    The Lower Mainland Biomedical Engineering department (LMBE) has been the largest biomedical engineering department in Canada since the consolidation of the four Health Authority (HA) in-house biomedical engineering departments. It provides knowledge-based services one of which is the maintenance management of medical device used on patients. Its human capital or workforce, with its technology expertise, is their key resource in achieving operational goals. In the next few years, the LMBE depa...

  7. Effective population management practices in diabetes care - an observational study

    Frølich, Anne; Bellows, Jim; Nielsen, Bo Friis;


    Of fifteen diabetes care management practices, our data indicate that high performance is most associated with provider alerts and more weakly associated with action plans and with guideline distribution and training. Lack of convergence in the literature on effective care management practices...... suggests that factors contributing to high performance may be highly context-dependent or that the factors involved may be too numerous or their implementation too nuanced to be reliably identified in observational studies....

  8. The Effect of Child Care Characteristics on Child Development

    Blau, David M.


    The effect of group size, staff-child ratio, training, and other characteristics of child care on child development is estimated using data from the National Longitudinal Survey of Youth. In contrast to most previous research, the sample is large and nationally representative, the data contain good measures of the home environment, and there are repeated measures of child development. Child care characteristics have little association with child development on average. Associations are found ...

  9. Cost effectiveness of chest pain unit care in the NHS

    Oluboyede, Yemi; Goodacre, Steve; Wailoo, Allan; ,


    Background Acute chest pain is responsible for approximately 700,000 patient attendances per year at emergency departments in England and Wales. A single centre study of selected patients suggested that chest pain unit (CPU) care could be less costly and more effective than routine care for these patients, although a more recent multi-centre study cast doubt on the generalisability of these findings. Methods Our economic evaluation involved modelling data from the ESCAPE multi-centre trial al...


    Igarashi, Toshiko; Fujita, Mineko


    Stress reduction care is important for pregnant women to decrease obstetric complications and children's health problems after birth. We investigated the long-term effects during pregnancy of daily self-care with aromatherapy using essential oils containing linalyl acetate and linalool. We randomly assigned 16 healthy pregnant women into an aromatherapy group and a control group. Nine participants were assigned to the aromatherapy group and seven participants to the control group. Interventio...

  11. Office of Disability, Aging and Long-Term Care Policy

    ... direct care workforce. Division of Behavioral Health and Intellectual Disabilities Policy The Division of Behavioral Health and Intellectual Disabilities Policy focuses on financing, delivery, and quality of ...

  12. Interdisciplinary training to build an informatics workforce for precision medicine

    Marc S. Williams


    Full Text Available The proposed Precision Medicine Initiative has the potential to transform medical care in the future through a shift from interventions based on evidence from population studies and empiric response to ones that account for a range of individual factors that more reliably predict response and outcomes for the patient. Many things are needed to realize this vision, but one of the most critical is an informatics workforce that has broad interdisciplinary training in basic science, applied research and clinical implementation. Current approaches to informatics training do not support this requirement. We present a collaborative model of training that has the potential to produce a workforce prepared for the challenges of implementing precision medicine.

  13. Training for impact: the socio-economic impact of a fit for purpose health workforce on communities.

    Pálsdóttir, Björg; Barry, Jean; Bruno, Andreia; Barr, Hugh; Clithero, Amy; Cobb, Nadia; De Maeseneer, Jan; Kiguli-Malwadde, Elsie; Neusy, André-Jacques; Reeves, Scott; Strasser, Roger; Worley, Paul


    Across the globe, a "fit for purpose" health professional workforce is needed to meet health needs and challenges while capitalizing on existing resources and strengths of communities. However, the socio-economic impact of educating and deploying a fit for purpose health workforce can be challenging to evaluate. In this paper, we provide a brief overview of six promising strategies and interventions that provide context-relevant health professional education within the health system. The strategies focused on in the paper are:1. Distributed community-engaged learning: Education occurs in or near underserved communities using a variety of educational modalities including distance learning. Communities served provide input into and actively participate in the education process.2. Curriculum aligned with health needs: The health and social needs of targeted communities guide education, research and service programmes.3. Fit for purpose workers: Education and career tracks are designed to meet the needs of the communities served. This includes cadres such as community health workers, accelerated medically trained clinicians and extended generalists.4. Gender and social empowerment: Ensuring a diverse workforce that includes women having equal opportunity in education and are supported in their delivery of health services.5. Interprofessional training: Teaching the knowledge, skills and attitudes for working in effective teams across professions.6. South-south and north-south partnerships: Sharing of best practices and resources within and between countries.In sum, the sharing of resources, the development of a diverse and interprofessional workforce, the advancement of primary care and a strong community focus all contribute to a world where transformational education improves community health and maximizes the social and economic return on investment. PMID:27523088

  14. Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives

    Morris J


    Full Text Available Joanne Morris,1 Karen Grimmer,2 Lisa Gilmore,1 Chandima Perera,3 Gordon Waddington,4 Greg Kyle,4 Bryan Ashman,5 Karen Murphy61The Physiotherapy Department, The Canberra Hospital, ACT Health, Canberra, ACT, Australia; 2International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia; 3Department of Rheumatology, The Canberra Hospital, Canberra, ACT, Australia; 4The Faculty of Health, University of Canberra, Canberra, ACT, Australia; 5Department of Surgical Services, The Canberra Hospital, Canberra, ACT, Australia; 6Office of Allied Health Advisor, ACT Health, Canberra, ACT, AustraliaAbstract: Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable

  15. The South Australian Allied Health Workforce survey: helping to fill the evidence gap in primary health workforce planning.

    Whitford, Deirdre; Smith, Tony; Newbury, Jonathan


    There is a lack of detailed evidence about the allied health workforce to inform proposed health care reforms. The South Australian Allied Health Workforce (SAAHW) survey collected data about the demographic characteristics, employment, education and recruitment and retention of allied health professionals in South Australia. The SAAHW questionnaire was widely distributed and 1539 responses were received. The average age of the sample was 40 years; males were significantly older than females, the latter making up 82% of respondents. Three-quarters of the sample worked in the city; 60% worked full time and the remainder in part-time, casual or locum positions. 'Work-life balance' was the most common attraction to respondents' current jobs and 'Better career prospects' the most common reason for intending to leave. Practice in a rural location was influenced by rural background and rural experience during training. A greater proportion of Generation Y (1982-2000) respondents intended to leave within 2 years than Generation X (1961-81) or Baby Boomers (1943-60). Most respondents were satisfied with their job, although some reported lack of recognition of their knowledge and skills. Systematic, robust allied health workforce data are required for integrated and sustainable primary health care delivery. PMID:23069367

  16. Workforce Planning over the Service Life Cycle

    Ruwen Qin


    Services usually have a limited life under modern conditions of competition. The life cycle phenomenon is characterized by time-varying demand and a learning curve of workforce efficiency, making it difficult to determine staffing requirements. This paper initiates a study of the service life cycle phenomenon, from which the learning curve is found to be manageable through workforce planning. Therefore, optimal control is employed to model workforce planning over a service life cycle. An iter...

  17. Workshop: health workforce governance and integration.

    Batenburg, R.


    Background: Health workforce governance is increasingly recognized as a burning policy issue and focused on workforce shortages. Yet the most pressing problem is to solve maldistributions through governance and integration. Poor management of health 242 European Journal of Public Health, Vol. 24, Supplement 2, 2014 human resources is relevant on all levels and areas of governance. Including, for instance, regional and international imbalances in the health workforce reinforced by austerity ag...

  18. Efficient generation of rotating workforce schedules

    Musliu, Nysret; Gaertner, Johannes; Slany, Wolfgang


    Generating high-quality schedules for a rotating workforce is a critical task in all settings where a certain staffing level must be guaranteed beyond the capacity of single employees, such as for instance in industrial plants, hospitals, or airline companies. Results from ergonomics \\cite{BEST91} indicate that rotating workforce schedules have a profound impact on the health and social life of employees as well as on their performance at work. Moreover, rotating workforce schedules must sati...

  19. Health workforce skill mix and task shifting in low income countries: a review of recent evidence

    Auh Erica


    Full Text Available Abstract Background Health workforce needs-based shortages and skill mix imbalances are significant health workforce challenges. Task shifting, defined as delegating tasks to existing or new cadres with either less training or narrowly tailored training, is a potential strategy to address these challenges. This study uses an economics perspective to review the skill mix literature to determine its strength of the evidence, identify gaps in the evidence, and to propose a research agenda. Methods Studies primarily from low-income countries published between 2006 and September 2010 were found using Google Scholar and PubMed. Keywords included terms such as skill mix, task shifting, assistant medical officer, assistant clinical officer, assistant nurse, assistant pharmacist, and community health worker. Thirty-one studies were selected to analyze, based on the strength of evidence. Results First, the studies provide substantial evidence that task shifting is an important policy option to help alleviate workforce shortages and skill mix imbalances. For example, in Mozambique, surgically trained assistant medical officers, who were the key providers in district hospitals, produced similar patient outcomes at a significantly lower cost as compared to physician obstetricians and gynaecologists. Second, although task shifting is promising, it can present its own challenges. For example, a study analyzing task shifting in HIV/AIDS in sub-Saharan Africa noted quality and safety concerns, professional and institutional resistance, and the need to sustain motivation and performance. Third, most task shifting studies compare the results of the new cadre with the traditional cadre. Studies also need to compare the new cadre's results to the results from the care that would have been provided--if any care at all--had task shifting not occurred. Conclusions Task shifting is a promising policy option to increase the productive efficiency of the delivery of health

  20. Nurse led care

    Cullum, N; Spilsbury, K; Richardson, G.


    What's the difference between medical and nursing care? The answer is not straightforward, but shortages in the medical workforce mean that nurses are increasingly called on to undertake work that was previously done by doctors (such as undertaking surgery,1 prescribing drugs, performing triage in emergency departments), whereas shortages in the nursing workforce mean that healthcare assistants now do many tasks that nurses are trained to do. This fluidity in professional roles and competenci...

  1. Effectiveness of "palliative care information booklet" in enhancing nurses′ knowledge

    Anita David


    Full Text Available Context: Patients diagnosed with a disease like cancer require not only physical control of disease but also they need psychological reassurance, social and spiritual support in coming to terms with their disease. Nurses working in the specialized cancer hospitals play a significant role in the care of terminally ill patients. They must be knowledgeable, skilled and sensitive to the needs of these patients and their families in order to provide active, holistic care. Aims: In this study, we attempted to assess the level of knowledge about palliative care among nurses working in the oncology department using a self administered structured questionnaire and also to assess the effectiveness of information booklet designed on various aspects of palliative care on their knowledge. Settings and Design: Indo American Cancer Hospital, Hyderabad, AP, India. The design adopted for this study was One Group pretest - posttest, pre - experimental design. Materials and Methods: Hundred nurses working in Indo American Cancer Hospital, Hyderabad, AP, India were selected by using the non probability purposive sampling technique. A structured self administered questionnaire was prepared and administered as a pretest. An information booklet was developed pertaining to the general concepts of palliative care, care components (physical, social, emotional and spiritual and role of the nurse in palliative care and it was given to the participants. As a post test, the same questionnaire was re-administered after four days to the same study subjects. Pretest and post test knowledge scores were compared and the findings were analyzed statistically. Statistical analysis used : Microsoft Excel and Statistical Package for Social Science package. Results: The post test scores were significantly higher than the pretest knowledge scores, which indicate that the developed information booklet regarding palliative care was highly effective in enhancing the knowledge levels of the

  2. The effect of foster care placement on paternal welfare dependency

    Fallesen, Peter

    The arrival of a child profoundly alters the life-course for men. Yet, children could change men's lives not only by arriving in them, but also by departing from them. In this article, I test how one such departure-foster care placement-affects men's labor market attachment, and in so doing I...... provide a novel parallel to existing research on how fatherhood affects men, which focuses almost exclusively on a child's arrival. Using population panel data from Denmark that include all first time fathers whose children were placed in foster care from 1995-2005, I find that having a child placed...... in foster care is associated with up to a 12 percentage point increase in welfare dependency. This result persists in analyses that control for individual and family level fixed effects, unobserved heterogeneity, and selection into having a child placed in foster care....

  3. Fusion in the Era of Burning Plasma Studies: Workforce Planning for 2004 to 2014. Final report to FESA C



    This report has been prepared in response to Dr. R. Orbach’s request of the Fusion Energy Sciences Advisory Committee (FESAC) to “address the issue of workforce development in the U.S. fusion program.” The report addresses three key questions: what is the current status of the fusion science, technology, and engineering workforce; what is the workforce that will be needed and when it will be needed to ensure that the U.S. is an effective partner in ITER and to enable the U.S. to successfully carry out the fusion program; and, what can be done to ensure a qualified, diversified, and sufficiently large workforce and a pipeline to maintain that workforce? In addressing the charge, the Panel considers a workforce that allows for a vigorous national program of fusion energy research that includes participation in magnetic fusion (ITER) and inertial fusion (NIF) burning plasma experiments.

  4. Effective strategy for improving health care outcomes: Multidisciplinary care in cerebral infarction patients.

    Han, Kyu-Tae; Park, Eun-Cheol; Kim, Sun Jung; Kim, Woorim; Hahm, Myung-Il; Jang, Sung-In; Lee, Sang Gyu


    Multidisciplinary teams provide effective patient treatment strategies. South Korea expanded its health program recently to include multidisciplinary treatment. This study characterized the relationship between multidisciplinary care and mortality within 30 days after hospitalization in cerebral infarction patients. We used the National Health Insurance claim data (n = 63,895) from 120 hospitals during 2010-2013 to analyze readmission within 30 days after hospitalization for cerebral infarction. We performed χ(2) tests, analysis of variance and multilevel modeling to investigate the associations between multidisciplinary care and death within 30 days after hospitalization for stroke. Deaths within 30 days of hospitalization due to cerebral infarction was 3.0% (n = 1898/63,895). Multidisciplinary care was associated with lower risk of death within 30 days in inpatients with cerebral infarction (odds ratio: 0.84, 95% confidence interval: 0.72-0.99). Patients treated by a greater number of specialists had lower risk of death within 30 days of hospitalization. Additional analyses showed that such associations varied by the combination of specialists (i.e., neurologist and neurosurgeon). In conclusion, death rates within 30 days of hospitalization for cerebral infarction were lower in hospitals with multidisciplinary care. Our findings certainly suggest that a high number of both neurosurgeon and neurologist is not always an effective alternative in managing stroke inpatients, and emphasize the importance of an optimal combination in the same number of hospital staffing. PMID:26169372

  5. Age and gender effects of workforce composition on productivity and profits: Evidence from a new type of data for German enterprises

    Christian Pfeifer


    Full Text Available This empirical paper documents the relationship between the composition of a firm’s workforce (with a special focus on age and gender and its performance (productivity and profitability for a large representative sample of enterprises from manufacturing industries in Germany using newly available, unique data. We find concave age-productivity profiles and a negative correlation of age on firms’ profitability. Moreover, our micro-econometric analysis reveals for the first time that the ceteris paribus lower level of productivity in firms with a higher share of female employees does not go hand in hand with a lower level of profitability in these firms.

  6. Developing the HIV Workforce: The MATEC Clinician Scholars Program.

    Boehler, Malinda; Schechtman, Barbara; Rivero, Ricardo; Jacob, Beth-Anne; Sherer, Renslow; Wagner, Cornelia; Alabduljabbar, Salma A; Linsk, Nathan L


    Engaging new clinical providers in the HIV workforce is a critical need due to rapidly evolving treatment paradigms, aging out of existing providers, and special population needs. The 1-year competency-based Clinician Scholar Program for minority-serving providers with limited HIV care experience was individually tailored for each provider (n = 74), mostly nurse practitioners, physicians, and clinical pharmacists. Baseline and endpoint self-assessments of clinical knowledge and skills showed significant improvements in all 11 targeted competencies, particularly in managing antiretroviral medications, screening and testing methods, incorporating prevention into HIV care, understanding risk reduction methods, and describing current care standards. Faculty mentor assessments also showed significant improvement in most competencies. Additional benefits included ongoing access to mentorship and training, plus sustained engagement in local and statewide HIV care networks. Our intensive mentoring program model is replicable in other AIDS Education and Training Centers and in other structured training programs. PMID:26253024

  7. Examining human resources' efforts to develop a culturally competent workforce.

    Whitman, Marilyn V; Valpuesta, Domingo


    The increasing diversification of the nation's population poses significant challenges in providing care that meets the needs of culturally diverse patients. Human resource management plays a vital role in developing a more culturally competent workforce. This exploratory study examines current efforts by human resource directors (HRDs) in Alabama's general hospitals to recruit more diverse candidates, train staff, and make language access resources available. A questionnaire was developed based on the Office of Minority Health's Culturally and Linguistically Appropriate Services standards. The HRDs of the 101 Alabama general hospitals served as the study's target population. A sample of 61 responses, or 60.4% of the population, was obtained. The findings indicate that most HRDs are focusing their efforts on recruiting racially/ethnically diverse candidates and training clerical and nursing staff to care for culturally and linguistically diverse patients. Less effort is being focused on recruiting candidates who speak a different language, and only 44.3% have a trained interpreter on the staff. The HRDs who indicated that they work closely with organizations that provide support to diverse groups were more likely to recruit diverse employees and have racially/ethnically and linguistically diverse individuals in leadership positions. It is crucial that health care organizations take the necessary steps to diversify their workforce to broaden access, improve the quality and equity of care, and capture a greater market share. PMID:20436328

  8. North Dakota Energy Workforce Development

    Carter, Drake [Bismarck State College, Bismarck, ND (United States)


    Bismarck State College, along with its partners (Williston State College, Minot State University and Dickinson State University), received funding to help address the labor and social impacts of rapid oilfield development in the Williston Basin of western North Dakota. Funding was used to develop and support both credit and non-credit workforce training as well as four major symposia designed to inform and educate the public; enhance communication and sense of partnership among citizens, local community leaders and industry; and identify and plan to ameliorate negative impacts of oil field development.

  9. Strategic workforce planning for a multihospital, integrated delivery system.

    Datz, David; Hallberg, Colleen; Harris, Kathy; Harrison, Lisa; Samples, Patience


    Banner Health has long recognized the need to anticipate, beyond the immediate operational realities or even the annual budgeting projection exercises, the necessary workforce needs of the future. Thus, in 2011, Banner implemented a workforce planning model that included structures, processes, and tools for predicting workforce needs, with particular focus on identified critical systemwide practice areas. The model represents the incorporation of labor management tools and processes with more strategic, broad-view, long-term assessment and planning mechanisms. The sequential tying of the workforce planning lifecycle with the organization's strategy and financial planning process supports alignment of goals, objectives, and resource allocation. Collaboration among strategy, finance, human resources, and operations has provided us with the ability to identify critical position groups based on 3-year strategic priorities. By engaging leaders from across the organization, focusing on activities at facility, regional, and system levels, and building in mechanisms for accountability, we are now engaged in continuous evaluations of our delivery models, the competencies and preparations necessary for the staff to effectively function within those delivery models, and developing and implementing action plans designed to ensure adequate numbers of the staff whose competencies will be suited to the work expected of them. PMID:22955225

  10. Workforce Planning for New Nuclear Power Programmes

    An appropriate infrastructure is essential for the efficient, safe, reliable and sustainable use of nuclear power. The IAEA continues to be encouraged by its Member States to provide assistance to those considering the introduction of nuclear power. Its response has been to increase technical assistance, organize more missions and hold workshops, as well as to issue new and updated publications in the IAEA Nuclear Energy Series. Milestones in the Development of a National Infrastructure for Nuclear Power, an IAEA Nuclear Energy Series publication (NG-G-3.1), provides detailed guidance on a holistic approach to national nuclear infrastructure development involving three phases. Nineteen issues are identified in this guide, ranging from development of a government's national position on nuclear power to planning for procurement related to the first nuclear power plant. One of these 19 issues upon which each of the other 18 depend is suitable human resources development. As a growing number of Member States begin to consider the nuclear power option, they ask for guidance from the IAEA on how to develop the human resources necessary to launch a nuclear power programme. The nuclear power field, comprising industry, government authorities, regulators, R and D organizations and educational institutions, relies on a specialized, highly trained and motivated workforce for its sustainability and continued success, quite possibly more than any other industrial field. This report has been prepared to provide information on the use of integrated workforce planning as a tool to effectively develop these resources for the spectrum of organizations that have a stake in such nuclear power programmes. These include, during the initial stages, a nuclear energy programme implementing organization (NEPIO), as well as the future operating organization, nuclear regulatory body, government authorities and technical support organizations if a decision is made to initiate a nuclear power

  11. Effectively marketing prepaid medical care with decision support systems.

    Forgionne, G A


    The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches. PMID:10111964

  12. Policy and Workforce Reform in England

    Gunter, Helen M.


    Current workforce reform, known as Remodelling the School Workforce, is part of an enduring policy process where there have been tensions between public and private sector structures and cultures. I show that the New Right and New Labour governments who have built and configured site based performance management over the past quarter of a century…

  13. CTE's Role in Workforce Readiness Credentialing

    Hyslop, Alisha


    The career and technical education (CTE) programs play critical roles in the growth of workforce readiness credentials. This article presents an ACTE issue brief that highlighting the need for workforce readiness credentials, and the role CTE plays in helping students acquire them. CTE is at the forefront of preparing students at all levels for…

  14. Workshop: health workforce governance and integration.

    Batenburg, R.


    Background: Health workforce governance is increasingly recognized as a burning policy issue and focused on workforce shortages. Yet the most pressing problem is to solve maldistributions through governance and integration. Poor management of health 242 European Journal of Public Health, Vol. 24, S

  15. Employee Engagement: Motivating and Retaining Tomorrow's Workforce

    Shuck, Michael Bradley; Wollard, Karen Kelly


    Tomorrow's workforce is seeking more than a paycheck; they want their work to meet their needs for affiliation, meaning, and self-development. Companies willing to meet these demands will capture the enormous profit potential of a workforce of fully engaged workers. This piece explores what engagement is, why it matters, and how human resource…

  16. Augmenting health care failure modes and effects analysis with simulation

    Staub-Nielsen, Ditte Emilie; Dieckmann, Peter; Mohr, Marlene;


    This study explores whether simulation plays a role in health care failure mode and effects analysis (HFMEA); it does this by evaluating whether additional data are found when a traditional HFMEA is augmented with simulation. Two multidisciplinary teams identified vulnerabilities in a process by ...

  17. Student perceptions: the influence of a Nursing Workforce Diversity Grant on retention.

    Evans, Bronwynne C


    This article reports the perceptions of Hispanic/Latino and American Indian students concerning the influence of a Nursing Workforce Diversity Grant (ALCANCE) on their educational experiences in a baccalaureate nursing program. The grant provided an educational pipeline for these students, supporting them financially, personally, and academically from middle school through graduation from the nursing program. Fifteen students receiving grant services during the upper-division nursing major completed a 76-item questionnaire assessing the influence of such services at the end of each of four semesters in the nursing program. Analysis of these questionnaires and examination of responses to open-ended questions at the end of each instrument indicated a generally positive influence of ALCANCE on student experiences. However, there remains a need for the creation of additional caring educational environments and further research to better understand effective strategies for addressing recruitment and retention in American Indian and Hispanic/Latino nursing students. PMID:17726998

  18. A comparative analysis of emotional intelligence in the UK and Australian radiographer workforce

    Emotional intelligence (EI) in the UK radiographer workforce has been benchmarked using the trait emotional intelligence model and the profile of the profession in the UK has begun to emerge. There are cultural differences between countries that have been shown to have an effect on EI, therefore this paper aims to benchmark the Global and four factor scores of Trait EI in the Australian radiographer population; to explore any differences within the two main professional groupings, diagnostic and therapeutic radiographers, and to compare the Australian radiographer workforce scores with those of the UK previously published. The published and validated trait EI questionnaire of Petrides was used as the survey tool for the Global EI and the four factors of Well-being, Emotionality, Self-control and Sociability. There was only one difference found in the five factors studied between the UK and Australian radiographer workforce, that of Well-being (p ≤ 0.01). No differences emerged between the diagnostic and therapy disciplines nor was a relationship found between EI and the Australian leadership in contrast to the UK workforce findings. Differences were found in the demographic profiles of the two countries and the implications of the above findings are discussed. This paper has benchmarked the EI of the Australian workforce and found a difference in well-being between the UK and Australian radiographer workforce. The Australian diagnostic and therapy disciplines were no different in their EI profiles. No relationship was found between EI and leadership in the Australian radiographer workforce

  19. Effects of Dementia-Care Mapping on Residents and Staff of Care Homes: A Pragmatic Cluster-Randomised Controlled Trial

    Geertje van de Ven; Irena Draskovic; Eddy M M Adang; Rogier Donders; Zuidema, Sytse U.; Koopmans, Raymond T C M; Vernooij-Dassen, Myrra J. F. J.


    BACKGROUND: The effectiveness of dementia-care mapping (DCM) for institutionalised people with dementia has been demonstrated in an explanatory cluster-randomised controlled trial (cRCT) with two DCM researchers carrying out the DCM intervention. In order to be able to inform daily practice, we studied DCM effectiveness in a pragmatic cRCT involving a wide range of care homes with trained nursing staff carrying out the intervention. METHODS: Dementia special care units were randomly assigned ...

  20. Promoting Patient- and Family-Centered Care Through Personal Stories.

    Johnson, Beverley H


    Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among patients, their families, and health care professionals. It redefines the relationships in health care by placing an emphasis on collaborating with patients of all ages, and their families, at all levels of care, in all health care settings, and in organizational change and improvement. This collaboration ensures that health care is responsive to an individual's priorities, preferences, and values. In patient- and family-centered care, patients define their "family" and determine how they and their family will participate in care and decision making. While patient- and family-centered care can improve the experience of care, safety, and quality, it also can improve the learning environment for students and trainees. The author shares personal stories to illustrate the core concepts of patient- and family-centered care, when they are present in health care interactions, and when they are not. Drawing from these stories and the author's experience in working with academic medical centers and other health care organizations over many decades, recommendations for changes in medical education are suggested that can contribute to the development of a health care workforce with the skills and commitment to partner respectfully, effectively, and authentically with patients and families. The implementation of the Affordable Care Act gives new impetus for building a health care delivery system and related educational programs to support patient- and family-centered practice. PMID:26796094

  1. [Dentists' workforce in Hungary and international migration].

    Balázs, Péter


    In Hungary, cross-national migration in dental care was performed rather by patients from abroad instead of the domestic dentists' migration for working abroad. Actually, this tacitly realized and so-called dental tourism experienced two basic changes. The National Medical Tourism Ltd. arranged the First Conference for Development of Dental Tourism on 21 April 2011. Hungary's prime minister addressed the meeting and finally signed an agreement with the organizing Ltd. about governmental financial support for development of dental tourism. On the other hand, Germany and Austria deleted all restrictions against the free cross-national workforce migration since 1 May this year. For understanding and prognosis of dentists' future migration, it is inevitable to collect and analyse relevant data of the previous years. This study is presenting data obtained from January 1, 2006 to December 31, 2010. According to the net outcome, the dentists' human resource system was balanced down to the end of 2010. However, this state is unsure even for the near future, thus preventing the deficit of dentists all necessary measures must be taken to keep up the present level of the domestic dentral service. PMID:22826911

  2. Bullying, mentoring, and patient care.

    Frederick, Dorothea


    The literature suggests that acts of bullying are a root cause of new nurses leaving their units or the profession entirely and have the potential to worsen the nursing shortage. As an effective way to address bullying in the perioperative setting, mentoring benefits the nursing profession. Mentoring can have a direct influence on nurses' longevity in a health care organization, thereby strengthening the nursing workforce. Magnet-designated hospitals support the importance of mentor-mentee relationships for positive employee retention and positive recruitment outcomes. One of the most important tasks that a mentor should undertake is that of a role model. Establishing a culture of mentoring requires authentic leadership, genuine caring and respect for employees, and open communication. The entire nursing profession benefits from a culture of mentoring, as do the patients and families who receive care. PMID:24766920

  3. Effective health care for older people living and dying in care homes: a realist review

    Goodman, Claire; Dening, Tom; Gordon, Adam L.; Davies, Susan L.; Meyer, Julienne; Martin, Finbarr C; Gladman, John R F; Bowman, Clive; Victor, Christina; Handley, Melanie; Gage, Heather; Iliffe, Steve; ZUBAIR, MARIA


    Background Care home residents in England have variable access to health care services. There is currently no coherent policy or consensus about the best arrangements to meet these needs. The purpose of this review was to explore the evidence for how different service delivery models for care home residents support and/or improve wellbeing and health-related outcomes in older people living and dying in care homes. Methods We conceptualised models of health care provision to care homes as comp...

  4. Workforce Issues and Consumer Satisfaction in Medicaid Personal Assistance Services

    Anderson, Wayne L.; Wiener, Joshua M.; Khatutsky, Galina


    This study used a survey of older people and younger persons with disabilities who were receiving Medicaid-financed home and community-based services (HCBS) to assess the effect of workforce issues on consumer satisfaction. We found that recruitment problems had very strong negative and significant effects on consumer satisfaction. An interruption in service was a more important and significant indicator of consumer dissatisfaction than not having the same worker over time. We also found that...

  5. Employment patterns of Notre Dame graduate physiotherapists 2006-12: targeting areas of workforce need.

    Bacopanos, Eleni; Edgar, Susan


    Objectives The Australian physiotherapy workforce is changing both in demographics and service needs. Physiotherapy curriculum and clinical education focus is ideally based on up-to-date knowledge of this changing workforce. The aim of the present study was to determine the employment patterns of physiotherapy graduates from The University of Notre Dame Australia (Notre Dame). Methods An online survey was conducted of Notre Dame physiotherapy graduates (2006-12) with a 50% response rate (n=157). Results Survey results established the employment location, employment status, healthcare sector, area of practice, salary and employment history of Notre Dame graduates. The results highlighted links between curriculum, clinical placements and workforce areas, with the spread of workforce directly linked to focuses in the undergraduate curriculum. Conclusion The present study highlights the effect of directing undergraduate curriculum and clinical placement experiences towards areas of workforce need. The findings identify the importance of producing graduates equipped to meet the changing service needs of the healthcare industry. What is known about the topic? No previous studies have been conducted on the employment patterns of Notre Dame physiotherapy graduates and specifically the impact of targeting curriculum and clinical placements towards areas of workforce need. What does this paper add? Through a self-administered survey design, the present study demonstrated that Notre Dame physiotherapy graduates have increased uptake in areas targeted within the curriculum, specifically geriatrics, paediatrics and rural health. Although graduates were more attracted to the rural health setting, they were not retained. What are the implications for practitioners? The present study informs educational institutions and workforce planners on the importance of linking curriculum, clinical placements and workforce to develop a sustainable workforce adaptable to clinical settings and

  6. Stepped care for depression and anxiety: from primary care to specialized mental health care: a randomised controlled trial testing the effectiveness of a stepped care program among primary care patients with mood or anxiety disorders

    Seekles Wike


    Full Text Available Abstract Background Mood and anxiety disorders are highly prevalent and have a large impact on the lives of the affected individuals. Therefore, optimal treatment of these disorders is highly important. In this study we will examine the effectiveness of a stepped care program for primary care patients with mood and anxiety disorders. A stepped care program is characterized by different treatment steps that are arranged in order of increasing intensity. Methods This study is a randomised controlled trial with two conditions: stepped care and care as usual, whereby the latter forms the control group. The stepped care program consists of four evidence based interventions: (1 Watchful waiting, (2 Guided self-help, (3 Problem Solving Treatment and (4 Medication and/or specialized mental health care. The study population consists of primary care attendees aged 18–65 years. Screeners are sent to all patients of the participating general practitioners. Individuals with a Diagnostic and Statistical Manual of mental disorders (DSM diagnosis of major depression, dysthymia, panic disorder (with or without agoraphobia, generalized anxiety disorder, or social phobia are included as well as individuals with minor depression and anxiety disorders. Primary focus is the reduction of depressive and anxiety symptoms. Both conditions are monitored at 8, 16 and 24 weeks. Discussion This study evaluates the effectiveness of a stepped care program for patients with depressive and anxiety disorder. If effective, a stepped care program can form a worthwhile alternative for care as usual. Strengths and limitations of this study are discussed. Trial Registration Current Controlled Trails: ISRCTN17831610.

  7. An Ecological Perspective on Early Years Workforce Competences in Italian ECEC Settings

    Migliorini, Laura; Rania, Nadia; Tassara, Tatiana


    Based on an ecological perspective on competence, this study analyzed the attitudes, skills, and knowledge of practitioners in educational services for 0-6-years-old children in Italy, examining competence profiles in the Early Childhood Education and Care (ECEC) workforce. Our study considered three areas of competence, which previously have…

  8. The Role of VET in Workforce Development: A Story of Conflicting Expectations. Research Report

    Bretherton, Tanya


    This is the final report from a three-year program of research investigating the role of vocational education and training (VET) in workforce development. The research focuses on meat processing and child care, both of which are characterised by low-skill entry points to the labour market. The author pulls together the key themes emerging from the…

  9. Retooling for an aging America: building the healthcare workforce. A white paper regarding implementation of recommendation 4.2 of this Institute of Medicine Report of April 14, 2008, that "All licensure, certification and maintenance of certification for healthcare professionals should include demonstration of competence in care of older adults as a criterion.".


    In Chicago, Illinois, on May 7, 2009, a group of 53 medical educators representing many U.S. certification boards, residency review committees, and medical societies met to review and approve a white paper intended to promote Recommendation 4.2 of the Institute of Medicine report of April 14, 2008, "Retooling for an Aging America: Building the Healthcare Workforce." This recommendation is one of 14 and states: "All licensure, certification and maintenance of certification for healthcare professionals should include demonstration of competence in care of older adults as a criterion." Background information given included the growing numbers of older adults, review of a 15-year initiative by a section of the American Geriatrics Society (AGS) to include geriatric education in all surgical and some related medical specialties, a recent announcement of 26 elder care competencies to be expected of graduating medical students from association of American Medical Colleges (AAMC) affiliated schools, and the American Board of Medical Specialties (ABMS) approach to 'Reinforcing Geriatric Competencies through Licensure and Certification Examinations." Nine points involved in the implementation of this recommendation received discussion, and approaches to realization were presented. In conclusion, this white paper, which those listed as being in attendance approved, proposes hat all ABMS member boards whose diplomates participate in the care of older adults select the floor competencies enumerated by the AAMC that apply to their specialty and add or subtract those completed during their trainees' initial (intern) year and then define those needed in subsequent years of residency and ultimate practice. This would fulfill the requirements of Recommendation 4.2 above. PMID:21797833

  10. 20 CFR 702.422 - Effect of failure to report on medical care after initial authorization.


    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Effect of failure to report on medical care... ADMINISTRATION AND PROCEDURE Medical Care and Supervision Medical Procedures § 702.422 Effect of failure to report on medical care after initial authorization. (a) Notwithstanding that medical care is...

  11. The Effect of Telephone Support Groups on Costs of Care for Veterans with Dementia

    Wray, Laura O.; Shulan, Mollie D.; Toseland, Ronald W.; Freeman, Kurt E.; Vasquez, Bob Edward; Gao, Jian


    Purpose: Few studies have addressed the effects of caregiver interventions on the costs of care for the care recipient. This study evaluated the effects of a caregiver education and support group delivered via the telephone on care recipient health care utilization and cost. Design and Methods: The Telehealth Education Program (TEP) is a…

  12. The leadership labyrinth: leveraging the talents of women to transform health care.

    McDonagh, Kathryn J; Paris, Nancy M


    Women have had a transformative influence on the health care field as highly effective leaders known to produce superior results. Women make up the vast majority of the health care workforce as well as health care graduates. Women also make most health care decisions on behalf of their families. Yet, despite this omnipresence in health care, there is a dearth of women in chief executive and governance roles. A lack of leadership development and succession planning in health care and other obstacles to career progression make it challenging for women to advance to top leadership levels. The traditional linear career ladder that has existed in health care is not conducive to women's advancement. Women have taken a different pathway to career development referred to as the leadership labyrinth. This is a development process leading to wisdom and insights essential for today's health care challenges. This crucial stage in the evolution of health care calls for new models of care and leadership. The most abundant resource at risk of being overlooked is the optimal engagement of women. Women leaders are the backbone of the health care workforce but have yet to be strategically deployed in key leadership positions. The talents of women leaders can be a significant factor in the transformation of health care. PMID:23222748

  13. Productivity impact of headache on a heavy-manufacturing workforce in Turkey

    Selekler, Macit H; Gökmen, Gürsel; Steiner, Timothy J.


    Background Headache disorders cause substantial productivity losses through absenteeism and impaired effectiveness at work (presenteeism). We measured productivity losses from both causes at a heavy-manufacturing company with a largely male workforce in north-western Turkey. Methods We used the HALT Index as the survey instrument. We first assessed productivity losses by surveying the entire workforce. Because we anticipated much non-participation, we also applied HALT at the annual health-ch...

  14. Current legal initiative to integrated care - effects of outpatient care in hospitals

    The strict separation of the out-patient and hospital-based health care delivery sectors in Germany leads to deficits in effectiveness and efficiency. Newly introduced legal initiatives to overcome this separation, namely 'Ambulantes Operieren' (Paragraph 115b SGB V), 'Ambulante Behandlung durch Krankenhaeuser' and Disease Management Programs (Paragraphen 116a-b SGB V) are described in detail in this article. Their impact on hospital-based health provision for out-patients is discussed. The aim of a better integration of different sectors with a better quality and a more efficient use of resources seems to be the target of these initiatives. (orig.)

  15. Should I stay or should I go? The impact of working time and wages on retention in the health workforce

    S. Steinmetz; D.H. de Vries; K.G. Tijdens


    Background: Turnover in the health workforce is a concern as it is costly and detrimental to organizational performance and quality of care. Most studies have focused on the influence of individual and organizational factors on the intention to quit. Based on the observation that providing care is b

  16. Effects of snoezelen, integrated in 24 h dementia care, on nurse-patient communication during morning care.

    Weert, J.C.M. van; Dulmen, A.M. van; Spreeuwenberg, P.M.M.; Ribbe, M. W.; Bensing, J.M.


    OBJECTIVE: To investigate the effectiveness of snoezelen, integrated in 24-hour care, on the communication of Certified Nursing Assistants (CNAs) and demented nursing home residents during morning care. METHODS: A quasi-experimental pre- and post-test design was conducted, comparing sic psychogeriatric wards, that implemented snoezelen, to six control wards, that continued in giving usual care. Measurements were performed at baseline and 18 months after a training 'snoezelen for caregivers'. ...

  17. Maintaining a Sufficient and Quality Physician Workforce: The Role of For-profit Medical Schools

    Babcock, Jessica M.; Babcock, Blake D.; Schwartz, Marshall Z.


    Currently, in the United States there is a significant physician workforce shortage. This problem is likely to persist as there is no quick solution. The nature of this shortage is complex and involves factors such as an absolute physician shortage, as well as physician shortages in primary care and certain specialty care areas. In addition, there is a misdistribution of physicians to medically underserved areas and populations. The medical education system trains medical school graduates tha...

  18. Nursing assistants' behavior during morning care: effects of the implementation of snoezelen, integrated in 24-hours dementia care.

    Weert, J.C.M. van; Janssen, B.M.; Dulmen, A.M. van; Spreeuwenberg, P.M.M.; Bensing, J.M.; Ribbe, M.W.


    Aim: This paper reports an investigation of the effects of the implementation of snoezelen, or multisensory stimulation, on the quality of nursing assistants' behaviour during morning care. Background: Nursing assistants in long-term dementia care are often unaware of the impact of their behaviour o

  19. Cost-effectiveness of centralised and partly centralised care compared to usual care for patients with type 2 diabetes

    Van Der Heijden, A.A.W.; Feenstra, T.L.; De Bruijne, M.C.; Baan, C.A.; Donker, G.A.; Dekker, J.M.; Nijpels, G.


    Background and aims: Due to an ever increasing number of type 2 diabetes patients, innovations to control the increasing health care use and costs are needed. Results of diabetes care programs on the costs or (cost-) effectiveness are heterogeneous. The aim of this study is to compare the cost-effec

  20. Nursing workforce retention: challenging a bullying culture.

    Stevens, Stella


    Discussions surrounding nursing shortages typically focus on recruitment, but retention is also a problem. Emerging research suggests that intimidation in the nursing workforce is a problem that planners need to deal with as part of an overall strategy aimed at maintaining a balance between supply and demand. This paper explores issues surrounding intimidation in the nursing workforce and looks at how one major teaching hospital in Australia attempted to address the problem. PMID:12224882

  1. Leveraging the Experiences of Informal Caregivers to Create Future Healthcare Workforce Options.

    Phillips, Sara S; Ragas, Daiva M; Hajjar, Nadia; Tom, Laura S; Dong, XinQi; Simon, Melissa A


    The objective of this study was gather pilot data from informal caregivers regarding the potential for a training program to assist current or past caregivers in reentering the job market, and thus offering a pathway to economic resilience. In an effort that could foster a sustainable and competent caregiving market to help meet the needs of an aging America, whether training informal caregivers might help them transition into a paid caregiving or other health service role was explored. Caregivers (N=55) of a chronically or terminally ill family member or friend in a suburban county near Chicago were interviewed. The interview guide addressed household economic effect of illness, emotional burden, and training program interest. Fifty-six percent of caregivers were interested in training to work outside the home, caring for people in other households, 84% indicated a desire to learn more about health care, and 68% reported a desire to explore job possibilities in health care. Eighty-two percent were experienced in working with an individual aged 50 and older. Informal caregivers' interest in a training program to bolster their qualifications for a role in the healthcare workforce, including the option of a formal caregiver position, supports the demand for such a program. Considering the need for healthcare workers to serve the growing elderly population and the desire of informal caregivers to find gainful employment, these informal caregivers could provide the impetus to invest in informal caregiver training. PMID:26782869

  2. Aligning career development with organizational goals: working towards the development of a strong and sustainable workforce.

    Saxe-Braithwaite, Marcy; Carlton, Sandra; Bass, Brenda


    The rapidly changing world of healthcare is faced with many challenges, not the least of which is a diminishing workforce. Healthcare organizations must develop multiple strategies, not only to attract and retain employees, but also to ensure that workers are prepared for continuous change in the workplace, are working at their full scope of practice and are committed to, and accountable for, the provision of high-quality care. There is evidence that by creating a healthier workplace, improved patient care will follow. Aligning Healthy Workplace Initiatives with an organization's strategic goals, corporate culture and vision reinforces their importance within the organization. In this paper, we describe an innovative pilot to assess a career development program, one of multiple Healthy Workplace Initiatives taking place at Providence Care in Kingston, Ontario in support of our three strategic goals. The results of the pilot were very encouraging; subsequent success in obtaining funding from HealthForceOntario has allowed the implementation of a sustainable program of career development within the organization. More work is required to evaluate its long-term effectiveness. PMID:19289913

  3. Assessing effective care in normal labor: the Bologna score.

    Chalmers, B; Porter, R


    The intention of the "Bologna score" is to quantify, both in an individual labor and in a wider population, the extent to which labors have been managed as if they are normal as opposed to complicated. In this way it may be possible to assess both attitudes and practices within a maternity service toward the effective care of normal labor. A scoring system for normal labor was proposed at the World Health Organization (Regional Office for Europe) Task Force Meeting on Monitoring and Evaluation of Perinatal Care, held in Bologna in January 2000. This paper describes conceptual development of the scale. Recommendations for future evaluation of the Bologna score's validity and potential include field testing globally, comparison with the Apgar score, and evaluation of the relative weight contributed by each of the five measures comprising the Bologna score. PMID:11380378

  4. Space commercialization trends and consequences for the workforce

    Peeters, W.


    Space Commercialization has considerably changed the space era over the last few years. Besides a number of facilitators, such as improved regulatory frameworks, it can clearly be demonstrated that reduced public funding has been the prime catalyst for this commercialization process. Space industry has proactively reacted to this new situation by forming strategic alliances, in the first place to be able to reach the global space market. This effect, in turn, induces a number of new skills which are needed for the future space work force. Transnational activities require a more international approach and better understanding of cultural differences, far beyond linguistic ones. Transfer of workforce from other sectors remains difficult, mainly due to the uniqueness of the space sector. Tailored space education curricula will therefore be needed to prepare the new space workforce for timely take over from the present — rapidly aging — space professionals without the risk of losing know-how.

  5. Inequality of Paediatric Workforce Distribution in China.

    Song, Peige; Ren, Zhenghong; Chang, Xinlei; Liu, Xuebei; An, Lin


    Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of paediatric workforce distribution. This study aimed to analyse the inequality of the distributions of the paediatric workforce (including paediatricians and paediatric nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the paediatric workforce was the most inequitable regarding the distribution of children region. For different professional types, we found that, except the Central region, the level of inequality of paediatric nurses was higher than that of the paediatricians regarding both the demographic and geographic distributions. The inner-regional inequalities were the main sources of the paediatric workforce distribution inequality. To conclude, this study revealed the inadequate distribution of the paediatric workforce in China for the first time, substantial inequality of paediatric workforce distribution still existed across the nation in 2010, more research is still needed to explore the in-depth sources of inequality, especially the urban-rural variance and the inner- and inter-provincial differences, and to guide national and local health policy-making and resource allocation. PMID:27420083

  6. Dynamic professional boundaries in the healthcare workforce.

    Nancarrow, Susan A; Borthwick, Alan M


    The healthcare professions have never been static in terms of their own disciplinary boundaries, nor in their role or status in society. Healthcare provision has been defined by changing societal expectations and beliefs, new ways of perceiving health and illness, the introduction of a range of technologies and, more recently, the formal recognition of particular groups through the introduction of education and regulation. It has also been shaped by both inter-professional and profession-state relationships forged over time. A number of factors have converged that place new pressures on workforce boundaries, including an unmet demand for some healthcare services; neo-liberal management philosophies and a greater emphasis on consumer preferences than professional-led services. To date, however, there has been little analysis of the evolution of the workforce as a whole. The discussion of workforce change that has taken place has largely been from the perspective of individual disciplines. Yet the dynamic boundaries of each discipline mean that there is an interrelationship between the components of the workforce that cannot be ignored. The purpose of this paper is to describe four directions in which the existing workforce can change: diversification; specialisation and vertical and horizontal substitution, and to discuss the implications of these changes for the workforce. PMID:16313522

  7. Generational differences of the frontline nursing workforce in relation to job satisfaction: what does the literature reveal?

    Saber, Deborah A


    The job satisfaction of registered nurses has been found to be associated with retention, organizational commitment, workforce safety, and cost savings to health care organizations. Satisfaction of the workforce is vital because nursing turnover can be detrimental for a labor force that is growing older. However, the summation of the most important variables that are linked to job satisfaction has been difficult to discern in part because the workforce includes 3 main generations (ie, Baby Boomers, Gen Xers, and Millennials) with unique work values that drive their job satisfiers. This article provides a review of existing literature to examine the differences in variables that are linked to job satisfaction that exist between the generational cohorts. Differences in stress sources, need for work-life balance, and compensation are discussed. The knowledge about generationally driven variables that influence job satisfaction can help managers develop strategies to maintain a diverse nursing workforce. PMID:24168868

  8. Effectiveness of Stepped Care for Chronic Fatigue Syndrome: A Randomized Noninferiority Trial

    Tummers, Marcia; Knoop, Hans; Bleijenberg, Gijs


    Objective: In this randomized noninferiority study, the effectiveness and efficiency of stepped care for chronic fatigue syndrome (CFS) was compared to care as usual. Stepped care was formed by guided self-instruction, followed by cognitive behavior therapy (CBT) if the patient desired it. Care as usual encompassed CBT after a waiting period.…

  9. Early Efforts By Medicare Accountable Care Organizations Have Limited Effect On Mental Illness Care And Management.

    Busch, Alisa B; Huskamp, Haiden A; McWilliams, J Michael


    People with mental illness use more health care and have worse outcomes than those without such illnesses. In response to incentives to reduce spending, accountable care organizations (ACOs) may therefore attempt to improve their management of mental illness. We examined changes in mental health spending, utilization, and quality measures associated with ACO contracts in the Medicare Shared Savings Program and Pioneer model for beneficiaries with mental illness, using Medicare claims for the period 2008-13 and difference-in-differences comparisons with local non-ACO providers. Pioneer contracts were associated with lower spending on mental health admissions in the first year of the contract, an effect that was attenuated in the second year. Otherwise, ACO contracts were associated with no changes in mental health spending or readmissions, outpatient follow-up after mental health admissions, rates of depression diagnosis, or mental health status. These results suggest that ACOs have not yet focused on mental illness or have been largely unsuccessful in early efforts to improve their management of it. PMID:27385241

  10. Cost-effectiveness of collaborative care for the treatment of depressive disorders in primary care: a systematic review.

    Thomas Grochtdreis

    Full Text Available For the treatment of depressive disorders, the framework of collaborative care has been recommended, which showed improved outcomes in the primary care sector. Yet, an earlier literature review did not find sufficient evidence to draw robust conclusions on the cost-effectiveness of collaborative care.To systematically review studies on the cost-effectiveness of collaborative care, compared with usual care for the treatment of patients with depressive disorders in primary care.A systematic literature search in major databases was conducted. Risk of bias was assessed using the Cochrane Collaboration's tool. Methodological quality of the articles was assessed using the Consensus on Health Economic Criteria (CHEC list. To ensure comparability across studies, cost data were inflated to the year 2012 using country-specific gross domestic product inflation rates, and were adjusted to international dollars using purchasing power parities (PPP.In total, 19 cost-effectiveness analyses were reviewed. The included studies had sample sizes between n = 65 to n = 1,801, and time horizons between six to 24 months. Between 42% and 89% of the CHEC quality criteria were fulfilled, and in only one study no risk of bias was identified. A societal perspective was used by five studies. Incremental costs per depression-free day ranged from dominance to US$PPP 64.89, and incremental costs per QALY from dominance to US$PPP 874,562.Despite our review improved the comparability of study results, cost-effectiveness of collaborative care compared with usual care for the treatment of patients with depressive disorders in primary care is ambiguous depending on willingness to pay. A still considerable uncertainty, due to inconsistent methodological quality and results among included studies, suggests further cost-effectiveness analyses using QALYs as effect measures and a time horizon of at least 1 year.