WorldWideScience

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.

    Science.gov (United States)

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

    2013-12-01

    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

    OpenAIRE

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

    2013-01-01

    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

    OpenAIRE

    Schwartz, Mark D

    2011-01-01

    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.

    Science.gov (United States)

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

    2015-01-01

    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.

    OpenAIRE

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

    2009-01-01

    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

    OpenAIRE

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

    2015-01-01

    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

    Science.gov (United States)

    2010-05-07

    ...: Nominations can be submitted by either of the following: E- mail: HCWorkforce@gao.gov . 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.

    NARCIS (Netherlands)

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

    2014-01-01

    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

    Directory of Open Access Journals (Sweden)

    Bloom Judy

    2012-08-01

    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

    Directory of Open Access Journals (Sweden)

    Henrickson Michael

    2011-08-01

    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.

    Science.gov (United States)

    Moye, Janet P; Swan, Beth Ann

    2009-01-01

    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.

    Science.gov (United States)

    Collins, Sandra K; Collins, Kevin S

    2007-01-01

    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

    OpenAIRE

    Schulz, Erika; Geyer, Johannes

    2013-01-01

    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.

    Science.gov (United States)

    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

    OpenAIRE

    Schulz, Erika

    2013-01-01

    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.

    Science.gov (United States)

    Segal, Leonie; Bolton, Tom

    2009-01-01

    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

    International Nuclear Information System (INIS)

    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.

    Science.gov (United States)

    Bui, Thomas

    2012-09-01

    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

    OpenAIRE

    Schulz, Erika

    2014-01-01

    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

    Directory of Open Access Journals (Sweden)

    M. Mutingi

    2012-10-01

    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.

    Science.gov (United States)

    Henning-Smith, Carrie; Kozhimannil, Katy B

    2016-06-01

    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

    Science.gov (United States)

    Mittal, Vikas; Rosen, Jules; Leana, Carrie

    2009-01-01

    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.

    Science.gov (United States)

    Nichols, Pam; Horner, Barbara; Fyfe, Katrina

    2015-01-01

    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.

    Science.gov (United States)

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

    1998-01-01

    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.

    Science.gov (United States)

    Manion, Jo

    2004-01-01

    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.

    Science.gov (United States)

    Zeng, Xiaoming

    2016-01-01

    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.

    Science.gov (United States)

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

    2013-12-01

    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

    OpenAIRE

    Bridges, Jaqueline

    2004-01-01

    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

    Science.gov (United States)

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

    2010-01-01

    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.

    Science.gov (United States)

    Nelsey, Lorraine; Brownie, Sonya

    2012-01-01

    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?

    NARCIS (Netherlands)

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

    2015-01-01

    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

    Science.gov (United States)

    Dennehy, Julie; Marshall, Nancy L.

    2005-01-01

    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

    Science.gov (United States)

    Gruber, David

    2004-01-01

    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

    Science.gov (United States)

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

    2012-01-01

    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.

    Science.gov (United States)

    Swenson, Cathy

    2008-01-01

    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.

    Science.gov (United States)

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

    2016-01-01

    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

    International Nuclear Information System (INIS)

    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

    Directory of Open Access Journals (Sweden)

    Ghosh Basu

    2009-06-01

    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.

    Science.gov (United States)

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

    2015-01-01

    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

  20. THE IMPACT OF WORKFORCE DIVERSITY ON ORGANIZATIONAL EFFECTIVENESS: A STUDY OF A NIGERIAN BANK

    Directory of Open Access Journals (Sweden)

    OMANKHANLEN ALEX EHIMARE

    2011-01-01

    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.

    Science.gov (United States)

    Almutairi, Adel F; Rondney, Patricia

    2013-01-01

    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.

    Science.gov (United States)

    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.

    Science.gov (United States)

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

    2016-01-01

    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

    Data.gov (United States)

    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

    OpenAIRE

    Jackson, C; Manley, K.

    2015-01-01

    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

    Directory of Open Access Journals (Sweden)

    Shujin Qin

    2016-01-01

    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

    OpenAIRE

    Drennan, Vari; Davis, Kathy

    2008-01-01

    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?

    Science.gov (United States)

    Gallagher, J E; Wilson, N H F

    2009-02-28

    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.

    Science.gov (United States)

    Parsons, Lynn C

    2002-01-01

    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?

    Science.gov (United States)

    Blue, Christine M; Lopez, Naty

    2011-01-01

    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

    Data.gov (United States)

    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

    Data.gov (United States)

    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.

    Science.gov (United States)

    Buiser, M

    2000-06-01

    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.

    Science.gov (United States)

    Jones, Aled; Kelly, Daniel

    2014-09-01

    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

    OpenAIRE

    Kuvandikov, A.

    2010-01-01

    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.

    Science.gov (United States)

    Harms, Roxanne

    2009-01-01

    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.

    Science.gov (United States)

    Goodwin, Kristine

    2014-12-01

    (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

    OpenAIRE

    Samal, Janmejaya

    2015-01-01

    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.

    Science.gov (United States)

    Faller, Marcia; Gogek, Jim

    2016-01-01

    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

    OpenAIRE

    Rendon, Rene G.

    2010-01-01

    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!

    Science.gov (United States)

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

    2016-02-01

    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

    Directory of Open Access Journals (Sweden)

    Ricardo Andres Cartes-Velasquez

    2013-12-01

    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

    International Nuclear Information System (INIS)

    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.

    Science.gov (United States)

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

    2010-01-01

    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

    Science.gov (United States)

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

    2014-01-01

    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.

    Science.gov (United States)

    Essary, Alison C; Wade, Nathaniel L

    2016-01-01

    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

    OpenAIRE

    Garnero, Andrea; Kampelmann, Stephan; Rycx, François

    2013-01-01

    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

    Directory of Open Access Journals (Sweden)

    Buchan James

    2010-12-01

    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

    Science.gov (United States)

    Ryan, Sharon; Whitebook, Marcy; Cassidy, Deborah

    2014-01-01

    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.

    Science.gov (United States)

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

    2013-01-01

    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

    OpenAIRE

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

    2016-01-01

    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.

    Science.gov (United States)

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

    2014-03-01

    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

    OpenAIRE

    Uteng, Karoline

    2013-01-01

    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

    Science.gov (United States)

    ... 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.

    Science.gov (United States)

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

    2008-03-01

    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

    Science.gov (United States)

    Sterk, Steve; Chesley, Stephan

    2008-01-01

    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.

    Science.gov (United States)

    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

    OpenAIRE

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

    2011-01-01

    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.

    Science.gov (United States)

    Krive, Jacob

    2013-01-01

    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

    OpenAIRE

    Glazer Greer

    2012-01-01

    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.

    Science.gov (United States)

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

    2011-01-01

    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.

    Science.gov (United States)

    2005-08-01

    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

    Science.gov (United States)

    Sterk, Steve; Chesley, Stephen

    2008-01-01

    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.

    Science.gov (United States)

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

    2016-08-01

    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?

    Science.gov (United States)

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

    2011-12-01

    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

    International Nuclear Information System (INIS)

    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

    Energy Technology Data Exchange (ETDEWEB)

    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: james.b.yu@yale.edu [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)

    2012-04-01

    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

    OpenAIRE

    Berwick, D

    2003-01-01

    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

    Science.gov (United States)

    Schultz, Roger W.

    2010-01-01

    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

    OpenAIRE

    Evans, M. D. R.; Jonathan Kelley

    2004-01-01

    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.

    Directory of Open Access Journals (Sweden)

    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.

    Science.gov (United States)

    Christmas, Kate; Hart, Karen A

    2007-01-01

    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

    OpenAIRE

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

    2006-01-01

    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.

    Science.gov (United States)

    Habte, Demissie; Dussault, Gilles; Dovlo, Delanyo

    2004-01-01

    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

    Directory of Open Access Journals (Sweden)

    Saltman Deborah C

    2012-07-01

    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

    International Nuclear Information System (INIS)

    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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

    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

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

    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.

    Science.gov (United States)

    Garrett, J Hudson

    2016-08-01

    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

    OpenAIRE

    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

    2008-01-01

    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?

    NARCIS (Netherlands)

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

    2010-01-01

    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.

    Science.gov (United States)

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

    2016-05-01

    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

    Directory of Open Access Journals (Sweden)

    James A. Ejiwale

    2012-09-01

    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

    OpenAIRE

    Mertz, Elizabeth A.; Finocchio, Len

    2010-01-01

    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

    OpenAIRE

    DIMITROVA, Margarita

    2012-01-01

    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

    OpenAIRE

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

    2014-01-01

    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

    OpenAIRE

    De Silva, Maduwage

    2012-01-01

    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

    DEFF Research Database (Denmark)

    Clausen, Lisbeth; Kruuse, Mikkel

    2015-01-01

    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

    OpenAIRE

    World Bank

    2014-01-01

    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

    Science.gov (United States)

    Davis, Dannielle Joy

    2014-01-01

    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.

    NARCIS (Netherlands)

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

    2013-01-01

    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.

    Science.gov (United States)

    Oddone, Eugene Z; Boulware, L Ebony

    2016-01-01

    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.

    NARCIS (Netherlands)

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

    2005-01-01

    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.

    Science.gov (United States)

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

    2016-06-01

    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

    Science.gov (United States)

    Hoffman, Edward

    2010-01-01

    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

    Directory of Open Access Journals (Sweden)

    Grace Sandra

    2012-11-01

    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.

    Science.gov (United States)

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

    2014-01-01

    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.

    Science.gov (United States)

    Adams, Susie M; Black, Patricia

    2016-01-01

    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.

    Science.gov (United States)

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

    2014-06-01

    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

    Science.gov (United States)

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

    2013-12-01

    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.

    Science.gov (United States)

    Gerdtham, U G; Sundberg, G

    1998-01-01

    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.

    Science.gov (United States)

    Johnson, Sherryl W

    2005-01-01

    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

    OpenAIRE

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

    2015-01-01

    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.

    Science.gov (United States)

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

    2016-01-01

    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.

    Science.gov (United States)

    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

    2009-12-01

    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.

    Science.gov (United States)

    Easmon, Charles

    2014-01-01

    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

    OpenAIRE

    Doan, Duong

    2016-01-01

    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.

    Science.gov (United States)

    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

    International Nuclear Information System (INIS)

    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

    International Nuclear Information System (INIS)

    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

    Directory of Open Access Journals (Sweden)

    Tianan Yang

    2015-12-01

    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.

    Science.gov (United States)

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

    2015-07-01

    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.

    Science.gov (United States)

    Otto, Laureen A; Gurney, Cindy

    2006-01-01

    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

    OpenAIRE

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

    2012-01-01

    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.

    Science.gov (United States)

    Abrahm, Janet L

    2012-10-01

    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.

    Science.gov (United States)

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

    2015-08-01

    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

    OpenAIRE

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

    2014-01-01

    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

    International Nuclear Information System (INIS)

    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

    Energy Technology Data Exchange (ETDEWEB)

    Leonard Bond; Kevin Kostelnik; Richard Holman

    2006-11-01

    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.

    Science.gov (United States)

    McKay, Niccie L; Meng, Xiaoxian

    2007-01-01

    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.

    Science.gov (United States)

    Andersen, Signe Hald; Fallesen, Peter

    2015-10-01

    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

    NARCIS (Netherlands)

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

    2007-01-01

    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?

    Directory of Open Access Journals (Sweden)

    Girgis Afaf

    2010-12-01

    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

    OpenAIRE

    Granbo, Sanna Mari Dyrkorn

    2013-01-01

    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

    OpenAIRE

    Nancarrow, Susan A

    2015-01-01

    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

    Data.gov (United States)

    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.

    Science.gov (United States)

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

    1984-01-01

    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.

    Science.gov (United States)

    Maier, Claudia B; Aiken, Linda H

    2016-01-01

    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

    OpenAIRE

    Denise Doiron; Glenn Jones

    2005-01-01

    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*

    Directory of Open Access Journals (Sweden)

    Jorge E Machado -Alba

    2011-04-01

    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

    Directory of Open Access Journals (Sweden)

    Jorge E. Machado-Alba

    2011-03-01

    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.

    Science.gov (United States)

    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

    NARCIS (Netherlands)

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

    2015-01-01

    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

    OpenAIRE

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

    2015-01-01

    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

    Directory of Open Access Journals (Sweden)

    Anderson Claire

    2009-06-01

    , 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

    OpenAIRE

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

    2014-01-01

    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.

    Science.gov (United States)

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

    2016-01-01

    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

    Science.gov (United States)

    Elsdon, Ron

    2010-01-01

    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

    International Nuclear Information System (INIS)

    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.

    Science.gov (United States)

    Mas, Núria

    2013-06-01

    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

    DEFF Research Database (Denmark)

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

    2013-01-01

    . 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

    Directory of Open Access Journals (Sweden)

    Gunn Jane M

    2010-08-01

    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

    OpenAIRE

    Yang, He

    2013-01-01

    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

    OpenAIRE

    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

    2006-01-01

    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

    Science.gov (United States)

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

    2011-01-01

    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

    OpenAIRE

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

    2015-01-01

    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

    NARCIS (Netherlands)

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

    2001-01-01

    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.

    Science.gov (United States)

    Vicarelli, Giovanna; Pavolini, Emmanuele

    2015-12-01

    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

    Science.gov (United States)

    Dorris, John Peter

    2012-01-01

    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.

    OpenAIRE

    Cameron, J; Parkes, C. M.

    1983-01-01

    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

    OpenAIRE

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

    2009-01-01

    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

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-03-31

    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.

    Science.gov (United States)

    Mechanic, David; Olfson, Mark

    2016-03-28

    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

    Directory of Open Access Journals (Sweden)

    Vahid Zamanzadeh

    2015-01-01

    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

    Science.gov (United States)

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

    2014-01-01

    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.

    Science.gov (United States)

    Moak, Gary S

    2011-01-01

    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

    Directory of Open Access Journals (Sweden)

    Agra Yolanda

    2011-05-01

    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.

    Science.gov (United States)

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

    2002-03-01

    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

    Directory of Open Access Journals (Sweden)

    Riner, R. Myles

    2009-01-01

    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

    Science.gov (United States)

    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

    Directory of Open Access Journals (Sweden)

    Segal Leonie

    2011-09-01

    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.

    Science.gov (United States)

    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.

    Science.gov (United States)

    Carr, Dana Deravin

    2007-01-01

    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

    OpenAIRE

    AL MUTAIRI ANED O; AL MUTAIRI ALYA O.

    2013-01-01

    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

    Directory of Open Access Journals (Sweden)

    Terry L. Howard

    2011-07-01

    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

    OpenAIRE

    Foo, Ginny Gin Siew

    2011-01-01

    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

    DEFF Research Database (Denmark)

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

    2010-01-01

    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

    OpenAIRE

    Blau, David M.

    1999-01-01

    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

    OpenAIRE

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

    2008-01-01

    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...

  10. EFFECTS OF AROMATHERAPY FOR SELF-CARE DURING PREGNANCY

    OpenAIRE

    Igarashi, Toshiko; Fujita, Mineko

    2010-01-01

    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

    Science.gov (United States)

    ... 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

    Directory of Open Access Journals (Sweden)

    Marc S. Williams

    2015-09-01

    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.

    Science.gov (United States)

    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

    2016-01-01

    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

    Directory of Open Access Journals (Sweden)

    Morris J

    2014-06-01

    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.

    Science.gov (United States)

    Whitford, Deirdre; Smith, Tony; Newbury, Jonathan

    2012-01-01

    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

    OpenAIRE

    Ruwen Qin

    2011-01-01

    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.

    OpenAIRE

    Batenburg, R.

    2014-01-01

    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

    OpenAIRE

    Musliu, Nysret; Gaertner, Johannes; Slany, Wolfgang

    2000-01-01

    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

    Directory of Open Access Journals (Sweden)

    Auh Erica

    2011-01-01

    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

    OpenAIRE

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

    2005-01-01

    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

    Directory of Open Access Journals (Sweden)

    Anita David

    2010-01-01

    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

    DEFF Research Database (Denmark)

    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

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2004-03-29

    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.

    Science.gov (United States)

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

    2015-08-01

    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

    Directory of Open Access Journals (Sweden)

    Christian Pfeifer

    2014-03-01

    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.

    Science.gov (United States)

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

    2016-01-01

    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.

    Science.gov (United States)

    Whitman, Marilyn V; Valpuesta, Domingo

    2010-01-01

    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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-29

    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.

    Science.gov (United States)

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

    2012-01-01

    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

    International Nuclear Information System (INIS)

    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.

    Science.gov (United States)

    Forgionne, G A

    1991-01-01

    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

    Science.gov (United States)

    Gunter, Helen M.

    2008-01-01

    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

    Science.gov (United States)

    Hyslop, Alisha

    2008-01-01

    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.

    NARCIS (Netherlands)

    Batenburg, R.

    2014-01-01

    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

    Science.gov (United States)

    Shuck, Michael Bradley; Wollard, Karen Kelly

    2008-01-01

    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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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.

    Science.gov (United States)

    Evans, Bronwynne C

    2007-08-01

    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

    International Nuclear Information System (INIS)

    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

    OpenAIRE

    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.

    2013-01-01

    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.

    Science.gov (United States)

    Johnson, Beverley H

    2016-03-01

    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].

    Science.gov (United States)

    Balázs, Péter

    2012-06-01

    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.

    Science.gov (United States)

    Frederick, Dorothea

    2014-05-01

    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

    OpenAIRE

    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

    2016-01-01

    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

    OpenAIRE

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

    2006-01-01

    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.

    Science.gov (United States)

    Bacopanos, Eleni; Edgar, Susan

    2016-04-01

    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

    Directory of Open Access Journals (Sweden)

    Seekles Wike

    2009-06-01

    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

    Science.gov (United States)

    Migliorini, Laura; Rania, Nadia; Tassara, Tatiana

    2016-01-01

    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

    Science.gov (United States)

    Bretherton, Tanya

    2011-01-01

    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.".

    Science.gov (United States)

    2011-08-01

    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.

    Science.gov (United States)

    2010-04-01

    ... 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

    Science.gov (United States)

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

    2010-01-01

    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.

    Science.gov (United States)

    McDonagh, Kathryn J; Paris, Nancy M

    2013-01-01

    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

    OpenAIRE

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

    2013-01-01

    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

    International Nuclear Information System (INIS)

    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

    NARCIS (Netherlands)

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

    2014-01-01

    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.

    OpenAIRE

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

    2005-01-01

    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

    OpenAIRE

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

    2013-01-01

    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.

    NARCIS (Netherlands)

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

    2006-01-01

    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

    NARCIS (Netherlands)

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

    2014-01-01

    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.

    Science.gov (United States)

    Stevens, Stella

    2002-01-01

    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.

    Science.gov (United States)

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

    2016-01-01

    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.

    Science.gov (United States)

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

    2009-01-01

    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.

    Science.gov (United States)

    Chalmers, B; Porter, R

    2001-06-01

    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

    Science.gov (United States)

    Peeters, W.

    2003-08-01

    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.

    Science.gov (United States)

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

    2016-01-01

    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.

    Science.gov (United States)

    Nancarrow, Susan A; Borthwick, Alan M

    2005-11-01

    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?

    Science.gov (United States)

    Saber, Deborah A

    2013-01-01

    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

    Science.gov (United States)

    Tummers, Marcia; Knoop, Hans; Bleijenberg, Gijs

    2010-01-01

    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.

    Science.gov (United States)

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

    2016-07-01

    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.

    Directory of Open Access Journals (Sweden)

    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.

  11. 78 FR 55731 - Health Workforce Research Center Cooperative Agreement Program

    Science.gov (United States)

    2013-09-11

    ... effectiveness in care delivery. Suggested topics for study included novel health care roles, team-based care (including the composition of teams and division of responsibilities across a team), professionals working...

  12. Responding to the Marketplace: Workforce Balance and Financial Risk at Academic Health Centers.

    Science.gov (United States)

    Retchin, Sheldon M

    2016-07-01

    Elsewhere in this issue, Welch and Bindman present research demonstrating that academic health centers (AHCs) continue to disproportionately comprise specialists and subspecialist faculty physicians compared with community-based physician groups. This workforce composition has served AHCs well through the years-specialists fuel the clinical engine of the major tertiary and quaternary missions of AHCs, and they also dominate much of the clinical and translational research enterprise. AHCs are not alone-less than one-third of U.S. physicians practice primary care. However, health reform has prompted many health systems to reconsider this configuration. Payers, employers, and policy makers are shifting away from fee-for-service toward value-based care. Large community-based physician groups and their parent health systems appear to be far ahead of AHCs with a more balanced physician workforce. Many are leveraging their emphasis on primary care to participate in population health initiatives, such as accountable care organizations, and some own their own health plans. These approaches largely assume some element of financial risk and require both a more balanced workforce and an infrastructure to accommodate the management of covered lives. It remains to be seen whether AHCs will reconsider their own physician specialty composition to emphasize primary care-and, if they do, whether the traditional academic model, or a more community-based approach, will prevail. PMID:27224298

  13. Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hypertension outcomes in primary care

    OpenAIRE

    Ramli, Anis S; Lakshmanan, Sharmila; Haniff, Jamaiyah; Selvarajah, Sharmini; Tong, Seng F; Bujang, Mohamad-Adam; Abdul-Razak, Suraya; Shafie, Asrul A.; Lee, Verna KM; Abdul-Rahman, Thuhairah H; Daud, Maryam H; Ng, Kien K; Ariffin, Farnaza; Abdul-Hamid, Hasidah; Mazapuspavina, Md-Yasin

    2014-01-01

    Background Chronic disease management presents enormous challenges to the primary care workforce because of the rising epidemic of cardiovascular risk factors. The chronic care model was proven effective in improving chronic disease outcomes in developed countries, but there is little evidence of its effectiveness in developing countries. The aim of this study was to evaluate the effectiveness of the EMPOWER-PAR intervention (multifaceted chronic disease management strategies based on the chr...

  14. Assessing the role and effectiveness of prenatal care: history, challenges, and directions for future research.

    OpenAIRE

    Alexander, G R; Kotelchuck, M

    2001-01-01

    Despite the widespread use of prenatal care, the evidence for its effectiveness remains equivocal and its primary purpose and effects continue to be a subject of debate. To provide some perspective on why the effectiveness and organization of prenatal care continue to be debated, the authors (a) briefly review the history of the development of prenatal care in the US; (b) attempt to conceptually define prenatal care in terms of its utilization, content, and quality; and, (c) highlight some of...

  15. Ageing medical workforce in Australia - where will the medical educators come from?

    Directory of Open Access Journals (Sweden)

    Callander Emily J

    2009-11-01

    Full Text Available Abstract Background As the general practitioner and specialist medical workforce ages there is likely to be a large number of retirees in the near future. However, few Australian studies have specifically examined medical practitioner retirement and projected retirement patterns, and the subsequent impact this may have on training future health care professionals. Methods Extracts from the Australian Medicare database and Medical Labour Force Surveys are used to examine trends in attrition of general medical practitioners and specialists over the age of 45 years from the workforce and to predict their rate of retirement to 2025. Results The general medical practitioner workforce has aged significantly (p Conclusion The ageing of the baby boomer and older cohorts of the general practitioner and specialist workforce will lead to a significant number of retirements over the next 20 years. Increasing the numbers of students and new medical schools has been heralded as a means of alleviating service shortages from about 2015 onwards; however, the retirement of a large proportion of experienced health care professionals may lead to shortages of educators for these students.

  16. Women as Care Managers: The Effect of Gender and Partnership Status on Grandparent Care for Grandchildren

    OpenAIRE

    Hasmanová Marhánková, Jaroslava; Štípková, Martina

    2015-01-01

    Grandparental care of grandchildren is a highly gendered institution, with women being more likely to participate in it than men. This article studies whether and why care by grandmothers and grandfathers is influenced by their family arrangement. Following previous research, the authors focus on the mediating role of grandmothers in the involvement of men in caring for their grandchildren. We use a combination of quantitative and qualitative data about grandparents with small grandchildren (...

  17. Review of the Effectiveness of the Nutrition Care Process.

    Science.gov (United States)

    Ichimasa, Akiko

    2015-01-01

    This author (A.I.) has witnessed the introduction of the Nutrition Care Process (NCP) and its subsequent adjustment over 10 y of her career in an acute and critical setting. A.I. observed that the NCP went through several revisions to better suit the actual clinical practices and the NCP was gradually incorporated into everyday work and accepted in a clinical setting. The NCP helped ensure that all practicing registered dietitians (RDs, RDNs) have up-to-date skill sets. The NCP is a systematic problem-solving tool with four distinct and interrelated steps that help RDs to improve critical thinking and address practice-related problems so that RDs can more effectively intervene and evaluate. In summary, RDs using the NCP are producing consistent and easy-to-read documentation of clinical practices that benefit other healthcare members. The intention to provide diagnosis-oriented assessment and to treat nutrition problems with intervention plans opens up opportunities for communication within healthcare teams and clients. The best practice requires interactive and ongoing communication with healthcare teams and clients. The NCP has resulted in improved productivity as the RDs are writing diagnosis- focused documentation with specific plans for intervention. In addition, analysis of common problems and nutrition diagnoses resolution rates appear to be in process in some facilities and may further promote RD roles in practice settings. In conclusion, the NCP is an effective tool to provide improved nutrition care. PMID:26598881

  18. Effects of dementia-care mapping on residents and staff of care homes: a pragmatic cluster-randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Geertje van de Ven

    Full Text Available 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 to DCM or usual care. Nurses from the intervention care homes received DCM training and conducted the 4-months DCM-intervention twice during the study. The primary outcome was agitation, measured with the Cohen-Mansfield agitation inventory (CMAI. The secondary outcomes included residents' neuropsychiatric symptoms (NPSs and quality of life, and staff stress and job satisfaction. The nursing staff made all measurements at baseline and two follow-ups at 4-month intervals. We used linear mixed-effect models to test treatment and time effects. RESULTS: 34 units from 11 care homes, including 434 residents and 382 nursing staff members, were randomly assigned. Ten nurses from the intervention units completed the basic and advanced DCM training. Intention-to-treat analysis showed no statistically significant effect on the CMAI (mean difference between groups 2·4, 95% CI -2·7 to 7·6; p = 0·34. More NPSs were reported in the intervention group than in usual care (p = 0·02. Intervention staff reported fewer negative and more positive emotional reactions during work (p = 0·02. There were no other significant effects. CONCLUSIONS: Our pragmatic findings did not confirm the effect on the primary outcome of agitation in the explanatory study. Perhaps the variability of the extent of implementation of DCM may explain the lack of effect. TRIAL REGISTRATION: Dutch Trials Registry NTR2314.

  19. The new radiology workforce: changing expectations.

    Science.gov (United States)

    Cronan, John J

    2004-05-01

    The zeitgeist of the new radiology workforce can best be described by a Bob Dylan song title: "The Times They Are A-Changin'." The new generation of physicians, although embracing the same foundations of medical practice as previous generations, places greater emphasis on personal satisfaction than its predecessors. Gone are the days when physicians operated as sole practitioners; today's workforce member is content to function in the role of "employee" in a trade-off for more lifestyle flexibility. This change has occurred not because of one specific factor but because of a change in the profession of medicine coupled with a combination of factors; familial responsibilities, avocational activities, and personal satisfaction have surfaced as motivating factors in choosing a profession. Today's workforce has a personal perception of success that may not be fulfilled solely by the contemporary practice of medicine. With the radiologist shortages that are now occurring and anticipated increased demand for staff radiologists, today's radiology workforce has helped shape the specialty into one that is altering its structure to attract and retain its workforce. PMID:17411594

  20. Architectural firms: workforce, business strategy and performance

    Directory of Open Access Journals (Sweden)

    Adedapo Adewunmi Oluwatayo

    2011-12-01

    Full Text Available The intent of this research was to investigate the relationship between the workforce, business strategy and performance of architectural firms. Data was collected from 92 firms randomly selected from the cities where architectural firms were most concentrated in Nigeria using questionnaires. Hierarchical regression analysis was carried out to investigate the direct and indirect impacts of the workforce of architectural firms on their performance. The findings confirm the significant positive impact. With business strategy controlled, the specific characteristics of the workforce and its management which influenced performance were the number of architects, the work structure, and the age and experience of the principal partners. The impact of the number of non- architecture professionals and staff participation in decision-making on performance was moderated by the business strategy adopted by the firms. The results suggest that workforce characteristics are more important than the management of the workforce in determining performance of architectural firms. This is contrary to the results of previous studies which suggest higher importance of the management. This probably indicates the peculiarity of architectural firm as a professional service firm in the construction industry.

  1. The Effect of Foster Care Experience and Characteristics on Academic Achievement

    Science.gov (United States)

    Calix, Alexandra

    2009-01-01

    This study examined the effect of foster care experience and characteristics on educational outcomes. The typical strategy in examining the effect foster care has on educational outcomes is to compare the educational achievement of youth with foster care experience to that of their peers or to national norms. This strategy fails to take selection…

  2. Which European Model for Elderly Care? Equity and Cost-Effectiveness in Home Based Care in Three European Countries

    OpenAIRE

    Francesca Bettio; Giovanni Solinas

    2009-01-01

    Long term care for the elderly is growing apace in developed economies. As growth is forcing change in existing production and delivery systems of elderly care services, the question arises as to how different systems compare in terms of cost-effectiveness, equity or quality. Based on an in depth survey carried out in Denmark, Ireland and Italy – the GALCA survey – this articles compares prevailing arrangements of home based long-term care in these three countries, focussing on the overall co...

  3. MANAGING HUMAN TALENT. WORKFORCE DIVERSITY VS. INDIVIDUAL DIFFERENCES. CHALLENGES OF THE WORKFORCE MOTIVATION AND RETENTION

    Directory of Open Access Journals (Sweden)

    Monica Boldea

    2011-01-01

    Full Text Available Each day presents a new set of challenges and risks to companies operating in this age ofboth a global economy and of multiculturalism, i.e. a fast-changing marketplace. Globalcompetition and escalating economic pressures make the business environment bothdynamic and difficult, especially given the workforce diversity which has to be managed soas to achieve the highest levels of task performance and job satisfaction; managers must beprepared to respect alternative cultures and value diversity. Based on this background ourpaper has as starting point the consideration that organizations are seeking out methods torefine their operations in order to navigate often-difficult economic terrain effectively,analyzing the organizations’ ability to being responsive to changing market conditions,competitive threats, and new market opportunities, therefore focusing on an organization’screative and innovative ability, highlighting the people component of a business process, aswith so much emphasis on automation, it’s easy to overlook the human element, anoversight which – in most cases – hinders efficient business process management.Considering that processes don’t do work, but people do, our research highlights the factthat a “want to motivate” attitude by the employee can be encouraged, even if pastmanagerial efforts have rather concentrated on “how to motivate” the employee, trying toshed some light on how BPM with a hint of the Six Sigma method offers a clearer path toan increasing number of organizations hoping to best the challenges they have to face, thisoften translating into workforce motivation and retention, by creating positive workenvironments in which the cultural and demographic diversity of members helps to createcompetitive advantage.

  4. Incentive and selection effects of Medigap insurance on inpatient care.

    Science.gov (United States)

    Dardanoni, Valentino; Li Donni, Paolo

    2012-05-01

    The Medicare program, which provides insurance coverage to the elderly in the United States, does not protect them fully against high out-of-pocket costs. For this reason private supplementary insurance, named Medigap, has been available to cover Medicare gaps. This paper studies how Medigap affects the utilization of inpatient care, separating the incentive and selection effects of supplementary insurance. For this purpose, we use two alternative estimation methods: a standard recursive bivariate probit and a discrete multivariate finite mixture model. We find that estimated incentive effects are modest and quite similar across models. There seems to be very significant selection, with the presence of both adversely and advantageously selected individuals, stemming from the multidimensional nature of residual heterogeneity. PMID:22525715

  5. Effects of person-centered care on residents and staff in aged-care facilities: a systematic review

    Directory of Open Access Journals (Sweden)

    Nancarrow S

    2013-01-01

    increased risk of falls. The findings from this review need to be interpreted cautiously due to limitations in study designs and the potential for confounding bias.Conclusion: Typically, person-centered interventions are multifactorial, comprising: elements of environmental enhancement; opportunities for social stimulation and interaction; leadership and management changes; staffing models focused on staff empowerment; and assigning residents to the same care staff and an individualized philosophy of care. The complexity of the interventions and range of outcomes examined makes it difficult to form accurate conclusions about the impact of person-centered care interventions adopted and implemented in aged-care facilities. The few negative consequences of the introduction of person-centered care models suggest that the introduction of person-centered care is not always incorporated within a wider "hierarchy of needs" structure, where safety and physiological need are met before moving onto higher level needs. Further research is necessary to establish the effectiveness of these elements of person-centered care, either singly or in combination.Keywords: individualized care, nursing homes, culture change in care homes, residential aged-care facilities

  6. What are the effective ways to translate clinical leadership into health care quality improvement?

    OpenAIRE

    McSherry, Robert

    2016-01-01

    Robert McSherry,1 Paddy Pearce2 1School of Health and Social Care, University of Teesside, Middlesbrough, 2PKP Consulting, Yarm, United Kingdom Abstract: The presence and/or absence of effective leaders in health care can have a stark consequence on the quality and outcomes of care. The delivery of safe, quality, compassionate health care is dependent on having effective clinical leaders at the frontline. In light of the Kirkup and Francis reports, this article explores some ways of translat...

  7. Inequality of Paediatric Workforce Distribution in China

    Science.gov (United States)

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

    2016-01-01

    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 policy-making and resource allocation. PMID:27420083

  8. National Wildlife Refuge System : Strategic Workforce Planning Report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this report is to describe the current and future workforce challenges and workforce development efforts underway by the Refuge System to address...

  9. Life-Cycle and Intergenerational Effects of Child Care Reforms

    OpenAIRE

    Marc K Chan; Liu, Kai

    2015-01-01

    We investigate the importance of various mechanisms by which child care policies can affect life-cycle patterns of employment and fertility among women, as well as long-run cognitive outcomes among children. A structural life-cycle model of employment, fertility, and child care use is estimated using Norwegian administrative data. The estimation exploits a large-scale child care reform, which provided generous cash transfers to mothers who did not use formal child care facilities. Combining w...

  10. Appendix: XXII: TVA workforce planning model

    International Nuclear Information System (INIS)

    Tennessee Valley Authority (TVA) is a government owned Federal agency consisting of multiple sites with three NPP sites, and five reactors in operation, one (Browns Ferry Unit 1) being returned to service. The TVA Workforce Planning process was developed to provide an integrated approach to address aging workforce issues. At the time the process was developed in 1998 the average age was 47 years. Thirty to forty percent of TVA's employees would be eligible to retire within 5 years. The process linked related process such as succession planning, training, recruiting and knowledge retention to ensure that qualified human resources were available when needed

  11. Endogenous cost-effectiveness analysis and health care technology adoption.

    Science.gov (United States)

    Jena, Anupam B; Philipson, Tomas J

    2013-01-01

    Increased health care spending has placed pressure on public and private payers to prioritize spending. Cost-effectiveness (CE) analysis is the main tool used by payers to prioritize coverage of new therapies. We argue that reimbursement based on CE is subject to a form of the "Lucas critique"; the goals of CE policies may not materialize when firms affected by the policies respond optimally to them. For instance, because 'costs' in CE analysis reflect prices set optimally by firms rather than production costs, observed CE levels will depend on how firm pricing responds to CE policies. Observed CE is therefore endogenous. When CE is endogenously determined, policies aimed at lowering spending and improving overall CE may paradoxically raise spending and lead to the adoption of more resource-costly treatments. We empirically illustrate whether this may occur using data on public coverage decisions in the United Kingdom. PMID:23202262

  12. 77 FR 36549 - Nursing Workforce Diversity Invitational Summit-“Nursing in 3D: Workforce Diversity, Health...

    Science.gov (United States)

    2012-06-19

    ... HUMAN SERVICES Health Resources and Services Administration Nursing Workforce Diversity Invitational Summit--``Nursing in 3D: Workforce Diversity, Health Disparities, and Social Determinants of Health...). ACTION: Notice of meeting. SUMMARY: HRSA's Bureau of Health Professions, Division of Nursing, will...

  13. What's the matter with the information technology workforce?

    OpenAIRE

    Subramaniam, Manimegalai M; Burnett, Kathleen

    2006-01-01

    Information technology and the information technology workforce are essential to Internet innovation, infrastructure, development, and maintenance. A comprehensive and dynamic definition of information technology will help develop and coordinate interventions to ensure that a viable, diverse, and talented workforce is available to support information technology innovation, development, implementation, maintenance and application. A viable, diverse, and talented workforce is essential if the U...

  14. Strategic management of the health workforce in developing countries: what have we learned?

    Directory of Open Access Journals (Sweden)

    Fritzen Scott A

    2007-02-01

    Full Text Available Abstract The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they affect overall system performance as well as the feasibility and sustainability of health reforms. Viewing workforce issues strategically forces health authorities to confront the yawning gaps between policy and implementation in many developing countries. Lessons emerge in four areas. One concerns imbalances in workforce structure, whether from a functional specialization, geographical or facility lens. These imbalances pose a strategic challenge in that authorities must attempt to steer workforce distribution over time using a limited range of policy tools. A second group of lessons concerns the difficulties of central-level steering of the health workforce, often critically weak due to the lack of proper information systems and the complexities of public sector decentralization and service commercialization trends affecting the grassroots. A third cluster examines worker capacity and motivation, often shaped in developing countries as much by the informal norms and incentives as by formal attempts to support workers or to hold them accountable. Finally, a range of reforms centering on service contracting and improvements to human resource management are emerging. Since these have as a necessary (but not sufficient condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising. The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed.

  15. Do Effects of Early Child Care Extend to Age 15 Years? Results From the NICHD Study of Early Child Care and Youth Development

    OpenAIRE

    Vandell, Deborah Lowe; Belsky, Jay; Burchinal, Margaret; Vandergrift, Nathan; STEINBERG, LAURENCE

    2010-01-01

    Relations between nonrelative child care (birth to 4 ½ years) and functioning at age 15 were examined (N = 1364). Both quality and quantity of child care were linked to adolescent functioning. Effects were similar in size as those observed at younger ages. Higher quality care predicted higher cognitive-academic achievement at age 15, with escalating positive effects at higher levels of quality. The association between quality and achievement was mediated, in part, by earlier child care effect...

  16. State of the art in risk analysis of workforce criticality influencing disaster preparedness for interdependent systems.

    Science.gov (United States)

    Santos, Joost R; Herrera, Lucia Castro; Yu, Krista Danielle S; Pagsuyoin, Sheree Ann T; Tan, Raymond R

    2014-06-01

    The objective of this article is to discuss a needed paradigm shift in disaster risk analysis to emphasize the role of the workforce in managing the recovery of interdependent infrastructure and economic systems. Much of the work that has been done on disaster risk analysis has focused primarily on preparedness and recovery strategies for disrupted infrastructure systems. The reliability of systems such as transportation, electric power, and telecommunications is crucial in sustaining business processes, supply chains, and regional livelihoods, as well as ensuring the availability of vital services in the aftermath of disasters. There has been a growing momentum in recognizing workforce criticality in the aftermath of disasters; nevertheless, significant gaps still remain in modeling, assessing, and managing workforce disruptions and their associated ripple effects to other interdependent systems. The workforce plays a pivotal role in ensuring that a disrupted region continues to function and subsequently recover from the adverse effects of disasters. With this in mind, this article presents a review of recent studies that have underscored the criticality of workforce sectors in formulating synergistic preparedness and recovery policies for interdependent infrastructure and regional economic systems. PMID:24593287

  17. Effectiveness of a Care Coordination Model for Stroke Survivors: A Randomized Study

    Science.gov (United States)

    Claiborne, Nancy

    2006-01-01

    This study evaluated the effectiveness of systematically integrating biopsychosocial interventions with coordinated delivery of care for outpatients recovering from stroke. Care coordination coordinates resources across the health care system and routinely addresses the psychological and social risks affecting patient outcomes, while monitoring…

  18. The effect of medical treatment of attention deficit hyperactivity disorder (ADHD) on foster care caseloads

    DEFF Research Database (Denmark)

    Fallesen, Peter; Wildeman, Christopher

    2015-01-01

    = 157,938) in the period from 1998 to 2010 to show that increasing medical treatment of attention deficit hyperactivity disorder (ADHD) accounts for a substantial share of the decrease in foster care caseloads. According to our estimates, the decline in foster care caseloads during this period would...... problems could also have a powerful effect on foster care caseloads....

  19. Ageing medical workforce in Australia - where will the medical educators come from?

    OpenAIRE

    Callander Emily J; Fletcher Susan L; Schofield Deborah J

    2009-01-01

    Abstract Background As the general practitioner and specialist medical workforce ages there is likely to be a large number of retirees in the near future. However, few Australian studies have specifically examined medical practitioner retirement and projected retirement patterns, and the subsequent impact this may have on training future health care professionals. Methods Extracts from the Australian Medicare database and Medical Labour Force Surveys are used to examine trends in attrition of...

  20. The Workforce Education and Development in Taiwan

    Science.gov (United States)

    Lee, Lung-Sheng

    2012-01-01

    Workforce education and development (WED) can be broadly defined as those formal, informal and nonformal activities that prepare people for work. In Taiwan, it includes technological and vocational education (TVE), human resource development (HRD), public vocational training and adult education. In order to promote information exchanges and…

  1. Skills Governance and the Workforce Development Programme

    Science.gov (United States)

    Hordern, Jim

    2013-01-01

    In the United Kingdom higher education environment, government may make efforts to encourage institutions to engage in governance structures to secure policy objectives through a steering approach. In this article connections between skills governance structures and the recent Higher Education Funding Council for England workforce development…

  2. Growing Our Workforce through Business and Education

    Science.gov (United States)

    Pauley, Douglas R.; Davidchik, Daniel

    2010-01-01

    In 2004, Central Community College (CCC) established the Mechatronics Education Center (MEC), a regional center of excellence, to help the state address the shortage of skilled technicians in the area of industrial automation. The MEC addresses the needs of the current and future workforce through the implementation of its three main components:…

  3. Math for Textile Technicians. Workforce 2000 Partnership.

    Science.gov (United States)

    Enterprise State Junior Coll., AL.

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

  4. Wind Energy Technology: Training a Sustainable Workforce

    Science.gov (United States)

    Krull, Kimberly W.; Graham, Bruce; Underbakke, Richard

    2009-01-01

    Through innovative teaching and technology, industry and educational institution partnerships, Cloud County Community College is preparing a qualified workforce for the emerging wind industry estimated to create 80,000 jobs by 2020. The curriculum blends on-campus, on-line and distance learning, land-lab, and field training opportunities for…

  5. Economic and Workforce Development Program Annual Report

    Science.gov (United States)

    California Community Colleges, Chancellor's Office, 2014

    2014-01-01

    California's community colleges continue to play a crucial role in the state's economy by providing students with the skills and knowledge to succeed and by advancing the economic growth and global competitiveness of California and its regional economies through the Economic and Workforce Development Program (EWD). The EWD program invests in the…

  6. Information Literacy and the Workforce: A Review

    Science.gov (United States)

    Weiner, Sharon

    2011-01-01

    This paper is a review of reports on information literacy and the workforce. There is a substantial body of literature on information literacy in K-16 educational settings, but there is much less literature on implications for the workplace and job-related lifelong learning. The topical categories of the reports are: the importance of information…

  7. Organizational Leadership For Building Effective Health Care Teams

    OpenAIRE

    Taplin, Stephen H.; Foster, Mary K.; Shortell, Stephen M.

    2013-01-01

    The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they al...

  8. Employee motivation and employee performance in child care : the effects of the introduction of market forces on employees in the Dutch child-care sector

    NARCIS (Netherlands)

    Plantinga, Mirjam

    2006-01-01

    Employee Motivation and Employee Performance in Child Care: The Effects of the Introduction of Market Focus on Employees in the Dutch Child-Care Sector Mirjam Plantinga (RUG) This research describes and explains the effects of the introduction of market forces in the Dutch child-care sector on emplo

  9. Workforce planning for DOE/EM: Assessing workforce demand and supply

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, R.E.; Ulibarri, C.A.

    1993-10-01

    The US Department of Energy (DOE) has committed to bringing its facilities into regulatory compliance and restoring the environment of sites under its control by the year 2019. Responsibility for accomplishing this goal is vested with the Office of Environmental Restoration and Waste Management (EM). Concerns regarding the availability of workers with the necessary technical skills and the prospect of retraining workers from other programs within DOE or other industries are addressed in this report in several ways. First, various workforce projections relevant to EM occupations are compared to determine common findings and resolve inconsistencies. Second, case studies, interviews, and published data are used to examine the potential availability of workers for these occupations via occupational mobility, training/retraining options, and salary adjustments. Third, demand and supply factors are integrated in a framework useful for structuring workforce analyses. The analyses demonstrate that workforce skills are not anticipated to change due to the change in mission; science, engineering, and technician occupations tend to be mobile within and across occupational categories; experience and on-the-job training are more crucial to issues of worker supply than education; and, the clarity of an organization`s mission, budget allocation process, work implementation and task assignment systems are critical determinants of both workforce need and supply. DOE is encouraged to create a more stable platform for workforce planning by resolving organizational and institutional hindrances to accomplishing work and capitalizing on workforce characteristics besides labor {open_quotes}supply{close_quotes} and demographics.

  10. Building effective service linkages in primary mental health care: a narrative review part 2

    OpenAIRE

    Parker Sharon; Holdsworth Louise; Perkins David; Fuller Jeffrey D; Kelly Brian; Roberts Russell; Martinez Lee; Fragar Lyn

    2011-01-01

    Abstract Background Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health ...

  11. Blueprint for Action: Visioning Summit on the Future of the Workforce in Pediatrics.

    Science.gov (United States)

    Sectish, Theodore C; Hay, William W; Mahan, John D; Mendoza, Fernando S; Spector, Nancy D; Stanton, Bonita; Szilagyi, Peter G; Turner, Teri L; Walker, Leslie R; Slaw, Kenneth

    2015-07-01

    The Federation of Pediatric Organizations engaged members of the pediatric community in an 18-month process to envision the future of the workforce in pediatrics, culminating in a Visioning Summit on the Future of the Workforce in Pediatrics. This article documents the planning process and methods used. Four working groups were based on the 4 domains that are likely to affect the future workforce: Child Health Research and Training, Diversity and Inclusion, Gender and Generations, and Pediatric Training Along the Continuum. These groups identified the issues and trends and prioritized their recommendations. Before the summit, 5 key megatrends cutting across all domains were identified:1. Aligning Education to the Emerging Health Needs of Children and Families 2. Promoting Future Support for Research Training and for Child Health Research 3. Striving Toward Mastery Within the Profession 4. Aligning and Optimizing Pediatric Practice in a Changing Health Care Delivery System 5. Taking Advantage of the Changing Demographics and Expertise of the Pediatric Workforce At the Visioning Summit, we assembled members of each of the working groups, the Federation of Pediatric Organizations Board of Directors, and several invited guests to discuss the 5 megatrends and develop the vision, solutions, and actions for each megatrend. Based on this discussion, we offer 10 recommendations for the field of pediatrics and its leading organizations to consider taking action. PMID:26034250

  12. Using staffing ratios for workforce planning: evidence on nine allied health professions

    Directory of Open Access Journals (Sweden)

    Cartmill Linda

    2012-02-01

    Full Text Available Abstract Background Modern healthcare managers are faced with pressure to deliver effective, efficient services within the context of fixed budget constraints. Managers are required to make decisions regarding the skill mix of the workforce particularly when staffing new services. One measure used to identify numbers and mix of staff in healthcare settings is workforce ratio. The aim of this study was to identify workforce ratios in nine allied health professions and to identify whether these measures are useful for planning allied health workforce requirements. Methods A systematic literature search using relevant MeSH headings of business, medical and allied health databases and relevant grey literature for the period 2000-2008 was undertaken. Results Twelve articles were identified which described the use of workforce ratios in allied health services. Only one of these was a staffing ratio linked to clinical outcomes. The most comprehensive measures were identified in rehabilitation medicine. Conclusion The evidence for use of staffing ratios for allied health practitioners is scarce and lags behind the fields of nursing and medicine.

  13. Cost Effectiveness of Facility-Based Care, Home-Based Care and Mobile Clinics for Provision of Antiretroviral Therapy in Uganda

    OpenAIRE

    Babigumira, Joseph B; Sethi, Ajay K.; Smyth, Kathleen A.; Singer, Mendel E.

    2009-01-01

    Background: Stakeholders in HIV/AIDS care currently use different programmes for provision of antiretroviral therapy (ART) in Uganda. It is not known which of these represents the best value for money. Objective: To compare the cost effectiveness of home-based care (HBC), facility-based care (FBC) and mobile clinic care (MCC) for provision of ART in Uganda. Methods: Incremental cost-effectiveness analysis was performed using decision and Markov modeling of adult AIDS patients in WHO Clinical ...

  14. Diabetes Care Protocol : effects on patient-important outcomes. A cluster randomized, non-inferiority trial in primary care

    NARCIS (Netherlands)

    Cleveringa, F. G. W.; Minkman, M. H.; Gorter, K. J.; van den Donk, M.; Rutten, G. E. H. M.

    2010-01-01

    P>Aims The Diabetes Care Protocol (DCP) combines task delegation, intensification of diabetes treatment and feedback. It reduces cardiovascular risk in Type 2 diabetes (T2DM) patients. This study determines the effects of DCP on patient-important outcomes. Methods A cluster randomized, non-inferiori

  15. Human dignity in paediatrics: the effects of health care.

    Science.gov (United States)

    Lundqvist, Anita; Nilstun, Tore

    2007-03-01

    Human dignity is grounded in basic human attributes such as life and self-respect. When people cannot stand up for themselves they may lose their dignity towards themselves and others. The aim of this study was to elucidate if dignity remains intact for family members during care procedures in a children's hospital. A qualitative approach was adopted, using open non-participation observation. The findings indicate that dignity remains intact in family-centred care where all concerned parties encourage each other in a collaborative relationship. Dignity is shattered when practitioners care from their own perspective without seeing the individual in front of them. When there is a break in care, family members can restore their dignity because the interruption helps them to master their emotions. Family members' dignity is shattered and remains damaged when they are emotionally overwhelmed; they surrender themselves to practitioners' care, losing their self-esteem and self-respect. PMID:17425150

  16. Conditions underpinning success in joint service-education workforce planning

    Directory of Open Access Journals (Sweden)

    Styles Laureen

    2009-02-01

    Full Text Available Abstract Vancouver Island lies just off the southwest coast of Canada. Separated from the large urban area of Greater Vancouver (estimated population 2.17 million by the Georgia Strait, this geographical location poses unique challenges in delivering health care to a mixed urban, rural and remote population of approximately 730 000 people living on the main island and the surrounding Gulf Islands. These challenges are offset by opportunities for the Vancouver Island Health Authority (VIHA to collaborate with four publicly funded post-secondary institutions in planning and implementing responses to existing and emerging health care workforce needs. In this commentary, we outline strategies we have found successful in aligning health education and training with local health needs in ways that demonstrate socially accountable outcomes. Challenges encountered through this process (i.e. regulatory reform, post-secondary policy reform, impacts of an ageing population, impact of private, for-profit educational institutions have placed demands on us to establish and build on open and collaborative working relationships. Some of our successes can be attributed to evidence-informed decision-making. Other successes result from less tangible but no less important factors. We argue that both rational and "accidental" factors are significant – and that strategic use of "accidental" features may prove most significant in our efforts to ensure the delivery of high-quality health care to our communities.

  17. Why we need interprofessional education to improve the delivery of safe and effective care

    Directory of Open Access Journals (Sweden)

    Scott Reeves

    2016-03-01

    Full Text Available Interprofessional education (IPE is an activity that involves two or more professions who learn interactively together to improve collaboration and the quality of care. Research has continually revealed that health and social care professionals encounter a range of problems with interprofessional coordination and collaboration which impact on the quality and safety of care. This empirical work resulted in policymakers across health care education and practice to invest in IPE to help resolve this collaborative failures. It is anticipated that IPE will provide health and social care professionals with the abilities required to work together effectively in providing safe high quality care to patients. Through a discussion of a range of key professional, educational and organization issues related to IPE, this paper argues that this form of education is an important strategy to improve the delivery of safe and effective care

  18. Perspectives on Mississippi's 21st century Physician Workforce Supply: findings from the 2007 MSMD survey.

    Science.gov (United States)

    Street, Debra; Cossman, Jeralynn S

    2008-04-01

    The capacity to recruit and retain physicians to practice in Mississippi has been a perennial concern of the profession. In the first Mississippi Physician Workforce Study (2003) conducted at the height of the state 'malpractice crisis,' Professor Cossman identified several looming threats to effective Mississippi physician recruitment and retention, including a high percentage of physicians who reported they were considering relocation or retirement in the near future. In this article, Street and Cossman report survey findings from actively practicing physicians (N=848) who responded to the second Mississippi Physician Workforce Study (2007 MSMD). This analysis updates perspectives on the physician workforce supply in the aftermath of malpractice legislative reform and Hurricane Katrina. PMID:19297906

  19. The Effects Of Cost-Sharing In Health Care: What Do We Know From Empirical Evidence?

    OpenAIRE

    Carrieri Vincenzo

    2010-01-01

    Political and academic debate about cost-sharing in health care is becoming very popular because of the massive health care expenditure growth. In this paper, we aim to validate the use of cost-sharing in health care by assessing the effects that different policies of cost-sharing have produced around the world. We review, then, several empirical papers dealing with cost-sharing effects with respect to three main issues: moral hazard-contrast, redistributive effects and health care cost-conta...

  20. Practice nurse involvement in primary care depression management: an observational cost-effectiveness analysis

    OpenAIRE

    Gray, Jodi; Haji Ali Afzali, Hossein; Beilby, Justin; Holton, Christine; Banham, David; Karnon, Jonathan

    2014-01-01

    Background Most evidence on the effect of collaborative care for depression is derived in the selective environment of randomised controlled trials. In collaborative care, practice nurses may act as case managers. The Primary Care Services Improvement Project (PCSIP) aimed to assess the cost-effectiveness of alternative models of practice nurse involvement in a real world Australian setting. Previous analyses have demonstrated the value of high level practice nurse involvement in the manageme...

  1. Prenatal Care Demand and its Effects on Birth Outcomes by Birth Defect Status in Argentina

    OpenAIRE

    Wehby, George L.; Murray, Jeffrey C.; Castilla, Eduardo E.; Lopez-Camelo, Jorge S.; Ohsfeldt, Robert L.

    2008-01-01

    Our objective was to identify determinants of prenatal care demand and evaluate the effects of this demand on low birth weight and preterm birth. Delay in initiating prenatal care was modeled as a function of pregnancy risk indicators, enabling factors, and regional characteristics. Conditional maximum likelihood (CML) estimation was used to model self-selection into prenatal care use when estimating its effectiveness. Birth registry data was collected post delivery on infants with and withou...

  2. Effect of the Uganda Newborn Study on care-seeking and care practices: a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Peter Waiswa

    2015-03-01

    Full Text Available Background: Care for women and babies before, during, and after the time of birth is a sensitive measure of the functionality of any health system. Engaging communities in preventing newborn deaths is a promising strategy to achieve further progress in child survival in sub-Saharan Africa. Objective: To assess the effect of a home visit strategy combined with health facility strengthening on uptake of newborn care-seeking, practices and services, and to link the results to national policy and scale-up in Uganda. Design: The Uganda Newborn Study (UNEST was a two-arm cluster-randomised controlled trial in rural eastern Uganda. In intervention villages volunteer community health workers (CHWs were trained to identify pregnant women and make five home visits (two during pregnancy and three in the first week after birth to offer preventive and promotive care and counselling, with extra visits for sick and small newborns to assess and refer. Health facility strengthening was done in all facilities to improve quality of care. Primary outcomes were coverage of key essential newborn care behaviours (breastfeeding, thermal care, and cord care. Analyses were by intention to treat. This study is registered as a clinical trial, number ISRCTN50321130. Results: The intervention significantly improved essential newborn care practices, although many interventions saw major increases in both arms over the study period. Immediate breastfeeding after birth and exclusive breastfeeding were significantly higher in the intervention arm compared to the control arm (72.6% vs. 66.0%; p=0.016 and 81.8% vs. 75.9%, p=0.042, respectively. Skin-to-skin care immediately after birth and cord cutting with a clean instrument were marginally higher in the intervention arm versus the control arm (80.7% vs. 72.2%; p=0.071 and 88.1% vs. 84.4%; p=0.023, respectively. Half (49.6% of the mothers in the intervention arm waited more than 24 hours to bathe the baby, compared to 35.5% in

  3. IAEA Support for Building-Up a Highly Skilled Workforce Necessary for an Effective State System of Accounting for and Control of Nuclear Material

    International Nuclear Information System (INIS)

    The need for highly qualified and well trained experts in the area of nuclear safeguards and non-proliferation has been emphasized at several International Atomic Energy Agency (IAEA) General Conferences and Board of Governors' meetings. To meet this need, the IAEA has developed a training programme dedicated to assisting Member States in building-up knowledge, skills and attitudes required for the sustainable establishment and maintenance of an effective State system of accounting for and control of nuclear material. The IAEA training programme in the area of nuclear safeguards and non-proliferation is designed for experts in governmental organizations, regulatory bodies, utilities and relevant industries and is provided on a regular basis at the regional and international level and, upon request, at the national level. It is based on training needs assessed, inter alia, during relevant IAEA advisory services and is updated periodically by applying the Systematic Approach to Training (SAT). In the framework of this human resources assistance programme, the IAEA also facilitates fellowship programmes for young professionals, regularly hosts the IAEA safeguards traineeship programme and supports safeguards related outreach activities organized by donor countries, universities or other institutions. This paper provides an overview of the IAEA's efforts in the area of nuclear safeguards and non-proliferation training and education, including assistance to Member States' initiatives and nuclear education networks, focusing on the development and delivery of nuclear safeguards training and academic courses. Further, it discusses the important role of IAEA advisory missions and other mechanisms that significantly contribute to the continuous improvement of the IAEA Member States training in the area of nuclear safeguards and non-proliferation. Finally, it outlines the forthcoming eLearning module on Safeguards that will complement the existing training

  4. Effects of parental smoking on medical care utilization by children.

    Science.gov (United States)

    Vogt, T M

    1984-01-01

    A household interview survey of 2,582 adult members of the Kaiser-Permanente Medical Care Program of Oregon conducted in 1970-71 contained detailed questions about cigarette smoking patterns. Detailed, computerized medical records were maintained for all inpatient and outpatient care rendered between 1967 and 1974 to the 1,761 children of the interviewed sample. Adjusted for age, family size, socioeconomic status, and duration of Health Plan membership, children in non-smoking households used significantly more outpatient services than did children in smoking households, a relationship largely accounted for by their use of more preventive medical services than by children in smoking households. There were no significant differences in inpatient medical care use and outpatient care use for respiratory illness by children of smoking and non-smoking households. PMID:6689838

  5. On your time: online training for the public health workforce.

    Science.gov (United States)

    Kenefick, Hope Worden; Ravid, Sharon; MacVarish, Kathleen; Tsoi, Jennifer; Weill, Kenny; Faye, Elizabeth; Fidler, Anne

    2014-03-01

    The need for competency-based training for the public health workforce is well documented. However, human and financial resource limitations within public health agencies often make it difficult for public health practitioners to attend classroom-based training programs. The Internet is an increasingly popular way of extending training beyond the workforce. Although research describes attributes of effective online learning modules, much of the available training delivered via the Internet does not incorporate such attributes. The authors describe the On Your Time training series, an effective distance education program and training model for public health practitioners, which includes a standardized process for development, review, evaluation, and continuous quality improvement. On Your Time is a series of awareness-level (i.e., addressing what practitioners should know), competency-based training modules that address topics related to regulatory responsibilities of public health practitioners (e.g., assuring compliance with codes and regulations governing housing, retail food safety, private water supplies, hazardous and solid waste, on-site wastewater systems, etc.), public health surveillance, case investigation, disease prevention, health promotion, and emergency preparedness. The replicable model incorporates what is known about best practices for online training and maximizes available resources in the interests of sustainability. PMID:24578365

  6. Effectiveness of supervised implementation of an oral health care guideline in care homes; a single-blinded cluster randomized controlled trial

    NARCIS (Netherlands)

    Putten, G.J. van der; Mulder, J.; Baat, C. de; De Visschere, L.M.; Vanobbergen, J.N.; Schols, J.M.

    2013-01-01

    OBJECTIVES: The objective of this study was to assess the effectiveness of a supervised implementation of the "Oral health care Guideline for Older people in Long-term care Institutions" (OGOLI) in The Netherlands. MATERIALS AND METHODS: A sample of 12 care homes in the Netherlands was allocated ran

  7. Do Effects of Early Child Care Extend to Age 15 Years? Results from the NICHD Study of Early Child Care and Youth Development

    Science.gov (United States)

    Vandell, Deborah Lowe; Belsky, Jay; Burchinal, Margaret; Steinberg, Laurence; Vandergrift, Nathan

    2010-01-01

    Relations between nonrelative child care (birth to 4 1/2 years) and functioning at age 15 were examined (N = 1,364). Both quality and quantity of child care were linked to adolescent functioning. Effects were similar in size as those observed at younger ages. Higher quality care predicted higher cognitive-academic achievement at age 15, with…

  8. Employee Motivation and Employee Performance in Child Care : The effects of the Introduction of Market Forces on Employees in the Dutch Child-Care Sector

    NARCIS (Netherlands)

    Plantinga, Mirjam

    2006-01-01

    This research describes and explains the effects of the introduction of market forces in the Dutch child-care sector on employee governance, motivation and performance. The Dutch child-care sector is transitioning from a welfare sector into a market sector. The transition process in child care is co

  9. Clinical research and medical care: towards effective and complete integration

    OpenAIRE

    Sacristán, José A.

    2015-01-01

    Background Despite their close relationship, clinical research and medical care have become separated by clear boundaries. The purpose of clinical research is to generate generalizable knowledge useful for future patients, whereas medical care aims to promote the well-being of individual patients. The evolution towards patient-centered medicine and patient-oriented research, and the gradual standardization of medicine are contributing to closer ties between clinical research and medical pract...

  10. Safeguards Workforce Repatriation, Retention and Utilization

    Energy Technology Data Exchange (ETDEWEB)

    Gallucci, Nicholas [Brookhaven National Lab. (BNL), Upton, NY (United States); Poe, Sarah [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2015-10-01

    Brookhaven National Laboratory was tasked by NA-241 to assess the transition of former IAEA employees back to the United States, investigating the rate of retention and overall smoothness of the repatriation process among returning safeguards professionals. Upon conducting several phone interviews, study authors found that the repatriation process went smoothly for the vast majority and that workforce retention was high. However, several respondents expressed irritation over the minimal extent to which their safeguards expertise had been leveraged in their current positions. This sentiment was pervasive enough to prompt a follow-on study focusing on questions relating to the utilization rather than the retention of safeguards professionals. A second, web-based survey was conducted, soliciting responses from a larger sample pool. Results suggest that the safeguards workforce may be oversaturated, and that young professionals returning to the United States from Agency positions may soon encounter difficulties finding jobs in the field.

  11. Personality assessments as a workforce diversity tool.

    Science.gov (United States)

    Collins, Sandra K; Sord, Brandy; Griffin, Caleigh; Borges, Lora

    2008-01-01

    * Employee recruitment, retention, and workforce diversity are essential ingredients in a successful radiology department. Since potential new hires and existing employees do not come with labels which accurately describe their innate characteristics, radiology managers need to use objective tools such as personality assessments in order to properly evaluate prospective employment candidates. * These tools have traditionally been under utilized in the healthcare industry, but when used as part of a complete employee selection program they have the potential of ensuring a cohesive radiology department filled with diverse and skilled professionals. * Legal concerns and time constraints withstanding, use of personality assessments as a workforce diversity tool will aid in building an integrated department culture which values the varying skills and attributes of every employee. The result is a radiology department with high levels of employee retention and satisfaction. PMID:18431938

  12. Workforce mobility: Contributing towards smart city

    Science.gov (United States)

    Nor, N. M.; Wahap, N. A.

    2014-02-01

    Smart cities gained importance as a means of making ICT enabled services and applications available to the citizens, companies and authorities that form part of a city's system. It aims at increasing citizen's quality of life, and improving the efficiency and quality of the services provided by governing entities and businesses. This perspective requires an integrated vision of a city and of its infrastructures in all components. One of the characteristics of a smart city is mobility. The concept of mobility, especially for the workforce, is studied through a research carried out on a daily work undertaken as a prototype in the administrative town of Putrajaya, Malaysia. Utilizing the location track from GNSS integrated with mobile devices platform, information on movement and mobility was analysed for quality and efficiency of services rendered. This paper will highlight the research and outcomes that were successfully carried out and will suggest that workforce mobility management can benefit the authorities towards implementing a smart city concept.

  13. Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study.

    NARCIS (Netherlands)

    Graff, M.J.L.; Adang, E.M.M.; Vernooij-Dassen, M.J.F.J.; Dekker, J.; Jonsson, L.; Thijssen, M.; Hoefnagels, W.H.L.; Olde Rikkert, M.G.M.

    2008-01-01

    OBJECTIVE: To assess the cost effectiveness of community based occupational therapy compared with usual care in older patients with dementia and their care givers from a societal viewpoint. DESIGN: Cost effectiveness study alongside a single blind randomised controlled trial. SETTING: Memory clinic,

  14. Beyond Human Capital Development: Balanced Safeguards Workforce Metrics and the Next Generation Safeguards Workforce

    International Nuclear Information System (INIS)

    Since its establishment in 2008, the Next Generation Safeguards Initiative (NGSI) has achieved a number of objectives under its five pillars: concepts and approaches, policy development and outreach, international nuclear safeguards engagement, technology development, and human capital development (HCD). As a result of these efforts, safeguards has become much more visible as a critical U.S. national security interest across the U.S. Department of Energy (DOE) complex. However, limited budgets have since created challenges in a number of areas. Arguably, one of the more serious challenges involves NGSI's ability to integrate entry-level staff into safeguards projects. Laissez fair management of this issue across the complex can lead to wasteful project implementation and endanger NGSI's long-term sustainability. The authors provide a quantitative analysis of this problem, focusing on the demographics of the current safeguards workforce and compounding pressures to operate cost-effectively, transfer knowledge to the next generation of safeguards professionals, and sustain NGSI safeguards investments.

  15. Health workforce governance: Processes, tools and actors towards a competent workforce for integrated health services delivery.

    Science.gov (United States)

    Barbazza, Erica; Langins, Margrieta; Kluge, Hans; Tello, Juan

    2015-12-01

    A competent health workforce is a vital resource for health services delivery, dictating the extent to which services are capable of responding to health needs. In the context of the changing health landscape, an integrated approach to service provision has taken precedence. For this, strengthening health workforce competencies is an imperative, and doing so in practice hinges on the oversight and steering function of governance. To aid health system stewards in their governing role, this review seeks to provide an overview of processes, tools and actors for strengthening health workforce competencies. It draws from a purposive and multidisciplinary review of literature, expert opinion and country initiatives across the WHO European Region's 53 Member States. Through our analysis, we observe distinct yet complementary roles can be differentiated between health services delivery and the health system. This understanding is a necessary prerequisite to gain deeper insight into the specificities for strengthening health workforce competencies in order for governance to rightly create the institutional environment called for to foster alignment. Differentiating between the contribution of health services and the health system in the strengthening of health workforce competencies is an important distinction for achieving and sustaining health improvement goals. PMID:26489924

  16. Strategies for enhancing perioperative safety: promoting joy and meaning in the workforce.

    Science.gov (United States)

    Morath, Julianne; Filipp, Rhonda; Cull, Michael

    2014-10-01

    Workforce safety is a precondition of patient safety, and safety from both physical and psychological harm in the workplace is the foundation for an environment in which joy and meaning can exist. Achieving joy and meaning in the workplace allows health care workers to continuously improve the care they provide. This requires an environment in which disrespectful and harmful behaviors are not tolerated or ignored. Health care leaders have an obligation to create workplace cultures that are characterized by respect, transparency, accountability, learning, and quality care. Evidence suggests, however, that health care settings are rife with disrespectful behavior, poor teamwork, and unsafe working conditions. Solutions for addressing workplace safety problems include defining core values, tasking leaders to act as role models, and committing to becoming a high-reliability organization. PMID:25260671

  17. The Crossroads between Workforce and Education

    OpenAIRE

    Jackson, Kathryn; Lower, Christi L.; Rudman, William J

    2016-01-01

    Concern is growing among industry leaders that students may not be obtaining the necessary skills for entry into the labor market. To gain an understanding of the perceived disconnect in the skill set of graduates entering the health information workforce, a survey was developed to examine the opinions of educators and employers related to graduate preparedness. The concern related to graduate preparedness is supported by findings in this research study, in which those working in industry and...

  18. Challenges related to managing an international workforce

    OpenAIRE

    MICHKOVÁ, Adéla

    2013-01-01

    This Diploma thesis focuses on the concept of managing international workforce and the challenges it entails. It also researches the question whether Czech managers are capable of managing a multi-cultural team. It is divided into two main parts. The first part is a literature overview of the topic. It starts with general managerial responsibilities and then it describes cultural differences that affect not only managers. Such differences include different cultural values and habits, the...

  19. Revisions to workforce jobs: December 2007

    OpenAIRE

    Nick Barford

    2008-01-01

    Describes the changes made to Annual Business Inquiry methods in the transition to a new survey, and the associated discontinuitiesThis article was first published on the National Statistics website on 12 December 2007, to coincide with the Labour Market Statistics First Release and the planned revisions made to the workforce jobs (WFJ) series. The revisions are mainly due to benchmarking the short-term employee jobs series to the latest estimates from the Annual Business Inquiry (ABI/1). The...

  20. Identification of Key Barriers in Workforce Development

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-03-31

    This report documents the identification of key barriers in the development of an adequate national security workforce as part of the National Security Preparedness Project, being performed under a Department of Energy/National Nuclear Security Administration grant. Many barriers exist that prevent the development of an adequate number of propertly trained national security personnel. Some barriers can be eliminated in a short-term manner, whereas others will involve a long-term strategy that takes into account public policy.

  1. Ethical Issues between Workforce and Religious Conviction

    OpenAIRE

    Mohamad Zaid Mohd Zin; Ahmad Faisal Mahdi; Azhar Abdul Rahman; Mohd Syahiran Abdul Latif; Rohaya Sulaiman; Nurul Khairiah Khalid; Nurfahiratul Azlina Ahmad; Ahamad Asmadi Sakat; Adi Yasran A A; Mohd Roslan Mohd Nor

    2012-01-01

    Problem statement: This article enhances the ethical issues consider the relationship between religious life and work ethics. Approach: Malaysia aim to achieved full developed nation’s, requires a professional workforce, not only educated and innovative, but ethically, with integrity, accountability, dynamic and committed to continuously increasing Muslim professionalism. In the context of the development of Muslim professionals with a holistic and integrated, Muslims needs to withholding Taw...

  2. Managing Diversity in Workforce: IT Projects

    OpenAIRE

    Acharya, Bhawna

    2015-01-01

    Organizations are turning globally to remain competitive in today´s world. It is important to have in place a strategy that builds cultural and other diversity awareness to avoid confusion and conflict during project execution. Certain types of customer projects in the case company were having problems in delivery due to its diverse workforce. The aim of the thesis was to create a set of common practices which project managers could follow to manage diversity during project execution stage of...

  3. Workforce Development and Wind for Schools (Poster)

    Energy Technology Data Exchange (ETDEWEB)

    Newcomb, C.; Baring-Gould, I.

    2012-06-01

    As the United States dramatically expands wind energy deployment, the industry is faced with the need to quickly develop a skilled workforce and to address public acceptance. Wind Powering America's Wind for Schools project addresses these challenges. This poster, produced for the American Wind Energy Association's annual WINDPOWER conference, provides an overview of the project, including objectives, methods, and results.

  4. Health and Health Care Disparities: The Effect of Social and Environmental Factors on Individual and Population Health

    Directory of Open Access Journals (Sweden)

    Billy Thomas

    2014-07-01

    Full Text Available Recently the existence and prevalence of health and health care disparities has increased with accompanying research showing that minorities (African Americans, Hispanics/Latinos, Native Americans, and Pacific Islanders are disproportionately affected resulting in poorer health outcomes compared to non-minority populations (whites. This is due to multiple factors including and most importantly the social determinants of health which includes lower levels of education, overall lower socioeconomic status, inadequate and unsafe housing, and living in close proximity to environmental hazards; all contributing to poor health. Given the ever widening gap in health and health care disparities, the growing number of individuals living at or below the poverty level, the low number of college graduates and the growing shortage of health care professionals (especially minority the goals of this paper are to: (1 Define diversity and inclusion as interdependent entities. (2 Review the health care system as it relates to barriers/problems within the system resulting in the unequal distribution of quality health care. (3 Examine institutional and global benefits of increasing diversity in research. (4 Provide recommendations on institutional culture change and developing a diverse culturally competent healthcare workforce.

  5. The organization and administration of community college non-credit workforce education and training cuts

    Science.gov (United States)

    Kozachyn, Karen P.

    Community colleges are struggling financially due to underfunding. Recent state budget cuts coupled with the elimination of federal stimulus money has exacerbated the issue as these funding streams had contributed to operating costs (Moltz, 2011). In response to these budget cuts, community colleges are challenged to improve, increase, and develop revenue producing programs. These factors heighten the need for community colleges to examine their non-credit workforce organizations. The community college units charged with delivering non-credit workforce education and training programs are historically ancillary to the academic divisions that deliver certificate, technical degree, and transfer degree programs. The perceptions of these units are that they are the community college's 'step child' (Grubb, Bradway, and Bell, 2002). This case study examined the organization and administration of community college non-credit workforce education and training units, utilizing observation, interviews, and document analysis. Observational data focused on the physical campus and the unit. Interviews were conducted onsite with decision-making personnel of the division units that deliver non-credit workforce education and training within each community college. Document analysis included college catalogues, program guides, marketing material, and website information. The study was grounded in the review of literature associated with the evolution of the community college, as well as the development of workforce education and training including funding, organizational structure and models, management philosophies, and effectiveness. The findings of the study report that all five units were self-contained and were organized and operated uniquely within the organization. Effectiveness was measured differently by each institution. However, two common benchmarks were revenue and student evaluations. Another outcome of this study is the perceived lack of college-wide alignment between

  6. A strategic approach to public health workforce development and capacity building.

    Science.gov (United States)

    Dean, Hazel D; Myles, Ranell L; Spears-Jones, Crystal; Bishop-Cline, Audriene; Fenton, Kevin A

    2014-11-01

    In February 2010, CDC's National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease (STD), and Tuberculosis (TB) Prevention (NCHHSTP) formally institutionalized workforce development and capacity building (WDCB) as one of six overarching goals in its 2010-2015 Strategic Plan. Annually, workforce team members finalize an action plan that lays the foundation for programs to be implemented for NCHHSTP's workforce that year. This paper describes selected WDCB programs implemented by NCHHSTP during the last 4 years in the three strategic goal areas: (1) attracting, recruiting, and retaining a diverse and sustainable workforce; (2) providing staff with development opportunities to ensure the effective and innovative delivery of NCHHSTP programs; and (3) continuously recognizing performance and achievements of staff and creating an atmosphere that promotes a healthy work-life balance. Programs have included but are not limited to an Ambassador Program for new hires, career development training for all staff, leadership and coaching for mid-level managers, and a Laboratory Workforce Development Initiative for laboratory scientists. Additionally, the paper discusses three overarching areas-employee communication, evaluation and continuous review to guide program development, and the implementation of key organizational and leadership structures to ensure accountability and continuity of programs. Since 2010, many lessons have been learned regarding strategic approaches to scaling up organization-wide public health workforce development and capacity building. Perhaps the most important is the value of ensuring the high-level strategic prioritization of this issue, demonstrating to staff and partners the importance of this imperative in achieving NCHHSTP's mission. PMID:25439247

  7. Perceived stress among a workforce 6 months following hurricane Katrina.

    Science.gov (United States)

    Leon, Kyla A; Hyre, Amanda D; Ompad, Danielle; Desalvo, Karen B; Muntner, Paul

    2007-12-01

    To determine stress levels among a workforce 6 months after hurricane Katrina made landfall, a web-based survey that included the four-item Perceived Stress Scale was administered to employees of the largest employer in New Orleans. An overall Perceived Stress Scale score was obtained by pooling responses for the four items. Among 1,542 adult respondents, 24.1% stated they felt that they were "fairly often" or "very often" unable to control the important things in their life and 21.4% considered that their difficulties were "fairly often" or "very often" piling up so high that they could not overcome them. Also, 6.1% reported that they "almost never" or "never" felt confident about their ability to handle their personal problems and 15.2% indicated that things were "almost never" or "never" going their way. The overall mean Perceived Stress Scale score was 6.3 (standard deviation = 3.1; range = 0-16). Higher stress scale scores, indicating more stress, were present for women, and for participants with lower income, displaced longer than 3 months, who were more afraid of losing their life during hurricane Katrina and its immediate aftermath, and who knew someone that died during the storm. Additionally, participants who were living in a relative of friend's house or in a temporary trailer at the time of the survey had higher stress scores compared to their counterparts who had returned to live in their pre-hurricane residence. There was a direct association between higher stress scores and symptoms of post-traumatic stress disorder. Employers and health care providers should be apprised of the need for monitoring stress and offering counseling opportunities for returning workforces following future large-scale disasters. PMID:17932611

  8. How Changes in Entry Requirements Alter the Teacher Workforce and Affect Student Achievement

    Science.gov (United States)

    Boyd, Donald; Grossman, Pamela; Lankford, Hamilton; Loeb, Susanna; Wyckoff, James

    2006-01-01

    We are in the midst of what amounts to a national experiment in how best to attract, prepare, and retain teachers, particularly for high-poverty urban schools. Using data on students and teachers in grades 3-8, this study assesses the effects of pathways into teaching in New York City on the teacher workforce and on student achievement. We ask…

  9. Experts Foresee a Major Shift From Inpatient to Ambulatory Care.

    Science.gov (United States)

    Beans, Bruce E

    2016-04-01

    An American Society of Health-System Pharmacists Research and Education Foundation report predicts trends in health care delivery and financing, drug development and therapeutics, pharmaceutical marketplace, pharmacy workforce, and more. PMID:27069342

  10. Building the Social Work Workforce: Saving Lives and Families

    Directory of Open Access Journals (Sweden)

    Katharine Briar-Lawson

    2014-05-01

    Full Text Available This article depicts a journey over the decades to address some of the needs of children and families in the child welfare system. Recounting a few key milestones and challenges in the past 40 years, it is argued that workforce development is one key to improved outcomes for abused and neglected children and their families. Major events and several turning points are chronicled. Emerging workforce needs in aging are also cited as lessons learned from child welfare have implications for building a gero savvy social work workforce. Funding streams involving IV-E and Medicaid are discussed. It is argued that workforce development can be a life and death issue for some of these most vulnerable populations. Thus, the workforce development agenda must be at the forefront of the social work profession for the 21st century. Key funding streams are needed to foster investments in building and sustaining the social work workforce.

  11. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    Science.gov (United States)

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:25397338

  12. Role of telemedicine and mid-level dental providers in expanding dental-care access: potential application in rural Australia.

    Science.gov (United States)

    Estai, Mohamed; Kruger, Estie; Tennant, Marc

    2016-08-01

    Despite great progress in oral health over the past three decades, the rates of caries remain high in Australia, particularly among underserved populations. The reasons for poor oral health amongst underserved populations are multiple, but rests with socio-economic determinants of health. The present review considers international workforce models that have been created to enhance the recruitment and retention of dental providers in rural areas. Several strategies have been developed to address care access problems in rural areas, including the use of telemedicine and mid-level dental providers (MLDPs). Despite ongoing opposition from dentistry organisations, the Alaska and Minnesota workforce models have proven that developing and deploying dental therapists from rural communities has the potential to address the unmet needs of underserved populations. It is more efficient and cost-effective for MLDPs to perform triage and treat simple cases and for dentists to treat complicated cases. The use of MLDPs is intended to increase the capacity of the dental workforce in areas that are too isolated to entice dentists. Telemedicine has emerged as one solution to address limited access to health care, particularly in locations where there is a lack of providers. Telemedicine not only provides access to care, but also offers support, consultations and access to continuing education for practicing dental providers in rural areas. This strategy has the potential to free up resources to increase care access and reduce oral health disparities, thereby contributing to closing the rural-urban oral health gap. PMID:26846683

  13. Leaders, leadership and future primary care clinical research

    Directory of Open Access Journals (Sweden)

    Qureshi Nadeem

    2008-09-01

    Full Text Available 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 countries. Emerging from this has been innovation in research design and focus, although less is known of the effect on research output. Conclusion Primary care research is now well placed to lead a broad re-vitalisation of academic medicine, answering questions of relevance to practitioners, patients, communities and Government. Key areas for future primary care research leaders to focus on include exposing undergraduates early to primary care research, integrating this early exposure with doctoral and postdoctoral research career support, further expanding cross disciplinary approaches, and developing useful measures of output for future primary care research investment.

  14. Labor supply and child care costs: the effect of rationing

    OpenAIRE

    Del Boca, Daniela; Vuri, Daniela

    2005-01-01

    In Italy the participation of women has not increased very much in the last few decades relative to other developed countries and it is still among the lowest in Europe. The female employment rate stands almost 13 percentage points below the EU average and 22 below the Lisbon target. One of the most important reasons is related to the characteristics of child care system. In this paper we analyze the characteristics of the child care system in Italy and its relationship to the labor market pa...

  15. Hawai‘i's Nursing Workforce: Keeping Pace with Healthcare

    OpenAIRE

    LeVasseur, Sandra A; Qureshi, Kristine

    2015-01-01

    Nursing is the largest segment of the healthcare workforce, but over the next decade even more nurses will be required. Changing population demographics, new technologies, and evolving models of healthcare will stimulate expansion of nursing roles and the need for a highly educated nursing workforce. The current nursing workforce is aging, and large numbers of retirements are anticipated. By 2025, the United States is expected to experience a nursing shortage; in Hawai‘i this shortfall is for...

  16. A scoping review of the nurse practitioner workforce in oncology.

    Science.gov (United States)

    Coombs, Lorinda A; Hunt, Lauren; Cataldo, Janine

    2016-08-01

    The quality of cancer care may be compromised in the near future because of work force issues. Several factors will impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. Between October 2014 and March 2015, an electronic literature search of English language articles was conducted using PubMed(®) , the Cumulative Index to Nursing and Allied Health Sciences (CINAHL(®) ), Web of Science, Journal Storage (JSTOR(®) ), Google Scholar, and SCOPUS(®) . Using the scoping review criteria, the research question was identified "How much care in oncology is provided by nurse practitioners (NPs)?" Key search terms were kept broad and included: "NP" AND "oncology" AND "workforce". The literature was searched between 2005 and 2015, using the inclusion and exclusion criteria, 29 studies were identified, further review resulted in 10 relevant studies that met all criteria. Results demonstrated that NPs are utilized in both inpatient and outpatient settings, across all malignancy types and in a variety of roles. Academic institutions were strongly represented in all relevant studies, a finding that may reflect the Accreditation Council for Graduate Medical Education (ACGME) duty work hour limitations. There was no pattern associated with state scope of practice and NP representation in this scoping review. Many of the studies reviewed relied on subjective information, or represented a very small number of NPs. There is an obvious need for an objective analysis of the amount of care provided by oncology NPs. PMID:27264203

  17. Shared Decision Making and Effective Physician-Patient Communication: The Quintessence of Patient-Centered Care

    Directory of Open Access Journals (Sweden)

    Huy Ming Lim

    2015-03-01

    Full Text Available The Institute of Medicine’s (IOM 2001 landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, identified patient-centeredness as one of the fundamental attributes of quality health care, alongside safety, effectiveness, timeliness, efficiency, and equity. The IOM defined patient-centeredness as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” This concept of patient-centered care represents a paradigm shift from the traditional disease-oriented and physician-centered care, grounding health care in the subjective experience of illness and the needs and preferences of individual patients rather than the evaluation and treatment of diseases which emphasizes on leveraging clinical expertise and evidence derived from population-based studies. Regrettably, despite the ubiquitous talk about patient-centered care in modern health care, shared decision-making and effective physician-patient communication—the two cruxes of patient-centered care—are yet to become the norms. Strategies to promote and enhance shared decision-making and effective communication between clinicians and patients should be rigorously implemented to establish a health care system that truly values patients as individuals and turn the rhetoric of patient-centered care into reality.

  18. Effectiveness of foot care education among people with type 2 diabetes in rural Puducherry, India

    Directory of Open Access Journals (Sweden)

    Suman Saurabh

    2014-01-01

    Full Text Available Background: The burden of diabetes and its foot complications is increasing in India. Prevention of these complications through foot care education should be explored. The objective of our study was to assess the risk factors of poor diabetic foot care and to find the effectiveness of health education in improving foot care practice among diabetes patients. Materials and Methods: A structured pre-tested questionnaire was administered to the outpatients of a rural health center with type 2 diabetes. Awareness regarding diabetes, care of diabetes and foot care practice ware assessed and scored. Individual and group health education focusing on foot care was performed. Foot care practice was reassessed after 2 weeks of education. Results: Only 54% were aware that diabetes could lead to reduced foot sensation and foot ulcers. Nearly 53% and 41% of the patients had good diabetes awareness and good diabetes care respectively. Only 22% of the patients had their feet examined by a health worker or doctor. The patients with poor, satisfactory and good practice scores were 44.7%, 35.9% and 19.4% respectively. Low education status, old age and low awareness regarding diabetes were the risk factors for poor practice of foot care. Average score for practice of foot care improved from 5.90 ± 1.82 to 8.0 ± 1.30 after 2 weeks of health education. Practice related to toe space examination, foot inspection and foot wear inspection improved maximally. Conclusion: Foot care education for diabetics in a primary care setting improves their foot care practice and is likely to be effective in reducing the burden of diabetic foot ulcer.

  19. The Effects of Service-Learning on College Students' Attitudes Toward Older Adults.

    Science.gov (United States)

    Augustin, Frankline; Freshman, Brenda

    2016-01-01

    The current U.S. health care workforce shortage is at crisis levels for providers who specialize in elder care. Barriers such as ageism, lack of awareness of the need for workers, and lack of contact with seniors can affect the career choice of young professionals. To explore ways to increase the number of students who pursue gerontology and to expand the elder care workforce, the researchers conducted a qualitative content analysis on the impact of service learning in senior care facilities on students' attitudes toward older adults. Students with senior contact reported increases in positive perceptions of seniors, discovered their own ageist stereotypes, and developed an interest in a career in elder care. Twenty-one months after the service-learning experience, students were surveyed again with their responses indicating continued positive attitude changes along with professional development demonstrating beneficial long-term effects from the experience. PMID:26679428

  20. Maternal Separation Anxiety and Child Care: Effects on Maternal Behavior.

    Science.gov (United States)

    Storm, Heidi A.; Ridley-Johnson, Robyn

    Maternal separation anxiety influences maternal behavior, attitudes about employment, and employment decisions made by mothers. This study examined the relationship between maternal separation anxiety and the number of hours a child was in substitute care. The sample consisted of 44 mothers and their children who ranged in age from 12 to 41 months…

  1. Gatekeeping – open door to effective medical care utilisation?

    Czech Academy of Sciences Publication Activity Database

    Hromádková, Eva

    -, č. 400 (2009), s. 1-46. ISSN 1211-3298 R&D Projects: GA MŠk LC542 Institutional research plan: CEZ:AV0Z70850503 Keywords : health insurance * health care utilization * episodic demand model Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp400.pdf

  2. How can we maintain effective and relevant wound care education?

    OpenAIRE

    Ousey, Karen; Poole, Maria; Holloway, Samantha; Harris, Sue

    2011-01-01

    Nurse education in England is entering a new era with the move to an all-graduate profession becoming a reality from September 2013. But, what does this mean for wound care and the clinical nursing skills that are required to ensure patient safety as well as evidence-based outcomes?

  3. Diversity in the imaging workforce.

    Science.gov (United States)

    Cerdena, Ernesto A

    2006-01-01

    Culture is the coherent, learned, shared view a group of people has about life's concerns that ranks what is important, and instills attitudes about those things which are considered appropriate as well as prescribed behavior. It notes that some things have more significance than others. "Culture shock" is what happens when a person suddenly finds himself or herself in a place where "yes may mean "no," where a fixed price is negotiable, where to be kept in an outer office is not a cause for insult, and where laughter may signify anger Effective leaders should be able to vary their styles of management, such as leading, planning, organizing, motivating, decision making, staffing, and more importantly, communicating with groups of workers from different cultural backgrounds. Leaders need to perceive conflict as both a challenge and an opportunity. Awareness about team members' cultural similarities and differences is key to foster effective conflict resolution. Synergistic organizations transcend the distinct cultures of the team members. They use these differences as a resource in designing and developing organizational systems. Effective leaders must become a champion and capable of acting in many ways, not experts rigidly adhering to a single approach. PMID:16676882

  4. The cost effectiveness of integrated care for people living with HIV including antiretroviral treatment in a primary health care centre in Bujumbura, Burundi

    OpenAIRE

    Renaud, Adrien; Basenya, Olivier; De Borman, Nicolas; Greindl, Isaline; Meyer-Rath, Gesine

    2009-01-01

    The incremental cost effectiveness of an integrated care package (i.e. medical care including antiretroviral therapy and other services such as psychological and social support) for people living with HIV/AIDS was calculated in a not-for-profit primary health care centre in Bujumbura run by Society of Women Against Aids (SWAA) - Burundi, an African non-governmental organisation (NGO). Results are expressed as cost-effectiveness ratio 2007, constant US$ per Disability-Adjusted Life Year (DALY)...

  5. The cost effectiveness of integrated care for people living with HIV including antiretroviral treatment in a primary health care centre in Bujumbura, Burundi

    OpenAIRE

    2009-01-01

    Abstract The incremental cost effectiveness of an integrated care package (i.e. medical care including antiretroviral therapy and other services such as psychological and social support) for people living with HIV/AIDS was calculated in a not-for-profit primary health care centre in Bujumbura run by Society of Women Against Aids (SWAA) - Burundi, an African non-governmental organisation (NGO). Results are expressed as cost-effectiveness ratio 2007, constant US$ per Disability-Ad...

  6. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    Science.gov (United States)

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  7. Neonatal Intensive Care for Low Birthweight Infants: Costs and Effectiveness. Health Technology Case Study 38.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    After a brief introduction delineating the scope of the case study, chapter 1 summarizes findings and conclusions about the costs and effectiveness of neonatal intensive care in the United States. Chapter 2 inventories the national supply of neonatal intensive care units and describes recent trends in use and costs. Chapter 3 reviews mortality and…

  8. Implementation of a shared care guideline for back pain: Effect on unnecessary referrals

    NARCIS (Netherlands)

    Fleuren, M.; Dusseldorp, E.; Bergh, S. van den; Vlek, H.; Wildschut, J.; Akker, E. van den; Wijkel, D.

    2010-01-01

    Objective: To determine the effect of the implementation of a shared care guideline for the lumbosacral radicular syndrome (LRS) on unnecessary early referrals and the duration of the total diagnostic procedure. Design: Introduction of shared care guideline in November 2005. Pre-test in 2005 (April

  9. Genetic Moderation of Early Child-Care Effects on Social Functioning Across Childhood: A Developmental Analysis

    Science.gov (United States)

    Belsky, Jay; Pluess, Michael

    2013-01-01

    Data from 508 Caucasian children in the NICHD Study of Early Child Care and Youth Development shows that the DRD4 (but not 5-HTTLPR) polymorphism moderates the effect of child-care quality (but not quantity or type) on caregiver-reported externalizing problems at 54 months and in kindergarten and teacher-reported social skills at kindergarten and…

  10. Effects of Universal Child Care Participation on Pre-teen Skills and Risky Behaviors

    DEFF Research Database (Denmark)

    Gupta, Nabanita Datta; Simonsen, Marianne

    This paper uses a Danish panel data child survey merged with administrative records along with a pseudo-experiment that generates variation in the take-up of preschool across municipalities to investigate pre-teenage effects of child care participation at age three (either parental care, preschoo...

  11. Effective Recognition and Treatment of Generalized Anxiety Disorder in Primary Care

    OpenAIRE

    2004-01-01

    This Academic Highlights section of The Primary Care Companion to The Journal of Clinical Psychiatry presents the highlights of the planning roundtable “Effective Recognition and Treatment of Generalized Anxiety Disorder (GAD) in the Primary Care Setting,” held December 11, 2003, in Pittsburgh, Pa. The planning roundtable and this Academic Highlights were supported by an unrestricted educational grant from Pfizer.

  12. Iraqi primary care system in Kurdistan region: providers’ perspectives on problems and opportunities for improvement

    Directory of Open Access Journals (Sweden)

    Shabila Nazar P

    2012-09-01

    Full Text Available Abstract Background As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers’ perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. Methods A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Results Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene, health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system, shortage in resources (shortage and low quality of medical supplies and shortage in financing, poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. Conclusions This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq’s Kurdistan region from the perspective of primary care providers. From their experience

  13. Health workforce development in the European Union: A matrix for comparing trajectories of change in the professions.

    Science.gov (United States)

    Pavolini, Emmanuele; Kuhlmann, Ellen

    2016-06-01

    This article assesses professional development trajectories in top-, middle- and basic-level health workforce groups (doctors, nurses, care assistants) in different European Union countries using available international databases. Three theoretical strands (labour market, welfare state, and professions studies) were connected to explore ideal types and to develop a matrix for comparison. With a focus on larger EU-15 countries and four different types of healthcare systems, Germany, Italy, Sweden and the United Kingdom serve as empirical test cases. The analysis draws on selected indicators from public statistics/OECD data and micro-data from the EU Labour Force Survey. Five ideal typical trajectories of professional development were identified from the literature, which served as a matrix to compare developments in the three health workforce groups. The results reveal country-specific trajectories with uneven professional development and bring opportunities for policy interventions into view. First, there is a need for integrated health labour market monitoring systems to improve data on the skills mix of the health workforce. Second, a relevant number of health workers with fixed contracts and involuntary part-time reveals an important source for better recruitment and retention strategies. Third, a general trend towards increasing numbers while worsening working conditions was identified across our country cases. This trend hits care assistants, partly also nurses, the most. The research illustrates how public data sources may serve to create new knowledge and promote more sustainable health workforce policy. PMID:27021776

  14. Hotspots critical care evaluation

    OpenAIRE

    D. Humphris; N A Connell; Meyer, E.; Lees, A

    2006-01-01

    This report evaluates a series of critical care education interventions for nurses which took place within Southampton University Hospital Trust (SUHT) and Portsmouth Hospital Trust (PHT) in 2004 and 2005. These interventions were funded by the Hotspots project and commissioned by the Hampshire and Isle of Wight Workforce Development Directorate (WDD). As part of the ongoing commitment to incorporate evidence into practice, the WDD commissioned an independent impact evaluation of these interv...

  15. Policy challenges for the pediatric rheumatology workforce: Part I. Education and economics.

    Science.gov (United States)

    Henrickson, Michael

    2011-01-01

    For children with rheumatic conditions, the available pediatric rheumatology workforce mitigates their access to care. While the subspecialty experiences steady growth, a critical workforce shortage constrains access. This three-part review proposes both national and international interim policy solutions for the multiple causes of the existing unacceptable shortfall. Part I explores the impact of current educational deficits and economic obstacles which constrain appropriate access to care. Proposed policy solutions follow each identified barrier.Challenges consequent to obsolete, limited or unavailable exposure to pediatric rheumatology include: absent or inadequate recognition or awareness of rheumatic disease; referral patterns that commonly foster delays in timely diagnosis; and primary care providers' inappropriate or outdated perception of outcomes. Varying models of pediatric rheumatology care delivery consequent to market competition, inadequate reimbursement and uneven institutional support serve as additional barriers to care.A large proportion of pediatrics residency programs offer pediatric rheumatology rotations. However, a minority of pediatrics residents participate. The current generalist pediatrician workforce has relatively poor musculoskeletal physical examination skills, lacking basic competency in musculoskeletal medicine. To compensate, many primary care providers rely on blood tests, generating referrals that divert scarce resources away from patients who merit accelerated access to care for rheumatic disease. Pediatric rheumatology exposure could be enhanced during residency by providing a mandatory musculoskeletal medicine rotation that includes related musculoskeletal subspecialties. An important step is the progressive improvement of many providers' fixed referral and laboratory testing patterns in lieu of sound physical examination skills.Changing demographics and persistent reimbursement disparities will require workplace innovation

  16. The effect of managed care on hospital marketing orientation.

    Science.gov (United States)

    Loubeau, P R; Jantzen, R

    1998-01-01

    Marketing is a central activity of modern organizations. To survive and succeed, organizations must know their markets, attract sufficient resources, convert these resources into appropriate services, and communicate them to various consuming publics. In the hospital industry, a marketing orientation is currently recognized as a necessary management function in a highly competitive and resource-constrained environment. Further, the literature supports a marketing orientation as superior to other orientation types, namely production, product and sales. In this article, the results of the first national cross-sectional study of the marketing orientation of U.S. hospitals in a managed care environment are reported. Several key lessons for hospital executives have emerged. First, to varying degrees, U.S. hospitals have adopted a marketing orientation. Second, hospitals that are larger, or that have developed strong affiliations with other providers that involve some level of financial interdependence, have the greatest marketing orientation. Third, as managed care organizations have increased their presence in a state, hospitals have become less marketing oriented. Finally, contrary to prior findings, for-profit institutions are not intrinsically more marketing oriented than their not-for-profit counterparts. This finding is surprising because of the traditional role of marketing in non-health for-profit enterprises and management's greater emphasis on profitability. An area of concern for hospital executives arises from the finding that as managed care pressure increases, hospital marketing orientation decreases. Although a marketing orientation is posited to lead to greater customer satisfaction and improved business results, a managed care environment seems to force hospitals to focus more on cost control than on customer satisfaction. Hospital executives are cautioned that cost-cutting, the primary focus in intense managed care environments, may lead to short

  17. Space Commercialization Trends and Consequences for the Workforce

    Science.gov (United States)

    Peeters, W.

    2002-01-01

    The major trend we are currently witnessing in space activities is an increasing level of commercialization. This trend is emphasized by: consolidation, mergers and forming strategic alliances. In USA, from the 20 major space companies in the 80's only 3 `prime' ones were left by 1997. A similar effect took place in Europe in the 90's, where at present only primarily 2 major space conglomerates are operating at prime contractor level. Such strategic alliances in the first place result in the creation of end-to-end capabilities, with larger internal R&D and broader access to technologies. Due to the bigger financial volume of such conglomerates there is also better access to new capital and sharing of risks. In a second step, we can at present observe the creation of transatlantic alliances to enter the worldwide market. These trends have a considerable effect on the workforce requirements in industry:

  18. Mandates for Collaboration: Health Care and Child Welfare Policy and Practice Reforms Create the Platform for Improved Health for Children in Foster Care.

    Science.gov (United States)

    Zlotnik, Sarah; Wilson, Leigh; Scribano, Philip; Wood, Joanne N; Noonan, Kathleen

    2015-10-01

    Improving the health of children in foster care requires close collaboration between pediatrics and the child welfare system. Propelled by recent health care and child welfare policy reforms, there is a strong foundation for more accountable, collaborative models of care. Over the last 2 decades health care reforms have driven greater accountability in outcomes, access to care, and integrated services for children in foster care. Concurrently, changes in child welfare legislation have expanded the responsibility of child welfare agencies in ensuring child health. Bolstered by federal legislation, numerous jurisdictions are developing innovative cross-system workforce and payment strategies to improve health care delivery and health care outcomes for children in foster care, including: (1) hiring child welfare medical directors, (2) embedding nurses in child welfare agencies, (3) establishing specialized health care clinics, and (4) developing tailored child welfare managed care organizations. As pediatricians engage in cross-system efforts, they should keep in mind the following common elements to enhance their impact: embed staff with health expertise within child welfare settings, identify long-term sustainable funding mechanisms, and implement models for effective information sharing. Now is an opportune time for pediatricians to help strengthen health care provision for children involved with child welfare. PMID:26403650

  19. The National Higher Education and Workforce Initiative: Strategy in Action: Building the Cybersecurity Workforce in Maryland

    Science.gov (United States)

    Business-Higher Education Forum, 2014

    2014-01-01

    The Business-Higher Education Forum (BHEF) has achieved particular success in operationalizing the National Higher Education and Workforce Initiative (HEWI) in Maryland around cybersecurity. Leveraging its membership of corporate CEOs, university presidents, and government agency leaders, BHEF partnered with the University System of Maryland to…

  20. Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts

    Directory of Open Access Journals (Sweden)

    McEvoy Maureen P

    2011-11-01

    Full Text Available Abstract Background Training in the five steps of evidence-based practice (EBP has been recommended for inclusion in entry-level health professional training. The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students. Few studies have investigated longitudinal changes in EBP attitudes and behaviours. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce. Methods A prospective, observational, longitudinal design was used, with two cohorts. From 2008, 29 participants were tested in their final year in a physiotherapy program, and after the first and second workforce years. From 2009, 76 participants were tested in their final entry-level and first workforce years. Participants completed an Evidence-Based Practice Profile questionnaire (EBP2, which includes self-report EBP domains [Relevance, Terminology (knowledge of EBP concepts, Confidence, Practice (EBP implementation, Sympathy (disposition towards EBP]. Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data. Effect sizes (ES (95% CI were calculated for all changes. Results Effect sizes of the changes in EBP domains were small (ES range 0.02 to 0.42. While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year (ES -0.42 to -0.29 followed by an improvement in the second year (ES +0.27. Scores in Terminology improved (ES +0.19 to +0.26 in each of the first two workforce years, while Practice scores declined (ES -0.23 to -0.19 in the first year and improved minimally in the second year (ES +0.04. Confidence scores improved during the second workforce year (ES +0.27. Scores for Sympathy showed little change. Conclusions During the first two years in the workforce, there was a

  1. The Effects of Foster Care Intervention on Socially Deprived Institutionalized Children's Attention and Positive Affect: Results from the BEIP Study

    Science.gov (United States)

    Ghera, Melissa M.; Marshall, Peter J.; Fox, Nathan A.; Zeanah, Charles H.; Nelson, Charles A.; Smyke, Anna T.; Guthrie, Donald

    2009-01-01

    Background: We examined the effects of a foster care intervention on attention and emotion expression in socially deprived children in Romanian institutions. Methods: Institutionalized children were randomized to enter foster care or to remain under institutional care. Subsequently, the institutionalized and foster care groups, along with a…

  2. Survey on workforce retention and attrition

    Science.gov (United States)

    Showstack, Randy

    2013-03-01

    The Society of Petroleum Engineers (SPE) is conducting a survey to gather information on why technical professionals change jobs or quit working. The survey, prompted by concern about the retention of skilled workers, aims to provide information to employers that can assist them in addressing practices that can lead to significant workforce attrition. To participate in the survey, which is open to everyone (including those who are not SPE members), go to http://research.spe.org/se.ashx?s=705E3F1335720258 through 15 May 2013. For more information, contact speresearch@spe.org.

  3. Workforce restructuring, Oak Ridge site, Tennessee

    International Nuclear Information System (INIS)

    The workforce strategy to be used needs to have been finalized before procurement activities begin. The outcome will need to include policy on 'make or buy' decisions in achieving safe, economic and timely project completion, scope for utilizing existing staff, need for renegotiation of existing agreements designed for the operating phase, level of encouragement to contractors to recruit locally, etc. If these issues are not addressed in a timely manner, future debate and conflict are likely, with the potential to harm both the project and the parties involved

  4. An Aging Workforce: Employment Opportunities and Obstacles

    OpenAIRE

    Full Professor, Institute of Economic Sciences

    2013-01-01

    The last decade has witnessed significant changes in the structure of unemployment in the global labour market. This is corroborated by the fact that the global workforce is rapidly aging and the share of people aged 50 and over in the structure of the labour market is increasing. In line with this trend, unemployment issues should be considered as a global problem that cannot be fully resolved at the level of any individual country separately.The main objective of this paper is to throw some...

  5. Long term youth unemployment or disposable workforce?

    OpenAIRE

    Bruno Contini; Elisa Grand

    2010-01-01

    This paper explores a process which I denote as “young workforce disposal” (YWD). YWD reflects the fact that many young people enter the labor market as dependent employees, at some later time they are dismissed and (presumably) move into never-ending unemployment. Long term unemployment may last two, three, four years, but, in the end, it should lead to re-entry in working activities. If it does not, i.e. if we observe young men separating from their jobs for whatever reason, and, for as lon...

  6. Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects

    Directory of Open Access Journals (Sweden)

    Oshima Sumiko

    2013-01-01

    Full Text Available Abstract Background Post-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access. Methods We conducted 4 semi-structured focus groups comprising altogether 28 Japanese gynecological cancer survivors to collect a variety of participants’ post-treatment care-seeking behaviors through active interaction with participants. Factors influencing access to treatment for adverse effects were analyzed qualitatively. Results Survivors sought care through specialty clinic visits when regular post-treatment gynecological follow-ups were inadequate or when symptoms seemed to be non-treatment related. Information provided by hospital staff during initial treatment influenced patients’ understanding and response to adverse effects. Lack of knowledge and inaccurate symptom interpretation delayed help-seeking, exacerbating symptoms. Gynecologists’ attitudes during follow-ups frequently led survivors to cope with symptoms on their own. Information from mass media, Internet, and support groups helped patients understand symptoms and facilitated care seeking. Conclusions Post-treatment adverse effects are often untreated during follow-up visits. Awareness of possible post-treatment adverse effects is important for gynecological cancer survivors in order to obtain appropriate care if the need arises. Consultation during the follow-up visit is essential for continuity in care.

  7. Primary care and ophthalmology in the United Kingdom

    OpenAIRE

    Riad, S F; Dart, J K G; Cooling, R J

    2003-01-01

    The National Health Service is now primary care led. There are different definitions for primary care and in this review they are analysed and related to ophthalmology to produce a working definition for ophthalmic primary care, summarised as the provision of first contact care for all ophthalmic conditions and follow up, preventive, and rehabilitative care of selected ophthalmic conditions, in a variety of settings, by a diverse workforce. The attributes of primary care are first contact, ac...

  8. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Sørensen, Jan; Vach, Werner;

    2016-01-01

    AIMS: To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. METHODS AND RESULTS: 115 adults aged 18-75 years with acute...... information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five...... QALYs between the groups were negligible. CONCLUSIONS: Chiropractic care was more cost-effective than self-management. Therefore, chiropractic care can be seen as a good example of a targeted primary care approach for a subgroup of patients with non-specific chest pain. TRIAL REGISTRATION NUMBER: NCT...

  9. A Cost-Effective Model for Increasing Access to Mental Health Care at the Primary Care Level in Nigeria.

    Science.gov (United States)

    Omigbodun, Olayinka O.

    2001-09-01

    BACKGROUND: Although effective treatment modalities for mental health problems currently exist in Nigeria, they remain irrelevant to the 70% of Nigeria's 120 million people who have no access to modern mental health care services. The nation's Health Ministry has adopted mental health as the 9th component of Primary Health Care (PHC) but ten years later, very little has been done to put this policy into practice. Mental Health is part of the training curriculum of PHC workers, but this appears to be money down the drain. AIMS OF THE STUDY: To review the weaknesses and problems with existing mode of mental health training for PHC workers with a view to developing a cost-effective model for integration. METHODS: A review and analysis of current training methods and their impact on the provision of mental health services in PHC in a rural and an urban local government area in Nigeria were done. An analysis of tested approaches for integrating mental health into PHC was carried out and a cost-effective model for the Nigerian situation based on these approaches and the local circumstances was derived. RESULTS: Virtually no mental health services are being provided at the PHC levels in the two local government areas studied. Current training is not effective and virtually none of what was learnt appears to be used by PHC workers in the field. Two models for integrating mental health into PHC emerged from the literature. Enhancement, which refers to the training of PHC personnel to carry out mental health care independently is not effective on its own and needs to be accompanied by supervision of PHC staff. Linkage, which occurs when mental health professionals leave their hospital bases to provide mental health care in PHC settings, requires a large number of skilled staff who are unavailable in Nigeria. In view of past experiences in Nigeria and other countries, a mixed enhancement-linkage model for mental health in PHC appears to be the most cost-effective approach for

  10. Effect of healing touch training on self-care awareness in nurses

    Science.gov (United States)

    Black, Pegi

    Nursing focuses on supporting clients' health and health behaviors; however, they tend to exhibit unproductive behaviors when it comes to caring for themselves. As nurses' self-neglect can undermine client care, supporting nurses' self-care practices are expected to translate into clients' self-care. Healing Touch (HT) is one option for supporting nurses' self-care, as it is an accepted nursing practice and studies suggest that HT may have beneficial effects for those delivering it. This study examined the impact of a 2-day HT training on awareness of the need for self-care in nurses. HT training was offered as continuing education for 45 nurses at a Veteran's Administration hospital in Long Beach, CA. This mixed-methods study used a pre/post-test design to measure the effects of HT Level 1 training on nurses' self-care self-awareness. Independent samples t-tests and analyses of variance were used to detect whether any significant differences emerged based on participant demographic data. Data were analyzed using paired t-tests to determine whether participants' self-awareness changed over the study period. Effect size for any differences were calculated using Cohen's d. Open-ended responses were reviewed and common themes were identified related to what participants believed they learned and how it affected their care for themselves and their clients. Two increases were found to be significant and of sufficient power when comparing pre- to delayed post-test scores: physical self-care awareness (mean difference = 0.956, t(44) = 5.085, p = .000, r = .61) and professional self-care awareness (mean difference = .955, t(43) = 5.277, p = .000, r = .63). Qualitative findings suggested that changes in their awareness, self-directed practices, and patient care practices are anticipated, evident, and sustained based upon themes across the three tests. Nurses are advised to take a course that teaches specific self-care techniques and strategies and continue practicing

  11. Learning effects of thematic peer-review : A qualitative analysis of reflective journals on spiritual care

    NARCIS (Netherlands)

    van Leeuwen, Rene; Tiesinga, Lucas J.; Jochemsen, Henk; Post, Doeke

    2009-01-01

    This study describes the learning effects of thematic peer-review discussion groups (Hendriksen, 2000. Begeleid intervisie model, Collegiate advisering en probleemoplossing, Nelissen, Baarn.) on developing nursing students' competence in providing spiritual care. It also discusses the factors that m

  12. Learning effects of thematic peer-review: A qualitative analysis of reflective journals on spiritual care

    NARCIS (Netherlands)

    Leeuwen, van L.J.; Tiesinga, L.J.; Jochemsen, H.

    2009-01-01

    This study describes the learning effects of thematic peer-review discussion groups (Hendriksen, 2000. Begeleid intervisie model, Collegiale advisering en probleemoplossing, Nelissen, Baarn.) on developing nursing students’ competence in providing spiritual care. It also discusses the factors that m

  13. For Low-Back Pain, Yoga More Effective Than Self-Care But Not Stretching

    Science.gov (United States)

    ... U V W X Y Z For Low-Back Pain, Yoga More Effective Than Self-Care But Not ... improving function and reducing symptoms of chronic low-back pain, according to a study. Results from previous smaller ...

  14. Improving Workforce Literacy for 21st Century Jobs.

    Science.gov (United States)

    Ott, Joyce A.

    This document introduces community leaders and practitioners to innovative approaches to improving workforce literacy by building accessible lifelong learning systems to prepare adults with the array of skills needed to prosper in the new economy. The introduction defines literacy and workforce literacy and outlines the challenges that education,…

  15. Information and Communication Technology Workforce Employability in Malaysia

    Science.gov (United States)

    Suhaimi, Mohammed Adam; Hasan, Muhammad; Hussin, Husnayati; Shah, Asadullah

    2012-01-01

    Purpose: The purposes of the study are to understand ICT workforce employability in Malaysia, to identify the causes that influence the growth of skill gaps in the ICT workforce, and to determine ways to reduce these gaps. Design/methodology/approach: The methodology of the study comprised project reports and a literature review. Findings: The…

  16. 5 CFR 9.2 - Reporting workforce information.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Reporting workforce information. 9.2 Section 9.2 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE RULES WORKFORCE... Management may require all Executive agencies to report information relating to civilian employees,...

  17. Definitions and Design Options: Workforce Initiatives Discussion Paper #1

    Science.gov (United States)

    Academy for Educational Development, 2011

    2011-01-01

    Workforce initiatives are about giving people the skills to do their jobs well, about strengthening the institutional infrastructure that provides job services, about positioning labor markets to lead growth and increased investment, and about creating sustainable employment and improved working conditions. Workforce initiatives aim to fill a…

  18. Influence of ICTs on workforce productivity in Egyptian industrial organizations

    OpenAIRE

    Elsaadani, Mohamed

    2014-01-01

    Present study aims to investigate the influence of ICTs dimensions: Information Technology, Management Information System, Office automation, Intranet and Internet on workforce productivity for a group of industrial organizations in Alexandria, Egypt. The study findings revealed that the specified dimensions of ICTs positively affect workforce productivity of industrial organizations in Alexandria, Egypt

  19. Operational workforce planning for check-in counters at airports

    DEFF Research Database (Denmark)

    Stolletz, Raik

    2010-01-01

    This paper addresses operation models for workforce planning for check-in systems at airports. We characterize different tasks of the hierarchical workforce planning problem with time-dependent demand. A binary linear programming formulation is developed for the fortnightly tour scheduling problem...

  20. Strategic information technology alliances for effective health-care supply chain management.

    Science.gov (United States)

    Shih, Stephen C; Rivers, Patrick A; Hsu, H Y Sonya

    2009-08-01

    To gain and sustain competitive advantage, health-care providers have to continuously review and renovate their operational and information technology (IT) strategies through collaborative and cooperative endeavour with their supply chain channel members. This paper explores new ways of enhancing a health-care organization's responsiveness to changes and increasing its competitiveness through implementing strategic information technology alliances among channel members in a health-care supply chain network. An overview of issues and problems (e.g. bullwhip effect, negative externalities and free-riding phenomenon in multichannel supply chains) presented in the health-care supply chains is first delineated. This paper further goes over the issues of health-care supply chain coordination and integration for strategic IT alliances, followed by the discussion of the spillover effect of IT investments. A number of viable IT practices (such as information sharing and Internet-enabled supply chain portal) for effective health-care supply chain collaboration and coordination are then examined in this research. Finally, the paper discusses how strategic IT alliances can help improve the effectiveness of health-care supply chain management. PMID:19633183

  1. More cost-effectiveness studies are needed across the continuum of care

    OpenAIRE

    Mangham-Jefferies, L.; Becker, AJ

    2014-01-01

    There is limited evidence that SUPPLY and DEMAND side strategies to help improve the health of mothers and babies are cost-effective. Of the few cost-effectiveness studies reported, most focus on pregnancy care and community-based strategies. A systematic review identified a range of strategies implemented at different levels of the health system and targeted different aspects of the continuum of care illustrated in this infographic.

  2. On the Effectiveness of Child Care Centers in Promoting Child Development in Ecuador

    OpenAIRE

    Rosero, Jose

    2012-01-01

    Although the literature on the effectiveness of child care centers in developing countries is thin, most of the studies have concluded that the provision of these services are beneficial to enhance the development of poor children at early ages. Using different matching techniques, the results in this paper contrast with that conclusion as it finds no support of a positive effect of a large scale child care program in Ecuador on any of the dimensions considered of cognitive development. This ...

  3. The effect of neuro-linguistic programming on occupational stress in critical care nurses

    OpenAIRE

    HemmatiMaslakpak, Masumeh; Farhadi, Masumeh; Fereidoni, Javid

    2016-01-01

    Background: The use of coping strategies in reducing the adverse effects of stress can be helpful. Nero-linguistic programming (NLP) is one of the modern methods of psychotherapy. This study aimed to determine the effect of NLP on occupational stress in nurses working in critical care units of Urmia. Materials and Methods: This study was carried out quasi-experimentally (before–after) with control and experimental groups. Of all the nurses working in the critical care units of Urmia Imam Khom...

  4. A Cost Effectiveness Analysis of Stepped Care Treatment for Bulimia Nervosa

    OpenAIRE

    Crow, Scott J.; Agras, W. Stewart; Halmi, Katherine A.; Fairburn, Christopher G.; Mitchell, James E; Nyman, John A.

    2013-01-01

    Background The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown. Aims To examine the cost effectiveness of stepped care treatment for BN. Method Randomized trial conducted at four clinical centers with intensive measurement of direct medical costs and repeated measurement of subject quality of life and family/significant other time involvement. Two hundred ninety-three women who met DSM-IV criteria for BN received stepped care treatment or cognitive behav...

  5. Effectiveness of the IAEA regulations: Enabling global health care

    International Nuclear Information System (INIS)

    Radioisotopes and radiation technology are used around the world to advance global health. Prevention, diagnosis and treatment of disease require a secure supply of radioisotopes, and transportation is a vital link in ensuring this secure supply. International Atomic Energy Agency (IAEA) transport regulations have facilitated global health by providing a consistent framework for safe international transport. However, the complexity of regulations and inconsistent application have compromised the ability to supply essential radioisotopes around the world. IAEA, competent authorities and the industry need to work together to ensure that the needs of global health care are considered during the development and implementation of international transport regulations. (author)

  6. An Aging Workforce: Employment Opportunities and Obstacles

    Directory of Open Access Journals (Sweden)

    Full Professor, Institute of Economic Sciences

    2013-05-01

    Full Text Available The last decade has witnessed significant changes in the structure of unemployment in the global labour market. This is corroborated by the fact that the global workforce is rapidly aging and the share of people aged 50 and over in the structure of the labour market is increasing. In line with this trend, unemployment issues should be considered as a global problem that cannot be fully resolved at the level of any individual country separately.The main objective of this paper is to throw some light on the aging workforce and the elderly population’s opportunity to realise their right to work and be treated equally with younger age groups. Hence, the paper simultaneously focuses on the age and gender discrimination of elderly population in terms of their employment prospects. The aim of our research is not only to point out certain stereotypes concerning the elderly labour force, but also to stress that unless preconditions for overcoming these stereotypes are created and employment opportunities are given to this segment of the labour force, full employment as an ultimate goal of global economic policy cannot be achieved. It is in accordance with these considerations that we offer a model to achieve this goal.

  7. Workforce mobility: Contributing towards smart city

    International Nuclear Information System (INIS)

    Smart cities gained importance as a means of making ICT enabled services and applications available to the citizens, companies and authorities that form part of a city's system. It aims at increasing citizen's quality of life, and improving the efficiency and quality of the services provided by governing entities and businesses. This perspective requires an integrated vision of a city and of its infrastructures in all components. One of the characteristics of a smart city is mobility. The concept of mobility, especially for the workforce, is studied through a research carried out on a daily work undertaken as a prototype in the administrative town of Putrajaya, Malaysia. Utilizing the location track from GNSS integrated with mobile devices platform, information on movement and mobility was analysed for quality and efficiency of services rendered. This paper will highlight the research and outcomes that were successfully carried out and will suggest that workforce mobility management can benefit the authorities towards implementing a smart city concept

  8. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    Science.gov (United States)

    Sørensen, Jan; Vach, Werner; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Flemming; Hartvigsen, Jan

    2016-01-01

    Aims To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. Methods and results 115 adults aged 18–75 years with acute, non-specific chest pain of musculoskeletal origin were recruited from a cardiology department in Denmark. After ruling out acute coronary syndrome and receiving usual care, patients with musculoskeletal chest pain were randomised to 4 weeks of community-based chiropractic care (n=59) or to a single information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five-dimension questionnaire (EQ-5D) and Short Form 36-item Health Survey (SF-36)) were compared in cost-effectiveness analyses over 12 months from baseline. Mean costs were €2183 lower for the group with chiropractic care, but not statistically significant (95% CI −4410.5 to 43.0). The incremental cost-effectiveness ratio suggested that chiropractic care was cost-effective with a probability of 97%, given a threshold value of €30 000 per QALY gained. In both groups, there was an increase in the health-related quality of life, and the mean increases were similar over the 12-month evaluation period. The mean differences in QALYs between the groups were negligible. Conclusions Chiropractic care was more cost-effective than self-management. Therefore, chiropractic care can be seen as a good example of a targeted primary care approach for a subgroup of patients with non-specific chest pain. Trial registration number NCT00462241. PMID:27175285

  9. Reviewing the effects of an educational program about sepsis care on knowledge, attitude, and practice of nurses in intensive care units

    OpenAIRE

    Yousefi, Hojatollah; Nahidian, Malihe; Sabouhi, Fakhri

    2012-01-01

    Background: The most common complication of hospitalization in intensive care units (ICUs) is infections caused by health care. Although sepsis results in a small percentage of infections, it has a high mortality rate. Intensive care nurses play a critical role in the prevention, early detection, and beginning of therapeutic interventions in patients with sepsis. This study aimed to review the effects of an educational program on knowledge, attitude, and practice of ICU nurses in Shariati Hos...

  10. Cost effectiveness of community-based therapeutic care for children with severe acute malnutrition in Zambia: decision tree model

    OpenAIRE

    Bachmann Max O

    2009-01-01

    Abstract Background Children aged under five years with severe acute malnutrition (SAM) in Africa and Asia have high mortality rates without effective treatment. Primary care-based treatment of SAM can have good outcomes but its cost effectiveness is largely unknown. Method This study estimated the cost effectiveness of community-based therapeutic care (CTC) for children with severe acute malnutrition in government primary health care centres in Lusaka, Zambia, compared to no care. A decision...

  11. Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review protocol

    OpenAIRE

    Blanchette, Marc-André; Bussières, André; Stochkendahl, Mette Jensen; Boruff, Jill; Harrison, Pamela

    2015-01-01

    Background Chiropractic care is a common treatment for low back pain (LBP). Previous studies have failed to clarify the relative cost-effectiveness of chiropractic care in comparison with other commonly used approaches because previous attempts to synthetize the economic literature has only included partial economic evaluations. The objective of this project is to estimate the clinical effectiveness and cost-effectiveness of chiropractic care compared to other commonly used care approaches am...

  12. Effectiveness of a transitional home care program in reducing acute hospital utilization: a quasi-experimental study

    OpenAIRE

    Low, Lian Leng; Vasanwala, Farhad Fakhrudin; Ng, Lee Beng; Chen, Cynthia; Lee, Kheng Hock; Tan, Shu Yun

    2015-01-01

    Background Improving healthcare utilization is essential as health systems around the world grapple with the escalating demands for acute hospital resources. Evidence suggests that transitional care programs are effective to improve utilization of healthcare. However, the evidence for transitional care programs that enhance the home medical care model and provide multi-disciplinary patient-centered care is not well established. We evaluated if a transitional home care program operated by the ...

  13. Caring for dying patients: Attitude of nursing students and effects of education

    Directory of Open Access Journals (Sweden)

    Mojtaba Jafari

    2015-01-01

    Full Text Available Background: Education about caring for dying patients could be effective in changing nursing students′ attitude toward caring for dying patients. Aim: The aim of the present study was to examine the nursing students′ attitude toward caring for dying patients and effects of education on their attitude. Materials and Methods: The present study enjoys a quasi-experimental method with using one-group pre-test/post-test design conducted in Bam in southeast of Iran. The attitude of nursing students was measured using Frommelt Attitude Toward Care of the Dying (FATCOD scale before and after an educational intervention. Data were analyzed using non-parametric tests in Statistical Package for the Social Sciences (SPSS 18 software. Results: Of 32 students, 30 participated in this study (response rate of 94%. Only 20% of the students reported previous experience of dying patients in their clinical courses. Students showed moderately negative to neutral attitudes toward caring for dying patients. Education has improved students′ attitude significantly (mean score of FATCOD before study were 3.5 ± 0.43 and after intervention were 4.7 ± 0.33 ( P < 0.001. Conclusion: Educational programs about death and caring for dying patients should be added to undergraduate nursing curricula. Further research recommended examining nursing students′ knowledge about caring for dying patients and the effect of education on their knowledge.

  14. Double Crowding-Out Effects of Means-Tested Public Provision for Long-Term Care

    Directory of Open Access Journals (Sweden)

    Christophe Courbage

    2015-02-01

    Full Text Available Publicly provided long-term care (LTC insurance with means-tested benefits is suspected to crowd out either private saving or informal care. This contribution predicts crowding-out effects for both private saving and informal care for policy measures designed to relieve the public purse from LTC expenditure such as more stringent means testing and increased taxation of inheritance. These effects result from the interaction of a parent who decides on the amount of saving in retirement and a caregiver who decides on the effort devoted to informal care which lowers the probability of admission to a nursing home. Double crowding-out effects are also found to be the consequence of exogenous influences, notably a higher opportunity cost of caregiving.

  15. Time to address gender discrimination and inequality in the health workforce.

    Science.gov (United States)

    Newman, Constance

    2014-01-01

    Gender is a key factor operating in the health workforce. Recent research evidence points to systemic gender discrimination and inequalities in health pre-service and in-service education and employment systems. Human resources for health (HRH) leaders' and researchers' lack of concerted attention to these inequalities is striking, given the recognition of other forms of discrimination in international labour rights and employment law discourse. If not acted upon, gender discrimination and inequalities result in systems inefficiencies that impede the development of the robust workforces needed to respond to today's critical health care needs.This commentary makes the case that there is a clear need for sex- and age-disaggregated and qualitative data to more precisely illuminate gender-related trends and dynamics in the health workforce. Because of their importance for measurement, the paper also presents definitions and examples of sex or gender discrimination and offers specific case examples.At a broader level, the commentary argues that gender equality should be an HRH research, leadership, and governance priority, where the aim is to strengthen health pre-service and continuing professional education and employment systems to achieve better health systems outcomes, including better health coverage. Good HRH leadership, governance, and management involve recognizing the diversity of health workforces, acknowledging gender constraints and opportunities, eliminating gender discrimination and equalizing opportunity, making health systems responsive to life course events, and protecting health workers' labour rights at all levels. A number of global, national and institution-level actions are proposed to move the gender equality and HRH agendas forward. PMID:24885565

  16. Cocaine Addiction in Mothers: Potential Effects on Maternal Care and Infant Development

    Science.gov (United States)

    Strathearn, Lane; Mayes, Linda C.

    2010-01-01

    Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may impact maternal care and infant development, exploring brain, behavioral and neuroendocrine mechanisms. There is evidence that cocaine may affect infant development both directly, via in utero exposure, and indirectly via alterations in maternal care. Two neural systems known to play an important role in both maternal care and cocaine addiction are the oxytocin and dopamine systems, mediating social and reward-related behaviors and stress reactivity. These same neural mechanisms may also be involved in the infant’s development of vulnerability to addiction. Understanding the neuroendocrine pathways involved in maternal behavior and addiction may help facilitate earlier, more effective interventions to help substance abusing mothers provide adequate care for their infant, and perhaps prevent the intergenerational transmission of risk. PMID:20201853

  17. Cocaine addiction in mothers: potential effects on maternal care and infant development.

    Science.gov (United States)

    Strathearn, Lane; Mayes, Linda C

    2010-02-01

    Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect, and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may affect maternal care and infant development, exploring brain, behavioral, and neuroendocrine mechanisms. There is evidence that cocaine affects infant development both directly, via in utero exposure, and indirectly via alterations in maternal care. Two neural systems known to play an important role in both maternal care and cocaine addiction are the oxytocin and dopamine systems, mediating social and reward-related behaviors and stress reactivity. These same neural mechanisms may also be involved in the infant's development of vulnerability to addiction. Understanding the neuroendocrine pathways involved in maternal behavior and addiction may help facilitate earlier, more effective interventions to help substance-abusing mothers provide adequate care for their infant and perhaps prevent the intergenerational transmission of risk. PMID:20201853

  18. What are the effective ways to translate clinical leadership into health care quality improvement?

    Directory of Open Access Journals (Sweden)

    McSherry R

    2016-02-01

    Full Text Available Robert McSherry,1 Paddy Pearce2 1School of Health and Social Care, University of Teesside, Middlesbrough, 2PKP Consulting, Yarm, United Kingdom Abstract: The presence and/or absence of effective leaders in health care can have a stark consequence on the quality and outcomes of care. The delivery of safe, quality, compassionate health care is dependent on having effective clinical leaders at the frontline. In light of the Kirkup and Francis reports, this article explores some ways of translating clinical leadership into health care quality improvement. This is achieved by exploring what is clinical leadership and why and how this is important to health care quality improvement, clinical leadership, and a duty of candor, along with the importance clinical leadership plays in the provision of quality care improvement and outcomes. Clinical leaders are not predefined roles but emerge from the complex clinical setting by gaining an acquired expertise and from how they then internalize this to develop and facilitate sound relationships within a team. Clinical leaders are effective in facilitating innovation and change through improvement. This is achieved by recognizing, influencing, and empowering individuals through effective communication in order to share and learn from and with each other in practice. The challenge for health care organizations in regard to creating organizational cultures where a duty of candor exists is not to reinvent the wheel by turning something that is simple into something complex, which can become confusing to health care workers, patients, and the public. By focusing on the clinical leader's role and responsibilities we would argue they play a crucial and pivotal role in influencing, facilitating, supporting, and monitoring that this duty of candor happens in practice. This may be possible by highlighting where and how the duty of candor can be aligned within existing clinical governance frameworks. Keywords: governance

  19. Using pressure and support to create a qualified workforce.

    Directory of Open Access Journals (Sweden)

    Sharon Ryan

    2005-03-01

    Full Text Available In order for any new initiative to be implemented, it is generally assumed that policy actors need both motivation to comply with a new initiative and adequate assistance to implement the required change successfully. The study reported here examined the impact of a system of pressure and supports created to encourage preschool teachers working in public school, Head Start, and child care settings to obtain a teaching credential by a court imposed deadline. Findings from the sample of 689 teachers indicate that the court mandate, in combination with a scholarship program and an accessible number of certification programs, motivated many preschool teachers to improve their qualifications. Paradoxically, it was also found that the mandate may contribute to a depletion of the workforce if teachers who obtain a qualification move out of preschool into higher status positions. Findings of this study suggest that policymakers should consider systems of pressure and support not only to achieve short term goals, but to maintain outcomes over the long term, as well.

  20. Retaining caregivers, improving care.

    Science.gov (United States)

    Bodwell, Wendy; Dent, Sara; Grant, Tracie; Hammerly, Milt; Mamula, Jeanie

    2006-01-01

    Text Summary In 2004, Centura Health's long-term care centers took part in a pilot project, sponsored by the Centers for Medicare & Medicaid Services, called "Improving Nursing Home Culture through Workforce Retention." A 30-member team comprising Centura leaders and long-term facility staff looked at Centura's eight participating facilities through residents' and employees' eyes. The goal of the team's reflection and subsequent changes was to create a culture in which decisions are focused on resident care and organizational policies are based on respect for employees. At the end of the first year, residents seemed happier and employee satisfaction and involvement increased at all eight Centura facilities. PMID:16519278

  1. Cost-effectiveness of Crohn’s disease post-operative care

    Science.gov (United States)

    Wright, Emily K; Kamm, Michael A; Dr Cruz, Peter; Hamilton, Amy L; Ritchie, Kathryn J; Bell, Sally J; Brown, Steven J; Connell, William R; Desmond, Paul V; Liew, Danny

    2016-01-01

    AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection. METHODS: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo. RESULTS: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P < 0.001]. FC to select patients for colonoscopy could reduce cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented. CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated. PMID:27076772

  2. The effectiveness and cost-effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care (AESOPS – A randomised control trial protocol

    Directory of Open Access Journals (Sweden)

    Morton Veronica

    2008-06-01

    Full Text Available Abstract Background There is a wealth of evidence regarding the detrimental impact of excessive alcohol consumption. In older populations excessive alcohol consumption is associated with increased risk of coronary heart disease, hypertension, stroke and a range of cancers. Alcohol consumption is also associated with an increased risk of falls, early onset of dementia and other cognitive deficits. Physiological changes that occur as part of the ageing process mean that older people experience alcohol related problems at lower consumption levels. There is a strong evidence base for the effectiveness of brief psychosocial interventions in reducing alcohol consumption in populations identified opportunistically in primary care settings. Stepped care interventions involve the delivery of more intensive interventions only to those in the population who fail to respond to less intensive interventions and provide a potentially resource efficient means of meeting the needs of this population. Methods/design The study design is a pragmatic prospective multi-centre two arm randomised controlled trial. The primary hypothesis is that stepped care interventions for older hazardous alcohol users reduce alcohol consumption compared with a minimal intervention at 12 months post randomisation. Potential participants are identified using the AUDIT questionnaire. Eligible and consenting participants are randomised with equal probability to either a minimal intervention or a three step treatment approach. The step treatment approach incorporates as step 1 behavioural change counselling, step 2 three sessions of motivational enhancement therapy and step 3 referral to specialist services. The primary outcome is measured using average standard drinks per day and secondary outcome measures include the Drinking Problems Index, health related quality of life and health utility. The study incorporates a comprehensive economic analysis to assess the relative cost-effectiveness

  3. A Multicultural Analysis of Factors Influencing Career Choice for Women in the Information Technology Workforce

    OpenAIRE

    Eileen M. Trauth; Jeria L. Quesenberry; Haijan Huang

    2008-01-01

    This article presents an analysis of cultural factors influencing the career choices of women in the IT workforce. The authors employ individual differences theory of gender and IT as a theoretical lens to analyze a qualitative data set of interviews with 200 women in four different countries. The themes that emerged from this analysis speak to the influence of cultural attitudes about maternity, childcare, parental care, and working outside the home on a woman’s choice of an IT career. In ...

  4. The Effectiveness of Inpatient Rehabilitation in the Acute Postoperative Phase of Care After Transtibial or Transfemoral Amputation: Study of an Integrated Health Care Delivery System

    OpenAIRE

    Stineman, Margaret G.; Kwong, Pui L.; Kurichi, Jibby E.; Prvu-Bettger, Janet A.; Vogel, W Bruce; Maislin, Greg; Bates, Barbara E.; Reker, Dean M.

    2008-01-01

    Stineman MG, Kwong PL, Kurichi JE, Prvu-Bettger JA, Vogel WB, Maislin G, Bates BE, Reker DM. The effectiveness of inpatient rehabilitation in the acute postoperative phase of care after transtibial or transfemoral amputation: study of an integrated health care delivery system. Arch Phys Med Rehabil 2008;89:1863-72.

  5. The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on

    OpenAIRE

    Halcomb, Elizabeth J; Salamonson, Yenna; Davidson, Patricia M; Kaur, Rajneesh; Young, Samantha AM

    2014-01-01

    Background Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. Methods In the nascence of the exp...

  6. Effects of integrated dental care on oral treatment needs in residents of nursing homes older than 70 years

    NARCIS (Netherlands)

    Gerritsen, Paul; Cune, Marco; van der Bilt, Andries; Abbink, Jan; de Putter, Cornelis

    2015-01-01

    Aim: To determine effects of integrated dental care in older nursing home residents. Methods: In three nursing homes offering integrated dental care, we studied the oral treatment need of 355 residents older than 70 years. To determine effects of integrated care, we discriminated between short-stay

  7. Identifying potentially cost effective chronic care programs for people with COPD

    Directory of Open Access Journals (Sweden)

    L M G Steuten

    2008-12-01

    Full Text Available L M G Steuten1, K M M Lemmens2, A P Nieboer2, H JM Vrijhoef31Maastricht University Medical Centre, School for Care and Public Health Research, Department of Health, Organisation, Policy and Economics, Maastricht, The Netherlands; 2Erasmus University Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands; 3Maastricht University Medical Centre, School for Care and Public Health Research, Department of Integrated Care, Maastricht, The NetherlandsObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified.Methods: Systematic search of Medline and Cochrane databases for evaluations of multi-component disease management or chronic care programs for adults with COPD, describing process, intermediate, and end results of care. Data were independently extracted by two reviewers and descriptively summarized.Results: Twenty articles describing 17 unique COPD programs were included. There is little evidence for significant improvements in process and intermediate outcomes, except for increased provision of patient self-management education and improved disease-specific knowledge. Overall, the COPD programs generate end results equivalent to usual care, but programs containing ≥3 components show lower relative risks for hospitalization. There is limited scope for programs to break-even or save money.Conclusion: Identifying cost effective multi-component COPD programs remains a challenge due to scarce methodologically sound studies that demonstrate significant improvements on process, intermediate and end results of care. Estimations of potential cost effectiveness of specific programs illustrated in this paper can, in the absence of ‘perfect data’, support timely decision-making regarding these programs. Nevertheless, well-designed health economic studies are needed to decrease the current decision

  8. Role of effective teamwork and communication in delivering safe, high-quality care.

    Science.gov (United States)

    Leonard, Michael W; Frankel, Allan S

    2011-01-01

    Healthcare is delivered in an extraordinary complex environment. Despite highly skilled, dedicated clinicians, there are currently unacceptably high levels of communication failures and adverse events. Effective teamwork, in conjunction with reliable processes of care, is essential for the consistent delivery of high-quality care. Practical concepts and tools are provided that address the team behaviors of structured communication, effective assertion/critical language, psychological safety, situational awareness, and effective leadership. Examples of the mounting clinical evidence of improved patient outcomes and reduced harm resulting from effective teamwork training are cited. PMID:22069205

  9. Cost-effectiveness of general practice care for low back pain: a systematic review

    OpenAIRE

    Lin, C.; De Haas, M; Maher, C. G.; Machado, L.A.C.; Tulder, van, R.J.M.

    2011-01-01

    Care from a general practitioner (GP) is one of the most frequently utilised healthcare services for people with low back pain and only a small proportion of those with low back pain who seek care from a GP are referred to other services. The aim of this systematic review was to evaluate the evidence on cost-effectiveness of GP care in non-specific low back pain. We searched clinical and economic electronic databases, and the reference list of relevant systematic reviews and included studies ...

  10. Strengthening health workforce capacity through work-based training

    Directory of Open Access Journals (Sweden)

    Matovu Joseph KB

    2013-01-01

    Full Text Available Abstract Background Although much attention has been given to increasing the number of health workers, less focus has been directed at developing models of training that address real-life workplace needs. Makerere University School of Public Health (MakSPH with funding support from the Centers for Disease Control and Prevention (CDC developed an eight-month modular, in-service work-based training program aimed at strengthening the capacity for monitoring and evaluation (M&E and continuous quality improvement (CQI in health service delivery. Methods This capacity building program, initiated in 2008, is offered to in-service health professionals working in Uganda. The purpose of the training is to strengthen the capacity to provide quality health services through hands-on training that allows for skills building with minimum work disruptions while encouraging greater involvement of other institutional staff to enhance continuity and sustainability. The hands-on training uses practical gaps and challenges at the workplace through a highly participatory process. Trainees work with other staff to design and implement ‘projects’ meant to address work-related priority problems, working closely with mentors. Trainees’ knowledge and skills are enhanced through short courses offered at specific intervals throughout the course. Results Overall, 143 trainees were admitted between 2008 and 2011. Of these, 120 (84% from 66 institutions completed the training successfully. Of the trainees, 37% were Social Scientists, 34% were Medical/Nursing/Clinical Officers, 5.8% were Statisticians, while 23% belonged to other professions. Majority of the trainees (80% were employed by Non-Government Organizations while 20% worked with the public health sector. Trainees implemented 66 projects which addressed issues such as improving access to health care services; reducing waiting time for patients; strengthening M&E systems; and improving data collection and

  11. What do we know about health care team effectiveness? A review of the literature.

    Science.gov (United States)

    Lemieux-Charles, Louise; McGuire, Wendy L

    2006-06-01

    This review of health care team effectiveness literature from 1985 to 2004 distinguishes among intervention studies that compare team with usual (nonteam) care; intervention studies that examine the impact of team redesign on team effectiveness; and field studies that explore relationships between team context, structure, processes, and outcomes. The authors use an Integrated Team Effectiveness Model (ITEM) to summarize research findings and to identify gaps in the literature. Their analysis suggests that the type and diversity of clinical expertise involved in team decision making largely accounts for improvements in patient care and organizational effectiveness. Collaboration, conflict resolution, participation, and cohesion are most likely to influence staff satisfaction and perceived team effectiveness. The studies examined here underscore the importance of considering the contexts in which teams are embedded. The ITEM provides a useful framework for conceptualizing relationships between multiple dimensions of team context, structure, processes, and outcomes. PMID:16651394

  12. MANAGING HUMAN TALENT. WORKFORCE DIVERSITY VS. INDIVIDUAL DIFFERENCES. CHALLENGES OF THE WORKFORCE MOTIVATION AND RETENTION

    OpenAIRE

    Monica Boldea; Ionuţ Drăgoi

    2011-01-01

    Each day presents a new set of challenges and risks to companies operating in this age ofboth a global economy and of multiculturalism, i.e. a fast-changing marketplace. Globalcompetition and escalating economic pressures make the business environment bothdynamic and difficult, especially given the workforce diversity which has to be managed soas to achieve the highest levels of task performance and job satisfaction; managers must beprepared to respect alternative cultures and value diversity...

  13. Quality and effectiveness of different approaches to primary care delivery in Brazil

    Directory of Open Access Journals (Sweden)

    Trindade Thiago G

    2006-12-01

    Full Text Available Abstract Background Since 1994, Brazil has developed a primary care system based on multidisciplinary teams which include not only a physician and a nurse, but also 4–6 lay community health workers. This system now consists of 26,650 teams, covering 46% of the Brazilian population. Yet relatively few investigations have examined its effectiveness, especially in contrast with that of the traditional multi-specialty physician team approach it is replacing, or that of other existing family medicine approaches placing less emphasis on lay community health workers. Primary health care can be defined through its domains of access to first contact, continuity, coordination, comprehensiveness, community orientation and family orientation. These attributes can be ascertained via instruments such as the Primary Care Assessment Tool (PCATool, and correlated with the effectiveness of care. The objectives of our study are to validate the adult version of this instrument in Portuguese, identify the extent (quality of primary care present in different models of primary care services, and correlate this extent with measures of process and outcomes in patients with diabetes, hypertension and coronary heart disease (CHD. Methods/Design We are conducting a population-based cross-sectional study of primary care in the municipality of Porto Alegre. We will interview a random sample totaling 3000 adults residing in geographic areas covered by four distinct models of primary care of the Brazilian national health system or, alternatively, by one nationally prominent complementary health care service, as well as the physicians and nurses of the health teams of these services. Interviews query perceived quality of care (PCATool-Adult Version, patient satisfaction, and process indicators of management of diabetes, hypertension and known CHD. We are measuring blood pressure, anthropometrics and, in adults with known diabetes, glycated hemoglobin. Discussion We hope to

  14. Effect of Collaborative Care System (CCS) on Blood Glucose Levels in Type 2 Diabetes Mellitus Outpatient

    OpenAIRE

    Nuryati Kuman; Bangunawati Rahajeng

    2016-01-01

    Some health system in various countries in the world is highly fragmented and is unable to resolve health problems. With collaborative care system, it is expected that DM patients can be managed well. We conducted a study to determine the effect of collaborative care system on blood glucose levels of patients with type 2 diabetes mellitus. This study uses a quasi-experimental design. Data was obtained by measuring random blood glucose levels in patients with type 2 diabetes mellitus. The samp...

  15. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    OpenAIRE

    Stochkendahl, Mette Jensen; Sørensen, Jan; Vach, Werner; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Flemming; Hartvigsen, Jan

    2016-01-01

    Aims To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. Methods and results 115 adults aged 18–75 years with acute, non-specific chest pain of musculoskeletal origin were recruited from a cardiology department in Denmark. After ruling out acute coronary syndrome and receiving usual care, patients with musculoskelet...

  16. The effects of psychological treatment in primary care in Sweden—A practice-based study

    OpenAIRE

    Holmqvist, Rolf; Ström, Thomas; Foldemo, Anniqa

    2014-01-01

    Background: Practice-based studies have found substantial effects of psychological treatment in routine care, often equivalent between treatment methods. Factors that moderate treatment outcome may be important to assess. Aim: The purpose of this study was to evaluate treatment outcome in psychological treatment in primary care, and to compare outcome between the most frequently used methods. An additional aim was to study factors that might moderate outcome differences. Method: The Clinical ...

  17. Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial

    OpenAIRE

    2012-01-01

    Objective To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. Design Multicentre randomised controlled trial. Setting Nine memory clinics and 159 general practitioners in the Netherlands. Participants 175 patients with a new diagnosis of mild to moderate dementia living in the community and their informal caregivers. Interventions Usual care provided by memory clinic or general practitioner. Main out...

  18. Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects

    OpenAIRE

    Oshima Sumiko; Kisa Kengo; Terashita Takayoshi; Kawabata Hidenobu; Maezawa Masaji

    2013-01-01

    Abstract Background Post-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access. Methods We conducted 4 semi-structured foc...

  19. The human factor: the critical importance of effective teamwork and communication in providing safe care

    OpenAIRE

    Leonard, M.; Graham, S.; Bonacum, D

    2004-01-01

    Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members...

  20. The Effect of Performance-Based Financial Incentives on Improving Patient Care Experiences: A Statewide Evaluation

    OpenAIRE

    Hector P. Rodriguez; Glahn, Ted; Elliott, Marc N.; Rogers, William H.; Safran, Dana Gelb

    2009-01-01

    BACKGROUND Patient experience measures are central to many pay-for-performance (P4P) programs nationally, but the effect of performance-based financial incentives on improving patient care experiences has not been assessed. METHODS The study uses Clinician & Group CAHPS data from commercially insured adult patients (n = 124,021) who had visits with 1,444 primary care physicians from 25 California medical groups between 2003 and 2006. Medical directors were interviewed to assess the magnitude ...

  1. Real teams and their effect on the quality of care in nursing homes

    OpenAIRE

    Havig, Anders Kvale; SKOGSTAD, Anders; Veenstra, Marijke; Romøren, Tor Inge

    2013-01-01

    Background: Use of teams has shown to be an important factor for organizational performance. However, research has shown that a team has to meet certain criteria and operate in a certain way to realize the potential benefits of team organizing. There are few studies that have examined how teams operate in the nursing home sector and their effect on quality of care. This study investigates the relationship between teams that meet an academic definition of the team concept and quality of care i...

  2. Effects of Obesity and Physical Activity on Health Care Utilization and Costs

    OpenAIRE

    Jan Häußler

    2014-01-01

    The study analyses the combined influence of obesity and lifestyle behaviors on health care utilization and health care costs. Therefore I analyze the interaction of obesity, nutrition and physical activity based on a community level dataset from a German city. In addition to the expected convex effects of age and chronic diseases for utilization, the results indicate that BMI and physical inactivity have an independent influence on G.P. visits as well as for hospitalization. The key finding ...

  3. Is The Essential Newborn Care Package an Effective Intervention for Reducing Neonatal Sepsis In India?

    OpenAIRE

    Masters, Rebecca

    2008-01-01

    Background: Neonatal sepsis is an important cause of morbidity and mortality in India. Neonatal health programmes such as the Essential Newborn Care Package focus on preventative and curative care for the reduction of neonatal sepsis. However, neonates continue to die as a consequence of sepsis, many of which deaths are preventable. This critical review examines the factors that impact on neonatal sepsis and evaluates the effectiveness of this package aimed at preventing neonatal death....

  4. Clean Technology Evaluation & Workforce Development Program

    Energy Technology Data Exchange (ETDEWEB)

    Patricia Glaza

    2012-12-01

    The overall objective of the Clean Technology Evaluation portion of the award was to design a process to speed up the identification of new clean energy technologies and match organizations to testing and early adoption partners. The project was successful in identifying new technologies targeted to utilities and utility technology integrators, in developing a process to review and rank the new technologies, and in facilitating new partnerships for technology testing and adoption. The purpose of the Workforce Development portion of the award was to create an education outreach program for middle & high-school students focused on clean technology science and engineering. While originally targeting San Diego, California and Cambridge, Massachusetts, the scope of the program was expanded to include a major clean technology speaking series and expo as part of the USA Science & Engineering Festival on the National Mall in Washington, D.C.

  5. Striving to Diversify the Geosciences Workforce

    Science.gov (United States)

    Velasco, Aaron A.; Jaurrieta de Velasco, Edith

    2010-08-01

    The geosciences continue to lag far behind other sciences in recruiting and retaining diverse populations [Czujko and Henley, 2003; Huntoon and Lane, 2007]. As a result, the U.S. capacity for preparedness in natural geohazards mitigation, natural resource management and development, national security, and geosciences education is being undermined and is losing its competitive edge in the global market. Two key populations must be considered as the United States looks to build the future geosciences workforce and optimize worker productivity: the nation's youth and its growing underrepresented minority (URM) community. By focusing on both of these demographics, the United States can address the identified shortage of high-quality candidates for knowledge-intensive jobs in the geosciences, helping to develop the innovative enterprises that lead to discovery and new technology [see National Research Council (NRCd), 2007].

  6. Growing the Nuclear Workforce Through Outreach

    Science.gov (United States)

    Kilburn, Micha

    2015-10-01

    Many students don't encounter physics in the classroom until college or the end of high school. Most college students never encounter nuclear physics in the classroom. In order to grow the nuclear science workforce, students need to be aware of the field much earlier in the education. However, teaching teens about nuclear science can be a daunting task at the outset. I will present and describe successful outreach curricula and programs that can be duplicated by any college, university or laboratory. These include workshops for boy scouts and girl scouts as well as teaching nuclear science with magnetic marbles. I will also present some results from assessments of JINA-CEE's more intensive programs aimed at recruiting youth to the field. JINA-CEE

  7. Comparative Effectiveness: Its Origin, Evolution, and Influence on Health Care

    OpenAIRE

    2009-01-01

    Comparative effectiveness, the evaluation of multiple treatments for one condition to find the best option, is essential to evidence-based medicine and coverage with evidence development. This article outlines comparative effectiveness and the changes it has undergone in recent decades.

  8. Status of Educational Efforts in National Security Workforce

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-03-31

    This report documents the status of educational efforts for the preparation of a 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. The need to adequately train and educate a national security workforce is at a critical juncture. Even though there are an increasing number of college graduates in the appropriate fields, many of these graduates choose to work in the private sector because of more desirable salary and benefit packages. This report includes an assessment of the current educational situation for the national security workforce.

  9. The effect of kangaroo care on neurodevelopmental outcomes in preterm infants.

    Science.gov (United States)

    Head, Lauren M

    2014-01-01

    Preterm birth is associated with long-term deficits in executive functioning and cognitive performance. As advances in neonatal care enable more preterm infants to survive, development of strategies to address high rates of neurodevelopmental disabilities and poor academic achievement in preterm infants are crucial. Evidence suggests that infants' brains are plastic in nature and, therefore, can be shaped by the environment. Kangaroo care has become popularized as a means of modifying the stress of the NICU environment. However, few studies have examined whether kangaroo care affects neurodevelopmental outcomes in preterm infants. This review examined available literature that investigated the effect of kangaroo care on cognition in preterm infants. Current evidence suggests that short-term benefits of kangaroo care are associated with improved neurodevelopment. However, few studies have examined the long-term impact of kangaroo care on cognitive outcomes in preterm infants. To address neurological disparities in children born preterm, research using kangaroo care as a strategy to improve neurodevelopment in preterm infants is warranted. PMID:25347107

  10. Workforce Diversity And Organizational Communication: Analysis Of Human Capital Performance And Productivity

    Directory of Open Access Journals (Sweden)

    Ephraim A. Okoro

    2012-03-01

    Full Text Available The twenty-first century organizations are increasingly becoming multicultural workplaces for communication. This paper explores recent literature on the increasing global influence of workforce diversity and its affect on workplace communication. It provides a model for the discussion of the opportunities and challenges of diversity in the workplace. The paper then provides an analytical framework that guides readers with practical ideas that can assist them in their endeavors to effectively communicate in a globally diverse work environment.  The paper stresses that effective communication in a diverse workforce ensures a high level of performance and productivity for human and intellectual capital and   provides business organizations a competitive advantage in their expanded markets and in the global economy.

  11. Computerized clinical decision support systems for acute care management: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes

    Directory of Open Access Journals (Sweden)

    Sahota Navdeep

    2011-08-01

    Full Text Available Abstract Background Acute medical care often demands timely, accurate decisions in complex situations. Computerized clinical decision support systems (CCDSSs have many features that could help. However, as for any medical intervention, claims that CCDSSs improve care processes and patient outcomes need to be rigorously assessed. The objective of this review was to systematically review the effects of CCDSSs on process of care and patient outcomes for acute medical care. Methods We conducted a decision-maker-researcher partnership systematic review. MEDLINE, EMBASE, Evidence-Based Medicine Reviews databases (Cochrane Database of Systematic Reviews, DARE, ACP Journal Club, and others, and the Inspec bibliographic database were searched to January 2010, in all languages, for randomized controlled trials (RCTs of CCDSSs in all clinical areas. We included RCTs that evaluated the effect on process of care or patient outcomes of a CCDSS used for acute medical care compared with care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results Thirty-six studies met our inclusion criteria for acute medical care. The CCDSS improved process of care in 63% (22/35 of studies, including 64% (9/14 of medication dosing assistants, 82% (9/11 of management assistants using alerts/reminders, 38% (3/8 of management assistants using guidelines/algorithms, and 67% (2/3 of diagnostic assistants. Twenty studies evaluated patient outcomes, of which three (15% reported improvements, all of which were medication dosing assistants. Conclusion The majority of CCDSSs demonstrated improvements in process of care, but patient outcomes were less likely to be evaluated and far less likely to show positive results.

  12. Effects of Group Prenatal Care on Food Insecurity during Late Pregnancy and Early Postpartum.

    Science.gov (United States)

    Heberlein, Emily C; Frongillo, Edward A; Picklesimer, Amy H; Covington-Kolb, Sarah

    2016-05-01

    Objective This study compared the effects of group to individual prenatal care in late pregnancy and early postpartum on (1) women's food security and (2) psychosocial outcomes among food-insecure women. Methods and Results We recruited 248 racially diverse, low-income, pregnant women receiving CenteringPregnancy™ group prenatal care (N = 124) or individual prenatal care (N = 124) to complete surveys in early pregnancy, late pregnancy, and early postpartum, with 84 % completing three surveys. Twenty-six percent of group and 31 % of individual care participants reported food insecurity in early pregnancy (p = 0.493). In multiple logistic regression models, women choosing group versus individual care were more likely to report food security in late pregnancy (0.85 vs. 0.66 average predicted probability, p food-insecure women, group participants were more likely to become food-secure in late pregnancy (0.67 vs. 0.35 individual care average predicted probability, p foods and stretching food resources. Group compared to individual care participants with early pregnancy food insecurity demonstrated higher maternal-infant attachment scale scores (89.8 vs. 86.2 points for individual care, p = 0.032). Conclusions Group prenatal care provides health education and the opportunity for women to share experiences and knowledge, which may improve food security through increasing confidence and skills in managing household food resources. Health sector interventions can complement food assistance programs in addressing food insecurity during pregnancy. PMID:26662280

  13. Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery.

    Science.gov (United States)

    Tanner, J; Kiernan, M; Hilliam, R; Davey, S; Collins, E; Wood, T; Ball, J; Leaper, D

    2016-04-01

    Introduction In 2010 a care bundle was introduced by the Department of Health (DH) to reduce surgical site infections (SSIs) in England. To date, use of the care bundle has not been evaluated despite incorporating interventions with resource implications. The aim of this study was to evaluate the DH SSI care bundle in open colorectal surgery. Methods A prospective cohort design was used at two teaching hospitals in England. The baseline group consisted of 127 consecutive patients having colorectal surgery during a 6-month period while the intervention group comprised 166 patients in the subsequent 6 months. SSI and care bundle compliance data were collected using dedicated surveillance staff. Results Just under a quarter (24%) of the patients in the baseline group developed a SSI compared with just over a quarter (28%) in the care bundle group (p>0.05). However, compliance rates with individual interventions, both before and after the implementation of the bundle, were similar. Interestingly, in only 19% of cases was there compliance with the total care bundle. The single intervention that showed an associated reduction in SSI was preoperative warming (p=0.032). Conclusions The DH care bundle did not reduce SSIs after open colorectal surgery. Despite this, it is not possible to state that the bundle is ineffective as compliance rates before and after bundle implementation were similar. All studies evaluating the effectiveness of care bundles must include data for compliance with interventions both before and after implementation of the care bundle; poor compliance may be one of the reasons for the lower than expected reduction of SSIs. PMID:26924481

  14. Nuclear cardiology: Its role in cost effective care

    International Nuclear Information System (INIS)

    would not otherwise have been achieved if the early disease remained undetected. This publication presents a comprehensive overview of CVDs as a public health problem in developing countries, the relative role of nuclear cardiology methods within a scenario of unprecedented technology advances, and the evidence behind appropriateness recommendations. The potential expanding role of non-invasive functional imaging through the transition from diagnosis of obstructive CAD to defining the global burden of CVDs is also discussed, as well as the need for thorough training, education, and quality in nuclear cardiology practice. This report will be of interest for all medical practitioners involved in the management of CAD, including internists, cardiologists, and nuclear medicine physicians, as well as hospital administrators and health care stakeholders.

  15. Five generations in the nursing workforce: implications for nursing professional development.

    Science.gov (United States)

    Bell, Julie A

    2013-01-01

    Positive patient outcomes require effective teamwork, communication, and technological literacy. These skills vary among the unprecedented five generations in the nursing workforce, spanning the "Silent Generation" nurses deferring retirement to the newest "iGeneration." Nursing professional development educators must understand generational differences; address communication, information technology, and team-building competencies across generations; and promote integration of learner-centered strategies into professional development activities. PMID:23877293

  16. Workforce Diversity And Organizational Communication: Analysis Of Human Capital Performance And Productivity

    OpenAIRE

    Ephraim A. Okoro; Melvin C. Washington

    2012-01-01

    The twenty-first century organizations are increasingly becoming multicultural workplaces for communication. This paper explores recent literature on the increasing global influence of workforce diversity and its affect on workplace communication. It provides a model for the discussion of the opportunities and challenges of diversity in the workplace. The paper then provides an analytical framework that guides readers with practical ideas that can assist them in their endeavors to effectively...

  17. Building effective service linkages in primary mental health care: a narrative review part 2

    Directory of Open Access Journals (Sweden)

    Parker Sharon

    2011-03-01

    Full Text Available Abstract Background Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health care. Methods A narrative and thematic review of English language papers published between 1998 and 2009. An expert reference group helped formulate strategies for policy makers. Studies of descriptive and qualitative design from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted on factors reported as enablers or barriers to development of service linkages. These were tabulated by theme at clinical and organisational levels and the inter-relationship between themes was explored. Results A thematic analysis of 30 papers found the most frequently cited group of factors was "partnership formation", specifically role clarity between health care workers. Other factor groups supporting clinical partnership formation were staff support, clinician attributes, clinic physical features and evaluation and feedback. At the organisational level a supportive institutional environment of leadership and change management was important. The expert reference group then proposed strategies for collaboration that would be seen as important, acceptable and feasible. Because of the variability of study types we did not exclude on quality and findings are weighted by the number of studies. Variability in local service contexts limits the generalisation of findings. Conclusion The findings provide a framework for health planners to develop effective service linkages in primary mental health care. Our expert reference group proposed five areas of

  18. Computerized clinical decision support systems for primary preventive care: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes

    Directory of Open Access Journals (Sweden)

    Wilczynski Nancy L

    2011-08-01

    Full Text Available Abstract Background Computerized clinical decision support systems (CCDSSs are claimed to improve processes and outcomes of primary preventive care (PPC, but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63% RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34% trials assessed patient outcomes, and four (29% reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15% and two (5% trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Conclusions

  19. Estimating health workforce needs for antiretroviral therapy in resource-limited settings

    Directory of Open Access Journals (Sweden)

    Fullem Andrew

    2006-01-01

    Full Text Available Abstract Background Efforts to increase access to life-saving treatment, including antiretroviral therapy (ART, for people living with HIV/AIDS in resource-limited settings has been the growing focus of international efforts. One of the greatest challenges to scaling up will be the limited supply of adequately trained human resources for health, including doctors, nurses, pharmacists and other skilled providers. As national treatment programmes are planned, better estimates of human resource needs and improved approaches to assessing the impact of different staffing models are critically needed. However there have been few systematic assessments of staffing patterns in existing programmes or of the estimates being used in planning larger programmes. Methods We reviewed the published literature and selected plans and scaling-up proposals, interviewed experts and collected data on staffing patterns at existing treatment sites through a structured survey and site visits. Results We found a wide range of staffing patterns and patient-provider ratios in existing and planned treatment programmes. Many factors influenced health workforce needs, including task assignments, delivery models, other staff responsibilities and programme size. Overall, the number of health care workers required to provide ART to 1000 patients included 1–2 physicians, 2–7 nurses, Discussion These data are consistent with other estimates of human resource requirements for antiretroviral therapy, but highlight the considerable variability of current staffing models and the importance of a broad range of factors in determining personnel needs. Few outcome or cost data are currently available to assess the effectiveness and efficiency of different staffing models, and it will be important to develop improved methods for gathering this information as treatment programmes are scaled up.

  20. A study on relationship between workforce agility and knowledge sharing

    Directory of Open Access Journals (Sweden)

    Hamed Suofi

    2014-05-01

    Full Text Available This paper presents an empirical survey to study the relationship between knowledge sharing and workforce agility among regular employees of Malek Ashtar University of Technology located in city of Tehran, Iran. The study uses two questionnaires for measuring knowledge sharing and workforce agility in Likert scale. In our survey, knowledge sharing consists of three dimensions of cognitive, structural and relationship while workforce agility includes seven dimensions including intelligence, maturity, perseverance and hard-working, creativity and innovation, being responsive, flexibility and information and communication. Using Pearson correlation ratio, the study has detected positive and meaningful relationships between various components of knowledge sharing, structural, relational and cognitive, and workforce agility (r = 0.708, P-value = 0.001.

  1. DOE Advanced Scientific Advisory Committee (ASCAC): Workforce Subcommittee Letter

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Barbara [University of Houston; Calandra, Henri [Total SA; Crivelli, Silvia [Lawrence Berkeley National Laboratory, University of California, Davis; Dongarra, Jack [University of Tennessee; Hittinger, Jeffrey [Lawrence Livermore National Laboratory; Lathrop, Scott A. [NCSA, University of Illinois Urbana-Champaign; Sarkar, Vivek [Rice University; Stahlberg, Eric [Advanced Biomedical Computing Center; Vetter, Jeffrey S. [Oak Ridge National Laboratory; Williams, Dean [Lawrence Livermore National Laboratory

    2014-07-23

    Simulation and computing are essential to much of the research conducted at the DOE national laboratories. Experts in the ASCR ¬relevant Computing Sciences, which encompass a range of disciplines including Computer Science, Applied Mathematics, Statistics and domain Computational Sciences, are an essential element of the workforce in nearly all of the DOE national laboratories. This report seeks to identify the gaps and challenges facing DOE with respect to this workforce. This letter is ASCAC’s response to the charge of February 19, 2014 to identify disciplines in which significantly greater emphasis in workforce training at the graduate or postdoctoral levels is necessary to address workforce gaps in current and future Office of Science mission needs.

  2. Networking and Information Technology Workforce Study: Final Report

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This report presents the results of a study of the global Networking and Information Technology NIT workforce undertaken for the Networking and Information...

  3. Leveraging multi-generational workforce values in interactive information societies

    OpenAIRE

    Sophie Van der Walt; Tanya du Plessis

    2010-01-01

    Background: The success of organisations relies on various factors including the ability of its multi-generational workforce to collaborate within the interactive information society. By developing an awareness of the different values of a diverse workforce, organisations may benefit from diversity. Various diversity factors, such as ethnicity, age and gender, impact on the way people interact, especially in the interactive information society.Objectives: This article advocates the need for g...

  4. Domestic Wind Energy Workforce; NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Tegen, Suzanne

    2015-07-30

    A robust workforce is essential to growing domestic wind manufacturing capabilities. NREL researchers conducted research to better understand today's domestic wind workforce, projected needs for the future, and how existing and new education and training programs can meet future needs. This presentation provides an overview of this research and the accompanying industry survey, as well as the Energy Department's Career Maps, Jobs & Economic Development Impacts models, and the Wind for Schools project.

  5. Long-Term Effects of Early Childhood Care and Education

    OpenAIRE

    Ruhm, Christopher J.; Waldfogel, Jane

    2011-01-01

    This paper critically reviews what we know about the long-term effects of parental leave and early childhood education programs. We find only limited evidence that expansions of parental leave durations improved long-run educational or labor market outcomes of the children whose parents were affected by them, perhaps because benefits are hard to measure or confined to sub-groups, or because leave entitlements were sufficiently long, even before recent extensions, to yield most potential benef...

  6. Long-term effects of early childhood care and education

    OpenAIRE

    Ruhm, Christopher; Waldfogel, Jane

    2011-01-01

    This paper critically reviews what we know about the long-term effects of parental leave and early childhood education programs. We find only limited evidence that expansions of parental leave durations improved long-run educational or labor market outcomes of the children whose parents were affected by them, perhaps because benefits are hard to measure or confined to sub-groups, or because leave entitlements were sufficiently long, even before recent extensions, to yield most potential benef...

  7. Psychological aspects of diabetes care: Effecting behavioral change in patients

    OpenAIRE

    Chew, Boon-How; Shariff-Ghazali, Sazlina; Fernandez, Aaron

    2014-01-01

    Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient’s adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. ...

  8. Health workforce governance and oral health: Diversity and challenges in Europe.

    Science.gov (United States)

    Gallagher, Jennifer E; Eaton, Kenneth A

    2015-12-01

    Throughout the life course, oral diseases are some of the most common non-communicable diseases globally, and in Europe. Human resources for oral health are fundamental to healthcare systems in general and dentistry is no exception. As political and healthcare systems change, so do forms of governance. The aim of this paper is to examine human resources for oral health in Europe, against a workforce governance framework, using England as a case study. The findings suggest that neo-liberalist philosophies are leading to multiple forms of soft governance at professional, system, organisational and individual levels, most notably in England, where there is no longer professional self-regulation. Benefits include professional regulation of a wider cadre of human resources for oral health, reorientation of care towards evidence-informed practice including prevention, and consideration of care pathways for patients. Across Europe there has been significant professional collaboration in relation to quality standards in the education of dentists, following transnational policies permitting freedom of movement of health professionals; however, the distribution of dentists is inequitable. Challenges include facilitating employment of graduates to serve the needs and demands of the population in certain countries, together with governance of workforce production and migration across Europe. Integrated trans-European approaches to monitoring mobility and governance are urgently required. PMID:26584576

  9. State Variability in Supply of Office-based Primary Care Providers: United States, 2012

    Science.gov (United States)

    ... outside of any MSA ( 12 ). Data sources and methods Data for this report are from the NAMCS ... the health care workforce: Scope-of-practice and payment policies for advanced practice nurses and physician assistants. ...

  10. [The effects of economic crises on health care].

    Science.gov (United States)

    Chang, Nai-Hsin; Huang, Chiu-Ling; Yang, Yu-O

    2010-08-01

    In September 2008, financial turmoil on Wall Street led to severe losses in that country's financial derivatives market and plunged the United States into the most severe financial crisis in over a decade. The backlash of this "financial tsunami" has affected countries around the world. The world economy, facing the most critical financial crisis since the 1930s, must deal with recession, severe unemployment and general fears of worse to come, which have, in turn, spawned a range of physical, psychological and spiritual problems. In this article we study the effects of the economic crisis on healthcare from several angles, including: decreasing incomes causing changing attitudes toward seeking healthcare; decreasing numbers of people covered by medical insurance; increasing impact on the job market of untreated illnesses; changing national healthcare policies in response to economic pressures; increasing physical, psychological and social problems resulting from economic problems; and the need for the nursing profession to respond to these and other rapid changes in the healthcare landscape. Nursing staff are sometimes unaware of social problems outside their profession. This article may, therefore, provide a general reference to medical and nursing staff on the effects of the economic crisis on healthcare. PMID:20661861

  11. Psychological aspects of diabetes care: Effecting behavioral change in patients

    Institute of Scientific and Technical Information of China (English)

    Boon-How; Chew; Sazlina; Shariff-Ghazali; Aaron; Fernandez

    2014-01-01

    Patients with diabetes mellitus(DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient’s adherence to the effective therapies, there would be persistent sub-optimal contro of diseases, increase diabetes-related complications,causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient’s psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation,self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors,coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relationto DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM.

  12. What makes primary care effective for people in poverty living with multiple chronic conditions?: study protocol

    Directory of Open Access Journals (Sweden)

    Barbeau David

    2010-11-01

    Full Text Available Abstract Background The inverse care law persists: people living in poverty have the greatest needs and face considerable challenges in getting the care they need. Evidence reveals that GPs encounter difficulties in delivering care to poor patients, while many of those patients feel stigmatized by healthcare professionals. Patients living in poverty report negative healthcare experiences and unmet healthcare needs. Indeed, there is a growing recognition in primary care research of the importance of addressing the capabilities and social conditions of the poor when delivering care. Few studies have looked at the factors contributing to effective and "socially responsive" care for people living in poverty. Methods/Design Our study adopts a qualitative ethnographic approach in four healthcare organizations in deprived areas of metropolitan Montreal (Québec, Canada, using patient shadowing techniques and interviews. Data will be collected through fieldwork observations and informal interviews with patients before and after consultations. We will observe medical consultations, care organization activities, and waiting areas and reception of patients. We will conduct a total of 36 individual interviews with 12 GPs and 24 patients. The interviews will be audio-recorded and transcribed for purposes of analysis. The analysis consists of debriefing sessions, coding and interpretive analysis. Discussion This study aims to investigate how positive healthcare interactions between physicians and patients can improve the management of chronic conditions. We hypothesize that factors related to care organization, to healthcare professionals' experience and to patients may enhance the quality of healthcare interactions, which may have positive impacts for preventing and managing chronic conditions. Our study will provide a unique set of data grounded in the perspectives of healthcare professionals and of patients living in poverty.

  13. Cost-effectiveness of cataract surgery in a public health eye care programme in Nepal.

    OpenAIRE

    Marseille, E.

    1996-01-01

    Presented is an assessment of the cost-effectiveness of cataract surgery using cost and services data from the Lumbini Zonal Eye Care Programme in Nepal. The analysis suggests that cataract surgery may be even more cost-effective than previously reported. Under a "best estimate" scenario, cataract surgery had a cost of US$5.06 per disability-adjusted life year (DALY). This places it among the most cost-effective of public health interventions. Sensitivity analysis indicates that cataract surg...

  14. Cost-effectiveness of supported self-management for CFS/ME patients in primary care

    OpenAIRE

    Richardson, Gerry; Epstein, David; Chew-Graham, Carolyn; Dowrick, Christopher; Bentall, Richard P.; Morriss, Richard K; Peters, Sarah; Riste, Lisa; Lovell, Karina; Dunn, Graham; Wearden, Alison J

    2013-01-01

    Background: Nurse led self-help treatments for people with chronic fatigue syndrome/myalgic encephalitis (CFS/ME) have been shown to be effective in reducing fatigue but their cost-effectiveness is unknown. Methods: Cost-effectiveness analysis conducted alongside a single blind randomised controlled trial comparing pragmatic rehabilitation (PR) and supportive listening (SL) delivered by primary care nurses, and treatment as usual (TAU) delivered by the general practitioner (GP) in ...

  15. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies

    Science.gov (United States)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André

    2016-01-01

    Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent

  16. Valuable human capital: the aging health care worker.

    Science.gov (United States)

    Collins, Sandra K; Collins, Kevin S

    2006-01-01

    With the workforce growing older and the supply of younger workers diminishing, it is critical for health care managers to understand the factors necessary to capitalize on their vintage employees. Retaining this segment of the workforce has a multitude of benefits including the preservation of valuable intellectual capital, which is necessary to ensure that health care organizations maintain their competitive advantage in the consumer-driven market. Retaining the aging employee is possible if health care managers learn the motivators and training differences associated with this category of the workforce. These employees should be considered a valuable resource of human capital because without their extensive expertise, intense loyalty and work ethic, and superior customer service skills, health care organizations could suffer severe economic repercussions in the near future. PMID:16905991

  17. How Changes in Entry Requirements Alter the Teacher Workforce and Affect Student Achievement. NBER Working Paper No. 11844

    Science.gov (United States)

    Boyd, Donald; Grossman, Pamela; Lankford, Hamilton; Loeb, Susanna; Wyckoff, James

    2005-01-01

    We are in the midst of what amounts to a national experiment in how best to attract, prepare, and retain teachers, particularly for high poverty urban schools. Using data on students and teachers in grades three through eight, this study assesses the effects of pathways into teaching in New York City on the teacher workforce and on student…

  18. Multi-agent systems: effective approach for cancer care information management.

    Science.gov (United States)

    Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

    2013-01-01

    Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management. PMID:24460364

  19. The World Health Organization Global Health Emergency Workforce: What Role Will the United States Play?

    Science.gov (United States)

    Burkle, Frederick M

    2016-08-01

    During the May 2016 World Health Assembly of 194 member states, the World Health Organization (WHO) announced the process of developing and launching emergency medical teams as a critical component of the global health workforce concept. Over 64 countries have either launched or are in the development stages of vetting accredited teams, both international and national, to provide surge support to national health systems through WHO Regional Organizations and the delivery of emergency clinical care to sudden-onset disasters and outbreak-affected populations. To date, the United States has not yet committed to adopting the emergency medical team concept in funding and registering an international field hospital level team. This article discusses future options available for health-related nongovernmental organizations and the required educational and training requirements for health care provider accreditation. (Disaster Med Public Health Preparedness. 2016;10:531-535). PMID:27364937

  20. Effectiveness of service linkages in primary mental health care: a narrative review part 1

    Directory of Open Access Journals (Sweden)

    Parker Sharon

    2011-04-01

    Full Text Available Abstract Background With the move to community care and increased involvement of generalist health care providers in mental health, the need for health service partnerships has been emphasised in mental health policy. Within existing health system structures the active strategies that facilitate effective partnership linkages are not clear. The objective of this study was to examine the evidence from peer reviewed literature regarding the effectiveness of service linkages in primary mental health care. Methods A narrative and thematic review of English language papers published between 1998 and 2009. Studies of analytic, descriptive and qualitative designs from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted to examine what service linkages have been used in studies of collaboration in primary mental health care. Findings from the randomised trials were tabulated to show the proportion that demonstrated clinical, service delivery and economic benefits. Results A review of 119 studies found ten linkage types. Most studies used a combination of linkage types and so the 42 RCTs were grouped into four broad linkage categories for meaningful descriptive analysis of outcomes. Studies that used multiple linkage strategies from the suite of "direct collaborative activities" plus "agreed guidelines" plus "communication systems" showed positive clinical (81%, service (78% and economic (75% outcomes. Most evidence of effectiveness came from studies of depression. Long term benefits were attributed to medication concordance and the use of case managers with a professional background who received expert supervision. There were fewer randomised trials related to collaborative care of people with psychosis and there were almost none related to collaboration with the wider human service sectors. Because of the variability of study types we did not exclude on quality or attempt to weight findings according to power or effect

  1. What is the place of interprofessional education in supporting the continuum of care for patients?

    Directory of Open Access Journals (Sweden)

    Annette Solman

    2016-05-01

    Full Text Available Advances in science and technology mean more people are living longer, resulting in multimorbidity and increasingly complex presentations later in life. People require healthcare that may include hospital admission, community-based care, social care and private healthcare input to support integrated person-centred healthcare. The aim of integrated care is to improve the quality of care and patient outcomes, so interprofessional education is on today’s health agenda and research is required to establish how best to structure it in the undergraduate setting and for the existing workforce that provides healthcare and supportive services. Interprofessional education occurs when healthcare professionals from two or more disciplines learn about, from and with each other to promote effective collaboration and improve health outcomes (World Health Organization, 2010. The WHO has issued a call to action for undergraduate studies to include interprofessional learning, and to create a suitable workforce, a two-pronged approach is required. First, the inclusion of selected shared-subject learning across undergraduate education programmes, for example in communication and social sciences, and second, a focus on what the existing healthcare workforce requires to be able to work and learn in an interprofessional way across government and non-government agencies to achieve the best outcomes. The development of existing staff requires educational material and experiences that reflect their everyday practice and patient journeys. Such an approach will enable the building of links between the different agencies that support healthcare, and the creation of patient-centred healthcare systems within and across traditional healthcare boundaries.

  2. Feasibility and effectiveness of a disease and care management model in the primary health care system for patients with heart failure and diabetes (Project Leonardo

    Directory of Open Access Journals (Sweden)

    Marco Matteo Ciccone

    2010-04-01

    Full Text Available Marco Matteo Ciccone1, Ambrogio Aquilino2, Francesca Cortese1, Pietro Scicchitano1, Marco Sassara1, Ernesto Mola3, Rodolfo Rollo4,Pasquale Caldarola5, Francesco Giorgino6, Vincenzo Pomo2, Francesco Bux21Section of Cardiovascular Disease, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy; 2Agenzia Regionale Sanitaria – Regione Puglia (ARES, Apulia, Italy; 3ASL, Lecce, Italy; 4ASL, Brindisi, Italy; 5Cardiologia, Ospedale “Sarcone”, Terlizzi, Italy; 6Section of Endocrinology, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, ItalyPurpose: Project Leonardo represented a feasibility study to evaluate the impact of a disease and care management (D&CM model and of the introduction of “care manager” nurses, trained in this specialized role, into the primary health care system. Patients and methods: Thirty care managers were placed into the offices of 83 general practitioners and family physicians in the Apulia Region of Italy with the purpose of creating a strong cooperative and collaborative “team” consisting of physicians, care managers, specialists, and patients. The central aim of the health team collaboration was to empower 1,160 patients living with cardiovascular disease (CVD, diabetes, heart failure, and/or at risk of cardiovascular disease (CVD risk to take a more active role in their health. With the support of dedicated software for data collection and care management decision making, Project Leonardo implemented guidelines and recommendations for each condition aimed to improve patient health outcomes and promote appropriate resource utilization.Results: Results show that Leonardo was feasible and highly effective in increasing patient health knowledge, self-management skills, and readiness to make changes in health behaviors. Patient skill-building and ongoing monitoring by the health care team of diagnostic tests and services

  3. Are care workers appropriate mentors for nursing students in residential aged care?

    OpenAIRE

    Annear, Michael; Lea, Emma; Robinson, Andrew

    2014-01-01

    Background The aged care sector is increasingly dominated by a less-qualified workforce at a time of increasing prevalence of complex health concerns, such as dementia. An Australian program to develop teaching aged care facilities is being undertaken to build the sector’s capacity and provide nursing students with positive experiences of engaging with vulnerable clients. This research aimed to examine care staff potential to facilitate nursing student engagement with clinically relevant know...

  4. The Crossroads between Workforce and Education

    Science.gov (United States)

    Jackson, Kathryn; Lower, Christi L.; Rudman, William J.

    2016-01-01

    Concern is growing among industry leaders that students may not be obtaining the necessary skills for entry into the labor market. To gain an understanding of the perceived disconnect in the skill set of graduates entering the health information workforce, a survey was developed to examine the opinions of educators and employers related to graduate preparedness. The concern related to graduate preparedness is supported by findings in this research study, in which those working in industry and those in academia noted a disconnect between academic training and preparedness to enter the labor market. A statistically significant difference was found between labor leaders and academics in their assessment of graduates' preparation in the areas of technical, communication, and leadership skills. Educators noted higher levels of preparedness of students with regard to professional and technical skills and leadership skills, while both educators and industry respondents noted a need for improved employability skills (e.g., communication skills and workplace etiquette). No difference was found between the two groups with regard to the need to increase apprenticeships and professional practice experience to cover this gap in formal training. Finally, when asked how the federal government might assist with preparing students, more than half of the respondents noted the importance of apprenticeships and funding for these opportunities. PMID:27134612

  5. Wind Energy Workforce Development: Engineering, Science, & Technology

    Energy Technology Data Exchange (ETDEWEB)

    Lesieutre, George A.; Stewart, Susan W.; Bridgen, Marc

    2013-03-29

    Broadly, this project involved the development and delivery of a new curriculum in wind energy engineering at the Pennsylvania State University; this includes enhancement of the Renewable Energy program at the Pennsylvania College of Technology. The new curricula at Penn State includes addition of wind energy-focused material in more than five existing courses in aerospace engineering, mechanical engineering, engineering science and mechanics and energy engineering, as well as three new online graduate courses. The online graduate courses represent a stand-alone Graduate Certificate in Wind Energy, and provide the core of a Wind Energy Option in an online intercollege professional Masters degree in Renewable Energy and Sustainability Systems. The Pennsylvania College of Technology erected a 10 kilowatt Xzeres wind turbine that is dedicated to educating the renewable energy workforce. The entire construction process was incorporated into the Renewable Energy A.A.S. degree program, the Building Science and Sustainable Design B.S. program, and other construction-related coursework throughout the School of Construction and Design Technologies. Follow-on outcomes include additional non-credit opportunities as well as secondary school career readiness events, community outreach activities, and public awareness postings.

  6. The Crossroads between Workforce and Education.

    Science.gov (United States)

    Jackson, Kathryn; Lower, Christi L; Rudman, William J

    2016-01-01

    Concern is growing among industry leaders that students may not be obtaining the necessary skills for entry into the labor market. To gain an understanding of the perceived disconnect in the skill set of graduates entering the health information workforce, a survey was developed to examine the opinions of educators and employers related to graduate preparedness. The concern related to graduate preparedness is supported by findings in this research study, in which those working in industry and those in academia noted a disconnect between academic training and preparedness to enter the labor market. A statistically significant difference was found between labor leaders and academics in their assessment of graduates' preparation in the areas of technical, communication, and leadership skills. Educators noted higher levels of preparedness of students with regard to professional and technical skills and leadership skills, while both educators and industry respondents noted a need for improved employability skills (e.g., communication skills and workplace etiquette). No difference was found between the two groups with regard to the need to increase apprenticeships and professional practice experience to cover this gap in formal training. Finally, when asked how the federal government might assist with preparing students, more than half of the respondents noted the importance of apprenticeships and funding for these opportunities. PMID:27134612

  7. Ethical Issues between Workforce and Religious Conviction

    Directory of Open Access Journals (Sweden)

    Mohamad Zaid Mohd Zin

    2012-10-01

    Full Text Available Problem statement: This article enhances the ethical issues consider the relationship between religious life and work ethics. Approach: Malaysia aim to achieved full developed nation’s, requires a professional workforce, not only educated and innovative, but ethically, with integrity, accountability, dynamic and committed to continuously increasing Muslim professionalism. In the context of the development of Muslim professionals with a holistic and integrated, Muslims needs to withholding Tawheed, the fundamentals of faith, based on Al-Quran and Hadith. Manifestations in life of the practice which accounts for worship and morality need to be implemented. Results: Islamic moral character requires the emphasize that following five key parameters of Islamic behavior which is justice, trust, righteousness, the struggle towards self-improvement and keeping promises. Conclusion: The properties of trust at work, honesty, responsibility and integrity should be established in each of the Muslims. Each institution needs to be continued in the religious education and level of consciousness must be nurtured and enhanced.

  8. Educating the undergraduate nanomanufacturing workforce in the United States

    Science.gov (United States)

    Elbadawi, Isam A.

    The National Nanotechnology Initiative (NNI) consensus shows that nanomanufacturing (NM) presents an opportunity for positively influencing the future development of the US economy. In order for this to happen, the outcomes and findings of nano-related research and science need to be effectively translated into innovative products by a qualified NM workforce. An effective workforce capable of handling nanoscale production is also essential to maintaining a competitive advantage in the international market. American universities are developing new ways to address the challenges that the evolution of NM and its emerging use in various industries present in terms of curricular design to the learning content. This study offered a proactive profile of a learning content for a standalone BS in NM in the United States. A BS in NM is defined as a bachelor of science that uses the term NM in a formal degree title. This delineation study aimed at validating and prioritizing the competency areas to be included in the learning content for a standalone BS in NM. The Delphi technique was employed to evaluate the collected data from nano-related programs in five US pioneering universities and to describe what experts from the industry and the academia consider to be important for students to know in order to become qualified in the discipline of NM. A number of experts from different NM-related areas were selected to serve on the Delphi panel. A convergence of opinion on the competency areas provided the basis for validating the body of knowledge for a standalone BS in NM. The study used recommendations made by the Delphi panelists, semi-formal interviews, structured internet searches, and existing nano-related degree programs from the course lists of five universities to identify a potentially appropriate learning content for a BS in NM. The majority of the panelists are directly involved in NM, whether from the academia or the industry. They agreed that a standalone BS in NM

  9. Bridging Language Barriers in Multilingual Care Encounters

    Science.gov (United States)

    Jansson, Gunilla

    2014-01-01

    The present case study demonstrates how the multilingual practices of a linguistically diverse workforce contribute to the functioning of a modern workplace. Based on ethnographic fieldwork and recordings in a residential home for elderly people with dementia in Sweden, the article explores how multilingual immigrant care workers creatively use…

  10. Transformation Education: A Vehicle for Structuring Group Care Organizations to Increase Service Quality and Effectiveness

    Science.gov (United States)

    Ross, Andrew L.

    2007-01-01

    Transformation Education, an organizational philosophy and operating system, is designed to increase service quality and effectiveness of group care through aligning its organizational structure with its purpose. This alignment is achieved through creating a culture designed to dispense transformation rather than treatment. The author presents how…

  11. Effectiveness of transdiagnostic Internet cognitive behavioural treatment for mixed anxiety and depression in primary care

    NARCIS (Netherlands)

    Newby, Jill M; Mewton, Louise; Williams, Alishia D; Andrews, Gavin

    2014-01-01

    BACKGROUND: Internet-delivered cognitive behavioural treatment (iCBT) has been shown to be effective for the combined treatment of depression and anxiety in randomised controlled trials. The degree to which these findings generalise to patients in primary care awaits further investigation. METHODS:

  12. Behavioral and mood effects of snoezelen integrated into 24-hour dementia care.

    NARCIS (Netherlands)

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

    2005-01-01

    OBJECTIVES: To investigate the effectiveness of snoezelen, integrated in 24-hour daily care, on the behavior and mood of demented nursing home residents. DESIGN: Quasiexperimental pre- and posttest design. SETTING: Twelve psychogeriatric wards of six nursing homes, spread over different parts of the

  13. The Effectiveness of Nutritional Screening in Hospital and Primary Care Settings: a Systematic Review

    Directory of Open Access Journals (Sweden)

    A Rashidian

    2005-10-01

    Full Text Available Objectives: To determine the effectiveness of nutritional screening programmes in improving quality of care and patient outcomes compared with usual care. Methods: Searches were performed on MEDLINE, EMBASE, CINHAL, the Cochrane database, and Current Controlled Trials. Due to the assumed scarcity of high quality evidence, interventional studies in hospital or primary care settings with adequate reporting and comparisons were considered as eligible. Team members met after reviewing the papers. Decisions on inclusion or exclusion of papers were made when all agreed. Two reviewers independently extracted data from included studies. Results: 705 abstracts were considered and thirty full-text papers were ordered and reviewed. Following further review of the extracted data two papers met the inclusion criteria. One was a clustered randomized study of 26 general practices to evaluate the effectiveness of screening for elderly ailments including malnutrition. It concluded nutritional screening did not improve referral to dieticians, detection of nutritional problems, or patients’ quality of life. This study was underpowered for evaluating the effectiveness of nutritional screening. A non-randomized controlled before-after study of four hospital wards concluded that intervention improved weight recording, but not referral to dieticians or care at the mealtime of at risk patients. Discussion: Very few studies assess the effectiveness of nutritional screening with relevant outcomes and acceptable quality. The available evidence does not support systematic application of screening tools to hospital, or general practice patients. Given the current level of interest and political support for nutritional screening, further studies are urgently required.

  14. Effectiveness of Continuing Education in Long-Term Care: A Literature Review.

    Science.gov (United States)

    Aylward, Sandra; Stolee, Paul; Keat, Nancy; Johncox, Van

    2003-01-01

    This review of the literature examines the effectiveness of continuing education programs in long-term care facilities. Because of the lack of follow-up evaluation, there is minimal evidence that knowledge gained from training programs in sustained in the long term. Concludes that there is a need for further rigorous research on the effectiveness…

  15. Patient satisfaction and side effects in primary care: An observational study comparing homeopathy and conventional medicine

    Directory of Open Access Journals (Sweden)

    Thurneysen André

    2008-09-01

    Full Text Available Abstract Background This study is part of a nationwide evaluation of complementary medicine in Switzerland (Programme Evaluation of Complementary Medicine PEK and was funded by the Swiss Federal Office of Public Health. The main objective of this study is to investigate patient satisfaction and perception of side effects in homeopathy compared with conventional care in a primary care setting. Methods We examined data from two cross-sectional studies conducted in 2002–2003. The first study was a physician questionnaire assessing structural characteristics of practices. The second study was conducted on four given days during a 12-month period in 2002/2003 using a physician and patient questionnaire at consultation and a patient questionnaire mailed to the patient one month later (including Europep questionnaire. The participating physicians were all trained and licensed in conventional medicine. An additional qualification was required for medical doctors providing homeopathy (membership in the Swiss association of homeopathic physicians SVHA. Results A total of 6778 adult patients received the questionnaire and 3126 responded (46.1%. Statistically significant differences were found with respect to health status (higher percentage of chronic and severe conditions in the homeopathic group, perception of side effects (higher percentage of reported side effects in the conventional group and patient satisfaction (higher percentage of satisfied patients in the homeopathic group. Conclusion Overall patient satisfaction was significantly higher in homeopathic than in conventional care. Homeopathic treatments were perceived as a low-risk therapy with two to three times fewer side effects than conventional care

  16. The Consequences of Caring: Effects of Mothering a Child with Special Needs

    Science.gov (United States)

    Leiter, Valerie; Krauss, Marty Wyngaarden; Anderson, Betsy; Wells, Nora

    2004-01-01

    This article broadens our knowledge about family caregiving across the life course by examining caregiving and employment effects experienced by women with children with special needs, using data from a survey conducted in 1998-1999. Almost one fifth of the mothers provide at least 20 hours a week of home health care to these children. More than…

  17. Short-run Effects of Job Loss on Health Conditions, Health Insurance, and Health Care Utilization

    OpenAIRE

    Jessamyn Schaller; Ann Huff Stevens

    2014-01-01

    Job loss in the United States is associated with long-term reductions in income and long-term increases in mortality rates. This paper examines the short- to medium-term changes in health, health care access, and health care utilization after job loss that lead to these long-term effects. Using a sample with more than 9800 individual job losses and longitudinal data on a wide variety of health-related measures and outcomes, we show that job loss results in worse self-reported health, includin...

  18. Effective Clinical Practices in Managed Care Findings From Ten Case Studies

    OpenAIRE

    Suzanne Felt-Lisk; Kleinman, Lawrence C.

    2000-01-01

    Presents findings from a study designed to look at how some of the nation's high-performing HMOs have achieved their success. Notes that delivering high-quality care is a driving force for nearly all of the plans studied, as is a culture of respect for clinicians. For printed copies call The Commonwealth Fund at (888) 777-2744, ask for publication number 427. The plan-specific summary reports are also available in a volume titled "Effective Clinical Practices in Managed Care: Ten Case Studies...

  19. Effect of interventions to improve health care services for ethnic minority populations

    Directory of Open Access Journals (Sweden)

    Louise Forsetlund

    2011-03-01

    Full Text Available Objectives: Since the early 1990s there has been an increasing awareness of social and ethnic inequity in health and for the last few years there has also been an increasing focus on disparities in the quality of health services to ethnic minority groups. The aim of this review was to collect and summarise in a systematic and transparent manner the effect of interventions to improve health care services for ethnic minorities.Methods: We searched several medical databases for systematic reviews and randomised controlled trials. Two researchers independently screened for and selected studies, assessed risk of bias, extracted data and graded the quality of the evidence for each outcome in the included studies. The analysis was done qualitatively by describing studies and presenting them in tables.Results: We included 19 primary studies. The interventions were targeted at reducing clinical, structural and organisational barriers against good quality health care services. Eight studies examined the effect of educational interventions in improving outcomes within cross-cultural communication, smoking cessation, asthma care, cancer screening and mental health care. In six comparisons the effect of reminders for improving health care services and patient outcomes within cancer screening and diabetes care was examined. Two studies compared professional remote interpretation services to traditional interpretation services, two studies compared ethnic matching of client and therapist and two studies examined the effect of providing additional support in the form of more personnel in the treatment of diabetes and kidney transplant patients. Most patients were African-Americans and Latin-Americans and all ages were represented.Conclusions: Educational interventions and electronic reminders to physicians may in some contexts improve health care and health outcomes for minority patients. The quality of the evidence varied from low to very low. The quality of

  20. Differential effects of early child care quality on children's socio-emotional development

    OpenAIRE

    Broekhuizen, Martine

    2015-01-01

    Drawing on Bronfenbrenner’s bioecological theory, the aim of this dissertation was to investigate whether effects of early child care quality on children’s socio-emotional development depended on children’s individual and contextual characteristics. Chapter 2 and 3 examined whether associations between child care quality and children’s socio-emotional competence at age 2 and 3 depended on children’s self-regulation abilities. Results showed that for children low on self-regulation, high quali...

  1. The effect of Value Added Tax change on health care services

    OpenAIRE

    Ylämö, Katja

    2016-01-01

    The aim of this thesis was to examine the effect of value added tax (VAT) change on certain health care services. VAT is a consumption tax which is added on the value of goods and services. The Finnish Tax Administration changed the value added tax (VAT) on Health care services and personnel renting (Terveydenhuollon työvoiman luovutus) to 0% instead of the previous 24% on 19 December 2013. Based on the same decision, VAT on some services such as aesthetic surgery rose from 0% to 24%. Th...

  2. Growing Your Business by Adapting Employer Child Care Practices

    Science.gov (United States)

    Spencer, Becky

    2012-01-01

    As an early childhood professional for 30 years operating both traditional and employer child care programs, the author believes that traditional center owners and operators have an opportunity to grow their business, serve more children and families, and stay relevant for future workforce needs by integrating employer child care practices into…

  3. A role for workforce competencies in evidence-based health promotion education.

    Science.gov (United States)

    Talbot, Lyn; Graham, Melissa; James, Erica L

    2007-01-01

    Education programs should be based on research about the knowledge and skills required for practice, rather than on intuition or tradition, but there is limited published curriculum research on health promotion education. This paper describes a case study of how workforce competencies have been used to assist evidence-based health promotion education in the areas of curriculum design, selection of assessment tasks and continuous quality assurance processes in an undergraduate program at an Australian university. A curriculum-competency mapping process successfully identified gaps and areas of overlap in an existing program. Previously published health promotion workforce competencies were effectively used in the process of selecting assessment items, providing clear guidelines for curriculum revision and a useful method to objectively assess competency content in an evidence informed framework. These health promotion workforce competencies constituted an additional tool to assess course quality. We recommend other tertiary institutions consider curriculum-competency mapping and curriculum based assessment selection as quality and evidence based curriculum review strategies. PMID:17526321

  4. Routinely collected data as a strategic resource for research: priorities for methods and workforce.

    Science.gov (United States)

    Jorm, Louisa

    2015-09-01

    In the era of 'big data', research using routinely collected data offers greater potential than ever before to drive health system effectiveness and efficiency, and population health improvement. In Australia, the policy environment, and emerging frameworks and processes for data governance and access, increasingly support the use of routinely collected data for research. Capitalising on this strategic resource requires investment in both research methods and research workforce. Priorities for methods development include validation studies, techniques for analysing complex longitudinal data, exploration of bias introduced through linkage error, and a robust toolkit to evaluate policies and programs using 'natural experiments'. Priorities for workforce development include broadening the skills base of the existing research workforce, and the formation of new, larger, interdisciplinary research teams to incorporate capabilities in computer science, partnership research, research translation and the 'business' aspects of research. Large-scale, long-term partnership approaches involving government, industry and researchers offer the most promising way to maximise returns on investment in research using routinely collected data. PMID:26536502

  5. Multinational corporations and health care in the United States and Latin America: strategies, actions, and effects.

    Science.gov (United States)

    Jasso-Aguilar, Rebeca; Waitzkin, Howard; Landwehr, Angela

    2004-01-01

    In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations' access to social security and related public sector funds for the support of privatized health services. International financial institutions and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector PMID:15779471

  6. Clinical Care Pathways for Patients With Hepatitis C: Reducing Critical Barriers to Effective Treatment.

    Science.gov (United States)

    Howes, Nik; Lattimore, Sam; Irving, William Lucien; Thomson, Brian James

    2016-01-01

    Background.  Engagement of individuals infected with hepatitis C virus (HCV) with care pathways remains a major barrier to realizing the benefits of new and more effective antiviral therapies. After an exploratory study, we have undertaken an evidence-based redesign of care pathways for HCV, including the following: (1) reflex testing of anti-HCV-positive samples for HCV RNA; (2) annotation of laboratory results to recommend referral of actively infected patients to specialist clinics; (3) educational programs for primary care physicians and nurses; and (4) the establishment of needs-driven community clinics in substance misuse services. Methods.  In this study, we conducted a retrospective cohort study of progression through care pathways of individuals with a new diagnosis of HCV infection made between January 2010 and January 2012. We also analyzed patient flow through new care pathways and compared this with our baseline study of identical design. Results.  A total of 28 980 samples were tested for anti-HCV antibody during the study period and yielded 273 unique patients with a new diagnosis of HCV infection. Of these, 38% were tested in general practice, 21% were tested in substance misuse services, 23% were tested in secondary care, and 18% were tested in local prisons. Overall, 80% of patients were referred to specialist clinics, 70% attended for assessment, and 38% commenced treatment, in comparison to 49%, 27%, and 10%, respectively, in the baseline study. Referral rates from all testing sources improved. Conclusions.  This study provides timely evidence that progression through care pathways can be enhanced, and it demonstrates reduction of key barriers to eradication of HCV. PMID:26900576

  7. Perceptions of effective relationships in an institutional care setting for older people

    Directory of Open Access Journals (Sweden)

    Vera Roos

    2014-02-01

    Full Text Available Orientation: The relocation of older people to residential facilities has implications for their relationships.Research purpose: This article reports older residents’ perceptions of effective relationships.Motivation for the study: Effective relationships protect against loneliness and depression and contribute to well-being. The facility was identified by a social worker as a showcase for effective relationships, but it was not clear what these consist of.Research approach, design and method: The World Café, a qualitative, participatory action research method, was applied to an economically deprived, urban facility caring for older people in Gauteng, South Africa. Three positively framed questions elicited perceptions from participants (nine men, ten women, aged 65–89. Visual and textual data were obtained and thematically analysed until saturation had been achieved. Themes were then subjected to deductive direct content analysis in terms of Self-Interactional Group Theory (SIGT.Main findings: Older residents perceive care managers as friendly and trustworthy and co-residents as caring. Care managers were seen as flexible, empathetic and congruent leaders and they confirmed residents. Relationships between residents were parallel-defined with relational qualities such as empathy and unconditional acceptance. Residents’ needs for privacy were honoured and they felt confirmed. Group dynamics were underpinned by caring and a stimulating environment provided opportunities for engagement.Practical/managerial implications: Relationships between managers and consumers are facilitated by flexibility, empathy, congruence and unconditional acceptance. Supportive group dynamics develop when people confirm and accept one another. A stimulating environment that encourages continuous and close interpersonal contact contributes to effective relationships.Contribution/value-add: Effective relationships should be understood on different levels.

  8. Evaluating the Effect of Software Quality Characteristics on Health Care Quality Indicators

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    Sakineh Aghazadeh

    2015-07-01

    Full Text Available Introduction: Various types of software are used in health care organizations to manage information and care processes. The quality of software has been an important concern for both health authorities and designers of Health Information Technology. Thus, assessing the effect of software quality on the performance quality of healthcare institutions is essential. Method: The most important health care quality indicators in relation to software quality characteristics are provided via an already performed literature review. ISO 9126 standard model is used for definition and integration of various characteristics of software quality. The effects of software quality characteristics and sub-characteristics on the healthcare indicators are evaluated through expert opinion analyses. A questionnaire comprising of 126 questions of 10-point Likert scale was used to gather opinions of experts in the field of Medical/Health Informatics. The data was analyzed using Structural Equation Modeling. Results: Our findings showed that software Maintainability was rated as the most effective factor on user satisfaction (R2 =0.89 and Functionality as the most important and independent variable affecting patient care quality (R2 =0.98. Efficiency was considered as the most effective factor on workflow (R2 =0.97, and Maintainability as the most important factor that affects healthcare communication (R2 =0.95. Usability and Efficiency were rated as the most effectual factor affecting patient satisfaction (R2 =0.80, 0.81. Reliability, Maintainability, and Efficiency were considered as the main factors affecting care costs (R2 =0.87, 0.74, 0.87. Conclusion: We presented a new model based on ISO standards. The model demonstrates and weighs the relations between software quality characteristics and healthcare quality indicators. The clear relationships between variables and the type of the metrics and measurement methods used in the model make it a reliable method to assess

  9. An opportunity for coordinated cancer care: intersection of health care reform, primary care providers, and cancer patients.

    Science.gov (United States)

    Collins, Lauren G; Wender, Richard; Altshuler, Marc

    2010-01-01

    The US health care system has become increasingly unsustainable, threatened by poor quality and spiraling costs. Many Americans are not receiving recommended preventive care, including cancer screening tests. Passage of the Affordable Care Act in March 2010 has the potential to reverse this course by increasing access to primary care providers, extending coverage and affordability of health insurance, and instituting proven quality measures. In order for health care reform to succeed, it will require a stronger primary care workforce, a new emphasis on patient-centered care, and payment incentives that reward quality over quantity. Innovations such as patient-centered medical homes, accountable care organizations, and improved quality reporting methods are central features of a redesigned health care delivery system and will ultimately change the face of cancer care in the United States. PMID:21131791

  10. Intercultural communication between patients and health care providers: an exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety.

    Science.gov (United States)

    Ulrey, K L; Amason, P

    2001-01-01

    Cultural diversity is becoming increasingly more important in the workplace. This is particularly true in health care organizations facing demographic shifts in the patients served and their families. This study serves to aid the development of intercultural communication training programs for health care providers by examining how cultural sensitivity and effective intercultural communication, besides helping patients, personally benefit health care providers by reducing their stress. Effective intercultural communication and cultural sensitivity were found to be related. Health care providers' levels of intercultural anxiety also were found to correlate with effective intercultural communication. PMID:11771806

  11. Is Fly in/Fly out (FIFO) a viable interim solution to address remote medical workforce shortages?

    Science.gov (United States)

    Margolis, Stephen A

    2012-01-01

    Geographically remote regions of Australia experience a higher degree of socioeconomic inequality and health inequity, amid poor resourcing and extreme climatic conditions, when compared with their more urban counterparts. Doctors with the knowledge, skills and interest in remote work remain a scarce resource, with only 58 practitioners per 100,000 people versus 196/100,000 in metropolitan areas. Pending the arrival of the full complement of long-term remote medical workforce, an alternative solution that has so far received little attention but could provide near equivalence to resident doctors is the 'fly in/fly out' (FIFO) model. Specifically, where one doctor has a continuous relationship with one town or community, albeit spending their rostered time off away from this location, rather than continuity of service with different doctors each time. In this model, doctors spend a fixed number of days at work geographically remote from their home and families, with logistical support (eg housing, transport) provided, followed by a fixed number of days back at home not working. This provides a the doctor with the benefits of remote clinical work plus guaranteed time off at home, a more acceptable roster than in many remote locations at present. This also avoids the complex issue of experienced doctors having to leave remote areas mid-career for the well-documented reasons of spouse employment and children's education, as well as providing easier access to professional development activities. The author followed this path and remains a FIFO doctor after 7 years of continuous service. For FIFO to be effective, there needs to be a commitment from the sponsoring organisation for short, balanced, flexible, family friendly rosters and a positive organizational structure with effective communication between management and front line staff. Evidence shows that families and children with healthy family functioning, who are able to balance separateness and togetherness and

  12. The effectiveness and safety of short-contact dithranol therapy in paediatric psoriasis: a prospective comparison of regular day care and day care with telemedicine

    NARCIS (Netherlands)

    Oostveen, A.M.; Beulens, C.A.; Kerkhof, P.C.M. van de; Jong, E.M.G.J. de; Seyger, M.M.B.

    2014-01-01

    BACKGROUND: Evidence on the effectiveness and safety of short-contact dithranol therapy in paediatric psoriasis is sparse and based only on retrospective data. The best results are achieved in a time-consuming day-care setting. OBJECTIVES: To study prospectively the effectiveness and safety of short

  13. Effects of Family Policy Reforms in Norway. Results from a Joint Labor Supply and Child Care Choice Microsimulation Analysis

    OpenAIRE

    Kornstad, Tom; Thoresen, Thor Olav

    2006-01-01

    Mothers of preschool children represent one part of the population that might be able to increase its labor supply. We discuss effects of family policy changes that encourage the labor supply of these mothers, as child care fee reductions and increased availability of center-based care. Effects of policy changes are described by employing a joint labor supply and child care choice decision model. Detailed empirical results are provided with respect to mothers’ labor supply, famili...

  14. The relative importance of leadership and payment system. Effects on quality of care and work environment.

    Science.gov (United States)

    Forsberg, Ewa; Axelsson, Runo; Arnetz, Bengt

    2004-07-01

    The key question addressed in this study is whether the introduction of stronger financial incentives in health care give rise to such a restrictive context that leadership has only a minor influence? Or is good leadership, on the contrary, important to the achievement of both financial and other goals, regardless of contextual factors? Physicians in one Swedish County Council with performance-based reimbursement and in 10 councils without such a system were studied in a cross-sectional questionnaire study. The result of this study indicates that although contextual factors were of substantial importance there is scope for leaders to act, and their actions make a considerable difference, both for the experience of the work process and for the outcome in terms of work environment and quality of care. A good leadership may be able to shield the health care organisation from unwanted side effects of increased financial pressure. PMID:15484608

  15. Effect of intermediate care on mortality following emergency abdominal surgery. The InCare trial: study protocol, rationale and feasibility of a randomised multicentre trial

    Directory of Open Access Journals (Sweden)

    Vester-Andersen Morten

    2013-02-01

    Full Text Available Abstract Background Emergency abdominal surgery carries a 15% to 20% short-term mortality rate. Postoperative medical complications are strongly associated with increased mortality. Recent research suggests that timely recognition and effective management of complications may reduce mortality. 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 potentially influence the survival of many high-risk surgical patients. As a pioneer trial in the area, it will provide important data on the feasibility of future large-scale randomised clinical trials evaluating different levels of postoperative care. Trial registration Clinicaltrials.gov identifier: NCT01209663

  16. Implementing Geriatric Resources for Assessment and Care of Elders Team Care in a Veterans Affairs Medical Center: Lessons Learned and Effects Observed.

    Science.gov (United States)

    Schubert, Cathy C; Myers, Laura J; Allen, Katie; Counsell, Steven R

    2016-07-01

    In a randomized clinical trial, Geriatric Resources for Assessment and Care of Elders (GRACE), a model of care that works in collaboration with primary care providers (PCPs) and patient-centered medical homes to provide home-based geriatric care management focusing on geriatric syndromes and psychosocial problems commonly found in older adults, improved care quality and reduced acute care use for high-risk, low-income older adults. To assess the effect of GRACE at a Veterans Affairs (VA) Medical Center (VAMC), veterans aged 65 and older from Marion County, Indiana, with PCPs from four of five VAMC clinics who were not on hospice or dialysis were enrolled in GRACE after discharge home from an acute hospitalization. After an initial home-based transition visit to GRACE enrollees, the GRACE team returned to conduct a geriatric assessment. Guided by 12 protocols and input from an interdisciplinary panel and the PCP, the GRACE team developed and implemented a veteran-centric care plan. Hospitalized veterans from the fifth clinic, who otherwise met enrollment criteria, served as a usual-care comparison group. Demographic, comorbidity, and usage data were drawn from VA databases. The GRACE and comparison groups were similar in age, sex, and burden of comorbidity, although predicted risk of 1-year mortality in GRACE veterans was higher. Even so, GRACE enrollment was associated with 7.1% fewer emergency department visits, 14.8% fewer 30-day readmissions, 37.9% fewer hospital admissions, and 28.5% fewer total bed days of care, saving the VAMC an estimated $200,000 per year after program costs during the study for the 179 veterans enrolled in GRACE. Having engaged, enthusiastic VA leadership and GRACE staff; aligning closely with the medical home; and accommodating patient acuity were among the important lessons learned during implementation. PMID:27305428

  17. The psychological effects of providing personal care to a partner: a multidimensional perspective

    Directory of Open Access Journals (Sweden)

    Thomas Hansen

    2013-07-01

    Full Text Available The expected increasing demand for informal care in aging societies underscores the importance of understanding the psychological implications of caregiving. This study explores the effect of providing regular help with personal care to a partner on different aspects of psychological well-being. We use cross-sectional data from the Norwegian Life Course, Ageing and Generation study (n. ~15,000; age 40-84 and two-wave panel data from the Norwegian study on Life Course, Ageing and Generation (n. ~3000; age 40-84. To separate the effects of providing care from those of the partner’s disability, caregivers are contrasted with non-caregivers with both disabled and nondisabled partners. We separate outcomes into cognitive well-being (life satisfaction, psychological functioning (self-esteem, mastery, and affective well-being (happiness, depression, loneliness. Findings show that caregiving has important cross-sectional and longitudinal detrimental psychological effects. These effects are fairly consistent across all aspects of well-being, demonstrating that caregiving has a broad-based negative impact. Among women, however, these effects are similar to if not weaker than the effects of a partner’s disability. Caregiving effects are constant by age, education, and employment status, but stronger among caregivers with health problems. Providing personal care to a partner is associated with marked adverse psychological effects for men and women irrespective of age and socio-economic status. Hence, no socio-demographic group is immune from caregiving stress, so programs should be targeted generally. The results also suggest that the health needs of caregivers demand more attention.

  18. The Psychological Effects of Providing Personal Care to a Partner: A Multidimensional Perspective.

    Science.gov (United States)

    Hansen, Thomas; Slagsvold, Britt

    2013-04-18

    The expected increasing demand for informal care in aging societies underscores the importance of understanding the psychological implications of caregiving. This study explores the effect of providing regular help with personal care to a partner on different aspects of psychological well-being. We use cross-sectional data from the Norwegian Life Course, Ageing and Generation study (n. ~15,000; age 40-84) and two-wave panel data from the Norwegian study on Life Course, Ageing and Generation (n. ~3000; age 40-84). To separate the effects of providing care from those of the partner's disability, caregivers are contrasted with non-caregivers with both disabled and nondisabled partners. We separate outcomes into cognitive well-being (life satisfaction), psychological functioning (self-esteem, mastery), and affective well-being (happiness, depression, loneliness). Findings show that caregiving has important cross-sectional and longitudinal detrimental psychological effects. These effects are fairly consistent across all aspects of well-being, demonstrating that caregiving has a broad-based negative impact. Among women, however, these effects are similar to if not weaker than the effects of a partner's disability. Caregiving effects are constant by age, education, and employment status, but stronger among caregivers with health problems. Providing personal care to a partner is associated with marked adverse psychological effects for men and women irrespective of age and socio-economic status. Hence, no sociodemographic group is immune from caregiving stress, so programs should be targeted generally. The results also suggest that the health needs of caregivers demand more attention. PMID:26973910

  19. Interpreting the quality of health care database studies on the comparative effectiveness of oral anticoagulants in routine care

    Directory of Open Access Journals (Sweden)

    Schneeweiss S

    2013-09-01

    Full Text Available Sebastian Schneeweiss, Krista F Huybrechts, Joshua J Gagne Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA Background: Dabigatran, an oral direct thrombin inhibitor, has now been available for 2 years in the US for the prevention of stroke in patients with nonvalvular atrial fibrillation, and direct Xa inhibitors are also starting to enter the market. Studies examining the effects of new oral anticoagulants in health care databases are beginning to emerge. The purpose of this study was to describe the validity of early published observational studies on the comparative safety and effectiveness of new oral anticoagulants in patients with atrial fibrillation. Methods: We identified published nonrandomized post-marketing studies (articles or conference abstracts or posters and critically appraised their internal validity, with a particular focus on their ability to control confounding and other biases. Results: Two full-length journal articles, three conference posters, two conference presentation abstracts, and a US Food and Drug Administration analysis form the basis of the early comparative effectiveness and safety experience with new oral anticoagulants. Some published studies exhibit substantial biases and have insufficient precision for several important endpoints. Several studies suffer from biases arising from comparing ongoing users of the older drug, warfarin, who seem to tolerate it, to initiators of the new treatment who may have switched from warfarin or have had no prior experience with anticoagulants. Analyses tended to not adjust or not adjust adequately for confounding, and unsound propensity score application was also observed. Several studies introduced selection bias by excluding patients who died during follow-up and by restricting the study population to those with continuous database enrollment following cohort entry. We

  20. Effective Linkages of Continuum of Care for Improving Neonatal, Perinatal, and Maternal Mortality: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Kimiyo Kikuchi

    Full Text Available Continuum of care has the potential to improve maternal, newborn, and child health (MNCH by ensuring care for mothers and children. Continuum of care in MNCH is widely accepted as comprising sequential time (from pre-pregnancy to motherhood and childhood and space dimensions (from community-family care to clinical care. However, it is unclear which linkages of care could have a greater effect on MNCH outcomes. The objective of the present study is to assess the effectiveness of different continuum of care linkages for reducing neonatal, perinatal, and maternal mortality in low- and middle-income countries.We searched for randomized and quasi-randomized controlled trials that addressed two or more linkages of continuum of care and attempted to increase mothers' uptake of antenatal care, skilled birth attendance, and postnatal care. The outcome variables were neonatal, perinatal, and maternal mortality.Out of the 7,142 retrieved articles, we selected 19 as eligible for the final analysis. Of these studies, 13 used packages of intervention that linked antenatal care, skilled birth attendance, and postnatal care. One study each used packages that linked antenatal care and skilled birth attendance or skilled birth attendance and postnatal care. Four studies used an intervention package that linked antenatal care and postnatal care. Among the packages that linked antenatal care, skilled birth attendance, and postnatal care, a significant reduction was observed in combined neonatal, perinatal, and maternal mortality risks (RR 0.83; 95% CI 0.77 to 0.89, I2 79%. Furthermore, this linkage reduced combined neonatal, perinatal, and maternal mortality when integrating the continuum of care space dimension (RR 0.85; 95% CI 0.77 to 0.93, I2 81%.Our review suggests that continuous uptake of antenatal care, skilled birth attendance, and postnatal care is necessary to improve MNCH outcomes in low- and middle-income countries. The review was conclusive for the