Conventional approaches to health care workforce planning are notoriously unreliable. In part, this is due to the uncertainty of the future health milieu. An approach to health care workforce planning that accommodates this uncertainty is not only possible but can also generate intelligence on which planning and consequent development can be reliably based. Drawing on the experience of Health Workforce New Zealand, the author outlines some of the approaches being used in New Zealand. Instead of relying simply on health care data, which provides a picture of current circumstances in health systems, the author argues that workforce planning should rely on health care intelligence--looking beyond the numbers to build understanding of how to achieve desired outcomes. As health care systems throughout the world respond to challenges such as reform efforts, aging populations of patients and providers, and maldistribution of physicians (to name a few), New Zealand's experience may offer a model for rethinking workforce planning to truly meet health care needs.
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Hoge, Michael A; Morris, John A; Stuart, Gail W; Huey, Leighton Y; Bergeson, Sue; Flaherty, Michael T; Morgan, Oscar; Peterson, Janice; Daniels, Allen S; Paris, Manuel; Madenwald, Kappy
Across all sectors of the behavioral health field there has been growing concern about a workforce crisis. Difficulties encompass the recruitment and retention of staff and the delivery of accessible and effective training in both initial, preservice training and continuing education settings. Concern about the crisis led to a multiphased, cross-sector collaboration known as the Annapolis Coalition on the Behavioral Health Workforce. With support from the Substance Abuse and Mental Health Services Administration, this public-private partnership crafted An Action Plan for Behavioral Health Workforce Development. Created with input from a dozen expert panels, the action plan outlines seven core strategic goals that are relevant to all sectors of the behavioral health field: expand the role of consumers and their families in the workforce, expand the role of communities in promoting behavioral health and wellness, use systematic recruitment and retention strategies, improve training and education, foster leadership development, enhance infrastructure to support workforce development, and implement a national research and evaluation agenda. Detailed implementation tables identify the action steps for diverse groups and organizations to take in order to achieve these goals. The action plan serves as a call to action and is being used to guide workforce initiatives across the nation.
Nemec, Patricia B; Chan, Steven
This column describes challenges for hiring, training, and supervising psychiatric rehabilitation service providers for positions that involve the use of digital health technology. Adoption and implementation of any new technology or technique requires workforce development. This article outlines considerations for policymakers, funders, and service agency administrators as digital health technologies become more widespread. The article discusses issues based on professional experience of the authors and available literature. The literature on adoption of innovations in general, and the adoption of psychiatric evidence-based practices in particular, indicates that funding and adoption of new techniques and technologies are not adequate to ensure full and sustained implementation. The use of any new treatment or technology requires training and other supports to ensure that users have the competencies needed to make it work and that the workplace supports its use. As new digital health technologies become available, considerations of their cost and effectiveness need to include an examination of the required competencies of the service providers who will use them and the added cost of developing, enhancing, and maintaining those competencies. Specific attitudes, knowledge, and skills will be relevant to hiring decisions. Relevant preservice and on-the-job training opportunities, technical assistance, and supervision will be needed. Implementation needs to be monitored, not assumed, and the rights of the people who use technology-supported services must be fully protected. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J
Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.
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
Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M.
In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested. PMID:25685381
Chastonay, Philippe; Moretti, Roberto; Zesiger, Veronique; Cremaschini, Marco; Bailey, Rebecca; Pariyo, George; Kabengele, Emmanuel Mpinga
In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential…
Leider, Jonathon P.; Harper, Elizabeth; Bharthapudi, Kiran; Castrucci, Brian C.
Context: Educational attainment is a critical issue in public health workforce development. However, relatively little is known about the actual attainment of staff in state health agencies (SHAs). Objective: Ascertain the levels of educational attainment among SHA employees, as well as the correlates of attainment. Design: Using a stratified sampling approaching, staff from SHAs were surveyed using the Public Health Workforce Interests and Needs Survey (PH WINS) instrument in late 2014. A nationally representative sample was drawn across 5 geographic (paired adjacent HHS) regions. Descriptive and inferential statistics were analyzed using balanced repeated replication weights to account for complex sampling. A logistic regression was conducted with attainment of a bachelor's degree as the dependent variable and age, region, supervisory status, race/ethnicity, gender, and staff type as independent variables. Setting and Participants: Web-based survey of SHA central office employees. Main Outcome Measure: Educational attainment overall, as well as receipt of a degree with a major in public health. Results: A total of 10 246 permanently-employed SHA central office staff participated in the survey (response rate 46%). Seventy-five percent (95% confidence interval [CI], 74-77) had a bachelor's degree, 38% (95% CI, 37-40) had a master's degree, and 9% (95% CI, 8%-10%) had a doctoral degree. A logistic regression showed Asian staff had the highest odds of having a bachelor's degree (odds ratio [OR] = 2.8; 95% CI, 2.2-3.7) compared with non-Hispanic whites, and Hispanic/Latino staff had lower odds (OR = 0.6; 95% CI, 0.4-0.8). Women had lower odds of having a bachelor's degree than men (OR = 0.5; 95% CI, 0.4-0.6). About 17% of the workforce (95% CI, 16-18) had a degree in public health at any level. Conclusions: Educational attainment among SHA central office staff is high, but relatively few have formal training of any sort in public health. This makes efforts to increase
Fritzen Scott A
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.
Becker, Bryan N
Given limited resources, adding another chronic illness to the panoply of chronic disease care is problematic. Nevertheless, chronic kidney disease (CKD) is increasing in recognition and prevalence across the world, and a management strategy for this growing population is necessary. A diverse group of health care professionals interacts with patients with CKD and their family members, including nurses, nurse practitioners, dieticians, social workers, pharmacists, physicians, physical therapists, physician assistants, and public health workers. All these individuals have the opportunity to reinforce CKD management. This potentially would bring a broader health care workforce to bear on CKD, reducing the impact of the nephrology workforce shortage. To realize such a strategy, it is necessary to bolster CKD awareness and knowledge in the diverse health care workforce. A faculty development program that extends CKD awareness to existing health care workers also has the possibility of migrating into the learner curriculum in health professional schools. This approach would expand CKD education, creating a skilled diverse health care workforce. Copyright Â© 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Benabentos, Rocio; Ray, Payal; Kumar, Deepak
Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health…
Benabentos, Rocio; Ray, Payal; Kumar, Deepak
Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health…
Wilson, Nairn H F; Shamshir, Z Abidin; Moris, Sylviana; Slater, Mabel; Kok, Ei Chuen; Dunne, Stephen M; Said, Samsiah H M; Lee, James M K; Gallagher, Jennifer E
Brunei Darussalam is a Sultanate with a Malay Islamic monarchy. There are high levels of dental disease among its 406,200 population. The population's oral health needs require an integrated blend of primary and specialist care, together with oral health promotion. This paper describes the planning and measures taken to address these needs. In accordance with an oral health agenda published and launched in 2008, focusing on access, health promotion and prevention, and the education and training of the dental workforce, the Brunei Darussalam Ministry of Health is seeking to improve oral health status and reduce the burden of oral disease. It also seeks to transform the country's oral health services into a preventatively orientated, high-quality, seamless service underpinned by the concept of 'teeth for life'. In the process of effecting this transition, the Brunei Darussalam Ministry of Health is developing a dental workforce fit for future purpose, with an emphasis on a modern approach to skill mix. An important element of this programme has been the development of a highly successful Brunei Darussalam Diploma in Dental Therapy and Dental Hygiene. It is concluded that the Brunei Darussalam oral health agenda and, in particular, the forward-looking programme of dental workforce development is a model for other countries facing similar oral health challenges. © 2013 FDI World Dental Federation.
Dean, Hazel D; Myles, Ranell L; Spears-Jones, Crystal; Bishop-Cline, Audriene; Fenton, Kevin A
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.
Burkle, Frederick M; Dallas, Cham E
This study argues that any nuclear weapon exchange or major nuclear plant meltdown, in the categories of human systems failure and conflict-based crises, will immediately provoke an unprecedented public health emergency of international concern. Notwithstanding nuclear triage and management plans and technical monitoring standards within the International Atomic Energy Agency and the World Health Organization (WHO), the capacity to rapidly deploy a robust professional workforce with the internal coordination and collaboration capabilities required for large-scale nuclear crises is profoundly lacking. A similar dilemma, evident in the early stages of the Ebola epidemic, was eventually managed by using worldwide infectious disease experts from the Global Outbreak Alert and Response Network and multiple multidisciplinary WHO-supported foreign medical teams. This success has led the WHO to propose the development of a Global Health Workforce. A strategic format is proposed for nuclear preparedness and response that builds and expands on the current model for infectious disease outbreak currently under consideration. This study proposes the inclusion of a nuclear global health workforce under the technical expertise of the International Atomic Energy Agency and WHO's Radiation Emergency Medical Preparedness and Assistance Network leadership and supported by the International Health Regulations Treaty. Rationales are set forth for the development, structure, and function of a nuclear workforce based on health outcomes research that define the unique health, health systems, and public health challenges of a nuclear crisis. Recent research supports that life-saving opportunities are possible, but only if a rapidly deployed and robust multidisciplinary response component exists.
Full Text Available Abstract This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce.
Vicarelli, Giovanna; Pavolini, Emmanuele
More precise health workforce governance has become a prominent issue in healthcare systems. This issue is particularly important in Italy, given its strongly doctor-centered healthcare system and the dramatic aging of its physicians' labor force. Using different sources of information (statistical data, official planning documents and interviews with key informants), the article attempts to answer two questions. Why has the Italian healthcare systems found itself in the situation of a potential drastic reduction in the amount of doctors in the medium term without a rebalancing through a different mix of skills and professionals? How good is the capacity of the Italian healthcare system to plan healthcare workforce needs? The widespread presence of 'older' physicians is the result of the strong entry of doctors into the Italian healthcare system in the 1970s and 1980s. Institutional fragmentation, difficulties in drafting broad healthcare reforms, political instability and austerity measures explain why Italian health workforce forecasting and planning are still unsatisfactory, although recent developments indicate that changes are under way. In order to tackle these problems it is necessary to foster closer cooperation among a wide range of stakeholders, to move from uni-professional to multi-professional health workforce planning, and to partially re-centralise decision making.
Joss, Nerida; Keleher, Helen
This project engaged a mental health rehabilitation organisation in health promotion research and development to build its capacity in evaluation research. Participatory research methods were used. Staff skills development occurred through training in research and evaluation methods applied to an evaluation project in mental health promotion that they conducted. All staff had some previous training in research but little, if any, experience of research practice. Staff demonstrated commitment to the idea of embedding research practice into the organisation to strengthen its ability to demonstrate program outcomes. However, the realities of work demands eventually took precedence over the tasks involved in the research process. Staff commitment, knowledge and skills are not sufficient if an organisation lacks the capacity to provide the resources or foster support for a research culture. The health promotion capacity-building framework is relevant for efforts to build health promotion research into mental health organisations. This project demonstrated that workforce development to build the capacity for mental health promotion is more likely to be successful if it is embedded into organisational strategy and culture, has sufficient resources allocated including staff time, and is supported by management.
Osman, Helen; Jorm, Anthony F; Killackey, Eoin; Francey, Shona; Mulcahy, Dianne
The aim of this study was to identify the core competencies required of mental health professionals working in the early psychosis field, which could function as an evidence-based tool to support the early psychosis workforce and in turn assist early psychosis service implementation and strengthen early psychosis model fidelity. The Delphi method was used to establish expert consensus on the core competencies. In the first stage, a systematic literature search was conducted to generate competency items. In the second stage, a panel consisting of expert early psychosis clinicians from around the world was formed. Panel members then rated each of the competency items on how essential they are to the clinical practice of all early psychosis clinicians. In total, 1023 pieces of literature including textbooks, journal articles and grey literature were reviewed. A final 542 competency items were identified for inclusion in the questionnaire. A total of 63 early psychosis experts participated in 3 rating rounds. Of the 542 competency items, 242 were endorsed as the required core competencies. There were 29 competency items that were endorsed by 62 or more experts, and these may be considered the foundational competencies for early psychosis practice. The study generated a set of core competencies that provide a common language for early psychosis clinicians across professional disciplines and country of practice, and potentially are a useful professional resource to support early psychosis workforce development and service reform. © 2017 John Wiley & Sons Australia, Ltd.
Pavolini, Emmanuele; Kuhlmann, Ellen
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.
Adily, A; Ward, J
To assess current capacity to implement evidence based practice (EBP) in population health. Postal survey of a regional population health workforce in Sydney, Australia. Division of Population Health, South Western Sydney Area Health Service. 104 population health staff (response rate: 73%). In the sample of regional population health practitioners, views about the current promotion of EBP were positive. Non-medical respondents with less that Masters degree were more likely to report "high self assessed need" to increase their capacity in EBP (p = 0.022). Confidence in understanding of EBP terminology was not associated with seniority but with highest level of education reached (pskills" or "need to increase their capacity in EBP" in their current position. The proportion of participants "strongly" supporting implementation of a colorectal cancer screening programme whose benefit was expressed as relative risk reduction was greater than that so supporting a programme whose benefit was expressed as number needed to screen (p = 0.008). Most respondents referred to their immediate managers when seeking support for EBP. The findings provide a quantitative baseline for capacity building through workplace programmes. Managerial commitment has been increased and performance development is now underway.
Sobelson, Robyn K; Young, Andrea C
The Centers for Public Health Preparedness (CPHP) program was a five-year cooperative agreement funded by the Centers for Disease Control and Prevention (CDC). The program was initiated in 2004 to strengthen terrorism and emergency preparedness by linking academic expertise to state and local health agency needs. The purposes of the evaluation study were to identify the results achieved by the Centers and inform program planning for future programs. The evaluation was summative and retrospective in its design and focused on the aggregate outcomes of the CPHP program. The evaluation results indicated progress was achieved on program goals related to development of new training products, training members of the public health workforce, and expansion of partnerships between accredited schools of public health and state and local public health departments. Evaluation results, as well as methodological insights gleaned during the planning and conduct of the CPHP evaluation, were used to inform the design of the next iteration of the CPHP Program, the Preparedness and Emergency Response Learning Centers (PERLC).
Hogan, Anne E.; Dillon, Colleen O.; Fernandes, Sherira; Spieker, Susan; ZeanahTulane, Paula D.
Developing a sustainable, competent workforce is an urgent and challenging task for the Infant Mental Health (IMH) field. In this article, the authors share their experiences and perspectives on the importance of and challenges in the development of the IMH workforce. The broad view of both workforce members and professional development…
Tumosa, Nina; Horvath, Kathy J.; Huh, Terri; Livote, Elayne E.; Howe, Judith L.; Jones, Lauren Ila; Kramer, B. Josea
The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics…
Tumosa, Nina; Horvath, Kathy J.; Huh, Terri; Livote, Elayne E.; Howe, Judith L.; Jones, Lauren Ila; Kramer, B. Josea
The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics…
Sánchez, Nelson F; Sánchez, John Paul; Lunn, Mitchell R; Yehia, Baligh R; Callahan, Edward J
The Institute of Medicine has identified significant health disparities and barriers to health care experienced by lesbian, gay, bisexual, and transgender (LGBT) populations. By lowering financial barriers to care, recent legislation and judicial decisions have created a remarkable opportunity for reducing disparities by making health care available to those who previously lacked access. However, the current health-care workforce lacks sufficient training on LGBT-specific health-care issues and delivery of culturally competent care to sexual orientation and gender identity minorities. The LGBT Healthcare Workforce Conference was developed to provide a yearly forum to address these deficiencies through the sharing of best practices in LGBT health-care delivery, creating LGBT-inclusive institutional environments, supporting LGBT personal and professional development, and peer-to-peer mentoring, with an emphasis on students and early career professionals in the health-care fields. This report summarizes the findings of the first annual LGBT Health Workforce Conference.
McCarty, Maureen V; Fenech, Bethany J
Health Workforce Australia (HWA) was established by the Council of Australian Governments through its 2008 National Partnership Agreement on Hospital and Health Workforce Reform, as the national agency to progress health workforce reform and address the challenges of providing a skilled, innovative and flexible health workforce in Australia. The Australian Health Ministers' Conference commissioned HWA to undertake a workforce planning exercise for doctors, nurses and midwives over a planning horizon to 2025. Health Workforce 2025 (HW 2025) was conducted in two phases: developing projections for the size and type of the health workforce (doctors, nurses and midwives) needed to meet future service requirements from 2012 to 2025; and modelling the training pipeline necessary to meet the size and type of this health workforce. HWA has used a number of key principles in developing HW 2025 to ensure the projections are robust and able to be applied nationally. HW 2025 is not a one-off project. Projections will be updated as new data become available, and methodology and assumptions underpinning the projections will be periodically reviewed. To also ensure the continued improvement of national health workforce planning, HWA is pursuing other areas for improvement, including better national data collections and improved estimation methodology for demand. Results of HW 2025 were presented to the Australian Health Ministers (through the Standing Council on Health) in April 2012.
Full Text Available Abstract Background Imbalance in the distribution of human resources for health (HRH, eventually leading to inequities in health services delivery and population health outcomes, is an issue of social and political concern in many countries. However, the empirical evidence to support decision-making is often fragmented, and many standard data sources that can potentially produce statistics relevant to the issue remain underused, especially in developing countries. This study investigated the uses of demographic census data for monitoring geographical imbalance in the health workforce for three developing countries, as a basis for formulation of evidence-based health policy options. Methods Population-based indicators of geographical variations among HRH were extracted from census microdata samples for Kenya, Mexico and Viet Nam. Health workforce statistics were matched against international standards of occupational classification to control for cross-national comparability. Summary measures of inequality were calculated to monitor the distribution of health workers across spatial units and by occupational group. Results Strong inequalities were found in the geographical distribution of the health workforce in all three countries, with the highest densities of HRH tending to be found in the capital areas. Cross-national differences were found in the magnitude of distributional inequality according to occupational group, with health professionals most susceptible to inequitable distribution in Kenya and Viet Nam but less so in Mexico compared to their associate professional counterparts. Some discrepancies were suggested between mappings of occupational information from the raw data with the international system, especially for nursing and midwifery specializations. Conclusions The problem of geographical imbalance among HRH across countries in the developing world holds important implications at the local, national and international levels, in
The United States needs a skilled and qualified wind energy workforce to produce domestic clean power. To assist with wind energy workforce development, the U.S. Department of Energy (DOE) and National Renewable Energy Laboratory are engaged with several efforts.This presentation by Suzanne Tegen describes these efforts, including a wind industry survey, DOE's Wind Career Map, the DOE Wind Vision report, and an in-depth discussion of the Jobs & Economic Development Impacts Model.
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.
There are recognised shortages in most health professions in Australia. This is evidence that previous attempts at health workforce planning have failed. This paper argues that one reason for such failure is the lack of appropriate structures for health workforce planning. It also suggests that Australia needs to move beyond planning for particular professions and that health workforce planning needs to be based on identifying skill shortages as much as shortages in particular named professio...
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,
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
Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M
In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested.
Full Text Available In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested.
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.
Yemen, which belongs to the category of Least Developed Countries according to the OECD s Development Assistance Committee, has faced many challenges during the last two decades in its endeavor to achieve an acceptable level of economic development. To inform policy dialogue on these important issues, this report presents a comprehensive diagnostic of the country s WfD policies and institu...
Arnold, Edwin W; Goodson, Jane R; Duarte, Neville T
It is ironic that perhaps the only constant in health care organizations today is change. To compete successfully in health care and position an organization for high performance amid continuous change, it is very important for managers to have knowledge of the best learning and development practices of high-performing organizations in their industry. The rapid increases in the rate of technological change and geometric increases in knowledge make it virtually imperative that human resources are developed effectively. This article discusses the best learning and development practices among the Malcolm Baldrige National Quality Award winners in the health care industry since 2002 when the industry had its first award-winning organization.
Funk, Sadie; Weatherston, Deborah J.; Warren, Mary G.; Schuren, Nicole R.; McCormick, Ashley; Paradis, Nichole; Van Horn, Jacqui
The Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting Infant Mental Health® (Endorsement®) recognizes knowledge, skills, and reflective experiences that promote quality service when working with or on behalf of infants, toddlers, and families. Developed by the Michigan Association for Infant Mental Health, the…
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
Carter, Drake [Bismarck State College, Bismarck, ND (United States)
Bismarck State College, along with its partners (Williston State College, Minot State University and Dickinson State University), received funding to help address the labor and social impacts of rapid oilfield development in the Williston Basin of western North Dakota. Funding was used to develop and support both credit and non-credit workforce training as well as four major symposia designed to inform and educate the public; enhance communication and sense of partnership among citizens, local community leaders and industry; and identify and plan to ameliorate negative impacts of oil field development.
Alianza mundial en pro del personal sanitario: aumentando el impulso para el desarrollo de personal de la salud Global health workforce alliance: increasing the momentum for health workforce development
Full Text Available La Alianza en Pro del Personal Sanitario fue lanzada en el año 2006 para brindar una plataforma conjunta a los gobiernos, a las asociaciones de desarrollo, las agencias internacionales, las organizaciones de la sociedad civil, academia, el sector privado, las asociaciones profesionales y otros actores interesados, para trabajar juntos a fin de enfrentar la crisis global de los recursos humanos en salud. Cinco años después, la visión y el mandato de la Alianza aún son válidos. A pesar de los avances, como el ubicar a personal de la salud en el ruedo internacional de la política de salud, el aumento del conocimiento, las herramientas disponibles y las señales alentadoras de compromisos de muchos países, los cuellos de botella de la fuerza laboral de la salud siguen impidiendo a muchos sistemas de salud entregar servicios de salud esenciales y de calidad. América Latina no está libre de estos desafíos. En el 2010 el Segundo Foro Mundial sobre Recursos Humanos para la Salud permitió revisar el progreso, identificar brechas persistentes, alcanzar un consenso sobre soluciones y renovar el impulso para el compromiso de las inversiones y actuaciones urgentemente requeridas.The Global Health Workforce Alliance was launched in 2006 to provide a joint platform for governments, development partners, international agencies, civil society organizations, academia, private sector, professional associations, and other stakeholders to work together to address a global crisis in human resources for health. Five years later the vision and mandate of the Alliance still remain valid. Despite advances in bringing the health workforce to the fore in international health policy arenas, more available knowledge and tools, and encouraging signs of commitments from many countries, health workforce bottlenecks continue to prevent many health systems from delivering essential and quality health services. Latin America is not spared from the challenges. The 2010
Paul Jacob Robyn
Full Text Available Background Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. Methods To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Results Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, P< 0.001 and improved health facility infrastructure (aOR= 3.54, 95% CI: 2.73-4.58 respectively were the attributes with the largest effect sizes. Among medical doctors and nurse aides, a rural retention bonus of 75% of base salary was the attribute with the largest effect size (medical doctors aOR= 5.60, 95% CI: 4.12-7.61, P< 0.001; nurse aides aOR= 4.29, 95% CI: 3.11-5.93, P< 0.001. On the other hand, improved health facility infrastructure (aOR= 3.56, 95% CI: 2.75-4.60, P< 0.001, was the attribute with the largest effect size among the state registered nurses surveyed. Willingness-to-Pay (WTP estimates were generated for each health worker cadre for all the attributes. Preference impact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Conclusion Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on
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,…
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,…
Amde, Woldekidan Kifle; Sanders, David; Lehmann, Uta
Health systems in many low-income countries remain fragile, and the record of human resource planning and management in Ministries of Health very uneven. Public health training institutions face the dual challenge of building human resources capacity in ministries and health services while alleviating and improving their own capacity constraints. This paper reports on an initiative aimed at addressing this dual challenge through the development and implementation of a joint Masters in Public Health (MPH) programme with a focus on health workforce development by four academic institutions from East and Southern Africa and the building of a joint teaching platform. Data were obtained through interviews and group discussions with stakeholders, direct and participant observations, and reviews of publications and project documents. Data were analysed using thematic analysis. The institutions developed and collaboratively implemented a 'Masters Degree programme with a focus on health workforce development'. It was geared towards strengthening the leadership capacity of Health ministries to develop expertise in health human resources (HRH) planning and management, and simultaneously build capacity of faculty in curriculum development and innovative educational practices to teach health workforce development. The initiative was configured to facilitate sharing of experience and resources. The implementation of this initiative has been complex, straddling multiple and changing contexts, actors and agendas. Some of these are common to postgraduate programmes with working learners, while others are unique to this particular partnership, such as weak institutional capacity to champion and embed new programmes and approaches to teaching. The partnership, despite significant inherent challenges, has potential for providing real opportunities for building the field and community of practice, and strengthening the staff and organizational capacity of participant institutions. Key
Dubus, Nicole; Howard, Heather
This article shares findings from an interprofessional symposium that took place in Boston in the spring of 2015. Educators and practitioners from various disciplines shared challenges, successes, and ideas on best interprofessional collaboration (IPC) and curricula development. The findings include the importance of patient-and-family-centered care, which includes the patient and his/her family in the decision-making process; increased education regarding IPC in universities and major hospitals; and educational opportunities within health care systems.
Hovenga, Evelyn J S
The health workforce constitutes a very significant health system building block. As such it needs to have the capacity to influence how health data are captured, processed and used at all levels of decision making. This requires a national strategy that ensures all new health professional graduates are adequately prepared and that the existing workforce is developed to make the best possible use of all available digital technologies. This chapter provides an argument for why and how the health workforce should be contributing to health information governance, followed by an historical overview of various initiatives undertaken, the results achieved and issues identified during these processes. It concludes with an exploration of strategies that may be adopted to bring about change and achieve improvements.
Key words: Decentralization, Health workforce, density, attrition, deployment, West Ethiopia. Health Workforce .... centralization 12(63.1%) higher level professionals,. 91(28%) ..... International Labour Organization/World Health. Organization ...
Greuningen, M. van; Batenburg, R.S.; Velden, L.F.J. van der
Background: Health workforce projections are important instruments to prevent imbalances in the health workforce. For both the tenability and further development of these projections, it is important to evaluate the accuracy of workforce projections. In the Netherlands, health workforce projections
... workforce policy and planning questions. Though the FOA indicated the intent to fund only one cooperative... HUMAN SERVICES Health Resources and Services Administration Health Workforce Research Center Cooperative...: The Bureau of Health Professions (BHPr) is announcing a change to its Health Workforce Research...
Bohmer, Richard M J; Imison, Candace
In 2000 the English National Health Service (NHS) began a series of workforce redesign initiatives that increased the number of doctors and nurses serving patients, expanded existing staff roles and developed new ones, redistributed health care work, and invested in teamwork. The English workforce redesign experience offers important lessons for US policy makers. Redesigning the health care workforce is not a quick fix to control costs or improve the quality of care. A poorly planned redesign can even result in increased costs and decreased quality. Changes in skill mix and role definitions should be preceded by a detailed analysis and redesign of the work performed by health care professionals. New roles and responsibilities must be clearly defined in advance, and teamwork models that include factors common in successful redesigns such as leadership, shared objectives, and training should be promoted. The focus should be on retraining current staff instead of hiring new workers. Finally, any workforce redesign must overcome opposition from professional bodies, individual practitioners, and regulators. England's experience suggests that progress is possible if workforce redesigns are planned carefully and implemented with skill.
Cometto, Giorgio; Sheikh, Mubashar
The health workforce is in many countries the weakest link in the effective and equitable delivery of quality health services, and the largest impediment to the achievement of health Millennium Development Goals. The Kampala Declaration and Agenda for Global Action, championed by the Global Health Workforce Alliance, provide an effective overarching framework for the bold, concerted and sustained action which is required at the international, national and local level.
Naccarella, Lucio; Greenstock, Louise; Wraight, Brenda
To ensure New Zealand's health workforce was fit for purpose, Health Workforce New Zealand (HWNZ) funded Workforce Service Reviews (WSRs) to develop visions for service reconfiguration and workforce for 2020. This paper describes what makes the WSR processes work, for whom, and in what circumstances. Semi-structured interviews informed by a realist evaluation approach were conducted to obtain perceptions and experiences of WSR participants from four WSRs: eye health, palliative care, anaesthesia and aged care. The WSR process was a successful means of bringing together professionals from across the health disciplines and building sector capacity to develop new ways of thinking about service and workforce planning. WSRs were constrained by: mixed signals about process and outcomes; being challenged not milestone focussed; lacking clarity about ownership of visions; and variable clarity about next steps. WSRs were optimised by having: a lead clinician with policy know-how, ability to inspire, bring people together, distil ideas into coherent frameworks; and a project manager with project enablement skill sets and expertise in complex systems, implementation, change management. Evidence now exists at a point in time about what makes the WSR processes work. Implications for HWNZ are presented using a capacity-building framework to inform future decision making regarding WSRs. WHAT IS KNOWN ABOUT THE TOPIC? More appropriate workforce planning is required to meet the challenges facing the health workforce, from both the demand and the workforce side. To ensure New Zealand's healthcare workforce was fit for purpose, HWNZ initiated an iterative WSR process in topic specific areas. The WSRs process was designed to develop a vision of the relevant health service and workforce for 2020, and models of care that were patient-centred and team-based. WHAT DOES THIS PAPER ADD? The paper provides evidence that the WSR process was a successful means for bringing together
Full Text Available OBJECTIVES: To reveal the equity of health workforce distribution in urban community health service (CHS, and to provide evidence for further development of community health service in China. METHODS: A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. RESULTS: On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39 was better than that of doctors per square kilometer (G = 0.44 (P = 0.005. Among the total 6,573 health workers, 1,755(26.7% had undergraduate degree or above, 2,722(41.4%had junior college degree and 215(3.3% had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52, which was worse than that of health works per 10000 population (P<0.001. CONCLUSIONS: Health workforce inequity was found in this study, especially in quality and geographic distribution. These findings suggest a need for more innovative policies to improve health equity in Chinese urban CHS centers.
... 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...
Chen, Rui; Zhao, Yali; Du, Juan; Wu, Tao; Huang, Yafang; Guo, Aimin
To reveal the equity of health workforce distribution in urban community health service (CHS), and to provide evidence for further development of community health service in China. A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39) was better than that of doctors per square kilometer (G = 0.44) (P = 0.005). Among the total 6,573 health workers, 1,755(26.7%) had undergraduate degree or above, 2,722(41.4%)had junior college degree and 215(3.3%) had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52), which was worse than that of health works per 10000 population (Purban CHS centers.
Williams, L; Rycroft-Malone, J; Burton, C R; Edwards, S; Fisher, D; Hall, B; McCormack, B; Nutley, S M; Seddon, D; Williams, R
Objectives This evidence review was conducted to understand how and why workforce development interventions can improve the skills and care standards of support workers in older people's services. Design Following recognised realist synthesis principles, the review was completed by (1) development of an initial programme theory; (2) retrieval, review and synthesis of evidence relating to interventions designed to develop the support workforce; (3) ‘testing out’ the synthesis findings to refine the programme theories, and establish their practical relevance/potential for implementation through stakeholder interviews; and (4) forming actionable recommendations. Participants Stakeholders who represented services, commissioners and older people were involved in workshops in an advisory capacity, and 10 participants were interviewed during the theory refinement process. Results Eight context–mechanism–outcome (CMO) configurations were identified which cumulatively comprise a new programme theory about ‘what works’ to support workforce development in older people's services. The CMOs indicate that the design and delivery of workforce development includes how to make it real to the work of those delivering support to older people; the individual support worker's personal starting points and expectations of the role; how to tap into support workers' motivations; the use of incentivisation; joining things up around workforce development; getting the right mix of people engaged in the design and delivery of workforce development programmes/interventions; taking a planned approach to workforce development, and the ways in which components of interventions reinforce one another, increasing the potential for impacts to embed and spread across organisations. Conclusions It is important to take a tailored approach to the design and delivery of workforce development that is mindful of the needs of older people, support workers, health and social care services and the
Liu, Jenny X; Goryakin, Yevgeniy; Maeda, Akiko; Bruckner, Tim; Scheffler, Richard
In low- and middle-income countries, scaling essential health interventions to achieve health development targets is constrained by the lack of skilled health professionals to deliver services. We take a labor market approach to project future health workforce demand based on an economic model based on projected economic growth, demographics, and health coverage, and using health workforce data (1990-2013) for 165 countries from the WHO Global Health Observatory. The demand projections are compared with the projected growth in health worker supply and the health worker "needs" as estimated by WHO to achieve essential health coverage. The model predicts that, by 2030, global demand for health workers will rise to 80 million workers, double the current (2013) stock of health workers, while the supply of health workers is expected to reach 65 million over the same period, resulting in a worldwide net shortage of 15 million health workers. Growth in the demand for health workers will be highest among upper middle-income countries, driven by economic and population growth and aging. This results in the largest predicted shortages which may fuel global competition for skilled health workers. Middle-income countries will face workforce shortages because their demand will exceed supply. By contrast, low-income countries will face low growth in both demand and supply, which are estimated to be far below what will be needed to achieve adequate coverage of essential health services. In many low-income countries, demand may stay below projected supply, leading to the paradoxical phenomenon of unemployed ("surplus") health workers in those countries facing acute "needs-based" shortages. Opportunities exist to bend the trajectory of the number and types of health workers that are available to meet public health goals and the growing demand for health workers.
Full Text Available Abstract The challenges in the health workforce are well known and clearly documented. What is not so clearly understood is how to address these issues in a comprehensive and integrated manner that will lead to solutions. This editorial presents – and invites comments on – a technical framework intended to raise awareness among donors and multisector organizations outside ministries of health and to guide planning and strategy development at the country level.
The established relationships among social determinants of health (SDH), health disparities, and race/ethnicity highlight the need for health-care professionals to adequately address SDH in their encounters with patients. The ethnic demographic transition slated to occur during the next several decades in the United States will have numerous effects on the health-care sector, particularly as it pertains to the need for a more diverse and culturally aware workforce. In recent years, a substantial body of literature has developed, exploring the extent to which diversity in the health-care workforce may be used as a tool to eliminate racial/ethnic disparities in health and health care in the U.S. We explore existing literature on this topic, propose a conceptual framework, and identify next steps in health-care policy for reducing and eliminating health disparities by addressing SDH and diversification of the health-care workforce. PMID:24385659
LaVeist, Thomas A; Pierre, Geraldine
The established relationships among social determinants of health (SDH), health disparities, and race/ethnicity highlight the need for health-care professionals to adequately address SDH in their encounters with patients. The ethnic demographic transition slated to occur during the next several decades in the United States will have numerous effects on the health-care sector, particularly as it pertains to the need for a more diverse and culturally aware workforce. In recent years, a substantial body of literature has developed, exploring the extent to which diversity in the health-care workforce may be used as a tool to eliminate racial/ethnic disparities in health and health care in the U.S. We explore existing literature on this topic, propose a conceptual framework, and identify next steps in health-care policy for reducing and eliminating health disparities by addressing SDH and diversification of the health-care workforce.
The public health workforce is a key resource of population health. How many people work in public health in the Netherlands, what are their characteristics and who does what? Remarkably, such information about the size and composition of the public health workforce in the Netherlands is lacking. A
Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah
Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services
Okun, Andrea H; Guerin, Rebecca J; Schulte, Paul A
Young workers (aged 15-24) suffer disproportionately from workplace injuries, with a nonfatal injury rate estimated to be two times higher than among workers age 25 or over. These workers make up approximately 9% of the U.S. workforce and studies have shown that nearly 80% of high school students work at some point during high school. Although young worker injuries are a pressing public health problem, the critical knowledge and skills needed to prepare youth for safe and healthy work are missing from most frameworks used to prepare the emerging U.S. workforce. A framework of foundational workplace safety and health knowledge and skills (the NIOSH 8 Core Competencies) was developed based on the Health Belief Model (HBM). The proposed NIOSH Core Competencies utilize the HBM to provide a framework for foundational workplace safety and health knowledge and skills. An examination of how these competencies and the HBM apply to actions that workers take to protect themselves is provided. The social and physical environments that influence these actions are also discussed. The NIOSH 8 Core Competencies, grounded in one of the most widely used health behavior theories, fill a critical gap in preparing the emerging U.S. workforce to be cognizant of workplace risks. Integration of the NIOSH 8 Core Competencies into school curricula is one way to ensure that every young person has the foundational workplace safety and health knowledge and skills to participate in, and benefit from, safe and healthy work. Published by Elsevier Ltd.
Mertz, Elizabeth; Mouradian, Wendy E
Oral Health in America: A Report of the Surgeon General (SGROH) and National Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity, and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist-to-population ratio is declining while shortages of dentists continue in rural and underserved communities. The diversity of the dental workforce has only improved slightly, and the the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include enhanced training in children's oral health for general dentists, expanded scope of practice for allied dental health professionals, new dental practitioners including the dental health aid therapist, and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts, and strong partnerships with communities will be needed to effect substantive changes in children's oral health.
McQuide Pamela A; Spero Julie C; Matte Rita
Abstract Background Health workforce planning is important in ensuring that the recruitment, training and deployment of health workers are conducted in the most efficient way possible. However, in many developing countries, human resources for health data are limited, inconsistent, out-dated, or unavailable. Consequently, policy-makers are unable to use reliable data to make informed decisions about the health workforce. Computerized human resources information systems (HRIS) enable countries...
This article offers practical strategies to managers and others for supporting overseas trained nurses and managing cultural diversity in the health workforce. Widespread nursing shortages have led managers to recruit nurses from overseas, mainly from developing countries. This paper draws on evidence from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study reported elsewhere in this issue, which indicates that overseas trained nurses encountered widespread discriminatory practices including an overuse of complaints and grievances against them. The researchers also found that the overseas trained nurses responded to their experiences by using various personal strategies to resist or re-negotiate and overcome such discriminatory practices. A research workshop was held in June 2005 at the midpoint of the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study. Twenty-five participants attended the workshop. They were the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study researchers, advisory group members, including the author of this paper and other researchers in the field of migration. The overall aim of the workshop was to share emerging research data from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals and related studies. The final session of the workshop on which this paper is based, was facilitated by the author, with the specific aim of asking the participants to discuss and determine the challenges to managers when managing a culturally diverse workforce. The discussion yielded four main themes collated by the author from which a framework of strategies to facilitate equality and cultural diversity management of the healthcare workers may be developed. The four themes are: assumptions and expectations; education and training to include
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.
Zurn, Pascal; Dumont, Jean-Christophe
This paper examines health workforce and migration policies in New Zealand, with a special focus on the international recruitment of doctors and nurses. The health workforce in New Zealand, as in all OECD countries, plays a central role in the health system. Nonetheless, maybe more than for any other OECD country, the health workforce in New…
Full Text Available Abstract Background In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Methods Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. Results We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. Conclusion We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.
Newcomb, C.; Baring-Gould, I.
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.
Michalski, Daniel S.; Kohout, Jessica L.
Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of…
Keeping the existing information technology (IT) workforce viable and rapidly increasing the number of these workers presents a United States public policy workforce development (WD) challenge at all government levels. Public policy human capital investments have been undertaken to address the IT workforce supply and demand mismatch. States seem…
Kenefick, Hope Worden; Ravid, Sharon; MacVarish, Kathleen; Tsoi, Jennifer; Weill, Kenny; Faye, Elizabeth; Fidler, Anne
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.
Mather, Carey; Cummings, Elizabeth
Digital technology provides opportunities for using mobile learning strategies in healthcare environments. To realise the vision of the National Workforce Development Strategy there needs to be innovation of health professionals to further develop knowledge and skills of clinical supervisors to access and gain an understanding of the value of mobile learning at the workplace. The use of digital technology by clinical supervisors was explored in 2012 as part of a teaching development grant to evaluate the use of Web 2.0 technology to develop a community of practice about clinical supervision. Prior to developing the virtual network of clinical supervisors, feedback about the use of Web 2.0 technology by clinicians was sought via an online survey. Over 90% of respondents used social media, 85% understood what a blog and wiki were and approximately half of the respondents used smart phones. More than one-third indicated they would participate in a virtual community of practice and would like to receive information about clinical facilitation at least once per week. Findings indicate both inhibitors and opportunities for workforce development within healthcare environments that need to be addressed. Support of graduate-ready nurses can be achieved through an integrated outlook that enables health professionals within organisations to undertake mobile learning in situ. A flexible and collaborative approach to continuing professional development within organisations could enhance practice development and could positively impact on workforce development.
(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.
Collins, Sandra K; Collins, Kevin S
Health care organizations continue to be plagued by labor shortage issues. Further complicating the already existing workforce challenges is an aging population poised to retire en masse within the next few years. With fewer cohorts in the age group of 25 to 44 years (Vital Speeches Day. 2004:71:23-27), a more mobile workforce (Grow Your Own Leaders: How to Identify, Develop, and Retain Leadership Talent, 2002), and an overall reduction in the number of individuals seeking employment in the health care field (J Healthc Manag. 2003:48:6-11), the industry could be faced with an unmanageable number of vacant positions throughout the organization. Bracing for the potential impact of these issues is crucial to the ongoing business continuity of health care organization. Many health care organizations have embraced succession planning to combat the potential labor famine. However, the health care industry as a whole seems to lag behind other industries in terms of succession planning efforts (Healthc Financ Manage. 2005;59:64-67). This article seeks to provide health care managers with a framework for improving the systematic preparation of the next generation of managers by analyzing the succession planning process. The proposition of these models is to initiate and simplify the gap reduction between theoretical concepts and future organizational application.
Full Text Available Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the worldÃ¢Â€Â™s population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada are home to 14% of the worldÃ¢Â€Â™s population, bear only 10% of the worldÃ¢Â€Â™s disease burden, have 37% of the global health workforce and spend about 50% of the worldÃ¢Â€Â™s financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the worldÃ¢Â€Â™s population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the worldÃ¢Â€Â™s financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the countryÃ¢Â€Â™s doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2
Dailey, Wayne F; Morris, John A; Hoge, Michael A
This study describes findings from a national search to identify innovative workforce practices designed to improve the lives of direct care workers serving individuals with mental health and substance use conditions, while simultaneously improving client care, and the business vitality of the employer. The search process, conducted by The Annapolis Coalition on the Behavioral Health Workforce, resulted in the selection of five programs to receive the Pacesetter Award from among 51 nominations received. Awardees understood the value of investing in direct care workers, who constitute an essential, but often overlooked, group within the behavioral health workforce. A review of these innovations yielded six cross-cutting principles that should inform future workforce efforts (a) supporting educational and career development (b) increasing wages and benefits (c) creating workforce development partnerships (d) using evidence-based practices to train staff and assess service fidelity (e) strengthening supervision and (f) employing people in recovery in direct care roles.
Salinas-Miranda, Abraham A; Nash, Michelle C; Salemi, Jason L; Mbah, Alfred K; Salihu, Hamisu M
A critical mass of public health practitioners with expertise in analytic techniques and best practices in comparative effectiveness research is needed to fuel informed decisions and improve the quality of health care. The purpose of this case study is to describe the development and formative evaluation of a technology-enhanced comparative effectiveness research learning curriculum and to assess its potential utility to improve core comparative effectiveness research competencies among the public health workforce. Selected public health experts formed a multidisciplinary research collaborative and participated in the development and evaluation of a blended 15-week comprehensive e-comparative effectiveness research training program, which incorporated an array of health informatics technologies. Results indicate that research-based organizations can use a systematic, flexible, and rapid means of instructing their workforce using technology-enhanced authoring tools, learning management systems, survey research software, online communities of practice, and mobile communication for effective and creative comparative effectiveness research training of the public health workforce.
Giepmans. P.; Dussault, G.; Batenburg, R.; Frich, J.; Olivers, R.; Sermeus, W.
With health care services significantly changing, the challenge is to initiate innovative, situational and integrated workforce forecasting and planning. Many health systems require a shift in mindset to move to the planning of skill mixes for health care professionals. This implies great challenges
Although it is widely acknowledged that health workforce planning is critical for health care systems, it is probably one of the least strategically planned resources. One could argue that there are good reasons for this: demand and supply of the health labour market are in constant flux, and policy
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.
Grover, Atul; Niecko-Najjum, Lidia M
Workforce planning in an era of health care reform is a challenge as both delivery systems and patient demographics change. Current workforce projections are based on a future health care system that is either an identified "ideal" or a modified version of the existing system. The desire to plan for such an "ideal system," however, may threaten access to necessary services if it does not come to fruition or is based on theoretical rather than empirical data.Historically, workforce planning that concentrated only on an "ideal system" has been centered on incorrect assumptions. Two examples of such failures presented in the 1980s when the Graduate Medical Education National Advisory Committee recommended a decrease in the physician workforce on the basis of predetermined "necessary and appropriate" services and in the 1990s, when planners expected managed care and health maintenance organizations to completely overhaul the existing health care system. Neither accounted for human behavior, demographic changes, and actual demand for health care services, leaving the nation ill-prepared to care for an aging population with chronic disease.In this article, the authors argue that workforce planning should begin with the current system and make adjustments based on empirical data that accurately reflect current trends. Actual health care use patterns will become evident as systemic changes are realized-or not-over time. No single approach will solve the looming physician shortage, but the danger of planning only for an ideal system is being unprepared for the actual needs of the population.
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.
Naccarella, Lucio; Buchan, Jim; Brooks, Peter
Australia is facing a primary health care workforce shortage. To inform primary health care (PHC) workforce policy reforms, reflection is required on ways to strengthen the evidence base and its uptake into policy making. In 2008 the Australian Primary Health Care Research Institute funded the Australian Health Workforce Institute to host Professor James Buchan, Queen Margaret University, UK, an expert in health services policy research and health workforce planning. Professor Buchan's visit enabled over forty Australian PHC workforce mid-career and senior researchers and policy stakeholders to be involved in roundtable policy dialogue on issues influencing PHC workforce policy making. Six key thematic questions emerged. (1) What makes PHC workforce planning different? (2) Why does the PHC workforce need to be viewed in a global context? (3) What is the capacity of PHC workforce research? (4) What policy levers exist for PHC workforce planning? (5) What principles can guide PHC workforce planning? (6) What incentives exist to optimise the use of evidence in policy making? The emerging themes need to be discussed within the context of current PHC workforce policy reforms, which are focussed on increasing workforce supply (via education/training programs), changing the skill mix and extending the roles of health workers to meet patient needs. With the Australian government seeking to reform and strengthen the PHC workforce, key questions remain about ways to strengthen the PHC workforce evidence base and its uptake into PHC workforce policy making.
compensation and workplace environment structure to motivate the target generational workforce demographic to improve productivity. The deliverables from this...factors. We developed a closed-loop survey instrument and analysis methodology to identify distinct generational workforce motivational factors. Nine...United States Army Research Development and Engineering Command (RDECOM) supervisory engineers, General Schedule (GS) 14 and 15, reviewed the survey
Full Text Available Background . Canada's North is a diverse, sparsely populated land, where inequalities and public health issues are evident, particularly for Aboriginal people. The Northern public health workforce is a unique mix of professional and paraprofessional workers. Few have formal public health education. From 2009 to 2012, the Public Health Agency of Canada (PHAC collaborated with a Northern Advisory Group to develop and implement a strategy to strengthen public health capacity in Canada's 3 northern territories. Access to relevant, effective continuing education was identified as a key issue. Challenges include diverse educational and cultural backgrounds of public health workers, geographical isolation and variable technological infrastructure across the north. Methods . PHAC's Skills Online program offers Internet-based continuing education modules for public health professionals. In partnership with the Northern Advisory Group, PHAC conducted 3 pilots between 2008 and 2012 to assess the appropriateness of the Skills Online program for Northern/Aboriginal public health workers. Module content and delivery modalities were adapted for the pilots. Adaptations included adding Inuit and Northern public health examples and using video and teleconference discussions to augment the online self-study component. Results . Findings from the pilots were informative and similar to those from previous Skills Online pilots with learners in developing countries. Online learning is effective in bridging the geographical barriers in remote locations. Incorporating content on Northern and Aboriginal health issues facilitates engagement in learning. Employer support facilitates the recruitment and retention of learners in an online program. Facilitator assets included experience as a public health professional from the north, and flexibility to use modified approaches to support and measure knowledge acquisition and application, especially for First Nations, Inuit and
Stone, Robyn; Sutton, Janet P; Bryant, Natasha; Adams, Annelise; Squillace, Marie
The demand for home health aides is expected to rise, despite concerns about the sustainability of this workforce. Home health workers receive low wages and little training and have high turnover. It is difficult to recruit and retain workers to improve clinical outcomes. This study presents national estimates to examine how home health workers and the subgroup of workers differ in terms of sociodemographic characteristics, compensation, benefits, satisfaction, and retention. Hospice aides fare better than other categories of workers and are less likely to leave their job. Policymakers should consider strategies to increase the quality and stability of this workforce.
Matovu, Joseph K B; Wanyenze, Rhoda K; Mawemuko, Susan; Okui, Olico; Bazeyo, William; Serwadda, David
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. 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. 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 reporting. The projects implemented aimed to improve trainees
Matovu Joseph KB
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
Holmes, George M; Fraher, Erin P
To understand factors affecting specialty heterogeneity in physician migration. Physicians in the 2009 American Medical Association Masterfile data were matched to those in the 2013 file. Office locations were geocoded in both years to one of 293 areas of the country. Estimated utilization, calculated for each specialty, was used as the primary predictor of migration. Physician characteristics (e.g., specialty, age, sex) were obtained from the 2009 file. Area characteristics and other factors influencing physician migration (e.g., rurality, presence of teaching hospital) were obtained from various sources. We modeled physician location decisions as a two-part process: First, the physician decides whether to move. Second, conditional on moving, a conditional logit model estimates the probability a physician moved to a particular area. Separate models were estimated by specialty and whether the physician was a resident. Results differed between specialties and according to whether the physician was a resident in 2009, indicating heterogeneity in responsiveness to policies. Physician migration was higher between geographically proximate states with higher utilization for that specialty. Models can be used to estimate specialty-specific migration patterns for more accurate workforce modeling, including simulations to model the effect of policy changes. © Health Research and Educational Trust.
Gonzales, L. M.; Keane, C. M.; Martinez, C. M.
Increased demands for resources and environmental activities, relative declines in college students entering technical fields, and expectations of growth commensurate with society as a whole challenge the competitiveness of the U.S. geoscience workforce. Because of prior business cycles, more than 50% of the workforce needed in natural resource industries in 10 years is currently not in the workforce. This issue is even more acute in government at all levels and in academic institutions. Here, we present a snapshot of the current status of the geoscience profession that spans geoscientists in training to geoscience professionals in government, industry, and academia to understand the disparity between the supply of and demand for geoscientists. Since 1996, only 1% of high school SAT test takers plan to major in geosciences at college. Although the total number of geoscience degrees granted at community colleges have increased by 9% since 1996 , the number of geoscience undergraduate degrees has decreased by 7%. The number of geoscience master's and doctoral degrees have increased 4% and 14% respectively in the same time period. However, by 2005, 68 geoscience departments were consolidated or closed in U.S. universities. Students who graduate with geoscience degrees command competitive salaries. Recent bachelors geoscience graduates earned an average salary of 31,366, whereas recent master's recipients earned an average of 81,300. New geosciences doctorates commanded an average salary of 72,600. Also, fFederal funding for geoscience research has increase steadily from 485 million in 1970 to $3.5 billion in 2005. Economic indicators suggest continued growth in geoscience commodity output and in market capitalization of geoscience industries. Additionally, the Bureau of Labor Statistics projects a 19% increase in the number of geoscience jobs from 2006 to 2016. Despite the increased demand for geoscientists and increase in federal funding of geoscience research
Yamalik, Nermin; Ensaldo-Carrasco, Eduardo; Bourgeois, Denis
Workforce planning is a resource to measure and compare current versus future workforce. Organised dentistry needs to focus on the benefits and the determinants and various systems of workforce planning together with the challenges, new trends and threats. The aim of the study was to identify data sources from countries relating to a selection of oral health indicators in a sample of FDI member countries. The potential for differences between developed and developing countries was also examined. A cross-sectional survey study was carried out among FDI member countries classified in developed and developing countries between October 2011 and January/February 2012. A questionnaire was developed addressing the availability of 40 selected indicators distributed in four domains. Mann-Whitney U-tests to identify differences between developed and developing countries and chi-square tests for the degree of information regularly available were carried out. There is an important lack of information about indicators relevant to oral health between FDI participating countries regardless of their level of economic development. Although not significant, the availability of indicators for developing countries showed higher variability and minimum values of zero for all domains. Surveys were the source of information more frequently reported. Standardised and reliable methodologies are needed to gather information for successful workforce planning. It is of utmost importance to increase the awareness and understanding of the member National Dental Associations regarding the role, basic elements, benefits, challenges, models and critical elements of an ideal workforce planning system.
Hall, Jennifer; Cohen, Deborah J; Davis, Melinda; Gunn, Rose; Blount, Alexander; Pollack, David A; Miller, William L; Smith, Corey; Valentine, Nancy; Miller, Benjamin F
To identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. Observational cross-case comparison study of 19 U.S. practices, 11 participating in Advancing Care Together, and 8 from the Integration Workforce Study. Practices varied in size, ownership, geographic location, and experience delivering integrated care. Multidisciplinary teams collected data (field notes from direct practice observations, semistructured interviews, and online diaries as reported by practice leaders) and then analyzed the data using a grounded theory approach. Organizations had difficulty finding clinicians possessing the skills and experience necessary for working in an integrated practice. Practices newer to integration underestimated the time and resources needed to train and organizationally socialize (onboard) new clinicians. Through trial and error, practices learned that clinicians needed relevant training to work effectively as integrated care teams. Training efforts exclusively targeting behavioral health clinicians (BHCs) and new employees were incomplete if primary care clinicians (PCCs) and others in the practice also lacked experience working with BHCs and delivering integrated care. Organizations' methods for addressing employees' need for additional preparation included hiring a consultant to provide training, sending employees to external training programs, hosting residency or practicum training programs, or creating their own internal training program. Onboarding new employees through the development of training manuals; extensive shadowing processes; and protecting time for ongoing education, mentoring, and support opportunities for new and established clinicians and staff were featured in these internal training programs. Insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration
In this article, the different dimensions and determinants of health workforce planning (HWF) are investigated to improve context-sensitivity and mutual learning among groups of countries with similar HWF characteristics. A novel approach to scoring countries according to their HFW characteristics a
Lesieutre, George A.; Stewart, Susan W.; Bridgen, Marc
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.
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.
Lees, Jessica; Webb, Gillian; Coulston, Frances; Smart, Aidan; Remedios, Louisa
To design and implement an international and interprofessional Global Learning Partnership Model, which involves shared learning between academics and students from Universitas 21 network with other universities with United Nations Millennium Development Goal needs. Two literature reviews were conducted to inform ethical aspects and curriculum design of the GLP model. Feedback from conference presentations and consultation with experts in education and public health has been incorporated to inform the current iteration of the GLP model. The pilot group of 25 students from U21 universities and Kathmandu University, representing six health disciplines will meet in Nepal in April 2016 for a shared learning experience, including a one week university based workshop and three week community based experience. A multi-phase, mixed method design was selected for the evaluation of the GLP model, utilising a combination of focus groups and questionnaires to evaluate the efficacy of the placement through student experience and learning outcomes in cultural competency, UN SDG knowledge, community engagement and health promotion skills. The literature review demonstrated that cultural awareness and cultural knowledge were improved through participation in cultural immersion programs that incorporated preparatory workshops and clinical experiences. Data will be gathered in April 2006 and the results of the evaluation will be published in the future. The GLP model proposes a project around the fundamental concept of engagement and sharing between students and academics across universities and cultural contexts to build capacity through education, while capitalising on strengths of existing global health placements. Further the inclusion of host-country students and academics in this learning exchange will promote the establishment of an international and interprofessional network for ongoing health promotion. Significance for public healthThe Global Learning Partnership model
O' Neil, Lori Ross; Assante, Michael; Tobey, D. H.; Conway, T. J.; Vanderhorst, Jr, T. J.; Januszewski, III, J.; Leo, R.; Perman, K.
This document is a summarization of the report, Developing Secure Power Systems Professional Competence: Alignment and Gaps in Workforce Development Programs, the final report for phase 2 of the SPSP (DOE workforce study) project.
Ferrier, Fran; Burke, Gerald; Selby Smith, Chris
In the context of aging populations, governments in Australia and in other Western nations fear that slower growth in the numbers of people of working age (15-64 years) will have a dampening effect on economic growth. They are thus considering how to encourage older workers to remain in the workforce beyond the point at which many currently…
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…
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
Internationally there are growing numbers of migrant workers in the field of health who may represent an untapped resource in terms of workforce development. Although these workers often have higher-level skills and qualifications, they often find themselves in unskilled roles. This paper reports on a case study in the South West of England that…
Grignon, Jessica S; Ledikwe, Jenny H; Makati, Ditsapelo; Nyangah, Robert; Sento, Baraedi W; Semo, Bazghina-Werq
To address health systems challenges in limited-resource settings, global health initiatives, particularly the President's Emergency Plan for AIDS Relief, have seconded health workers to the public sector. Implementation considerations for secondment as a health workforce development strategy are not well documented. The purpose of this article is to present outcomes, best practices, and lessons learned from a President's Emergency Plan for AIDS Relief-funded secondment program in Botswana. Outcomes are documented across four World Health Organization health systems' building blocks. Best practices include documentation of joint stakeholder expectations, collaborative recruitment, and early identification of counterparts. Lessons learned include inadequate ownership, a two-tier employment system, and ill-defined position duration. These findings can inform program and policy development to maximize the benefit of health workforce secondment. Secondment requires substantial investment, and emphasis should be placed on high-level technical positions responsible for building systems, developing health workers, and strengthening government to translate policy into programs.
Kaplan, Avril D; Dominis, Sarah; Palen, John Gh; Quain, Estelle E
Research on practical and effective governance of the health workforce is limited. This paper examines health system strengthening as it occurs in the intersection between the health workforce and governance by presenting a framework to examine health workforce issues related to eight governance principles: strategic vision, accountability, transparency, information, efficiency, equity/fairness, responsiveness and citizen voice and participation. This study builds off of a literature review that informed the development of a framework that describes linkages and assigns indicators between governance and the health workforce. A qualitative analysis of Health System Assessment (HSA) data, a rapid indicator-based methodology that determines the key strengths and weaknesses of a health system using a set of internationally recognized indicators, was completed to determine how 20 low- and middle-income countries are operationalizing health governance to improve health workforce performance. The 20 countries assessed showed mixed progress in implementing the eight governance principles. Strengths highlighted include increasing the transparency of financial flows from sources to providers by implementing and institutionalizing the National Health Accounts methodology; increasing responsiveness to population health needs by training new cadres of health workers to address shortages and deliver care to remote and rural populations; having structures in place to register and provide licensure to medical professionals upon entry into the public sector; and implementing pilot programs that apply financial and non-financial incentives as a means to increase efficiency. Common weaknesses emerging in the HSAs include difficulties with developing, implementing and evaluating health workforce policies that outline a strategic vision for the health workforce; implementing continuous licensure and regulation systems to hold health workers accountable after they enter the workforce
Kaplan Avril D
Full Text Available Abstract Background Research on practical and effective governance of the health workforce is limited. This paper examines health system strengthening as it occurs in the intersection between the health workforce and governance by presenting a framework to examine health workforce issues related to eight governance principles: strategic vision, accountability, transparency, information, efficiency, equity/fairness, responsiveness and citizen voice and participation. Methods This study builds off of a literature review that informed the development of a framework that describes linkages and assigns indicators between governance and the health workforce. A qualitative analysis of Health System Assessment (HSA data, a rapid indicator-based methodology that determines the key strengths and weaknesses of a health system using a set of internationally recognized indicators, was completed to determine how 20 low- and middle-income countries are operationalizing health governance to improve health workforce performance. Results/discussion The 20 countries assessed showed mixed progress in implementing the eight governance principles. Strengths highlighted include increasing the transparency of financial flows from sources to providers by implementing and institutionalizing the National Health Accounts methodology; increasing responsiveness to population health needs by training new cadres of health workers to address shortages and deliver care to remote and rural populations; having structures in place to register and provide licensure to medical professionals upon entry into the public sector; and implementing pilot programs that apply financial and non-financial incentives as a means to increase efficiency. Common weaknesses emerging in the HSAs include difficulties with developing, implementing and evaluating health workforce policies that outline a strategic vision for the health workforce; implementing continuous licensure and regulation systems to
Whitford, Deirdre; Smith, Tony; Newbury, Jonathan
There is a lack of detailed evidence about the allied health workforce to inform proposed health care reforms. The South Australian Allied Health Workforce (SAAHW) survey collected data about the demographic characteristics, employment, education and recruitment and retention of allied health professionals in South Australia. The SAAHW questionnaire was widely distributed and 1539 responses were received. The average age of the sample was 40 years; males were significantly older than females, the latter making up 82% of respondents. Three-quarters of the sample worked in the city; 60% worked full time and the remainder in part-time, casual or locum positions. 'Work-life balance' was the most common attraction to respondents' current jobs and 'Better career prospects' the most common reason for intending to leave. Practice in a rural location was influenced by rural background and rural experience during training. A greater proportion of Generation Y (1982-2000) respondents intended to leave within 2 years than Generation X (1961-81) or Baby Boomers (1943-60). Most respondents were satisfied with their job, although some reported lack of recognition of their knowledge and skills. Systematic, robust allied health workforce data are required for integrated and sustainable primary health care delivery.
Nivet, Marc A; Berlin, Anne
While the levers for the social determinants of health reside largely outside institutional walls, this does not absolve health professional schools from exercising their influence to improve the communities in which they are located. Fulfilling this charge will require a departure from conventional thinking, particularly when it comes to educating future health professionals. We describe efforts within medical education to transform recruitment, admissions, and classroom environments to emphasize diversity and inclusion. The aim is to cultivate a workforce with the perspectives, aptitudes, and skills needed to fuel community-responsive health-care institutions.
Marchal, Bruno; Kegels, Guy
The health workforce is of strategic importance to the performance of national health systems as well as of international disease control initiatives. The brain drain from rural to urban areas, and from developing to industrialized countries is a long-standing phenomenon in the health professions but has in recent years taken extreme proportions, particularly in Africa. Adopting the wider perspective of health workforce balances, this paper presents an analysis of the underlying mechanisms of health professional migration and possible strategies to reduce its negative impact on health services. The opening up of international borders for goods and labour, a key strategy in the current liberal global economy, is accompanied by a linguistic shift from 'human capital flight' and 'brain drain' to 'professional mobility' or 'brain circulation'. In reality, this mobility is very asymmetrical, to the detriment of less developed countries, which lose not only much-needed human resources, but also considerable investments in education and fiscal income. It is argued that low professional satisfaction and the decreasing social valuation of the health professionals are important determinants of the decreasing attraction of the health professions, which underlies both the push from the exporting countries, as well as the pull from the recipient countries. Solutions should therefore be based on this wider perspective, interrelating health workforce imbalances between, but also within developing and developed countries.
Saltman Deborah C
Full Text Available Abstract Background In workforces that are traditionally mobile and have long lead times for new supply, such as health, effective global indicators of tertiary education are increasingly essential. Difficulties with transportability of qualifications and cross-accreditation are now recognised as key barriers to meeting the rapidly shifting international demands for health care providers. The plethora of mixed education and service arrangements poses challenges for employers and regulators, let alone patients; in determining equivalence of training and competency between individuals, institutions and geographical locations. Discussion This paper outlines the shortfall of the current indicators in assisting the process of global certification and competency recognition in the health care workforce. Using Organisation for Economic Cooperation and Development (OECD data we highlight how International standardisation in the tertiary education sector is problematic for the global health workforce. Through a series of case studies, we then describe a model which enables institutions to compare themselves internally and with others internationally using bespoke or prioritised parameters rather than standards. Summary The mobility of the global health workforce means that transportability of qualifications is an increasing area of concern. Valid qualifications based on workplace learning and assessment requires at least some variables to be benchmarked in order to judge performance.
The global context. A stable human resource base in the health sector is critical to .... Africa than in its benchmarked countries, including Brazil, Russia,. India and ... person in terms of the Companies Act of 1973, proof of financial viability and ...
Baumann, Andrea; Hunsberger, Mabel; Crea-Arsenio, Mary
Historically, economic changes have negatively affected the nursing workforce in Ontario. The trend towards part-time and casual employment emerged from healthcare restructuring in the 1990s. The severe acute respiratory syndrome (SARS) outbreak in 2003 alerted the Ontario government to the issue of part-time and casual nursing. In 2007, the Nursing Graduate Guarantee (NGG), a health human resources employment policy, was developed as a financial incentive for employers to hire and mentor new graduate nurses for a six-month period. The purpose of this study was to examine facilitators and barriers to policy implementation and assess the impact of the NGG on full-time employment and workforce integration of new graduate nurses in Ontario. A mixed-methods approach was used and included surveys, interviews and focus groups. Results indicated that full-time employment of new graduate nurses increased during the study period and that mentorship facilitated workforce integration of new graduate nurses.
Brandon L Grimm
Full Text Available IntroductionIn 2012, the Great Plains Public Health Training Center (Grant #UB6HP22821 conducted an online survey of state and local health departments and the American Indian (tribal clinics, tribal health departments and urban Indian clinic public health workforce across three professional levels. The objectives of the needs assessment were to, determine the competency levels of the state’s public health workforce, assess gaps in public health competencies, identify public health training interests, needs and preferences and, determine the barriers and motivators to participating in public health training.MethodsThe assessment was developed using the Council on Linkages Between Academia and Public Health Practice, Core Competencies for Public Health Professionals survey (Council of Linkages, 2010. The final assessment was created and piloted by numerous individuals representing practice and academia. ResultsRespondents identified cultural competency and communication skills as the two most important public health competency domains. Although the public health professionals perceived that they were least proficient in the area of policy development and program planning, participants identified the greatest needs for training in financial planning & management skills and analytical/assessment skills. In general, respondents preferred instructor-led interactive training sessions offered as onsite multi-day workshops or computer-based courses. Respondents identified obesity, health disparities, physical activity, chronic diseases and diabetes as the top five public health topical areas. ConclusionThese priorities align with State and National public health plans. The findings of the needs assessment were used to tailor educational opportunities to build the capacity of Nebraska’s public health system. Additionally, the results were used to develop workforce development plans for numerous local health departments throughout Nebraska.
Stephen B. Thacker, MD, MSc
Full Text Available The events of September 11, 2001, brought unprecedented attention to public health in the United States. The national response to these events included a large infusion of resources into the public health system that enhanced the capacity for the system to respond to terrorist threats and other public health emergencies. However, as illustrated by the emerging epidemics of obesity and diabetes in this country, a disproportionate burden of disease, death, and disability in this century will continue to be attributable to chronic disease. To address this burden effectively requires the development of a workforce with new skills in addition to maintenance of evolving traditional competencies. In 2002, the Institute of Medicine (IOM published a report, Who Will Keep the Public Healthy?, that targeted the training needs of the public health workforce in this century (1. The IOM report included a recommendation for federal agencies to provide incentives for developing academicpractice partnerships.
Castro Lopes, Sofia; Guerra-Arias, Maria; Buchan, James; Pozo-Martin, Francisco; Nove, Andrea
Attrition or losses from the health workforce exacerbate critical shortages of health workers and can be a barrier to countries reaching their universal health coverage and equity goals. Despite the importance of accurate estimates of the attrition rate (and in particular the voluntary attrition rate) to conduct effective workforce planning, there is a dearth of an agreed definition, information and studies on this topic. We conducted a rapid review of studies published since 2005 on attrition rates of health workers from the workforce in different regions and settings; 1782 studies were identified, of which 51 were included in the study. In addition, we analysed data from the State of the World's Midwifery (SoWMy) 2014 survey and associated regional survey for the Arab states on the annual voluntary attrition rate for sexual, reproductive, maternal and newborn health workers (mainly midwives, doctors and nurses) in the 79 participating countries. There is a diversity of definitions of attrition and barely any studies distinguish between total and voluntary attrition (i.e. choosing to leave the workforce). Attrition rate estimates were provided for different periods of time, ranging from 3 months to 12 years, using different calculations and data collection systems. Overall, the total annual attrition rate varied between 3 and 44% while the voluntary annual attrition rate varied between 0.3 to 28%. In the SoWMy analysis, 49 countries provided some data on voluntary attrition rates of their SRMNH cadres. The average annual voluntary attrition rate was 6.8% across all cadres. Attrition, and particularly voluntary attrition, is under-recorded and understudied. The lack of internationally comparable definitions and guidelines for measuring attrition from the health workforce makes it very difficult for countries to identify the main causes of attrition and to develop and test strategies for reducing it. Standardized definitions and methods of measuring attrition are
California Community Colleges, Chancellor's Office, 2013
The California Community Colleges Workforce and Economic Development program (WED program) helps students, incumbent workers, business partners and industries develop skilled competencies in critical industry sectors. As a source for developing and implementing training and curriculum, the WED program is instrumental in helping the community…
Serneels, Pieter; Lindelöw, Magnus; Garcia-Montalvo, Jose; Barr, Abigail
Geographical imbalances in the health workforce have been a consistent feature of nearly all health systems, especially in developing countries. The authors investigate the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analyzing data obtained from contingent valuation questions, they find that household consumption and the student's motivation to help the poor, which is their proxy for intrinsic motivation, are the main determinants of willingn...
Serneels, Pieter; Lindelow, Magnus; Garcia Montalvo, José; Barr, Abigail
Geographical imbalances in the health workforce have been a consistent feature of nearly all health systems, and especially in developing countries. In this paper we investigate the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analyzing data obtained from contingent valuation questions, we find that household consumption and the student’s motivation to help the poor, which is our proxy for intrinsic motivation, are the main determinants of wil...
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.
The UK government is committed to the introduction of electronic health records and has announced an intention for a 'paper-free' NHS by 2018. This has particular implications for the specialist community public health nurse (SCPHN) workforce, mainly due to staff members' general lack of experience with information technology (IT). There are further potential issues arising from the use of skill mix staff within teams and their role in record keeping and governance. This article advocates the use of practice teachers as change agents and educational theory to empower and support the workforce during the introduction of electronic records. Robust information governance and record-keeping policies are essential in driving the introduction of electronic records successfully. Clinical supervision is a suitable arena to support, and obtain feedback from the workforce before, during and after change, to ensure quality and governance are at the forefront of practice. To support a transition from paper to electronic health records, it is essential to view resistance as a predictable phenomenon and to learn from other areas that have already introduced electronic records successfully. It is recommended that the workforce's IT skills and learning styles are assessed before the development of training programmes for electronic records. This information can then be used to establish the appropriate educational approach.
Mertz, Elizabeth; Mouradian, Wendy
The Surgeon General's Report on Oral Health (SGROH) and the Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs.
Iowa Department of Education, 2015
The Department of Education, Division of Community Colleges, will annually provide the State Board of Education with The Workforce Training and Economic Development (WTED) Fund Annual Progress Report. Administration and oversight responsibility for the fund was transferred from the Iowa Economic Development Authority to the Iowa Department of…
McFarlane, Kathryn; Devine, Sue; Judd, Jenni; Nichols, Nina; Watt, Kerrianne
Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.
In this article, the different dimensions and determinants of health workforce planning (HWF) are investigated to improve context-sensitivity and mutual learning among groups of countries with similar HWF characteristics. A novel approach to scoring countries according to their HFW characteristics and type of planning is introduced using data collected in 2012 by a large European Union project involving 35 European countries (the 'Matrix Study' ). HWF planning is measured in terms of three major dimensions: (1) data infrastructure to monitor the capacities and dynamics of health workforces, (2) the institutions involved in defining and implementing labour market regulations, and (3) the availability of models to estimate supply-demand gaps and to forecast imbalances. The result shows that the three dimensions of HWF planning are weakly interrelated, indicating that countries invest in HWF in different ways. Determinant analysis shows that countries with larger health labour markets, National Healthcare Service (NHS), mobility, and strong primary health care score higher on HWF planning dimensions than others. Consequently, the results suggest that clustering countries with similar conditions in terms of HWF planning is a way forward towards mutual and contextual learning.
R. Brugha; J. Kadzandira; J. Simbaya; P. Dicker; V. Mwapasa; A. Walsh
Background Shortages of health workers are obstacles to utilising global health initiative (GHI) funds effectively in Africa. This paper reports and analyses two countries' health workforce responses during a period of large increases in GHI funds. Methods Health facility record reviews were conduct
Full Text Available Background: Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. Methods: An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported. Results: Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making.Conclusions: Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential. In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice.
Sutton, Keith; Maybery, Darryl; Moore, Terry
This paper reports on preliminary findings of a novel program piloted in 2010 to address rural mental health workforce shortages. The program involved exposing allied health and nursing students from rural backgrounds studying in Melbourne to mental health service employment opportunities in Gippsland. A longitudinal study is underway to evaluate the effect and outcomes of the program and includes surveying participants' interest in rural mental health work through an online questionnaire immediately prior to and following the program; and surveying career decisions at 6 months and yearly intervals. Paired sample t-tests were used to analyse participants' level of interest in rural work (pre-event 4.67 (1.50); post-event 5.93 (0.96); P=0.001), career in a rural setting (pre-event 4.67 (1.63); post-event 5.67 (1.23); P=0.006), mental health work (pre-event 4.73 (1.39); post-event 6.07 (0.80); P<0.000) and rural mental health career (pre-event 4.73 (1.33); post-event 5.80 (1.21); P=0.002). These findings indicate a significant increase from pre- to post-event and are supported by strong effect sizes suggesting that the program had a significant effect on participant interest in rural mental health work. Longer-term evaluation will determine whether the program influences participant career decisions and thereby addressing mental health workforce shortages in Gippsland.
Lakes, Richard D.
Neoliberal governments consider global business competitiveness to be thwarted by costly bureaucratic regulation and programme duplication. In an effort to downsize the costs of operating a state, the governors now streamline job training functions via a coordinated workforce and economic development effort known as sector strategies, with…
Kwamie, Aku; Asiamah, Miriam; Schaaf, Marta; Agyepong, Irene Akua
tensions between individual and organisational goals. This article contributes to a burgeoning literature on postings and transfers as a distinct dynamic which bridges the interactions between health systems governance and health workforce development. Importantly, this article helps to expand the notion of health systems governance beyond 'good' governance towards understanding governance as a process of negotiation.
Weise, Janelle; Fisher, Karen R; Trollor, Julian N
People with intellectual disability experience high rates of mental ill health but multiple barriers to access to quality mental health care. One significant barrier to access is a generalist mental health workforce that lacks capacity, and consensus on what constitutes core workforce competencies in this area. As such, the first step in developing a comprehensive strategy that addresses these barriers is to define the core mental health workforce attributes. Thirty-six intellectual disability mental health experts from across Australia participated in a modified online Delphi which aimed to reach consensus on the core attributes required of the generalist mental health workforce. At the end of each Delphi round, descriptive analyses and thematic analyses were completed. Consensus was reached among the participants for 102 attributes across 14 clinical domains. The results highlighted specific attributes in all areas of clinical practice, especially for communication (e.g., utilizes assistive communication technology), assessment (e.g., assess contributing factors to behaviours) and intervention (e.g., uses integrative interventions). A comprehensive strategy is required to facilitate the generalist mental health workforce to obtain these attributes. © 2017 John Wiley & Sons Ltd.
The Centers for Disease Control and Prevention, Association of Schools and Programs of Public Health, and the Council on Linkages Between Academia and Public Health Practice have emphasized the increasing need to train the public health workforce in social marketing. With only 21 U.S. academic institutions offering course work in social marketing and only four institutions offering degrees in social marketing there is a gap between what academic institutions are offering and these recommendations (Kelly, 2013 ). The successful application of social marketing in public health practice relies on academic institutions creating and promoting social marketing-related programs.
Tavabie, Jacqueline A; Simms, Jacqueline M
Many health and social care systems worldwide have been developing a variety of navigator and signposting roles to help patients negotiate care through increasingly complex systems and multiple provider agencies. This UK project aims to explore, through a combination of job description review and workshops of stakeholders, the common competencies and features of non-clinical roles. The information is collated to develop common job descriptions at four key levels. These form the basis for a career pathway supported by portfolio-based educational programmes, embracing Apprenticeship Training Programmes. The programmes have the potential to support recruitment and retention of an increasingly skilled workforce to move between traditional health and social care provider boundaries. This offers the opportunity to release clinicians from significant administrative workload and support patients in an integrated care system.
Leach Matthew J
Full Text Available Abstract Background The delivery of best practice care can markedly improve clinical outcomes in patients with chronic disease. While the provision of a skilled, multidisciplinary team is pivotal to the delivery of best practice care, the occupational or skill mix required to deliver this care is unclear; it is also uncertain whether such a team would have the capacity to adequately address the complex needs of the clinic population. This is the role of needs-based health workforce planning. The objective of this article is to describe the development of an evidence-informed, needs-based health workforce model to support the delivery of best-practice interdisciplinary chronic disease management in the primary and community care setting using diabetes as a case exemplar. Discussion Development of the workforce model was informed by a strategic review of the literature, critical appraisal of clinical practice guidelines, and a consensus elicitation technique using expert multidisciplinary clinical panels. Twenty-four distinct patient attributes that require unique clinical competencies for the management of diabetes in the primary care setting were identified. Patient attributes were grouped into four major themes and developed into a conceptual model: the Workforce Evidence-Based (WEB planning model. The four levels of the WEB model are (1 promotion, prevention, and screening of the general or high-risk population; (2 type or stage of disease; (3 complications; and (4 threats to self-care capacity. Given the number of potential combinations of attributes, the model can account for literally millions of individual patient types, each with a distinct clinical team need, which can be used to estimate the total health workforce requirement. Summary The WEB model was developed in a way that is not only reflective of the diversity in the community and clinic populations but also parsimonious and clear to present and operationalize. A key feature of the
and Responsibilities of Key Department of Defense (DOD) Organizations Involved in Defense Acquisition Workforce Development Fund (DAWDF) Management 7...DEFENSE ACQUISITION WORKFORCE DOD Has Opportunities to Further Enhance Use and Management of Development Fund...House of Representatives March 2017 DEFENSE ACQUISITION WORKFORCE DOD Has Opportunities to Further Enhance Use and Management of Development Fund
Zurn, P.; Vujicic, M.; Lemiere, C.; Juquois, M.; Stormont, L.; Campbell, J.; Rutten, M.M.; Braichet, J.M.
Background: Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite
Zurn, P.; Vujicic, M.; Lemiere, C.; Juquois, M.; Stormont, L.; Campbell, J.; Rutten, M.M.; Braichet, J.M.
Background: Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite
Jesus, Tiago S; Landry, Michel D; Dussault, Gilles; Fronteira, Inês
People with disabilities face challenges accessing basic rehabilitation health care. In 2006, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) outlined the global necessity to meet the rehabilitation needs of people with disabilities, but this goal is often challenged by the undersupply and inequitable distribution of rehabilitation workers. While the aggregate study and monitoring of the physical rehabilitation workforce has been mostly ignored by researchers or policy-makers, this paper aims to present the 'challenges and opportunities' for guiding further long-term research and policies on developing the relatively neglected, highly heterogeneous physical rehabilitation workforce. The challenges were identified through a two-phased investigation. Phase 1: critical review of the rehabilitation workforce literature, organized by the availability, accessibility, acceptability and quality (AAAQ) framework. Phase 2: integrate reviewed data into a SWOT framework to identify the strengths and opportunities to be maximized and the weaknesses and threats to be overcome. The critical review and SWOT analysis have identified the following global situation: (i) needs-based shortages and lack of access to rehabilitation workers, particularly in lower income countries and in rural/remote areas; (ii) deficiencies in the data sources and monitoring structures; and (iii) few exemplary innovations, of both national and international scope, that may help reduce supply-side shortages in underserved areas. Based on the results, we have prioritized the following 'Six Rehab-Workforce Challenges': (1) monitoring supply requirements: accounting for rehabilitation needs and demand; (2) supply data sources: the need for structural improvements; (3) ensuring the study of a whole rehabilitation workforce (i.e. not focused on single professions), including across service levels; (4) staffing underserved locations: the rising of education, attractiveness and
Background: The EU Joint Action on Health Workforce Planning and Forecasting has taken up the challenge to let countries share and exchange practices in health workforce planning. It appears however, that not many countries actually apply (needs-based forecasting) models to support this. But does ev
multidisciplinary public health workforce is needed, supported by new skills and expertise. It has been demonstrated that public health education needs to include a wider range of health related professionals including: managers, health promotion specialists, health economists, lawyers and pharmacists. In the future, public health professionals will increasingly require enhanced communication and leadership skills, as well as a broad, interdisciplinary focus, if they are to truly impact upon the health of the population and compete successfully in today‘s job market. New developments comprise flexible academic programmes, lifelong learning, employability, and accreditation. In Europe‘s current climate of extreme funding constraints, the need for upgrading public health training and education is more important than ever. The broad supportive environment and context for change are in place. By focusing on assessment and evaluation of the current context, coordination and joint efforts to promote competency-based education, and support and growth of new developments, a stronger, more versatile and much needed workforce will be developed.
Heggeness, Misty L; Evans, Lisa; Pohlhaus, Jennifer Reineke; Mills, Sherry L
To measure diversity within the National Institutes of Health (NIH)-funded workforce. The authors use a relevant labor market perspective to more directly understand what the NIH can influence in terms of enhancing diversity through NIH policies. Using the relevant labor market (defined as persons with advanced degrees working as biomedical scientists in the United States) as the conceptual framework, and informed by accepted economic principles, the authors used the American Community Survey and NIH administrative data to calculate representation ratios of the NIH-funded biomedical workforce from 2008 to 2012 by race, ethnicity, sex, and citizenship status, and compared this against the pool of characteristic individuals in the potential labor market. In general, the U.S. population during this time period was an inaccurate comparison group for measuring diversity of the NIH-funded scientific workforce. Measuring accurately, we found the representation of women and traditionally underrepresented groups in NIH-supported postdoc fellowships and traineeships and mentored career development programs was greater than their representation in the relevant labor market. The same analysis found these demographic groups are less represented in the NIH-funded independent investigator pool. Although these findings provided a picture of the current NIH-funded workforce and a foundation for understanding the federal role in developing, maintaining, and renewing diverse scientific human resources, further study is needed to identify whether junior- and early-stage investigators who are part of more diverse cohorts will naturally transition into independent NIH-funded investigators, or whether they will leave the workforce before achieving independent researcher status.
Full Text Available Jessica S Grignon,1,2 Jenny H Ledikwe,1,2 Ditsapelo Makati,2 Robert Nyangah,2 Baraedi W Sento,2 Bazghina-werq Semo1,2 1Department of Global Health, University of Washington, Seattle, WA, USA; 2International Training and Education Center for Health, Gaborone, Botswana Abstract: To address health systems challenges in limited-resource settings, global health initiatives, particularly the President's Emergency Plan for AIDS Relief, have seconded health workers to the public sector. Implementation considerations for secondment as a health workforce development strategy are not well documented. The purpose of this article is to present outcomes, best practices, and lessons learned from a President's Emergency Plan for AIDS Relief-funded secondment program in Botswana. Outcomes are documented across four World Health Organization health systems' building blocks. Best practices include documentation of joint stakeholder expectations, collaborative recruitment, and early identification of counterparts. Lessons learned include inadequate ownership, a two-tier employment system, and ill-defined position duration. These findings can inform program and policy development to maximize the benefit of health workforce secondment. Secondment requires substantial investment, and emphasis should be placed on high-level technical positions responsible for building systems, developing health workers, and strengthening government to translate policy into programs. Keywords: human resources, health policy, health worker, HIV/AIDS, PEPFAR
Groenewegen, P.; Heinemann, S.; Gress, S.; Schäfer, W.
Background: There is a large variation in the organization of primary care in Europe. In some health care systems, primary care is the gatekeeper to more specialized care, whilst in others patients have the choice between a wide range of providers. Primary care has increasingly become teamwork.
Groenewegen, P.; Heinemann, S.; Gress, S.; Schäfer, W.
Background: There is a large variation in the organization of primary care in Europe. In some health care systems, primary care is the gatekeeper to more specialized care, whilst in others patients have the choice between a wide range of providers. Primary care has increasingly become teamwork. Meth
McQuide Pamela A
Full Text Available Abstract Background Health workforce planning is important in ensuring that the recruitment, training and deployment of health workers are conducted in the most efficient way possible. However, in many developing countries, human resources for health data are limited, inconsistent, out-dated, or unavailable. Consequently, policy-makers are unable to use reliable data to make informed decisions about the health workforce. Computerized human resources information systems (HRIS enable countries to collect, maintain, and analyze health workforce data. Methods The purpose of this article is twofold. First, we describe Uganda's transition from a paper filing system to an electronic HRIS capable of providing information about country-specific health workforce questions. We examine the ongoing five-step HRIS strengthening process used to implement an HRIS that tracks health worker data at the Uganda Nurses and Midwives Council (UNMC. Secondly, we describe how HRIS data can be used to address workforce planning questions via an initial analysis of the UNMC training, licensure and registration records from 1970 through May 2009. Results The data indicate that, for the 25 482 nurses and midwives who entered training before 2006, 72% graduated, 66% obtained a council registration, and 28% obtained a license to practice. Of the 17 405 nurses and midwives who obtained a council registration as of May 2009, 96% are of Ugandan nationality and just 3% received their training outside of the country. Thirteen per cent obtained a registration for more than one type of training. Most (34% trainings with a council registration are for the enrolled nurse training, followed by enrolled midwife (25%, registered (more advanced nurse (21%, registered midwife (11%, and more specialized trainings (9%. Conclusion The UNMC database is valuable in monitoring and reviewing information about nurses and midwives. However, information obtained from this system is also important in
Health workers play a key role in increasing access to health care services. Global and country-level estimates show that staffing in many developing countries - particularly in Sub-Saharan Africa - is far leaner than needed to deliver essential health services to the population. One factor that can limit scaling up the health workforce in developing countries is the government's overall wage policy which sometimes creates restrictions on hiring in the health sector. But while there is considerable debate, the information base in this important area has been quite limited. This paper summarizes the process that determines the budget for health wages in the public sector, how it is linked to overall wage policies, and how this affects staffing in the health sector. The author draws mainly from a recent World Bank report.
Whittaker, Maxine; Hodge, Nicola; Mares, Renata E; Rodney, Anna
Health information is required for a variety of purposes at all levels of a health system, and a workforce skilled in collecting, analysing, presenting, and disseminating such information is essential to fulfil these demands. While it is established that low- and middle-income countries (LMICs) are facing shortages in human resources for health (HRH), there has been little systematic attention focussed on non-clinical competencies. In response, we developed a framework that defines the minimum health information competencies required by health workers at various levels of a health system. Using the Delphi method, we consulted with leading global health information system (HIS) experts. An initial list of competencies and draft framework were developed based on results of a systematic literature review. During the second half of 2012, we sampled 38 experts with broad-based HIS knowledge and extensive development experience. Two rounds of consultation were carried out with the same group to establish validity of the framework and gain feedback on the draft competencies. Responses from consultations were analysed using Qualtrics® software and content analysis. In round one, 17 experts agreed to participate in the consultation and 11 (65%) completed the survey. In the second round, 11 experts agreed to participate and eight (73%) completed the survey. Overall, respondents agreed that there is a need for all health workers to have basic HIS competencies and that the concept of a minimum HIS competency framework is valid. Consensus was reached around the inclusion of 68 competencies across four levels of a health system. This consultation is one of the first to identify the HIS competencies required among general health workers, as opposed to specialist HIS roles. It is also one of the first attempts to develop a framework on minimum HIS competencies needed in LMICs, highlighting the skills needed at each level of the system, and identifying potential gaps in current
Ventre, Jerry; Weissman, Jane
This paper presents information and data collected during 2008 on PV workforce needs by the Interstate Renewable Energy Council for the U.S. Department of Energy. The data was collected from licensed contractors, PV practitioners, educators and expert instructors at training sessions, and at focus group and advisory committee meetings. Respondents were primarily from three states: Florida, New York and California. Other states were represented, but to a lesser extent. For data collection, a 12-item questionnaire was developed that addressed key workforce development issues from the perspectives of both the PV industry and training institutions. A total of 63 responses were collected, although not every respondent answered every question. Industry representatives slightly outnumbered the educators, although the difference in responses was not significant.
Bingham, Michelle [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bala, Marsha [Idaho National Lab. (INL), Idaho Falls, ID (United States); Beierschmitt, Kelly [Idaho National Lab. (INL), Idaho Falls, ID (United States); Steele, Carolyn [Argonne National Lab. (ANL), Argonne, IL (United States); Sattelberger, Alfred P. [Argonne National Lab. (ANL), Argonne, IL (United States); Bruozas, Meridith A. [Argonne National Lab. (ANL), Argonne, IL (United States)
The U.S. Department of Energy (DOE) national laboratories use their expertise in nuclear science and technology (S&T) to support a robust national nuclear S&T enterprise from the ground up. Traditional academic programs do not provide all the elements necessary to develop this expertise, so the DOE has initiated a number of supplemental programs to develop and support the nuclear S&T workforce pipeline. This document catalogs existing workforce development programs that are supported by a number of DOE offices (such as the Offices of Nuclear Energy, Science, Energy Efficiency, and Environmental Management), and by the National Nuclear Security Administration (NNSA) and the Naval Reactor Program. Workforce development programs in nuclear S&T administered through the Department of Homeland Security, the Nuclear Regulatory Commission, and the Department of Defense are also included. The information about these programs, which is cataloged below, is drawn from the program websites. Some programs, such as the Minority Serving Institutes Partnership Programs (MSIPPs) are available through more than one DOE office, so they appear in more than one section of this document.
Shtasel, Derri; Hobbs-Knutson, Katherine; Tolpin, Harriet; Weinstein, Debra; Gottlieb, Gary L
Community health centers (CHCs) face challenges recruiting and retaining primary care clinicians. Providing advanced training that enhances clinical skills within a public health framework, teaches leadership, protects time for scholarly activities, and focuses on the social mission may be a successful career development strategy. In July 2012, the Kraft Center for Community Health Leadership developed and implemented two 2-year programs to develop physician and nursing leaders with blended academic-community career paths and identities. The fellowship program for physicians and the practitioner program for early-career physicians and advanced practice nurses include mentored practice in a CHC; monthly learning days; completion of a community-based research project; and, for fellows, matriculation in an MPH program and engagement in a bimonthly leadership seminar. The first classes of 5 fellows and 14 practitioners graduated in June 2014. All 5 fellowship graduates were offered full-time positions at the CHCs where they practiced, and 2 have accepted leadership positions at their CHCs. All 14 practitioner graduates remain in community health, 5 have accepted leadership positions, and 2 have obtained grants to support ongoing projects. The authors are tracking graduates' career paths and the programs' impact on CHCs while modifying the programs on the basis of feedback; identifying elements of the programs that may be amenable to more cost-effective delivery; and exploring the potential for federal funding to support expansion of the practitioner program, and for the practitioner program to increase the return on investment provided by the National Health Service Corps.
Naccarella, Lucio; Wraighe, Brenda; Gorman, Des
The growing demands on the health system to adapt to constant change has led to investment in health workforce planning agencies and approaches. Health workforce planning approaches focusing on identifying, predicting and modelling workforce supply and demand are criticised as being simplistic and not contributing to system-level resiliency. Alternative evidence- and needs-based health workforce planning approaches are being suggested. However, to contribute to system-level resiliency, workforce planning approaches need to also adopt system-based approaches. The increased complexity and fragmentation of the healthcare system, especially for patients with complex and chronic conditions, has also led to a focus on health literacy not simply as an individual trait, but also as a dynamic product of the interaction between individual (patients, workforce)-, organisational- and system-level health literacy. Although it is absolutely essential that patients have a level of health literacy that enables them to navigate and make decisions, so too the health workforce, organisations and indeed the system also needs to be health literate. Herein we explore whether health workforce planning is recognising the dynamic interplay between health literacy at an individual, organisation and system level, and the potential for strengthening resiliency across all those levels.
Drehobl, Patricia; Stover, Beth H; Koo, Denise
The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges to the workforce that threaten the public's health. These challenges are complex, often involve multiple influencing or related causal factors, and demand comprehensive solutions. However, proposed solutions often focus on selected factors and might be fragmented rather than comprehensive. This paper describes approaches to characterizing the situation more comprehensively and includes two visual tools: (1) a fishbone, or Ishikawa, diagram that depicts multiple factors affecting the public health workforce; and (2) a roadmap that displays key elements-goals and strategies-to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward solutions. The visual tools aid thinking about ways to strengthen the public health workforce through collective solutions and to help leverage resources and build on each other's work. The strategic roadmap is intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC's commitment to working with partners on the highest priorities for strengthening the workforce to improve the public's health. Published by Elsevier Inc.
Collins, Dale E.
A literature review was conducted to establish criteria for the development and establishment of an associate degree program in radiologic technology in Alaska, where traditional education programs had been slow to respond to the current personnel shortage. The information was obtained from a variety of state, regional, and national organizations…
Robiner, William N
The U.S. mental health (MH) workforce is comprised of core disciplines: psychology, psychiatry, social work, psychiatric nursing, and marriage and family therapy. A broader group of practitioners also deserves recognition. Diverse professions provide significant services in a variety of settings, extending the de facto mental health workforce. A tally of key disciplines estimates there are 537,857 MH professionals, or 182 per 100,000 U.S. population. This article provides an overview of the need and demand for mental health services and summarizes the MH professions (e.g., training, educational credentials, workforce estimates). It also discusses a range of challenges confronting MH professionals and the need for greater understanding of the workforce and integration of services. Methodological factors that confound estimates of the magnitude of the MH workforce are reviewed.
Since the Productivity Commission released its research report Australia's Health Workforce in 2005, there has been a significant increase in government funding and policy capacity aimed at health workforce reform and innovation in Australia. This research paper presents the results of semistructured interviews with three key stakeholders in health policy formation in Australia: (1) The Honourable Lindsay Tanner, former Federal Minister for Finance and therefore 100% shareholder of Medibank Private on behalf of the Commonwealth; (2) The Honourable Daniel Andrews, former Victorian Minister for Health and current Victorian Opposition Leader; and (3) The Honourable Jim McGinty, former Minister for Health and Attorney General of Western Australia and current inaugural Chair of Health Workforce Australia. The paper examines key issues they identified in relation to health workforce policy in Australia, particularly where it intersects with industrial relations, and conducts a comparative analysis between their responses and theoretical methodologies of policy formation as a means of informing a reform process.
Schoenwald, Sonja K; Hoagwood, Kimberly Eaton; Atkins, Marc S; Evans, Mary E; Ringeisen, Heather
The industrialization of health care, underway for several decades, offers instructive guidance and models for speeding access of children and families to clinically and cost effective preventive, treatment, and palliative interventions. This industrialization--i.e., the systematized production of goods or services in large-scale enterprises--has the potential to increase the value and effects of care for consumers, providers, and payers (Hayes and Gregg in Integrated behavioral healthcare: Positioning mental health practice with medical/surgical practice. Academic Press, San Diego, 2001), and to generate efficiencies in care delivery, in part because workforce responsibilities become more functional and differentiated such that individuals with diverse educational and professional backgrounds can effectively execute substantive clinical roles (Rees in Clin Exp Dermatol, 33, 39-393, 2008). To date, however, the models suggested by this industrialization have not been applied to children's mental health services. A combination of policy, regulatory, fiscal, systemic, and organizational changes will be needed to fully penetrate the mental health and substance abuse service sectors. In addition, problems with the availability, preparation, functioning, and status of the mental health workforce decried for over a decade will need to be addressed if consumers and payers are to gain access to effective interventions irrespective of geographic location, ethnic background, or financial status. This paper suggests that critical knowledge gaps exist regarding (a) the knowledge, skills, and competencies of a workforce prepared to deliver effective interventions; (b) the efficient and effective organization of work; and (c) the development and replication of effective workforce training and support strategies to sustain effective services. Three sets of questions are identified for which evidence-based answers are needed. Suggestions are provided to inform the development of a
Priddis, Lynn E; Matacz, Rochelle; Weatherston, Deborah
This article describes findings from a project conducted in Western Australia (Mental Health Commission WA, 2015) that investigated the education and training needs of the Infant/Early Childhood Mental Health (I/ECMH) workforce. We examined international training programs and models of delivery in infant mental health, including a review of the current training available in Australia. Data collected from over 60 interviews were analyzed, and a staged delivery model for I/ECMH training and supervision that aligned with the Michigan Association for Infant Mental Health (2014) Competency Guidelines was recommended. These findings led to the purchase of the Michigan Association for Infant Mental Health (2014) for use in Western Australia. In a very short time, use of the Michigan Competency Framework by the Australian Association for Infant Mental Health West Australian Branch Incorporated has begun to change the training and education opportunities for upskilling the infant and early childhood workforce in Western Australia. It has resulted in a map to guide and develop training in the I/ECMH field for individual practitioners and professionals as well as for workplaces that will ultimately benefit Western Australian infants, young children, and their families during the perinatal period and in the early years.
Marcus, Kanchan; Quimson, Gabriella; Short, Stephanie D
The Philippines continues to overproduce nurses for export. Little first-hand evidence exists from leading organisations in the Philippines concerning their experiences and perceptions in relation to Filipino nurse migration. What are their views about health workforce migration? This paper addresses this research gap by providing a source country perspective on Filipino nurse migration to Australia. Focus-group interviews were conducted with key informants from nine Filipino organisations in the Philippines by an Australian-Filipino research team. The organisations were purposively selected and contacted in person, by phone, and/or email. Qualitative thematic analysis was performed using a coding framework. Health workforce migration is perceived to have both positive and negative consequences. On the one hand, emigration offers a welcome opportunity for individual Filipino nurses to migrate abroad in order to achieve economic, professional, lifestyle, and social benefits. On the other, as senior and experienced nurses are attracted overseas, this results in the maldistribution of health workers particularly affecting rural health outcomes for people in developing countries. Problems such as 'volunteerism' also emerged in our study. In the context of the WHO (2010) Code of Practice on the International Recruitment of Health Personnel it is to be hoped that, in the future, government recruiters, managers, and nursing leaders can utilise these insights in designing recruitment, orientation, and support programmes for migrant nurses that are more sensitive to the experience of the Philippines' education and health sectors and their needs.
Benavides-Vaello, Sandra; Katz, Janet R; Peterson, Jeffery Chaichana; Allen, Carol B; Paul, Robbie; Charette-Bluff, Andrea Lelana; Morris, Phyllis
This participatory study used PhotoVoice and qualitative description to (a) mentor baccalaureate nursing and college students in workforce diversity research; (b) explore barriers and facilitators encountered by rural American Indian, Hispanic, and other high school students when attending college and pursuing careers in nursing or the health sciences; and (c) model a process of social action to help existing and future students. Baccalaureate nursing and graduate students participated in all stages of research, including dissemination. Five themes emerged from analysis of PhotoVoice data: (a) being afraid; (b) believing; (c) taking small steps; (d) facing fears; and (e) using support systems. Findings underscore the importance of helping students participate in efforts to increase work-force diversity through research. Increasing nursing and health sciences workforce diversity may require strategies developed within and tailored to specific cultures and communities. Copyright 2014, SLACK Incorporated.
Haughton, Betsy; George, Alexa
To describe the US public health nutrition workforce and its future social, biological and fiscal challenges. Literature review primarily for the four workforce surveys conducted since 1985 by the Association of State and Territorial Public Health Nutrition Directors. The United States. Nutrition personnel working in governmental health agencies. The 1985 and 1987 subjects were personnel in full-time budgeted positions employed in governmental health agencies providing predominantly population-based services. In 1994 and 1999 subjects were both full-time and part-time, employed in or funded by governmental health agencies, and provided both direct-care and population-based services. The workforce primarily focuses on direct-care services for pregnant and breast-feeding women, infants and children. The US Department of Agriculture funds 81.7 % of full-time equivalent positions, primarily through the WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children). Of those personnel working in WIC, 45 % have at least 10 years of experience compared to over 65 % of the non-WIC workforce. Continuing education needs of the WIC and non-WIC workforces differ. The workforce is increasingly more racially/ethnically diverse and with 18.2 % speaking Spanish as a second language. The future workforce will need to focus on increasing its diversity and cultural competence, and likely will need to address retirement within leadership positions. Little is known about the workforce's capacity to address the needs of the elderly, emergency preparedness and behavioural interventions. Fiscal challenges will require evidence-based practice demonstrating both costs and impact. Little is known about the broader public health nutrition workforce beyond governmental health agencies.
Sellers, Katie; Leider, Jonathon P; Harper, Elizabeth; Castrucci, Brian C; Bharthapudi, Kiran; Liss-Levinson, Rivka; Jarris, Paul E; Hunter, Edward L
Public health practitioners, policy makers, and researchers alike have called for more data on individual worker's perceptions about workplace environment, job satisfaction, and training needs for a quarter of a century. The Public Health Workforce Interests and Needs Survey (PH WINS) was created to answer that call. Characterize key components of the public health workforce, including demographics, workplace environment, perceptions about national trends, and perceived training needs. A nationally representative survey of central office employees at state health agencies (SHAs) was conducted in 2014. Approximately 25,000 e-mail invitations to a Web-based survey were sent out to public health staff in 37 states, based on a stratified sampling approach. Balanced repeated replication weights were used to account for the complex sampling design. A total of 10,246 permanently employed SHA central office employees participated in PH WINS (46% response rate). Perceptions about training needs; workplace environment and job satisfaction; national initiatives and trends; and demographics. Although the majority of staff said they were somewhat or very satisfied with their job (79%; 95% confidence interval [CI], 78-80), as well as their organization (65%; 95% CI, 64-66), more than 42% (95% CI, 41-43) were considering leaving their organization in the next year or retiring before 2020; 4% of those were considering leaving for another job elsewhere in governmental public health. The majority of public health staff at SHA central offices are female (72%; 95% CI, 71-73), non-Hispanic white (70%; 95% CI, 69-71), and older than 40 years (73%; 95% CI, 72-74). The greatest training needs include influencing policy development, preparing a budget, and training related to the social determinants of health. PH WINS represents the first nationally representative survey of SHA employees. It holds significant potential to help answer previously unaddressed questions in public health
Sellers, Katie; Leider, Jonathon P.; Harper, Elizabeth; Castrucci, Brian C.; Bharthapudi, Kiran; Liss-Levinson, Rivka; Jarris, Paul E.; Hunter, Edward L.
Context: Public health practitioners, policy makers, and researchers alike have called for more data on individual worker's perceptions about workplace environment, job satisfaction, and training needs for a quarter of a century. The Public Health Workforce Interests and Needs Survey (PH WINS) was created to answer that call. Objective: Characterize key components of the public health workforce, including demographics, workplace environment, perceptions about national trends, and perceived training needs. Design: A nationally representative survey of central office employees at state health agencies (SHAs) was conducted in 2014. Approximately 25 000 e-mail invitations to a Web-based survey were sent out to public health staff in 37 states, based on a stratified sampling approach. Balanced repeated replication weights were used to account for the complex sampling design. Setting and Participants: A total of 10 246 permanently employed SHA central office employees participated in PH WINS (46% response rate). Main Outcome Measures: Perceptions about training needs; workplace environment and job satisfaction; national initiatives and trends; and demographics. Results: Although the majority of staff said they were somewhat or very satisfied with their job (79%; 95% confidence interval [CI], 78-80), as well as their organization (65%; 95% CI, 64-66), more than 42% (95% CI, 41-43) were considering leaving their organization in the next year or retiring before 2020; 4% of those were considering leaving for another job elsewhere in governmental public health. The majority of public health staff at SHA central offices are female (72%; 95% CI, 71-73), non-Hispanic white (70%; 95% CI, 69-71), and older than 40 years (73%; 95% CI, 72-74). The greatest training needs include influencing policy development, preparing a budget, and training related to the social determinants of health. Conclusions: PH WINS represents the first nationally representative survey of SHA employees. It
Yamalik, Nermin; Ensaldo-Carrasco, Eduardo; Cavalle, Edoardo; Kell, Kathyrn
A range of factors needs to be taken into account for an ideal oral health workforce plan. The figures related to dentists, specialists, auxiliaries, practice patterns, undergraduate and continuing dental education, laws/regulations, the attitudes of oral health-care providers and the general trends affecting the practice patterns, work conditions and preferences of oral health-care providers are among such determinants. Thus, the aim of the present study was to gather such information from a sample of World Dental Federation (FDI) member countries with different characteristics. A cross-sectional survey study was carried out among a sample of FDI member countries between March 2, 2012 and March 27, 2012. A questionnaire was developed addressing some main determinants of oral health workforce, such as its structure, involvement of the public/private sector to provide oral health-care services, specialty services, dental schools, trends in workforce and compliance with oral health needs, and a descriptive analysis was performed. The countries were classified as developed and developing countries and Mann-Whitney U-tests and chi-square tests were used to identify potential significant differences (P > 0.05) between developed and developing countries. All data were processed in SPSS v.19. In the18 questionnaires processed, the median number of dentists (P = 0.005), dental practices (P = 0.002), hygienists (P = 0.005), technicians (P = 0.013) and graduates per year (P = 0.037) was higher in developed countries. Only 12.5% of developed and 22.2% of developing countries reported having optimal number of graduates per year. It was noted that 66.7% of developing countries had more regions lacking enough dentists to meet the demand (P = 0.050) and 77.8% lacked the necessary specialist care (P = 0.015). Although developing countries reported mostly an oversupply of dentists, regardless of the level of development most countries did not report an oversupply of specialists
Waters, Keith P; Zuber, Alexandra; Willy, Rankesh M; Kiriinya, Rose N; Waudo, Agnes N; Oluoch, Tom; Kimani, Francis M; Riley, Patricia L
, management, and development. KHWIS data have impacted a range of improvements in health worker regulation, human resources management, and workforce policy and planning at Kenya's ministries of health. Published by Elsevier Ireland Ltd.
Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon
Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.
Friedman, J. S.; Diaz, A.; Trujillo, E.; Saltares, R.; Floran, L.; Gordillo, R.
At the Puerto Rico Photonics Institute we have responded to the need of a workforce competitively prepared for entry into the fields of lasers and photonics by creating a 1-year Photonics and Lasers Technical certificate, supported under a grant from the US Department of Labor. The project, entitled New Horizons: Puerto Rico Lasers and Photonics Career Pathways offers displaced workers, veterans, and others in Puerto Rico an opportunity to develop new and highly marketable skills for the 21st century. We give a roadmap of plans and pitfalls, and share our successes, challenges, solutions, and future expectations for those planning similar programs.
Dal Poz Mario R
Full Text Available Abstract Recent studies have shown evidence of a direct and positive causal link between the number of health workers and health outcomes. Several studies have identified an adequate health workforce as one of the key ingredients to achieving improved health outcomes. Global health initiatives are faced with human resources issues as a major, system-wide constraint. This article explores how the Global Fund addresses the challenges of a health workforce bottleneck to the successful implementation of priority disease programmes. Possibilities for investment in human resources in the Global Fund's policy documents and guidelines are reviewed. This is followed by an in-depth study of 35 Global Fund proposals from five African countries: Ethiopia, Ghana, Kenya, Malawi and Tanzania. The discussion presents specific human resources interventions that can be found in proposals. Finally, the comments on human resources interventions in the Global Fund's Technical Review Panel and the budget allocation for human resources for health were examined. Policy documents and guidelines of the Global Fund foster taking account of human resources constraints in recipient countries and interventions to address them. However, the review of actual proposals clearly shows that countries do not often take advantage of their opportunities and focus mainly on short-term, in-service training in their human resources components. The comments of the Technical Review Panel on proposed health system-strengthening interventions reveal a struggle between the Global Fund's goal to fight the three targeted diseases, on the one hand, and the need to strengthen health systems as a prerequisite for success, on the other. In realizing the opportunities the Global Fund provides for human resources interventions, countries should go beyond short-term objectives and link their activities to a long-term development of their human resources for health.
Buchan, James M; Naccarella, Lucio; Brooks, Peter M
This paper assesses what health workforce 'sustainability' might mean for Australia and New Zealand, given the policy direction set out in the World Health Organization draft code on international recruitment of health workers. The governments in both countries have in the past made policy statements about the desirability of health workforce 'self-sufficiency', but OECD data show that both have a high level of dependence on internationally recruited health professionals relative to most other OECD countries. The paper argues that if a target of 'self-sufficiency' or sustainability were to be based on meeting health workforce requirements from home based training, both Australia and New Zealand fall far short of this measure, and continue to be active recruiters. The paper stresses that there is no common agreed definition of what health workforce 'self-sufficiency', or 'sustainability' is in practice, and that without an agreed definition it will be difficult for policy-makers to move the debate on to reaching agreement and possibly setting measurable targets or timelines for achievement. The paper concludes that any policy decisions related to health workforce sustainability will also have to taken in the context of a wider community debate on what is required of a health system and how is it to be funded.
Fraher, Erin P; Ricketts, Thomas C; Lefebvre, Ann; Newton, Warren P
Inspired by the Affordable Care Act and health care payment models that reward value over volume, health care delivery systems are redefining the work of the health professionals they employ. Existing workers are taking on new roles, new types of health professionals are emerging, and the health workforce is shifting from practicing in higher-cost acute settings to lower-cost community settings, including patients' homes. The authors believe that although the pace of health system transformation has accelerated, a shortage of workers trained to function in the new models of care is hampering progress. In this Perspective, they argue that urgent attention must be paid to retraining the 18 million workers already employed in the system who will actually implement system change.Their view is shaped by work they have conducted in helping practices transform care, by extensive consultations with stakeholders attempting to understand the workforce implications of health system redesign, and by a thorough review of the peer-reviewed and gray literature. Through this work, the authors have become increasingly convinced that academic health centers (AHCs)-organizations at the forefront of innovations in health care delivery and health workforce training-are uniquely situated to proactively lead efforts to retrain the existing workforce. They recommend a set of specific actions (i.e., discovering and disseminating best practices; developing new partnerships; focusing on systems engineering approaches; planning for sustainability; and revising credentialing, accreditation, and continuing education) that AHC leaders can undertake to develop a more coherent workforce development strategy that supports practice transformation.
Abstract Background Research on practical and effective governance of the health workforce is limited. This paper examines health system strengthening as it occurs in the intersection between the health workforce and governance by presenting a framework to examine health workforce issues related to eight governance principles: strategic vision, accountability, transparency, information, efficiency, equity/fairness, responsiveness and citizen voice and participation. Methods This study builds ...
Judd, Jenni; Keleher, Helen
Reorienting work practices to include health promotion and prevention is complex and requires specific strategies and interventions. This paper presents original research that used 'real-world' practice to demonstrate that knowledge gathered from practice is relevant for the development of practice-based evidence. The paper shows how practitioners can inform and influence improvements in health promotion practice. Practitioner-informed evidence necessarily incorporates qualitative research to capture the richness of their reflective experiences. Using a participatory action research (PAR) approach, the research question asked 'what are the core dimensions of building health promotion capacity in a primary health care workforce in a real-world setting?' PAR is a method in which the researcher operates in full collaboration with members of the organisation being studied for the purposes of achieving some kind of change, in this case to increase the amount of health promotion and prevention practice within this community health setting. The PAR process involved six reflection and action cycles over two years. Data collection processes included: survey; in-depth interviews; a training intervention; observations of practice; workplace diaries; and two nominal groups. The listen/reflect/act process enabled lessons from practice to inform future capacity-building processes. This research strengthened and supported the development of health promotion to inform 'better health' practices through respectful change processes based on research, practitioner-informed evidence, and capacity-building strategies. A conceptual model for building health promotion capacity in the primary health care workforce was informed by the PAR processes and recognised the importance of the determinants approach. Practitioner-informed evidence is the missing link in the evidence debate and provides the links between evidence and its translation to practice. New models of health promotion service
Montes, J Henry; Webb, Susan C
The Affordable Care Act brings a renewed emphasis on the importance of public health services and those whose occupations are defined by performing the essential public health functions. The Affordable Care Act Prevention and Public Health Fund is a signal to the field that its work is important and critical to the health of the nation. Recent reports by the Institute of Medicine describe the changing dimensions of public health work in primary care integration and the need for enhanced financing of public health as investment. Gaining knowledge about the public health workforce, that is, how many workers there are and what they are doing, is of growing interest and concern for the field. Although enumeration of the public health workforce has been attempted several times by the federal government beginning as early as 1982, it was not until the year 2000 that a major effort was undertaken to obtain more complete information. Limitations that hampered Enumeration 2000 have persisted however. With implementation of the Affordable Care Act and other new ventures, key federal agencies are developing strategies to pursue a systemic and systematic enumeration and consistent taxonomy process. Included in these efforts is use of the Bureau of Labor Statistics, Standard Occupational Classification system. A clear and accurate understanding of the public health workforce and its characteristics is a major challenge. A well-constructed, systematic enumeration process can add to our understanding of the nature and functions of that workforce. In addition, discussion of enumeration must include the need for a consensus within the field that leads to a consistent taxonomy for the public health occupations. This article will provide a stage-setting brief of historical actions regarding enumeration, and it will examine selected enumeration activities taking place currently. It will discuss positive and negative implications facing public health and the potential for enhancing the
Aluttis, Christoph; Bishaw, Tewabech; Frank, Martina W
The 'crisis in human resources' in the health sector has been described as one of the most pressing global health issues of our time. The World Health Organization (WHO) estimates that the world faces a global shortage of almost 4.3 million doctors, midwives, nurses, and other healthcare professionals. A global undersupply of these threatens the quality and sustainability of health systems worldwide. This undersupply is concurrent with globalization and the resulting liberalization of markets, which allow health workers to offer their services in countries other than those of their origin. The opportunities of health workers to seek employment abroad has led to a complex migration pattern, characterized by a flow of health professionals from low- to high-income countries. This global migration pattern has sparked a broad international debate about the consequences for health systems worldwide, including questions about sustainability, justice, and global social accountabilities. This article provides a review of this phenomenon and gives an overview of the current scope of health workforce migration patterns. It further focuses on the scientific discourse regarding health workforce migration and its effects on both high- and low-income countries in an interdependent world. The article also reviews the internal and external factors that fuel health worker migration and illustrates how health workforce migration is a classic global health issue of our time. Accordingly, it elaborates on the international community's approach to solving the workforce crisis, focusing in particular on the WHO Code of Practice, established in 2010.
Pálsdóttir, Björg; Barry, Jean; Bruno, Andreia; Barr, Hugh; Clithero, Amy; Cobb, Nadia; De Maeseneer, Jan; Kiguli-Malwadde, Elsie; Neusy, André-Jacques; Reeves, Scott; Strasser, Roger; Worley, Paul
Across the globe, a "fit for purpose" health professional workforce is needed to meet health needs and challenges while capitalizing on existing resources and strengths of communities. However, the socio-economic impact of educating and deploying a fit for purpose health workforce can be challenging to evaluate. In this paper, we provide a brief overview of six promising strategies and interventions that provide context-relevant health professional education within the health system. The strategies focused on in the paper are:1. Distributed community-engaged learning: Education occurs in or near underserved communities using a variety of educational modalities including distance learning. Communities served provide input into and actively participate in the education process.2. Curriculum aligned with health needs: The health and social needs of targeted communities guide education, research and service programmes.3. Fit for purpose workers: Education and career tracks are designed to meet the needs of the communities served. This includes cadres such as community health workers, accelerated medically trained clinicians and extended generalists.4. Gender and social empowerment: Ensuring a diverse workforce that includes women having equal opportunity in education and are supported in their delivery of health services.5. Interprofessional training: Teaching the knowledge, skills and attitudes for working in effective teams across professions.6. South-south and north-south partnerships: Sharing of best practices and resources within and between countries.In sum, the sharing of resources, the development of a diverse and interprofessional workforce, the advancement of primary care and a strong community focus all contribute to a world where transformational education improves community health and maximizes the social and economic return on investment.
Brownie, Sharon Mary; Thomas, Janelle
This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable - in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project's genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers' commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia's current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented.
Campbell, Narelle; Eley, Diann S; McAllister, Lindy
.... Using case studies from the Australian allied health workforce, this paper adds new information by combining personality trait information with a detailed understanding of how the cases construe...
Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis
It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.
Halappa, Mythri; B H, Naveen; Kumar, Santhosh; H, Sreenivasa
India faces an acute shortage of health personnel. Together with inequalities in distribution of health workers, dental health workers also become a part contributing to it impeding the progress towards achievement of the Millennium Development Goals. To assess dental health-workforce distribution, identify inequalities in dental health-workers provision and report the impact of this mal distribution in India. Situational analysis done by using the primary data from the records of Dental Council of India. In India, 0.088% of dental health worker per 1000 population exists. Inequalities in the distribution of dentists exist in India. Certain states are experiencing an acute shortage of dental health personnel whereas certain cities are over fledged with dentists like Karnataka, Maharastra, Tamilnadu being states with high concentration & Jharkhand, Rajasthan, Uttaranchal being the least. Although the production of health workers has expanded greatly in recent years by increase in number of dental colleges the problems of imbalances in their distribution persist. In the race of increasing dentist population ratio in total, inequitable distribution of appropriately trained, motivated and supported dentists gives a mere feel of saturation in jobs making youngsters to not to choose dentistry as a career giving an alarm.
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
San Miguel, Sandra F; Carleton Parker, Loran; Adedokun, Omolola A; Burgess, Wilella D; Cipriani Davis, Kauline S; Blossom, Thaddaeus D; Schneider, Jessica L; Mennonno, Ann M; Ruhl, Joseph D; Veatch, Jennifer H; Wackerly, Amy J; Shin, Soo Yeon; Ratliff, Timothy L
Workforce development strategies to educate, inform, and diversify the veterinary profession of the future must begin with children in elementary school. This article provides a description of the Fat Dogs and Coughing Horses program, which takes a multifaceted approach toward informing young students, beginning in first grade, about the interesting work and career opportunities available in the field of veterinary medicine. The program, a collaboration among Purdue University and Indiana public schools, is supported by a Science Education Partnership Award from the Office of Research Infrastructure Programs, a component of the National Institutes of Health. The overall goal of the program is to provide formal and informal educational opportunities for students, parents, teachers, and the public about the science involved in keeping people and their animals healthy. Examples of health concerns that impact both people and their pets are used to inform and excite children about careers in the health sciences. The program resulted in (1) curricula for students in Grades 1-3, 6, and 9; (2) four children's books and a set of collectible cards which highlight veterinarians, veterinary technicians, and research scientists who work with animals; and (3) four traveling museum-level quality exhibits. Preliminary assessment data has shown that the implementation of the curricula enhanced student science learning and science attitudes and interests. The program provides evidence that partnerships among professionals in veterinary medicine and K-12 education can result in impactful workforce development programs.
Foster, Gwen; Morris, Meghan Brenna; Sirojudin, Sirojudin
The 2004 California Mental Health Services Act requires large-scale system change in the public mental health system through a shift to recovery-oriented services for diverse populations. This article describes an innovative strategy for workforce recruitment and retention to create and sustain these systemic changes. The California Social Work…
Full Text Available Abstract Background Shortages of health workers are obstacles to utilising global health initiative (GHI funds effectively in Africa. This paper reports and analyses two countries' health workforce responses during a period of large increases in GHI funds. Methods Health facility record reviews were conducted in 52 facilities in Malawi and 39 facilities in Zambia in 2006/07 and 2008; quarterly totals from the last quarter of 2005 to the first quarter of 2008 inclusive in Malawi; and annual totals for 2004 to 2007 inclusive in Zambia. Topic-guided interviews were conducted with facility and district managers in both countries, and with health workers in Malawi. Results Facility data confirm significant scale-up in HIV/AIDS service delivery in both countries. In Malawi, this was supported by a large increase in lower trained cadres and only a modest increase in clinical staff numbers. Routine outpatient workload fell in urban facilities, in rural health centres and in facilities not providing antiretroviral treatment (ART, while it increased at district hospitals and in facilities providing ART. In Zambia, total staff and clinical staff numbers stagnated between 2004 and 2007. In rural areas, outpatient workload, which was higher than at urban facilities, increased further. Key informants described the effects of increased workloads in both countries and attributed staff migration from public health facilities to non-government facilities in Zambia to PEPFAR. Conclusions Malawi, which received large levels of GHI funding from only the Global Fund, managed to increase facility staff across all levels of the health system: urban, district and rural health facilities, supported by task-shifting to lower trained staff. The more complex GHI arena in Zambia, where both Global Fund and PEPFAR provided large levels of support, may have undermined a coordinated national workforce response to addressing health worker shortages, leading to a less effective
Gallagher, Jennifer E; Eaton, Kenneth A
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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Huxley, Mary Pat
Life science and biotechnology companies are the fastest growing industries in the nation, with more than 30% of these companies and close to 50% of the nation's life science workers located in California. The need for well-trained biotechnology workers continues to grow. Educational institutions and industry professionals have attempted to create the training and the workforce for the bioscience and biotechnology industry. Many have concluded that one way would be to create a multiuse training center where trainees from high school age through late adulthood could receive up-to-date training. This case study had 2 unique phases. Phase 1 consisted of examining representative stakeholder interview data for characteristics of an ideal biotechnology shared-use regional education (B-SURE) center, which served as the basis for an assessment tool, with 107 characteristics in 8 categories. This represented what an ideal center model should include. Phase 2 consisted of using this assessment tool to gather data from 6 current biotechnology regional centers to determine how these centers compared to the ideal model. Results indicated that each center was unique. Although no center met all ideal model characteristics, the 6 centers could clearly be ranked. Recommendations include refining the core characteristics, further assessing the existing and planned centers; evaluating and refining the interview instrument in Phase 1 and the assessment tool in Phase 2 by including additional stakeholders in both phases and by adding reviewers of Phase 1 transcripts; and determining a method to demonstrate a clear return on investment in a B-SURE center.
Jacobs, Ronald L.
This article presents a perspective on the relationship between adult education and human resource development of the past two decades and the subsequent emergence of workforce development. The lesson taken from the article should be more than simply a recounting of events related to these fields of study. Instead, the more general lesson may be…
Jacobs, Ronald L.
This article presents a perspective on the relationship between adult education and human resource development of the past two decades and the subsequent emergence of workforce development. The lesson taken from the article should be more than simply a recounting of events related to these fields of study. Instead, the more general lesson may be…
Schulte, Paul A; Stephenson, Carol Merry; Okun, Andrea H; Palassis, John; Biddle, Elyce
The high rates of injury among young workers are a pressing public health issue, especially given the demand of the job market for new workers. Young and new workers experience the highest rates of occupational injuries of any age group. Incorporating occupational safety and health (OSH) information into the more than 20 000 vocational and other workforce preparation programs in the United States might provide a mechanism for reducing work-related injuries and illnesses among young and new workers. We assessed the status of including OSH information or training in workforce preparation programs and found there is an inconsistent emphasis on OSH information.
Full Text Available Abstract Background Sub-Saharan Africa faces a human resources crisis in the health sector. Over the past two decades its population has increased substantially, with a significant rise in the disease burden due to HIV/AIDS and recurrent communicable diseases and an increased incidence of noncommunicable diseases. This increased demand for health services is met with a rather low supply of health workers, but this notwithstanding, sub-Saharan African countries also experience significant wastage of their human resources stock. Methods This paper is a desk review to illustrate suggestions that the way human resources for health (HRH are trained and deployed in Africa does not enhance productivity and that countries are unable to realize the full potential expected from the working life of their health workers. The paper suggests data types for use in measuring various forms of "wastage". Results "Direct" wastage – or avoidable increases in loss of staff through factors such as emigration and death – is on the rise, perhaps as a result of the HIV/AIDS epidemic. "Indirect" wastage – which is the result of losses in output and productivity from health professionals' misapplied skills, absenteeism, poor support and lack of supervision – is also common. HIV/AIDS represents a special cause of wastage in Africa. Deaths of health workers, fear of infection, burnout, absenteeism, heavy workloads and stress affect productivity. Conclusion The paper reviews strategies that have been proposed and/or implemented. It suggests areas needing further attention, including: developing and using indicators for monitoring and managing wastage; enhancing motivation and morale of health workers; protecting and valuing the health worker with enhanced occupational safety and welfare systems; and establishing the moral leadership to effectively tackle HIV/AIDS and the brain drain.
Ahuriri-Driscoll, Annabel; Boulton, Amohia; Stewart, Albie; Potaka-Osborne, Gill; Hudson, Maui
Rongoā Māori practitioners make a valuable contribution towards Māori health outcomes, albeit with limited resourcing or formal training. This paper reports on a survey of healers/healing practices-specifically healers' aspirations for professional development and training-and considers the implications for healing practice and future training undertakings. Healers in seven districts around the country were surveyed about rongoā practice and service delivery during 2013. Consenting healers completed surveys either in person, via phone, or returned them via post, according to their preference and convenience. Resulting data were analysed and reported according to frequency of responses. Thirty-eight healers/rongoā clinics completed the survey--a 79% response rate. Respondents were primarily Māori (88%), female (69%), aged 50 years or older (60%), and worked as volunteers. Informal training modes focused on te reo, mātauranga and tikanga were the most common means of skill/ knowledge acquisition, and preferred modes for further training. The survey highlights the pressing need for expansion of the rongoā Māori workforce and training/service funding, to sustain rongoā practice. The findings add to what little is known about the training pathways and aspirations of practising healers, identified targets of the Māori Health Workforce Development Plan 2006.
Delaney, Kathleen R; Carlson-Sabelli, Linnea; Shephard, Rebekah; Ridge, Alison
In response to sustained concerns about the capability of the mental health workforce, federal groups have urged educators to adopt a competency-based system for training students in core mental health skills. A particular emphasis is training students to work in integrated systems, intervene with evidence-based practice, and employ culturally relevant therapies. Creating such a program, particularly one delivered online, requires structures that engage students in their own learning and tools for tracking competencies. We report on our competency-based graduate psychiatric mental health nursing program and the unique methods used to track student skill development and clinical reasoning.
Astronomy workforce development and public engagement in the United States are described. The number of professional astronomers has grown by about a third in the past 25 years, to about 4000. Only one in four are faculty in an academic setting; the rest work in a wide range of public and private research institutes. PhD production has remained steady at about 200 per year. Women account for roughly half of BSc degrees and a third of PhD degrees, but their participation declines to about 10% at the level of full professor. Minorities are underrepresented by a substantial factor at all levels of the profession. In terms of public engagement, astronomy has unique advantages associated with its visual appeal and the large and active amateur astronomy community. The are 1400 public planetaria in the US, with another 110 in schools and universities. Astronomers have made good use of new media such as blogs and podcasts and social networks, but the biggest impact has been in the area of citizen science, where people with no technical background contribute directly to a research project by, for example, classifying galaxies. The International Year of Astronomy and the remarkable success of the Galileoscope have inspired large numbers of people to appreciate astronomy, contributing indirectly to the professional vitality of the field.
Forsgren, Roger C.; Miller, Lauren L.
NASA engineers are some of the world's best-educated graduates, responsible for technically complex, highly significant scientific programs. Even though these professionals are highly proficient in traditional analytical competencies, there is a unique opportunity to offer continuing education that further enhances their overall scientific minds. With a goal of maintaining the Agency's passionate, "best in class" engineering workforce, the NASA Academy of Program/Project & Engineering Leadership (APPEL) provides educational resources encouraging foundational learning, professional development, and knowledge sharing. NASA APPEL is currently partnering with the scientific community's most respected subject matter experts to expand its engineering curriculum beyond the analytics and specialized subsystems in the areas of: understanding NASA's overall vision and its fundamental basis, and the Agency initiatives supporting them; sharing NASA's vast reservoir of engineering experience, wisdom, and lessons learned; and innovatively designing hardware for manufacturability, assembly, and servicing. It takes collaboration and innovation to educate an organization that possesses such a rich and important historyand a future that is of great global interest. NASA APPEL strives to intellectually nurture the Agency's technical professionals, build its capacity for future performance, and exemplify its core valuesalJ to better enable NASA to meet its strategic visionand beyond.
McGee, Richard; Saran, Suman; Krulwich, Terry A
Much has been written about the need for and barriers to achievement of greater diversity in the biomedical workforce from the perspectives of gender, race, and ethnicity; this is not a new topic. These discussions often center around a "pipeline" metaphor that imagines students flowing through a series of experiences to eventually arrive at a science career. Here we argue that diversity will only be achieved if the primary focus is on (1) what is happening within the pipeline, not just counting individuals entering and leaving it; (2) de-emphasizing the achievement of academic milestones by typical ages; and (3) adopting approaches that most effectively develop talent. Students may develop skills at different rates based on factors such as earlier access to educational resources, exposure to science (especially research experiences), and competing demands for time and attention during high school and college. Therefore, there is wide variety among students at any point along the pipeline. Taking this view requires letting go of imagining the pipeline as a sequence of age-dependent steps in favor of milestones of skill and talent development decoupled from age or educational stage. Emphasizing talent development opens up many new approaches for science training outside of traditional degree programs. This article provides examples of such approaches, including interventions at the postbaccalaureate and PhD levels, as well as a novel coaching model that incorporates well-established social science theories and complements traditional mentoring. These approaches could significantly impact diversity by developing scientific talent, especially among currently underrepresented minorities. © 2012 Mount Sinai School of Medicine.
Humphries, Niamh; Brugha, Ruairi; McGee, Hannah
Ireland began actively recruiting nurses internationally in 2000. Between 2000 and 2010, 35% of new recruits into the health system were non-EU migrant nurses. Ireland is more heavily reliant upon international nurse recruitment than the UK, New Zealand or Australia. This paper draws on in-depth interviews (N=21) conducted in 2007 with non-EU migrant nurses working in Ireland, a quantitative survey of non-EU migrant nurses (N=337) conducted in 2009 and in-depth interviews conducted with key stakeholders (N=12) in late 2009/early 2010. Available primary and secondary data indicate a fresh challenge for health workforce planning in Ireland as immigration slows and nurses (both non-EU and Irish trained) consider emigration. Successful international nurse recruitment campaigns obviated the need for health workforce planning in the short-term, however the assumption that international nurse recruitment had 'solved' the nursing shortage was short-lived and the current presumption that nurse migration (both emigration and immigration) will always 'work' for Ireland over-plays the reliability of migration as a health workforce planning tool. This article analyses Ireland's experience of international nurse recruitment 2000-2010, providing a case study which is illustrative of health workforce planning challenges faced internationally.
Full Text Available The United Arab Emirates (UAE has experienced tremendous economic and industrial growth in the petroleum, airline, maritime and construction sectors, especially since the discovery of oil reserves. Mass recruitment of low skilled or unskilled laborers from less-developed countries has been utilized to satisfy the manpower demands of these fast paced industrial developments. Such workforce recruitment has created an unusual populace demographic, with the total UAE population estimated at 8.3 million, composed of 950,000 Emiratis, with the remainder being multinational expatriate workers, with varying educational qualifications, work experience, religious beliefs, cultural practices, and native languages. These unique characteristics pose a challenge for health and safety professionals tasked with ensuring the UAE workforce adheres to specific occupational health and safety procedures. The paper discusses two case studies that employ a novel multimedia approach to raising health and safety awareness among a multinational workforce.
Loney, Tom; Cooling, Robert Fletcher; Aw, Tar-Ching
The United Arab Emirates (UAE) has experienced tremendous economic and industrial growth in the petroleum, airline, maritime and construction sectors, especially since the discovery of oil reserves. Mass recruitment of low skilled or unskilled laborers from less-developed countries has been utilized to satisfy the manpower demands of these fast paced industrial developments. Such workforce recruitment has created an unusual populace demographic, with the total UAE population estimated at 8.3 million, composed of 950,000 Emiratis, with the remainder being multinational expatriate workers, with varying educational qualifications, work experience, religious beliefs, cultural practices, and native languages. These unique characteristics pose a challenge for health and safety professionals tasked with ensuring the UAE workforce adheres to specific occupational health and safety procedures. The paper discusses two case studies that employ a novel multimedia approach to raising health and safety awareness among a multinational workforce.
Van Greuningen Malou
Full Text Available Abstract Introduction In many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years. Case description Since 1970, the Dutch government has explored different approaches to determine the inflow in medical schools. In 2000, a simulation model for health workforce planning was developed to estimate the required and available capacity of health professionals in the Netherlands. In this paper, this model is explained, using the Dutch general practitioners as an example. After the different steps in the model are clarified, it is shown how elements can be added to arrive at different versions of the model, or ‘scenarios’. A comparison is made of the results of different scenarios for different years. In addition, the subsequent stakeholder decision-making process is considered. Discussion and evaluation Discussion of this paper shows that workforce planning in the Netherlands is a complex modelling task, which is sensitive to different developments influencing the balance between supply and demand. It seems plausible that workforce planning has resulted in a balance between supply and demand of general practitioners. Still, it remains important that the modelling process is accepted by the different stakeholders. Besides calculating the balance between supply and demand, there needs to be an agreement between the stakeholders to implement the advised training inflow. The Dutch simulation model was evaluated using six criteria to be met by models suitable for policy objectives. This model meets these criteria, as it is a comprehensive and parsimonious model that can include all relevant factors. Conclusion Over the last decade, health workforce planning in the Netherlands has become an accepted instrument for calculating the required supply of
Summerfelt, Fred F
The 2010 U.S. Patient Protection and Affordable Care Act (PPACA) calls for training programs to develop mid-level dental health care providers to work in areas with underserved populations. In 2004, legislation was passed in Arizona allowing qualified dental hygienists to enter into an affiliated practice relationship with a dentist to provide oral health care services for underserved populations without general or direct supervision in public health settings. In response, the Northern Arizona University (NAU) Dental Hygiene Department developed a teledentistry-assisted, affiliated practice dental hygiene model that places a dental hygienist in the role of the mid-level practitioner as part of a digitally linked oral health care team. Utilizing current technologies, affiliated practice dental hygienists can digitally acquire and transmit diagnostic data to a distant dentist for triage, diagnosis, and patient referral in addition to providing preventive services permitted within the dental hygiene scope of practice. This article provides information about the PPACA and the Arizona affiliated practice dental hygiene model, defines teledentistry, identifies the digital equipment used in NAU's teledentistry model, give an overview of NAU's teledentistry training, describes NAU's first teledentistry clinical experience, presents statistical analyses and evaluation of NAU students' ability to acquire diagnostically efficacious digital data from remote locations, and summarizes details of remote applications of teledentistry-assisted, affiliated practice dental hygiene workforce model successes.
Saxe-Braithwaite, Marcy; Carlton, Sandra; Bass, Brenda
The rapidly changing world of healthcare is faced with many challenges, not the least of which is a diminishing workforce. Healthcare organizations must develop multiple strategies, not only to attract and retain employees, but also to ensure that workers are prepared for continuous change in the workplace, are working at their full scope of practice and are committed to, and accountable for, the provision of high-quality care. There is evidence that by creating a healthier workplace, improved patient care will follow. Aligning Healthy Workplace Initiatives with an organization's strategic goals, corporate culture and vision reinforces their importance within the organization. In this paper, we describe an innovative pilot to assess a career development program, one of multiple Healthy Workplace Initiatives taking place at Providence Care in Kingston, Ontario in support of our three strategic goals. The results of the pilot were very encouraging; subsequent success in obtaining funding from HealthForceOntario has allowed the implementation of a sustainable program of career development within the organization. More work is required to evaluate its long-term effectiveness.
Full Text Available Abstract Extending retirement ages and anti-age discrimination policies will increase the numbers of older workers in the future. Occupational health physicians may have to draw upon the principles and experience of geriatric medicine to manage these older workers. Examples of common geriatric syndromes that will have an impact on occupational health are mild cognitive impairment and falls at the workplace. Shifts in paradigms and further research into the occupational health problems of an ageing workforce will be needed.
Context:The feasibility study report published by Matrix Insight in 2012, is probably the first empirical and systematic comparison of health workforce planning systems in all European countries. As such, the report provides important data and information to explore what differences and similarities
Bourke-Taylor, H.; Howie, L.; Law, M.
Background: Families of children with disabilities experience extra financial strains, and mothers are frequently unable to participate in paid work because of caregiving obligations. Methods: A mailed survey and follow-up phone calls were used to gather data about mother's health, workforce participation and barriers to inclusion in the workplace…
Karmel, Tom; Blomberg, Davinia
This paper aims to provide a picture of the occupations in the community services and health industry, and how the workforce obtains the required skills. The authors argue that planning for the industry should concentrate on occupations specific to the industry and those which require high skill levels. Findings suggest that the qualification…
Context:The feasibility study report published by Matrix Insight in 2012, is probably the first empirical and systematic comparison of health workforce planning systems in all European countries. As such, the report provides important data and information to explore what differences and similarities
E3: North Carolina advances performance in sustainability and workforce development strategies for the state's manufacturers. The initiative helps communities and manufacturers address energy and sustainability challenges by leveraging expertise.
Full Text Available Objective. To design and implement an international and interprofessional Global Learning Partnership Model, which involves shared learning between academics and students from Universitas 21 network with other universities with United Nations Millennium Development Goal needs. Design. Two literature reviews were conducted to inform ethical aspects and curriculum design of the GLP model. Feedback from conference presentations and consultation with experts in education and public health has been incorporated to inform the current iteration of the GLP model. Intervention. The pilot group of 25 students from U21 universities and Kathmandu University, representing six health disciplines will meet in Nepal in April 2016 for a shared learning experience, including a one week university based workshop and three week community based experience.Outcome measures. A multi-phase, mixed method design was selected for the evaluation of the GLP model, utilising a combination of focus groups and questionnaires to evaluate the efficacy of the placement through student experience and learning outcomes in cultural competency, UN SDG knowledge, community engagement and health promotion skills. Results. The literature review demonstrated that cultural awareness and cultural knowledge were improved through participation in cultural immersion programs that incorporated preparatory workshops and clinical experiences. Data will be gathered in April 2006 and the results of the evaluation will be published in the future. Conclusions. The GLP model proposes a project around the fundamental concept of engagement and sharing between students and academics across universities and cultural contexts to build capacity through education, while capitalising on strengths of existing global health placements. Further the inclusion of host-country students and academics in this learning exchange will promote the establishment of an international and interprofessional network for
Bowen, Brent D.; Russell, Valerie; Vlasek, Karisa; Avery, Shelly; Calamaio, Larry; Carstenson, Larry; Farritor, Shane; deSilva, Shan; Dugan, James; Farr, Lynne
The NASA Nebraska Space Grant Consortium (NSGC) continues to recognize the necessity of increasing the quantity and quality of highly skilled graduates and faculty involved with NASA. Through NASA Workforce Development funds awarded in 2002, NSGC spearheaded customer- focused workforce training and higher education, industry and community partnerships that are significantly impacting the state s workforce in the science, technology, engineering, and mathematics (STEM) competencies. NSGC proposes to build upon these accomplishments to meet the steadily increasing demand for STEM skills and to safeguard minority representation in these disciplines. A wide range of workforce development activities target NASA s need to establish stronger connections among higher education, industry, and community organizations. Participation in the National Student Satellite Program (NSSP), Community Internship Program, and Nebraska Science and Technology Recruitment Fair will extend the pipeline of employees benefiting NASA as well as Nebraska. The diversity component of this proposal catapults from the exceptional reputation NSGC has built by delivering geospatial science experiences to Nebraska s Native Americans. For 6 years, NSGC has fostered and sustained partnerships with the 2 tribal colleges and 4 reservation school districts in Nebraska to foster aeronautics education and outreach. This program, the Nebraska Native American Outreach Program (NNAOP), has grown to incorporate more than educational institutions and is now a partnership among tribal community leaders, academia, tribal schools, and industry. The content focus has broadened from aeronautics in the school systems to aerospace technology and earth science applications in tribal community decision-making and workforce training on the reservations. To date, participants include faculty and staff at 4 Nebraska tribal schools, 2 tribal colleges, approximately 1,000 Native American youth, and over 1,200 community members
Ghaddar, Suad; Ronnau, John; Saladin, Shawn P; Martínez, Glenn
The underrepresentation of minorities among health care providers and researchers is often considered one of the contributing factors to health disparities in these populations. Recent demographic shifts and the higher proportion of minorities anticipated among the newly insured under the Patient Protection and Affordable Care Act make the need for a more diverse and culturally competent health care workforce an urgent national priority.The authors describe current and future strategies that have been developed at the College of Health Sciences and Human Services at the University of Texas-Pan American (an institution with 89% Hispanic students in 2012) to prepare a culturally competent and ethnically diverse health care workforce that can meet the needs of a diverse population, especially in the college's own community. The college graduates approximately 650 students annually for careers in nursing, physician assistant studies, occupational therapy, pharmacy, rehabilitation services, clinical laboratory sciences, dietetics, and social work. The college's approach centers on enriching student education with research, service, and community-based experiences within a social-determinants-of-health framework. The approach is promoted through an interdisciplinary health disparities research center, multiple venues for community-based service learning, and an innovative approach to improve cultural and linguistic competence. Although the different components of the college's approach are at different developmental stages and will benefit from more formal evaluations, the college's overall vision has several strengths that promise to serve as a model for future academic health initiatives.
Goldenberg, Matthew N; Krystal, John H
This study sought to determine whether and to what extent medical students with an undergraduate college major in neuroscience, relative to other college majors, pursue psychiatry relative to other brain-based specialties (neurology and neurosurgery) and internal medicine. The authors analyzed data from AAMC matriculation and graduation surveys for all students who graduated from US medical schools in 2013 and 2014 (n = 29,714). Students who majored in neuroscience, psychology, and biology were compared to all other students in terms of their specialty choice at both time points. For each major, the authors determined rates of specialty choice of psychiatry, neurology, neurosurgery, and, for comparison, internal medicine. This study employed Chi-square statistic to compare odds of various specialty choices among different majors. Among medical students with an undergraduate neuroscience major (3.5% of all medical students), only 2.3% preferred psychiatry at matriculation, compared to 21.5% who chose neurology, 13.1% neurosurgery, and 11% internal medicine. By graduation, psychiatry specialty choice increased to 5.1% among neuroscience majors while choice of neurology and neurosurgery declined. Psychology majors (OR = 3.16, 95% CI 2.60-4.47) but not neuroscience majors (OR 1.28, 0.92-1.77) were more likely than their peers to choose psychiatry. Psychiatry struggles to attract neuroscience majors to the specialty. This missed opportunity is an obstacle to developing the neuroscience literacy of the workforce and jeopardizes the neuroscientific future of our field. Several potential strategies to address the recruitment challenges exist.
This report documents the identification of strategies to leverage public and private resources for the development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP).There are numerous efforts across the United States to develop a properly skilled and trained national security workforce. Some of these efforts are the result of the leveraging of public and private dollars. As budget dollars decrease and the demand for a properly skilled and trained national security workforce increases, it will become even more important to leverage every education and training dollar. The leveraging of dollars serves many purposes. These include increasing the amount of training that can be delivered and therefore increasing the number of people reached, increasing the number and quality of public/private partnerships, and increasing the number of businesses that are involved in the training of their future workforce.
Stoneking, Beth C; McGuffin, Beverly A
The theoretical underpinnings, training content and initial training data of a workforce development program are described. The program was designed for people with psychiatric and/or substance use disorders, and provides skills to improve their employability in the behavioral health system. Trainees rated their knowledge, skills and attitudes as improved after training. Supervisor ratings of participants after three months of employment are consistent with the participant's self-ratings.
Mitchell, Dennis A; Lassiter, Shana L
The racial/ethnic composition of our nation is projected to change drastically in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. We reviewed literature concerning health care disparities and workforce diversity issues--particularly within the oral health field--and provide a synthesis of recommendations to address these issues. This review is highly relevant to both the medical and public health professions, because they are facing similar disparity and workforce issues. In addition, the recent establishment of relationships between oral health and certain systemic health conditions will elevate oral health promotion and disease prevention as important points of intervention in the quest to improve our nation's public health.
Rumsey, Michele; Fletcher, Stephanie M; Thiessen, Jodi; Gero, Anna; Kuruppu, Natasha; Daly, John; Buchan, James; Willetts, Juliet
There is a growing body of evidence that the impacts of climate change are affecting population health negatively. The Pacific region is particularly vulnerable to climate change; a strong health-care system is required to respond during times of disaster. This paper examines the capacity of the health sector in Pacific Island Countries to adapt to changing disaster response needs, in terms of: (i) health workforce governance, management, policy and involvement; (ii) health-care capacity and skills; and (iii) human resources for health training and workforce development. Key stakeholder interviews informed the assessment of the capacity of the health sector and disaster response organizations in Pacific Island Countries to adapt to disaster response needs under a changing climate. The research specifically drew upon and examined the adaptive capacity of individual organizations and the broader system of disaster response in four case study countries (Fiji, Cook Islands, Vanuatu and Samoa). 'Capacity' including health-care capacity was one of the objective determinants identified as most significant in influencing the adaptive capacity of disaster response systems in the Pacific. The research identified several elements that could support the adaptive capacity of the health sector such as: inclusive involvement in disaster coordination; policies in place for health workforce coordination; belief in their abilities; and strong donor support. Factors constraining adaptive capacity included: weak coordination of international health personnel; lack of policies to address health worker welfare; limited human resources and material resources; shortages of personnel to deal with psychosocial needs; inadequate skills in field triage and counselling; and limited capacity for training. Findings from this study can be used to inform the development of human resources for health policies and strategic plans, and to support the development of a coordinated and collaborative
McGrail, Matthew R; Russell, Deborah J; Humphreys, John S
Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning.Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations.Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions.Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities.What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making.What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is
Full Text Available Abstract Background Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite its importance for the sound selection, planning, implementation and evaluation of these policies. This lack of a systematic approach to costing poses a serious challenge for strong health policy decisions. Methods This paper proposes a framework for carrying out a costing analysis of interventions to increase the availability of health workers in rural and remote areas with the aim to help policy decision makers. It also underlines the importance of identifying key sources of financing and of assessing financial sustainability. The paper reviews the evidence on costing interventions to improve health workforce recruitment and retention in remote and rural areas, provides guidance to undertake a costing evaluation of such interventions and investigates the role and importance of costing to inform the broader assessment of how to improve health workforce planning and management. Results We show that while the debate on the effectiveness of policies and strategies to improve health workforce retention is gaining impetus and attention, there is still a significant lack of knowledge and evidence about the associated costs. To address the concerns stemming from this situation, key elements of a framework to undertake a cost analysis are proposed and discussed. Conclusions These key elements should help policy makers gain insight into the costs of policy interventions, to clearly identify and understand their financing sources and mechanisms, and to ensure their sustainability.
Retchin, Sheldon M
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.
Cogdill, Keith W.; Ruffin, Angela B.; Stavri, P. Zoë
Objective: The paper provides an overview of the National Network of Libraries of Medicine's (NN/ LM's) outreach to the public health workforce from 2001 to 2006. Description: NN/LM conducts outreach through the activities of the Regional Medical Library (RML) staff and RML-sponsored projects led by NN/LM members. Between 2001 and 2006, RML staff provided training on information resources and information management for public health personnel at national, state, and local levels. The RMLs also contributed significantly to the Partners in Information Access for the Public Health Workforce collaboration. Methods: Data were extracted from telephone interviews with directors of thirty-seven NN/LM-sponsored outreach projects directed at the public health sector. A review of project reports informed the interviews, which were transcribed and subsequently coded for emergent themes using qualitative analysis software. Results: Analysis of interview data led to the identification of four major themes: training, collaboration, evaluation of outcomes, and challenges. Sixteen subthemes represented specific lessons learned from NN/LM members' outreach to the public health sector. Conclusions: NN/LM conducted extensive information-oriented outreach to the public health workforce during the 2001-to-2006 contract period. Lessons learned from this experience, most notably the value of collaboration and the need for flexibility, continue to influence outreach efforts in the current contract period. PMID:17641766
Cogdill, Keith W; Ruffin, Angela B; Stavri, P Zoë
The paper provides an overview of the National Network of Libraries of Medicine's (NN/ LM's) outreach to the public health workforce from 2001 to 2006. NN/LM conducts outreach through the activities of the Regional Medical Library (RML) staff and RML-sponsored projects led by NN/LM members. Between 2001 and 2006, RML staff provided training on information resources and information management for public health personnel at national, state, and local levels. The RMLs also contributed significantly to the Partners in Information Access for the Public Health Workforce collaboration. Data were extracted from telephone interviews with directors of thirty-seven NN/LM-sponsored outreach projects directed at the public health sector. A review of project reports informed the interviews, which were transcribed and subsequently coded for emergent themes using qualitative analysis software. Analysis of interview data led to the identification of four major themes: training, collaboration, evaluation of outcomes, and challenges. Sixteen subthemes represented specific lessons learned from NN/LM members' outreach to the public health sector. NN/LM conducted extensive information-oriented outreach to the public health workforce during the 2001-to-2006 contract period. Lessons learned from this experience, most notably the value of collaboration and the need for flexibility, continue to influence outreach efforts in the current contract period.
Neuberger, John S; Montes, J Henry; Woodhouse, Carolyn Lynn; Nazir, Niaman; Ferebee, Annette
To examine the continuing education needs of and method of course delivery for American Public Health Association (APHA) members. The APHA Education Board developed a list of 37 potential continuing education courses, 20 of which were linked to course competencies. An electronic survey of 22 104 APHA members was conducted to determine members' priorities. Survey data included age, gender, race/ethnicity, highest academic degree obtained, workplace setting, educational needs, and preferred method of course delivery. Data were primarily analyzed using descriptive statistics. Demographic data, educational needs, and preferred method of course delivery. Respondents numbered 5058, with 3836 (75.8%) interested in continuing education. For those indicating an interest, approximately 6 course areas per person were identified. A number of specific course areas were emphasized, including Leadership and Systems Thinking Skills and Policy Development and Program Planning. More than 50% of respondents favored obtaining courses using an online or computer-based format. Of the 24% uninterested in continuing education, 78% were in the age range of 25 to 65 years. Although this study identified continuing education needs of a wide cross section of APHA members, the response rate was low. Additional surveys should be conducted periodically to update course offerings and identify gaps in workforce training. Reasons for any disinterest in continuing education in public health should be explored.
Full Text Available Abstract Designers and implementers of decentralization and other reform measures have focused much attention on financial and structural reform measures, but ignored their human resource implications. Concern is mounting about the impact that the reallocation of roles and responsibilities has had on the health workforce and its management, but the experiences and lessons of different countries have not been widely shared. This paper examines evidence from published literature on decentralization's impact on the demand side of the human resource equation, as well as the factors that have contributed to the impact. The elements that make such an impact analysis exceptionally complex are identified. They include the mode of decentralization that a country is implementing, the level of responsibility for the salary budget and pay determination, and the civil service status of transferred health workers. The main body of the paper is devoted to examining decentralization's impact on human resource issues from three different perspectives: that of local health managers, health workers themselves, and national health leaders. These three groups have different concerns in the human resource realm, and consequently, have been differently affected by decentralization processes. The paper concludes with recommendations regarding three key concerns that national authorities and international agencies should give prompt attention to. They are (1 defining the essential human resource policy, planning and management skills for national human resource managers who work in decentralized countries, and developing training programs to equip them with such skills; (2 supporting research that focuses on improving the knowledge base of how different modes of decentralization impact on staffing equity; and (3 identifying factors that most critically influence health worker motivation and performance under decentralization, and documenting the most cost-effective best
Fort, Alfredo L; Deussom, Rachel; Burlew, Randi; Gilroy, Kate; Nelson, David
Despite its importance, the field of human resources for health (HRH) has lagged in developing methods to measure its status and progress in low- and middle-income countries suffering a workforce crisis. Measures of professional health worker densities and distribution are purely numerical, unreliable, and do not represent the full spectrum of workers providing health services. To provide more information on the multi-dimensional characteristics of human resources for health, in 2013-2014, the global USAID-funded CapacityPlus project, led by IntraHealth International, developed and tested a 79-item HRH Effort Index modeled after the widely used Family Planning Effort Index. The index includes seven recognized HRH dimensions: Leadership and Advocacy; Policy and Governance; Finance; Education and Training; Recruitment, Distribution, and Retention; Human Resources Management; and Monitoring, Evaluation, and Information Systems. Each item is scored from 1 to 10 and scores are averaged with equal weights for each dimension and overall. The questionnaire is applied to knowledgeable informants from public, nongovernmental organization, and private sectors in each country. A pilot test among 49 respondents in Kenya and Nigeria provided useful information to improve, combine, and streamline questions. CapacityPlus applied the revised 50-item questionnaire in 2015 in Burkina Faso, Dominican Republic, Ghana, and Mali, among 92 respondents. Additionally, the index was applied subnationally in the Dominican Republic (16 respondents) and in a consensus-building meeting in Mali (43 respondents) after the national application. The results revealed a range of scores between 3.7 and 6.2 across dimensions, for overall scores between 4.8 and 5.5. Dimensions with lower scores included Recruitment, Distribution, and Retention, while Leadership and Advocacy had higher scores. The tool proved to be well understood and provided key qualitative information on the health workforce to assist
Orlowski, Simone; Lawn, Sharon; Matthews, Ben; Venning, Anthony; Wyld, Kaisha; Jones, Gabrielle; Winsall, Megan; Antezana, Gaston; Schrader, Geoffrey; Bidargaddi, Niranjan
Background Digital technologies show promise for reversing poor engagement of youth (16–24 years) with mental health services. In particular, mobile and internet based applications with communication capabilities can augment face-to-face mental health service provision. The literature in this field, however, fails to adequately capture the perspectives of the youth mental health workforce regarding utility and acceptability of technology for this purpose. Methods This paper describes results ...
Yeager, Valerie A; Wisniewski, Janna M; Amos, Kathleen; Bialek, Ron
We examined factors that influence the decision to join the public health workforce. In this cross-sectional study, we used 2010 secondary data representing 6939 public health workers. Factors influencing the decision to take jobs in public health were significantly associated with specific previous employment settings. Respondents generally rated organizational factors as more influential than personal factors in terms of their decision to work in governmental public health. Leaders should consider tailoring recruitment efforts to maximize job uptake and enhance the potential for long-term retention.
McGee, Victoria; Fraher, Erin
Increasing the racial and ethnic diversity of the health care workforce is vital to achieving accessible, equitable health care. This study provides baseline data on the diversity of health care practitioners in North Carolina compared with the diversity of the state's population. We analyzed North Carolina health workforce diversity using licensure data from the respective state boards of selected professions from 1994-2009; the data are stored in the North Carolina Health Professions Data System. North Carolina's health care practitioners are less diverse than is the state's population as a whole; only 17% of the practitioners are nonwhite, compared with 33% of the state's population. Levels of diversity vary among the professions, which are diversifying slowly over time. Primary care physicians are diversifying more rapidly than are other types of practitioners; the percentage who are nonwhite increased by 14 percentage points between 1994 and 2009, a period during which 1,630 nonwhite practitioners were added to their ranks. The percentage of licensed practical nurses who are nonwhite increased by 7 percentage points over the same period with the addition of 1,542 nonwhite practitioners to their ranks. Nonwhite health professionals cluster regionally throughout the state, and 79% of them practice in metropolitan counties. This study reports on only a selected number of health professions and utilizes race/ethnicity data that were self-reported by practitioners. Tracking the diversity among North Carolina's health care practitioners provides baseline data that will facilitate future research on barriers to health workforce entry, allow assessment of diversity programs, and be useful in addressing racial and ethnic health disparities.
Talbot, Lyn; Graham, Melissa; James, Erica L
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.
Girasek, Edmond; Kovács, Eszter; Aszalós, Zoltán; Eke, Edit; Ragány, Károly; Kovács, Réka; Cserháti, Zoltán; Szócska, Miklós
Health workforce (HWF) planning and monitoring processes face challenges regarding data and appropriate indicators. One such area fraught with difficulties is labour activity and, more specifically, defining headcount and full-time equivalent (FTE). This study aims to review national practices in FTE calculation formulas for selected EU Member States (MS). The research was conducted as a part of the Joint Action on European Health Workforce Planning and Forecasting. Definitions, categories and terms concerning the five sectoral professions were examined in 14 MS by conducting a survey. To gain a deeper understanding of the international data-reporting processes (Joint Questionnaire on Non-Monetary Health Care Statistics-JQ), six international expert interviews were conducted by using a semi-structured interview guide. Of the 14 investigated countries, four MS indicated that they report FTE to the JQ and that they also calculate FTE data for national planning purposes. The other countries do not use FTE data for national purposes, but most of them do use special calculations and/or estimation methods for converting headcount to FTE. The findings revealed significant differences between national calculation methods when reporting FTE data to the JQ. This diversity in terms of calculations and estimations can lead to biases with respect to international comparisons. This finding was reinforced by the expert interviews, since the experts agreed that the activities of healthcare professionals are a fundamental factor in HWF monitoring and planning. Experts underscored that activity should also be measured by FTE, and not only by headcount. FTE and headcount are significant factors in HWF planning and monitoring; therefore, national data collections should place emphasis on collecting data and calculating the appropriate indicators. National FTE could serve as a call to action for HWF planners due to the lack of matching international FTE data. At the international level
Jansen, Christel; Codjia, Laurence; Cometto, Giorgio; Yansané, Mohamed Lamine; Dieleman, Marjolein
Background Universal health coverage requires a health workforce that is available, accessible, and well-performing. This article presents a critical analysis of the health workforce needs for the delivery of maternal and neonatal health services in Guinea, and of feasible and relevant interventions to improve the availability, accessibility, and performance of the health workforce in the country. Methods A needs-based approach was used to project human resources for health (HRH) requirements. This was combined with modeling of future health sector demand and supply. A baseline scenario with disaggregated need and supply data for the targeted health professionals per region and setting (urban or rural) informed the identification of challenges related to the availability and distribution of the workforce between 2014 and 2024. Subsequently, the health labor market framework was used to identify interventions to improve the availability and distribution of the health workforce. These interventions were included in the supply side modeling, in order to create a “policy rich” scenario B which allowed for analysis of their potential impact. Results In the Republic of Guinea, only 44% of the nurses and 18% of the midwives required for maternal and neonatal health services are currently available. If Guinea continues on its current path without scaling up recruitment efforts, the total stock of HRH employed by the public sector will decline by 15% between 2014 and 2024, while HRH needs will grow by 22% due to demographic trends. The high density of HRH in urban areas and the high number of auxiliary nurses who are currently employed pose an opportunity for improving the availability, accessibility, and performance of the health workforce for maternal and neonatal health in Guinea, especially in rural areas. Conclusion Guinea will need to scale up its recruitment efforts in order to improve health workforce availability. Targeted labor market interventions need to be
Full Text Available Background: Training of health-care workforce including doctors, staff nurses, and Auxiliary Nurse Midwives using simulation techniques for skill enhancement have been used in a variety of clinical settings to improve the quality of training. India adopted the skills laboratories model for capacity building of health workers in maternal and child health in Bihar state. Objective: Current economic evaluation was performed with the objective of assessing the financial and economic cost of implementing skills laboratories. Methods: Data on all resources spent for the development of skill laboratory and implementing training during financial year 2011 were collected from Patna district in Bihar state. We used standard methods to estimate the full financial and economic costs of implementing the skills laboratories from a health system perspective. Results: Overall cost of implementing 20 permanent and 10 mobile skills laboratory training in Bihar was Indian Rupee (INR 8849895 from a financial perspective. The cost was nearly two times higher when using an economic perspective to account for opportunity cost of all resources used. The unit cost of training a participant using permanent and mobile laboratory was INR 6856 and INR 7474, respectively assuming an annual volume of 90 training. The optimum number of training which should be operated annually in a skills laboratory to make it most efficient is about 70–80 training per annum. Conclusions: Economic implications of skills laboratory organization should be borne while planning scale up in Bihar and other states. Further research on the effectiveness of two models of skill laboratory, that is, permanent and mobile and their cost is recommended.
Full Text Available INTRODUCTION: Trained human resources are fundamental for well-functioning health systems, and the lack of health workers undermines public sector capacity to meet population health needs. While external brain drain from low and middle-income countries is well described, there is little understanding of the degree of internal brain drain, and how increases in health sector funding through global health initiatives may contribute to the outflow of health workers from the public sector to donor agencies, non-governmental organisations (NGOs, and the private sector. METHODS: An observational study was conducted to estimate the degree of internal and external brain drain among Mozambican nationals qualifying from domestic and foreign medical schools between 1980-2006. Data were collected 26-months apart in 2008 and 2010, and included current employment status, employer, geographic location of employment, and main work duties. RESULTS: Of 723 qualifying physicians between 1980-2006, 95.9% (693 were working full-time, including 71.1% (493 as clinicians, 20.5% (142 as health system managers, and 6.9% (48 as researchers/professors. 25.5% (181 of the sample had left the public sector, of which 62.4% (113 continued working in-country and 37.6% (68 emigrated from Mozambique. Of those cases of internal migration, 66.4% (75 worked for NGOs, 21.2% (24 for donor agencies, and 12.4% (14 in the private sector. Annual incidence of physician migration was estimated to be 3.7%, predominately to work in the growing NGO sector. An estimated 36.3% (41/113 of internal migration cases had previously held senior-level management positions in the public sector. DISCUSSION: Internal migration is an important contributor to capital flight from the public sector, accounting for more cases of physician loss than external migration in Mozambique. Given the urgent need to strengthen public sector health systems, frank reflection by donors and NGOs is needed to assess how hiring
Greuningen, M. van; Batenburg, R.; Velden, L. van der
Context: Health workforce projections are important to prevent imbalances in the health workforce. Matrix Insight provided an overview of health workforce planning in the EU, which shows that 13 countries are engaged in model-based workforce planning using workforce projections. However, in most cas
durable medical equipment, and supplies, including medical, diagnostic, and radiation-detecting devices, pharmaceuticals, and biologic products in...imported food except meat, poultry , and egg products, which are under the authority of the USDA Food Safety and Inspection Service. The...may task HHS components to ensure the health, safety, and security of food-producing animals, animal feed , and therapeutics. (Note: HHS, through
Boehler, Malinda; Schechtman, Barbara; Rivero, Ricardo; Jacob, Beth-Anne; Sherer, Renslow; Wagner, Cornelia; Alabduljabbar, Salma A; Linsk, Nathan L
Engaging new clinical providers in the HIV workforce is a critical need due to rapidly evolving treatment paradigms, aging out of existing providers, and special population needs. The 1-year competency-based Clinician Scholar Program for minority-serving providers with limited HIV care experience was individually tailored for each provider (n = 74), mostly nurse practitioners, physicians, and clinical pharmacists. Baseline and endpoint self-assessments of clinical knowledge and skills showed significant improvements in all 11 targeted competencies, particularly in managing antiretroviral medications, screening and testing methods, incorporating prevention into HIV care, understanding risk reduction methods, and describing current care standards. Faculty mentor assessments also showed significant improvement in most competencies. Additional benefits included ongoing access to mentorship and training, plus sustained engagement in local and statewide HIV care networks. Our intensive mentoring program model is replicable in other AIDS Education and Training Centers and in other structured training programs.
This report documents the strategies for overcoming identified key barriers to development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP) being performed under a Department of Energy (DOE) National Nuclear Security Administration (NNSA) grant. Many barriers currently exist that prevent the development of an adequate number of properly trained national security personnel. The identified strategies to address the barriers will focus on both short-term and long-term efforts, as well as strategies to capture legacy knowledge of retiring national security workforce personnel.
This report documents implementation strategies to leverage public and private resources for the development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP), being performed under a U.S. Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. There are numerous efforts across the United States to develop a properly skilled and trained national security workforce. Some of these efforts are the result of the leveraging of public and private dollars. As budget dollars decrease and the demand for a properly skilled and trained national security workforce increases, it will become even more important to leverage every education and training dollar. This report details some of the efforts that have been implemented to leverage public and private resources, as well as implementation strategies to further leverage public and private resources.
Full Text Available Abstract Background Human resources (HR constraints have been reported as one of the main barriers to achieving the 2005 global tuberculosis (TB control targets in 18 of the 22 TB high-burden countries (HBCs; consequently we try to assess the current HR available for TB control in HBCs. Methods A standard questionnaire designed to collect information on staff numbers, skills, training activities and current staff shortages at different health service levels was sent to national TB control programme managers in all HBCs. Results Nineteen HBCs (86% replied, and 17 (77% followed the questionnaire format to provide data. Complete information on staff numbers at all service levels was available from nine countries and data on skill levels and training were complete in six countries. Data showed considerable variations in staff numbers, proportions of trained staff, length of courses and quality of training activities. Eleven HBCs had developed training materials, many used implementation guidelines for training and only three used participatory educational methods. Two countries reported shortages of staff at district health facility level, whereas 14 reported shortages at central level. There was no apparent association between reported staff numbers (and skills and the country's TB burden or current case detection rates (CDR. Conclusion There were few readily available data on HR for TB control in HBCs, particularly in the larger ones. The great variations in staff numbers and the poor association between information on workforce, proportion of trained staff, and length and quality of courses suggested a lack of valid information and/or poor data reliability. There is urgent need to support HBCs to develop a comprehensive HR strategy involving short-term and long-term HR development plans and strengthening their HR planning and management capabilities.
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.
Freedman, Ariela M; Simmons, Sheena; Lloyd, Laura M; Redd, Tara R; Alperin, Melissa Moose; Salek, Sahar S; Swier, Lori; Miner, Kathleen R
The nation's 37 public health training centers (PHTCs) provide competency-based trainings and practice-based opportunities to advance the current and future public health workforces. The Emory PHTC, based in Atlanta, Georgia, has developed a comprehensive evaluation plan to address the many evaluation-related questions that must be answered to inform decisions that improve practice. This plan, based on the center's logic model, includes formative assessment, outcome evaluation, process evaluation, and programmatic evaluation. Rigorous evaluation has been used to (a) assess what is working, what is not working, and why; (b) guide decision making about program improvement; and (c) ensure efficient use of resources, such as time and money. This article describes how the Emory PHTC uses its logic model to guide development of a comprehensive evaluation plan and to create specific data collection tools. It also explains the process used to analyze data and make decisions to maximize effectiveness and ensure the best use of resources. Simply conducting trainings and providing opportunities for real-world application are not enough; it is critical to assess whether or not these educational opportunities are, in fact, educating.
Full Text Available This study aims to explicate the strategic utilisation of e-learning is of upmost significance as e-learning plays a pivotal role in the improvement of healthcare learning and knowledge transfer, especially in developing countries and in pursuing of Millennium Development Goals (MDGs. Rapid technology changes in the learning and knowledge transfer landscape markedly, the swift pace of e-learning leaving healthcare providers no choice if they want to remain competitive. Human capital, an important element in contemporary employee relations scenario, has become the most significant competitive advantage in healthcare delivery systems. As such, healthcare providers need a new strategy for learning and training of their employees. Besides, the knowledge and competencies of healthcare providers are not only vital component but also essential to the quality of care and health of the society. Thus, these rationales exert that todayâs healthcare providers are embracing e-learning. The benefits of e-learning are extremely compelling. They include a reduction in costs associated with employee travelling; reduction in time spent away from the patients and reduced learning times. Also, this study describes the United Nations University International Institute for Global Health (UNU-IIGH strategies, best practices and experiences in delivering e-learning to healthcare workforce of developing countries.
Hougaard, Charlotte Ørsted; Nygaard, Else; Holm, Astrid Ledgaard
AIMS: The globalized economy has stimulated mobility in the labour market in many countries and Denmark has one of the highest rates of mobility between workplaces among the OECD countries. This raises the question of the potential health effects of mobility and the effect of disease on mobility...... confounders, an exposure-response relationship was seen between mobility and the incidence of ischaemic heart disease, stroke, duodenal ulcer, anxiety/depression and, most strongly, with alcohol-related disorders. The effects were not very strong, however, with odds ratios varying from 1.2 to 1.6. As expected......, no effect was seen for colorectal cancer. We also found an effect of both somatic and mental disorders on mobility, but not for the two cancer types. Mobility did not seem to prevent being out of the labour force after diagnosis. CONCLUSIONS FREQUENT MOBILITY IN THE LABOUR MARKET INCREASES THE RISK...
Mccann, Leo; Granter, Edward; Hassard, John; Hyde, Paula
Based on a three-year ethnographic study of four UK National Health Service (NHS) organizations, we explore the everyday cultural experience of managing clinical and administrative workforces. Although NHS organizations claim to function as enlightened HRM employers, we argue that the inflexible application of metrics-based target systems to clinical and administrative tasks, including HRM operations, can result in dysfunctional outcomes for patient care and workforce morale. Reminiscent of t...
Pellegrini, Lawrence C; Rodriguez-Monguio, Rosa; Qian, Jing
The healthcare sector was one of the few sectors of the US economy that created new positions in spite of the recent economic downturn. Economic contractions are associated with worsening morbidity and mortality, declining private health insurance coverage, and budgetary pressure on public health programs. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes. Data are collected for 50 states and the District of Columbia from 1999-2009. Labor market and healthcare workforce data are obtained from the Bureau of Labor Statistics. Mortality and health status data are collected from the Centers for Disease Control and Prevention's Vital Statistics program and Behavioral Risk Factor Surveillance System. Healthcare spending data are derived from the Centers for Medicare and Medicaid Services. Dynamic panel data regression models, with instrumental variables, are used to examine the effect of the labor market on healthcare spending, morbidity, and mortality. Regression analysis is also performed to model the effects of healthcare spending on the healthcare workforce composition. All statistical tests are based on a two-sided [Formula: see text] significance of [Formula: see text] .05. Analyses are performed with STATA and SAS. The labor force participation rate shows a more robust effect on healthcare spending, morbidity, and mortality than the unemployment rate. Study results also show that declining labor force participation negatively impacts overall health status ([Formula: see text] .01), and mortality for males ([Formula: see text] .05) and females ([Formula: see text] .001), aged 16-64. Further, the Medicaid and Medicare spending share increases as labor force participation declines ([Formula: see text] .001); whereas, the private healthcare spending share decreases ([Formula: see text] .001). Public and private healthcare spending also
Grover, Atul; Niecko-Najjum, Lidia M
Traditionally, projections of US health care demand have been based upon a combination of existing trends in usage and idealized or expected delivery system changes. For example, 1990s health care demand projections were based upon an expectation that delivery models would move toward closed, tightly managed care networks and would greatly decrease the demand for subspecialty care. Today, however, a different equation is needed on which to base such projections. Realistic workforce planning must take into account the fact that expanded access to health care, a growing and aging population, increased comorbidity, and longer life expectancy will all increase the use of health care services per capita over the next few decades--at a time when the number of physicians per capita will begin to drop. New technologies and more aggressive screening may also change the equation. Strategies to address these increasing demands on the health system must include expanded physician training.
Audet, Carolyn M; Hamilton, Erin; Hughart, Leighann; Salato, Jose
"Medical pluralism" is the use of multiple health systems and is common among people living with HIV/AIDS in sub-Saharan Africa. Healers and traditional birth attendants (TBAs) often are a patient's first and/or preferred line of treatment; this often results in delayed, interrupted, or abandoned diagnosis and therapy. Literature from the study of medical pluralism suggests that HIV care and treatment programs are infrequently and inconsistently engaging healers around the world. Mistrust and misunderstanding among patients, clinical providers, and traditional practitioners make the development of effective partnerships difficult, particularly regarding early HIV diagnosis and antiretroviral therapy. We provide recommendations for the development of successful collaboration health workforce efforts based on both published articles and case studies from our work in rural Mozambique.
Villarroel González, Sebastián Raúl
Healthcare workers have been widely recognized as the mainstay of healthcare systems. Mostly incorporated as human resources into healthcare planning, their expression in the public policies of Chile and Latin America has undergone changes in compliance with the socio-economic and economic development of the countries in the region as well as changes in their healthcare systems. This article offers a historical review of healthcare human resources planning in Chile from a government-level standpoint; thus, enabling the characterization of a path that has added tools from the economic sciences to the healthcare workers own diagnosis, promoting policy actions to improve planning and management at national level, although the results have been inconsistent. Today, the great interest by national and international entities in healthcare human resources constitutes a growing concern about current problems, asymmetries, and expected results-- all of which increase the complexity of healthcare staffing and human resources planning.
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…
Caringi, James C.; Lawson, Hal A.; Strolin-Goltzman, Jessica; McCarthy, Mary; Briar-Lawson, Katharine; Claiborne, Nancy
Workforce turnover in public child welfare is a national problem. Individual, supervisory, and organizational factors, individually and in combination, account for some of the turnover. Complex, comprehensive interventions are needed to address these several factors and their interactions. A research and development team is field testing one such…
Williams, Donna Elizabeth
Preparation, Development, and Transition of Learning-Disabled Students for Workforce Success. Donna Elizabeth Williams, 2011: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler School of Education. ERIC Descriptors: Learning Disabilities, Community Based Instruction, Academic Advising, Career Counseling, Career Planning. This…
Lambeth, Jeanea M.; Joerger, Richard M.; Elliot, Jack
Education and educational research is shaped by philosophy, psychology, practice, and ever changing educational policies. Previous studies have expressed a need for a relevant and focused research agenda for career and technical education (CTE), workforce development education and career and technical education. A need for a relevant and timely…
Houghton, Ted; Proscio, Tony
This publication describes four highly regarded workforce development programs, concentrating on how they cultivate emotional intelligence--how they prepare trainees for the cultural demands of the workplace. Section 1 describes how ACHIEVE, Cabrillo Community College, Watsonville, California (CA) teaches business dress, skills and culture in two…
Williams, Donna Elizabeth
Preparation, Development, and Transition of Learning-Disabled Students for Workforce Success. Donna Elizabeth Williams, 2011: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler School of Education. ERIC Descriptors: Learning Disabilities, Community Based Instruction, Academic Advising, Career Counseling, Career Planning. This…
Shaw Daniel MP
Full Text Available Abstract Introduction Responsible governance is crucial to national development and a catalyst for achieving the Millennium Development Goals. To date, governance seems to have been a neglected issue in the field of human resources for health (HRH, which could be an important reason why HRH policy formulation and implementation is often poor. This article aims to describe how governance issues have influenced HRH policy development and to identify governance strategies that have been used, successfully or not, to improve HRH policy implementation in low- and middle-income countries (LMIC. Methods We performed a descriptive literature review of HRH case studies which describe or evaluate a governance-related intervention at country or district level in LMIC. In order to systematically address the term 'governance' a framework was developed and governance aspects were regrouped into four dimensions: 'performance', 'equity and equality', 'partnership and participation' and 'oversight'. Results and discussion In total 16 case studies were included in the review and most of the selected studies covered several governance dimensions. The dimension 'performance' covered several elements at the core of governance of HRH, decentralization being particularly prominent. Although improved equity and/or equality was, in a number of interventions, a goal, inclusiveness in policy development and fairness and transparency in policy implementation did often not seem adequate to guarantee the corresponding desirable health workforce scenario. Forms of partnership and participation described in the case studies are numerous and offer different lessons. Strikingly, in none of the articles was 'partnerships' a core focus. A common theme in the dimension of 'oversight' is local-level corruption, affecting, amongst other things, accountability and local-level trust in governance, and its cultural guises. Experiences with accountability mechanisms for HRH policy
Kuhlmann, E; Lauxen, O; Larsen, C
As health workforce policy is gaining momentum, data sources and monitoring systems have significantly improved in the European Union and internationally. Yet data remain poorly connected to policy-making and implementation and often do not adequately support integrated approaches. This brings the importance of governance and the need for innovation into play. The present case study introduces a regional health workforce monitor in the German Federal State of Rhineland-Palatinate and seeks to explore the capacity of monitoring to innovate health workforce governance. The monitor applies an approach from the European Network on Regional Labour Market Monitoring to the health workforce. The novel aspect of this model is an integrated, procedural approach that promotes a 'learning system' of governance based on three interconnected pillars: mixed methods and bottom-up data collection, strong stakeholder involvement with complex communication tools and shared decision- and policy-making. Selected empirical examples illustrate the approach and the tools focusing on two aspects: the connection between sectoral, occupational and mobility data to analyse skill/qualification mixes and the supply-demand matches and the connection between monitoring and stakeholder-driven policy. Regional health workforce monitoring can promote effective governance in high-income countries like Germany with overall high density of health workers but maldistribution of staff and skills. The regional stakeholder networks are cost-effective and easily accessible and might therefore be appealing also to low- and middle-income countries.
in these facilities. • It is also necessary to document all relevant activities, including outreach activities and home visits, in order to give appropriate weight in the calculation of utilization and productivity. • Development of the provincial health workforce development plan requires validated human resources for health information and engagement of local health authorities, as well as strong collaboration with the national authorities and development partners, to ensure adequate support and resourcing.
d'Arc Kanakuze Jeanne
violence simultaneously should be a priority in workplace violence research, workforce policies, strategies, laws and human resources management training. This will go a long way in making workplaces safer and fairer for the health workforce. This is likely to improve workforce productivity and retention and the enjoyment of human rights at work. Finally, studies that involve stakeholders throughout the research process are likely to improve the utilization of results and policy impact.
Newman, Constance J; de Vries, Daniel H; d'Arc Kanakuze, Jeanne; Ngendahimana, Gerard
research, workforce policies, strategies, laws and human resources management training. This will go a long way in making workplaces safer and fairer for the health workforce. This is likely to improve workforce productivity and retention and the enjoyment of human rights at work. Finally, studies that involve stakeholders throughout the research process are likely to improve the utilization of results and policy impact.
be a priority in workplace violence research, workforce policies, strategies, laws and human resources management training. This will go a long way in making workplaces safer and fairer for the health workforce. This is likely to improve workforce productivity and retention and the enjoyment of human rights at work. Finally, studies that involve stakeholders throughout the research process are likely to improve the utilization of results and policy impact. PMID:21767411
Maisel, Natalya C; Haskell, Sally; Hayes, Patricia M; Balasubramanian, Vidhya; Torgal, Anupama; Ananth, Lakshmi; Saechao, Fay; Iqbal, Samina; Phibbs, Ciaran S; Frayne, Susan M
Veterans Health Administration (VHA) primary care providers (PCPs) often see few women, making it challenging to maintain proficiency in women's health (WH). Therefore, VHA in 2010 established Designated WH Providers, who would maintain proficiency in comprehensive WH care and be preferentially assigned women patients. To evaluate early implementation of this national policy. At each VHA health care system (N=140), the Women Veterans Program Manager completed a Fiscal Year 2012 workforce capacity assessment (response rate, 100%), representing the first time the national Designated WH Provider workforce had been identified. Assessment data were linked to administrative data. Of all VHA PCPs, 23% were Designated WH Providers; 100% of health care systems and 83% of community clinics had at least 1 Designated WH Provider. On average, women veterans comprised 19% (SD=27%) of the patients Designated WH Providers saw in primary care, versus 5% (SD=7%) for Other PCPs (Pprimary care (N=313,033), new patients were less likely to see a Designated WH Provider than established women veteran patients (52% vs. 64%; Phealth care system, and is approaching its goal of a Designated WH Provider at every hospital/community clinic. Designated WH Providers see more women than do Other PCPs. However, as the volume of women patients remains low for many providers, attention to alternative approaches to maintaining proficiency may prove necessary, and barriers to assigning new women patients to Designated WH Providers merit attention.
Schoenbaum, Stephen C
National planning and management of the physician workforce is a multifaceted, difficult, and even controversial activity. It is an important subset of overall health workforce planning and management, which contributes to a country's having an effective and efficient health care system. This commentary builds on a new survey of specialty considerations by Israeli medical students early in their clinical training, places it in the broader context of health workforce planning, and provides examples of some approaches and activities being taken in the United States that are applicable to other developed countries.This is a commentary on http://www.ijhpr.org/content/1/1/13.
Schoenbaum Stephen C
Full Text Available Abstract National planning and management of the physician workforce is a multifaceted, difficult, and even controversial activity. It is an important subset of overall health workforce planning and management, which contributes to a country's having an effective and efficient health care system. This commentary builds on a new survey of specialty considerations by Israeli medical students early in their clinical training, places it in the broader context of health workforce planning, and provides examples of some approaches and activities being taken in the United States that are applicable to other developed countries. This is a commentary on http://www.ijhpr.org/content/1/1/13.
M.A. Sousa (Angelica)
markdownabstractWeak health systems with a shortage of qualified staff, and lack of equipment and medicines impede the delivery of quality health care that is required to prevent maternal and newborn deaths and the attainment of the health-related Millennium Development Goals (MDGs). Using the cases
M.A. Sousa (Angelica)
markdownabstractWeak health systems with a shortage of qualified staff, and lack of equipment and medicines impede the delivery of quality health care that is required to prevent maternal and newborn deaths and the attainment of the health-related Millennium Development Goals (MDGs). Using the cases
Holland, Renee L. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Frey, Jodi [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)
This Executive Summary provides highlights from the company's full report quantifying the link between health conditions and their business outcomes based on 828 employee survey responses (8% of the workforce) to the HPQ-Select employee questionnaire. These highlights provide key findings on the magnitude of lost productivity, the prevalence of key chronic conditions, their treatment, key conditions driving lost productivity and the potential business impacts of improvements. Details on each of these dimensions can be found in the full report.
This article analyzes New York's Health Care Workforce Recruitment and Retention Act of 2002. The analysis comes in 4 parts: part 1 provides a brief overview of New York's economy as it relates to health care, a feel for the political climate at the time, and a detailed presentation of the chain of events that connect this climate to the birth of the Health Care Workforce Recruitment and Retention Act of 2002; part 2 consists of a breakdown of the provisions contained within bill, including major and minor goals, intended effects, and the mechanics behind raising supporting funds; part 3 explores what actually happened by evaluating available data to determine whether the bill's 2 major goals of workforce recruitment and retention were fulfilled; and finally, part 4 will take all the aforementioned information to determine the overall success of the bill, the implications, and specific suggestions for future policy changes that time has revealed since its inception.
Full Text Available Abstract Background National Health Service (NHS mental health workforce configuration is at the heart of successful delivery, and providers are advised to produce professional development strategies. Recent policy changes in England have sharpened the focus on competency based role development. We determined levels of intervention activities, engagement and competence and their influencing factors in a community-setting mental health workforce. Methods Using a modified questionnaire based on the Yorkshire Care Pathways Model we investigated 153 mental health staff working in Coventry and Warwickshire NHS Trust. A median score of competence was computed across 10 cluster activities. Low engagement and competence levels were examined in a logistic regression model. Results In 220 activities, Monitoring risk was the highest rate of engagement (97.6% and Group psychological therapy/Art/Drama therapy was the lowest engagement (3.6%. The median competence level based on all activities was 3.95 (proficient. There were significant differences in the competence level among professional groups; non-qualified support group (3.00 for competent, Counsellor/Psychologist/Therapist (3.38, Occupational therapists (3.76, Nurses (4.01, Medical staff (4.05, Social workers (4.25 and Psychologists (4.62 for proficient/expert. These levels varied with activity clusters; the lowest level was for Counsellor/Psychologist/Therapist in the accommodation activity (1.44 novice/advance beginner and the highest for Occupational therapists in personal activity (4.94 expert. In a multivariate analysis, low competence was significantly related to non-qualified community support professions, late time of obtaining first qualification, more frequencies of clinical training, and training of cognitive behavioural therapy. The associations were similar in the analysis for 10 activity clusters respectively. Conclusions There was a reasonable competence level in the community
Rukholm, Ellen E; Stamler, Lynnette Leeseberg; Talbot, Lise R; Bednash, Geraldine; Raines, Fay; Potempa, Kathleen; Nugent, Pauline; Clark, Dame Jill Macleod; Bernhauser, Sue; Parfitt, Barbara
In this paper key highlights of the scholarly work presented at the Toronto 2008 Global Alliance for Nursing Education & Scholarship (GANES) conference are summarized, challenges opportunities and issues facing nursing education globally arising from the conference discourse are outlined and initial steps are suggested as a way forward to a shared global view of baccalaureate and graduate nursing education and scholarship. This shared view arises from beginning understandings of the issues and opportunities we face globally starting with and building upon the lessons learned from the literature and from the experiences of nursing educators and nursing education organization locally, regionally, nationally and internationally. The theme of the groundbreaking GANES Toronto conference was "Educating the future nursing and health workforce: A global challenge". One hundred seventy delegates from 17 countries attended the event, with over 80 papers presented. A primary focus of GANES is the contribution of a strategic alliance of national nursing education organizations to contribute to nursing education leading practices and policy that address the scaling up of global nursing and health workforce. The founding members of GANES see a clear link between a strong educational infrastructure and strong scholarship activities in nursing and the ability of a society to be healthy and prosperous. Evidence presented at the recent GANES conference supports that belief. Through the strength of partnerships and other capacity-building efforts, member countries can support each other to address the global nursing education and health challenges while respecting the local issues.
尹爱田; 王文华; 杨文燕
Based on public policy nature and barrier analysis of rural health workforce building, we establish a theoretical frame from WHO health workforce strategy targets. From the four aspects of idea, model, action, measure, the policy recommendations conclude management policy, regulation policy, medical education policy and health workforce supporting policy.%文章以农村卫生人才建设的公共政策属性和对农村卫生人才建设的障碍分析为基础,基于世界卫生组织卫生人力战略目标建立理论框架,从思路、模式、行动、措施4个维度,提出建立和完善农村卫生人才管理政策、规制政策、医学教育政策和卫生人才支持政策的建议.
Kachan, Diana; Olano, Henry; Tannenbaum, Stacey L.; Annane, Debra W.; Mehta, Ashwin; Arheart, Kristopher L.; Fleming, Lora E.; McClure, Laura A.; Lee, David J.
Introduction Mindfulness-based practices can improve workers’ health and reduce employers’ costs by ameliorating the negative effect of stress on workers’ health. We examined the prevalence of engagement in 4 mindfulness-based practices in the US workforce. Methods We used 2002, 2007, and 2012 National Health Interview Survey (NHIS) data for adults (aged ≥18 y, n = 85,004) to examine 12-month engagement in meditation, yoga, tai chi, and qigong among different groups of workers. Results Reported yoga practice prevalence nearly doubled from 6.0% in 2002 to 11.0% in 2012 (P benefit from workplace mindfulness interventions. Improving institutional factors limiting access to mindfulness-based wellness programs and addressing existing beliefs about mindfulness practices among underrepresented worker groups could help eliminate barriers to these programs. PMID:28055821
Greuningen, M. van; Batenburg, R.S.; Velden, L.F.J. van der
INTRODUCTION: In many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years. Case description
Theppanya, Khampasong; Phathammavong, Outavong; Rotem, Arie
The purpose of this health workforce plan is to provide guidance for the staffing of the Bolikhamxay. Province health services and the training of health service personnel to the year 2020. It must be stressed, however, that this plan is in its first iteration and does not provide all the solutions. Rather, it identifies issues that need to be further investigated and resolved at the local level. For example, the provincial health department (PHD) will need to further investigate the reasons for the significant variability in the utilization of services in different facilities and in the different ratios of staff in relation to the activities performed. The accuracy of the data must be validated and specific interventions must be determined. For Bolikhamxay, particular attention by PHD and district health authorities should be given to the following issues identified in the analysis:• Shortage of clinical staff, particularly in the age group 30 to 40 years old, to provide supervision, guidance, and support for junior staff in coming years;• The existence of health centers with less than minimum staffing level (engagement of local health authorities, as well as strong collaboration with the national authorities and development partners, to ensure adequate support and resourcing.
Popper-Giveon, Ariela; Liberman, Ido; Keshet, Yael
In recent years, a growing body of literature has been calling for ethnic diversity in health systems, especially in multicultural contexts. Ethnic diversity within the health care workforce is considered to play an important role in reducing health disparities among different ethnic groups. The present study explores the topic using quantitative data on participation of Arab employees in the Israeli health system and qualitative data collected through semi-structured interviews with Arab physicians working in the predominantly Jewish Israeli health system. We show that despite the underrepresentation of Arabs in the Israeli health system, Arab physicians who hold positions in Israeli hospitals do not perceive themselves as representatives of the Arab sector; moreover, they consider themselves as having broken through the 'glass ceiling' and reject stereotyping as Arab 'niche doctors.' We conclude that minority physicians may prefer to promote culturally competent health care through integration and advocacy of interaction with the different cultures represented in the population, rather than serving as representatives of their own ethnic minority population. These findings may concern various medical contexts in which issues of ethnic underrepresentation in the health system are relevant, as well as sociological contexts, especially those regarding minority populations and professions.
Mitchell, Elayne N; Hawkshaw, Barbara N; Naylor, Carlie-Jane; Soewido, Dias; Sanders, John M
Tobacco-related disease is estimated to cost the NSW health system more than $476 million in direct health care costs annually. Population-based smoking-cessation interventions, including brief intervention by health professionals, are effective and cost effective. As the prevalence of smoking in the general community declines, more highly dependent 'treatment-resistant' smokers may present a challenge to the health system. International guidelines recommend that health systems invest in training for health professionals in best practice smoking cessation. As part of the NSW Tobacco Action Plan 2005-2009, NSW Department of Health developed national competency standards in smoking cessation, designed learning and assessment materials and delivered training to more than 300 health professionals via video conference. Building the capacity of the NSW Health workforce to address smoking cessation as part of their routine practice is essential for addressing future challenges in tobacco control.
Wind Powering America national technical director Ian Baring-Gould made this presentation about workforce development in the wind energy industry to an audience at the American Wind Energy Association's annual WINDPOWER conference in Anaheim. The presentation outlines job projections from the 20% Wind Energy by 2030 report and steps to take at all levels of educational institutions to meet those projections.
Li, Sisi; Bamidis, Panagiotis D; Konstantinidis, Stathis Th; Traver, Vicente; Car, Josip; Zary, Nabil
A major challenge for healthcare quality improvement is the lack of IT skills and knowledge of healthcare workforce, as well as their ambivalent attitudes toward IT. This article identifies and prioritizes actions needed to improve the IT skills of healthcare workforce across the EU. A total of 46 experts, representing different fields of expertise in healthcare and geolocations, systematically listed and scored actions that would improve IT skills among healthcare workforce. The Child Health and Nutrition Research Initiative methodology was used for research priority-setting. The participants evaluated the actions using the following criteria: feasibility, effectiveness, deliverability, and maximum impact on IT skills improvement. The leading priority actions were related to appropriate training, integrating eHealth in curricula, involving healthcare workforce in the eHealth solution development, improving awareness of eHealth, and learning arrangement. As the different professionals' needs are prioritized, healthcare workforce should be actively and continuously included in the development of eHealth solutions.
Full Text Available Kalada G McFubara,1 Elizabeth R Edoni,2 Rose E Ezonbodor-Akwagbe21Department of Community Medicine, Faculty of Clinical Sciences, 2Department of Community Health Nursing, Niger Delta University, Wilberforce Island, NigeriaBackground: Health manpower is one of the critical factors in the development of a region. This is because health is an index of development. Bayelsa State has a low level of health manpower. Thus, in this study, we sought to identify factors necessary for effective development of health manpower.Methods: Three methods were used to gather information, ie, face-to-face interviews, postal surveys, and documentary analysis. Critical incidents were identified, and content and thematic analyses were conducted.Results: There is no full complement of a primary health care workforce in any of the health centers in the state. The three health manpower training institutions have the limitations of inadequate health care educators and other manpower training facilities, including lack of a teaching hospital.Conclusion: Accreditation of health manpower training institutions is a major factor for effective development of health manpower. Public officers can contribute to the accreditation process by subsuming their personal interest into the state's common interest. Bayelsa is a fast-growing state and needs a critical mass of health care personnel. To develop this workforce requires a conscious effort rich in common interests in the deployment of resources.Keywords: health manpower, development, health care education
Burkle, Frederick M; Potokar, Tom; Gosney, James E; Dallas, Cham
Major challenges and crises in global health will not be solved by health alone; requiring rather a multidisciplinary, evidence-based analytical approach to prevention, preparedness and response. One such potential crisis is the continued spread of nuclear weapons to more nations concurrent with the increased volatility of international relations that has significantly escalated the risk of a major nuclear weapon exchange. This study argues for the development of a multidisciplinary global health response agenda based on the reality of the current political analysis of nuclear risk, research evidence suggesting higher-than-expected survivability risk, and the potential for improved health outcomes based on medical advances. To date, the medical consequences of such an exchange are not credibly addressed by any nation at this time, despite recent advances. While no one country could mount such a response, an international body of responders organized in the same fashion as the current World Health Organization's global health workforce initiative for large-scale natural and public health emergencies could enlist and train for just such an emergency. A Nuclear Global Health Workforce is described for addressing the unprecedented medical and public health needs to be expected in the event of a nuclear conflict or catastrophic accident. The example of addressing mass casualty nuclear thermal burns outlines the potential triage and clinical response management of survivors enabled by this global approach.
A.A. de Bont (Antoinette); N.J.A. van Exel (Job); Coretti, S. (Silvia); Ökem, Z.G. (Zeynep Güldem); Janssen, M. (Maarten); Hope, K.L. (Kristin Lofthus); Ludwicki, T. (Tomasz); Zander, B. (Britta); Zvonickova, M. (Marie); C.M. Bond (Christine); I. Wallenburg (Iris)
textabstractBackground: Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new
A.A. de Bont (Antoinette); N.J.A. van Exel (Job); Coretti, S.; Guldem Okem, Z.; M. Janssen (Maarten); Lofthus Hope, K.; Ludwicki, T.; Zvonickova, M.; Zander, B.; Bond, C.M.; I. Wallenburg (Iris)
textabstractBackground Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new
A.A. de Bont (Antoinette); N.J.A. van Exel (Job); Coretti, S.; Guldem Okem, Z.; M. Janssen (Maarten); Lofthus Hope, K.; Ludwicki, T.; Zvonickova, M.; Zander, B.; Bond, C.M.; I. Wallenburg (Iris)
textabstractBackground Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new serv
Steinmetz, S.; de Vries, D.H.; Tijdens, K.G.
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
Steinmetz, S.; de Vries, D.H.; Tijdens, K.G.
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
A.A. de Bont (Antoinette); N.J.A. van Exel (Job); Coretti, S. (Silvia); Ökem, Z.G. (Zeynep Güldem); Janssen, M. (Maarten); Hope, K.L. (Kristin Lofthus); Ludwicki, T. (Tomasz); Zander, B. (Britta); Zvonickova, M. (Marie); C.M. Bond (Christine); I. Wallenburg (Iris)
textabstractBackground: Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new serv
The goal of this research project is to tell the story of acquisition expertise development within the DOD using the evolution of the Defense Acquisition University as its backdrop. It is a story about the persistent frame that claims expertise leads to acquisition success. It is about 40 plus years of competing perspectives of how best to acquire that expertise and their shaping effects. It is about technology choices amidst cultural and political conflict. It is about how budget, users, ...
Friedman, Aaron L
This policy statement describes the key issues related to diversity within the pediatrician and health care workforce to identify barriers to enhancing diversity and offer policy recommendations to overcome these barriers in the future. The statement addresses topics such as health disparities, affirmative action, recent policy developments and reports on workforce diversity, and research on patient and provider diversity. It also broadens the discussion of diversity beyond the traditional realms of race and ethnicity to include cultural attributes that may have an effect on the quality of health care. Although workforce diversity is related to the provision of culturally effective pediatric care, it is a discrete issue that merits separate discussion and policy formulation. At the heart of this policy-driven action are multiorganizational and multispecialty collaborations designed to address substantive educational, financial, organizational, and other barriers to improved workforce diversity.
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.
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-located in 468 District Hospitals, 2483 Community Health Centers and 8520 Primary Health Centers in the country. Several therapeutics are currently in use and few drugs have been included in the ASHA drug kit to treat common ailments in the community. At the same time Government of India has recognized few principles and therapeutics of Ayurveda as modalities of intervention to some of the community health problems. These include Ksharasutra (medicine coated thread) therapy for ano-rectal surgeries and Rasayana Chikitsa (rejuvenative therapy) for senile degenerative disorders etc. Similarly respective principles and therapeutics can also be utilized from other systems of AYUSH such as Yoga and Naturopathy, Unani, Siddha and Homoeopathy. Akin to Ayurveda these principles and therapeutics can also help in managing community health problems if appropriately implemented. This paper is a review on the role of AYUSH, as a system, in the delivery of health care in India with special reference to National Rural Health Mission.
Fox, E. [Savannah River Site (SRS), Aiken, SC (United States); Edwards, T. [Savannah River Site (SRS), Aiken, SC (United States)
The Southeastern US has the largest potential for growth in the solar industry. However, currently they languish behind the rest of the US. There are several bright spots including the large number of utility scale installations in North Carolina and the recent successes in South Carolina under Act 236. In order to better understand the impacts of state legislation on the growth of the solar industry in the SE US, the Savannah River National Laboratory has undertaken a study to look at the growth in each state in order to develop recommendations to help reduce the cost of solar and to spur the industry. This is the second report in the series. The first focused on developing cost metrics for South Carolina under Act 236. This report focuses on Alabama, the 49th ranked state for solar business, which has very similar population and median income to South Carolina. For this survey, the ten known in-state installers were contacted. Responses were received from seven, representing 70% of the installers, a majority of which provide both residential and commercial installations. Interestingly, none of the respondents serve the utility scale sector. Overall, costs for Alabama are on track with the rest of the country with a reported average cost of $3.29/W-DC for residential systems and $2.44/W-DC for commercial systems. 60% of this cost is attributed to hardware only. Of the remaining costs, installation contributed to the largest percentage of soft costs followed by overhead, marketing and sales, and permitting, respectively. This also closely mirrors results seen in South Carolina. Job growth in the industry is expected to proceed well. An expected 34-42 additional full time equivalent jobs were expected to be added in Alabama within the six month window following the survey period. During the three years following the survey, this number was expected to double with 89-97 additional jobs being added to the market. In both cases, a vast majority of these jobs were for
Nancarrow, Susan A; Moran, Anna M; Graham, Iain
Health workforce training in the 21st century is still based largely on 20th century healthcare paradigms that emphasise professionalisation at the expense of patient-focussed care. This is illustrated by the paradox of increased training times for health workers that have corresponded with workforce shortages, the limited career options and pathways for paraprofessional workers, and inefficient clinical training models that detract from, rather than add to, service capacity. We propose instead that a 21st century health workforce training model should be: situated in the clinical setting and supported by outsourced university training (not the other way around); based on the achievement of specific milestones rather than being time-defined; and incorporate para-professional career pathways that allow trainees to 'step-off' with a useable qualification following the achievement of specific competencies. Such a model could be facilitated by existing technology and clinical training infrastructure, with enormous potential for economies of scale in the provision of formal training. The benefits of a clinically based, competency-based model include an increase in clinical service capacity, and clinical training resources become a resource for the delivery of healthcare, not just education. Existing training models are unsustainable, and are not preparing a workforce with the flexibility the 21st century demands.
McCabe, O Lee; DiClemente, Carlo C; Links, Jonathan M
When disasters and other broad-scale public health emergencies occur in the United States, they often reveal flaws in the pre-event preparedness of those individuals and agencies charged with responsibility for emergency response and recovery activities. A significant contributor to this problem is the unwillingness of some public health workers to participate in the requisite planning, training, and response activities to ensure quality preparedness. The thesis of this article is that there are numerous, empirically supported models of behavior change that hold potential for motivating role-appropriate behavior in public health professionals. The models that are highlighted here for consideration and prospective adaptation to the public health emergency preparedness system (PHEPS) are the Transtheoretical Model of Intentional Behavior Change (TTM) and Motivational Interviewing (MI). Core concepts in TTM and MI are described, and specific examples are offered to illustrate the relevance of the frameworks for understanding and ameliorating PHEPS-based workforce problems. Finally, the requisite steps are described to ensure the readiness of organizations to support the implementation of the ideas proposed.
Full Text Available Paucity of health workforce in rural India has always been a problem. Lack of interest of modern allopathic graduates in serving the rural poor has worsened the situation little more. The National Rural Health Mission brought an innovative concept of mainstreaming of AYUSH and revitalization of local health tradition by collocating AYUSH doctors at various rural health facilities such as community health centers and primary health centers. In this context a study was aimed, based on secondary data, to make a situational analysis of health workforce in rural India and thereby analyzing the status and role of AYUSH Doctors in filling this gap of health workforce inequality. As on 01/01/2010 there were 61% of Ayurveda, 31.40% of Homoeopathy, 6.50% of Unani, 0.90% of Siddha and 0.20% of Naturopathy doctors serving in India. AYUSH facilities had been collocated in 240 district hospitals, 1716 community health centers and 8938 primary health centers in 2010. About 39.8% District Hospitals (DH, 38% Community Health Centers (CHC and 38.2% Primary Health Centers (PHC had been collocated with AYUSH facilities by 2010. About 30.9 lakhs rural population were being served by district hospitals, 4.3 lakhs of rural population were being served by CHCs and 0.8 lakhs of rural population were being served by PHCs in various states/UTs wherever the corresponding facilities exist. Equitable distribution of health workforce is of paramount importance in achieving both the horizontal and vertical health equity in rural India which is doable with proper implementation of AYUSH workforce.
de Bont, Antoinette; van Exel, Job; Coretti, Silvia; Ökem, Zeynep Güldem; Janssen, Maarten; Hope, Kristin Lofthus; Ludwicki, Tomasz; Zander, Britta; Zvonickova, Marie; Bond, Christine; Wallenburg, Iris
Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new services, such as case managers. Hence the composition of health care teams has become increasingly diverse. The exact extent of this diversity is unknown across the different countries of Europe, as are the drivers of this change. The research questions guiding this study were: What extended professional roles are emerging on health care teams? How are extended professional roles created? What main drivers explain the observed differences, if any, in extended roles in and between countries? We performed a case-based comparison of the extended roles in care pathways for breast cancer, heart disease and type 2 diabetes. We conducted 16 case studies in eight European countries, including in total 160 interviews with physicians, nurses and other health care professionals in new roles and 600+ hours of observation in health care clinics. The results show a relatively diverse composition of roles in the three care pathways. We identified specialised roles for physicians, extended roles for nurses and technicians, and independent roles for advanced nurse practitioners and physician associates. The development of extended roles depends upon the willingness of physicians to delegate tasks, developments in medical technology and service (re)design. Academic training and setting a formal scope of practice for new roles have less impact upon the development of new roles. While specialised roles focus particularly on a well-specified technical or clinical domain, the generic roles concentrate on organising and integrating care and cure. There are considerable differences in the number and kind of extended roles between both countries and care pathways. The main drivers for new roles reside in the technological
Studer, D.; Kemkar, S.
For many commercial building operation job categories, industry consensus has not been reached on the knowledge, skills, and abilities that practitioners should possess. The goal of this guidance is to help streamline the minimum competencies taught or tested by organizations catering to building operations and maintenance personnel while providing a basis for developing and comparing new and existing training programs in the commercial building sector. The developed JTAs will help individuals identify opportunities to enhance their professional skills, enable industry to identify an appropriately skilled workforce, and allow training providers to ensure that they are providing the highest quality product possible.
Annang, Lucy; Richter, Donna L; Fletcher, Faith E; Weis, Megan A; Fernandes, Pearl R; Clary, Louis A
While public health has gained increased attention and placement on the national health agenda, little progress has been made in achieving a critical mass of underrepresented minority (URM) academicians in the public health workforce. In 2008, a telephone-based qualitative assessment was conducted with URM faculty of schools of public health to discuss this issue. As a result, we present successful strategies that institutional leaders can employ to extend the discourse about addressing limited diversity in the public health academy.
González López-Valcárcel, Beatriz; Barber Pérez, Patricia
The present article provides an overview of workforce planning for health professionals in Spain, with emphasis on physicians and primary care. We analyze trends, describe threats and make some suggestions. In Spain some structural imbalances remain endemic, such as the low number of nurses with respect to physicians, which may become a barrier to needed reforms. The new medical degree, with the rank of master, will not involve major changes to training. Nursing, which will require a university degree, leaves a gap that will be filled by nursing assistants.This domino effect ends in family medicine, which has no upgrading potential. Hence reasonable objectives for the system are to prioritize the post-specialization training of family physicians, enhance their research capacity and define a career that does not equate productivity with seniority. What is undergoing a crisis of identity and prestige is family medicine, not primary care. There is a risk that the specialty of family medicine will lose rank after the specialty of emergency medicine is approved. Today, about 40% of emergency physicians in the public network are specialists, most of them in family medicine. In 2010 a new fact emerged: an elite of foreign doctors obtained positions as resident medical interns in highly sought-after specialties through the national competitive examination. This phenomenon should be closely monitored and requires Spain to define the pattern of internationalization of health professionals in a clear and precise model.
John S. Ji; Lincoln Chen
China has made commendable progress in its economic development, but faces with growing chal-lenges in the health care sector. Demands from aging demographics, emergence of non-communicable diseases, and growing burdens of disability are now of high priority for sustaining health progress. Like many countries around the world, China suffers from a severe shortage and mal-distribution of health professionals. In this essay, we examine three key aspects of China’s development of its health workforce:Improving the balance in the skill-mix amongst nur-ses and doctors;modernizing medical education especially reform of instructional content and purpose;and standardi-zing and improving post-graduate and continuing clinical education.%近年来，中国经济发展取得长足进步，但在卫生领域还面临诸多挑战。人口老龄化以及不断加重的慢性非传染性疾病负担，是当前中国亟待解决的卫生问题。然而，和世界上大多数国家一样，中国也面临着卫生人力短缺以及分配不均的问题。本文认为，中国卫生人力的发展需要重点关注三个方面：通过技能组合改善医护比；医学教育现代化，尤其是对教学目标及其内容进行改革；研究生教育和继续医学教育的标准化及推广。
Ling, Ru; Liu, Jiawang
To construct prediction model for health workforce and hospital beds in county hospitals of Hunan by multiple linear regression. We surveyed 16 counties in Hunan with stratified random sampling according to uniform questionnaires,and multiple linear regression analysis with 20 quotas selected by literature view was done. Independent variables in the multiple linear regression model on medical personnels in county hospitals included the counties' urban residents' income, crude death rate, medical beds, business occupancy, professional equipment value, the number of devices valued above 10 000 yuan, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, and utilization rate of hospital beds. Independent variables in the multiple linear regression model on county hospital beds included the the population of aged 65 and above in the counties, disposable income of urban residents, medical personnel of medical institutions in county area, business occupancy, the total value of professional equipment, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, utilization rate of hospital beds, and length of hospitalization. The prediction model shows good explanatory and fitting, and may be used for short- and mid-term forecasting.
Yasutake, Jillian B; Caldwell, Ruth R; Powell, Anna S
Hawai'i lacks the number of skilled professionals needed to meet current and future healthcare demands. In order to meet the growing needs of Hawai'i's residents, the Workforce Development Council, a state agency attached to the State Department of Labor and Industrial Relations, is looking to expand the primary care workforce 20% by the year 2020. Using funds from a Healthcare Workforce Planning grant, the state formed several Healthcare Industry Skill Panels, a workforce development best practice from the State of Washington, to address the gap in healthcare services and healthcare workforce opportunities for Hawai'i residents. Over 150 stakeholders--from employers, education, the public workforce system, economic development and labor--contributed their time and expertise to identify current workforce issues and develop action-oriented strategies to close industry skill gaps. So far these Skill Panels have developed a Critical Care Nursing Course Curriculum, a Workforce Readiness Curriculum and Certification pilot project, and a group to address specific barriers that are impeding Certified Nurse Aides (CNA). Upcoming initiatives include the distribution of a comprehensive statewide healthcare workforce development plan entitled Hawai'i's Healthcare Workforce 20/20 Plan & Report: Addendum to the Comprehensive State Plan for Workforce Development 2009-2014, and the creation of HawaiiHealthCareers.org, a website to both recruit and support individuals interested in pursuing careers in the healthcare industry.
Full Text Available This paper describes research into the historic importance of the coppice industry, now largely restricted to south east England and the relevance of this to current rural development policy. The economic and social contexts have altered significantly over time with product substitution and changing consumer aspirations, and particularly the availability of alternative fuel sources. Over the last fifty years the “value” attached to coppiced woodlands has shifted away from resource exploitation and towards a greater appreciation of them for wildlife, recreation, amenity and cultural heritage. This has increased wider public awareness of and appreciation for coppicing as a management technique and, consequently rising concern over the reduction in area managed. This was assumed to be due to market failure but attempts to reverse this by creating new outlets failed. The reason for this has been explored by engaging directly with the workforce, both individually and in focus groups. Coppice workers were found to be more numerous, active and enterprising than previously thought, and many were found to be working in family groups servicing traditional markets. They were unaware of concerns about decline in the area coppiced or initiatives to address it. Issues currently affecting their businesses included housing costs, rural crime, harvesting restrictions, loss of yards and training needs. It is concluded that Government policies to promote woodfuel are not likely to succeed without active engagement with the workforce to understand their perspectives and enabling them to participate in policy decisions is recommended.
U.S. Department of Health & Human Services — The Area Health Resource Files (AHRF) website is are a set of query tools, interactive maps, and data downloads with extensive demographic, training, and resource...
Garr, David R; Margalit, Ruth; Jameton, Andrew; Cerra, Frank B
The crisis of the rising cost of health care in the United States is stimulating major changes in the way care is being delivered. New models such as patient-centered medical homes and accountable care organizations are being developed with the expectation that health care professionals will address and improve the health of populations. Electronic health records and interprofessional teams will be critical to achieving the goal of better health. It is now time to bring together educators and clinicians at academic health centers, public health educators and practitioners, along with researchers, representatives from the health care delivery and financing systems, and community partners to reengineer health professions education to prepare health professions students for the health care system of the future.
Osborn, Thor D.
Sandia National Laboratories has made major investments in microsystems-related infrastructure and research staff development over the past two decades, culminating most recently in the MESA project. These investment decisions have been made based in part upon the necessity for highly reliable, secure, and for some purposes, radiation-hardened devices and subsystems for safety and sustainability of the United States nuclear arsenal and other national security applications. SNL's microsystems development and fabrication capabilities are located almost entirely within its New Mexico site, rendering their effectiveness somewhat dependent on the depth and breadth of the local microsystems workforce. Consequently, the status and development capacity of this workforce has been seen as a key personnel readiness issue in relation to the maintenance of SNL's microsystems capabilities. For this reason SNL has supported the instantiation and development of the Southwest Center for Microsystems Education, an Advanced Technology Education center funded primarily by the National Science Foundation, in order to foster the development of local training capacity for microsystems technologists. Although the SCME and the associated Manufacturing Technology program at Central New Mexico Community College have developed an effective curriculum and graduated several highly capable microsystems technologists, the future of both the center and the degree program remain uncertain due to insufficient student enrollment. The central region of New Mexico has become home to many microsystems-oriented commercial firms. As the demands of those firms for technologists evolve, SNL may face staffing problems in the future, especially if local training capacity is lost.
US Department of Labor, 2009
In early 2006, The U.S. Department of Labor (DOL), Employment and Training Administration (ETA) began an initiative called Workforce Innovation in Regional Economic Development (WIRED) to help regions create competitive conditions, integrate economic and workforce development activities, and demonstrate that talent development can successfully…
Russo, Giuliano; Pavignani, Enrico; Guerreiro, Catia Sá; Neves, Clotilde
Guinea-Bissau is one of the world's poorest and least developed countries. Amid poverty, political turmoil and state withdrawal, its health workforce (HW) has been swamped for the last four decades in a deepening crisis of under-resourcing, poor performance and laissez-faire. The present study aimed at analysing the human resources for health (HRH) situation in Guinea-Bissau in light of the recent literature on distressed health systems, with the objective of contributing to understanding the ways health workers react to protracted turmoil, the resulting distortions and the counter-measures that might be considered. Through document analysis, focus group discussions, 14 semi-structured and 5 in-depth interviews, we explored patterns as they became visible on the ground. Since independence, Guinea-Bissau experienced political events that have reflected on the healthcare arena and on the evolution of its health workforce, such as different coup attempts, waves of diaspora and shifting external assistance. The chronic scarcity of funds and a 'stable political instability' have lead to the commercialisation of public health services and to flawed mechanisms for training and deploying health personnel. In absence of any form of governance, health workers have come to own and run the health system. We show that the HRH crisis in Guinea-Bissau can only be understood by looking at its historical evolution and at the wider socio-economic context. There are no quick fixes for the deterioration of HRH in undergoverned states; however, the recognition of the ingrained distortions and an understanding of the forces determining the behaviour of key actors are essential premises for the identification of solutions. Guinea-Bissau's case study suggests that any policy that does not factor in the limited clout of health authorities over a effectively privatised healthcare arena is doomed from the start. Improving health system governance and quality of training should take
Menrad, Robert J.; Larson, Wiley J.
This paper shares the findings of NASA's Integrated Learning and Development Program (ILDP) in its effort to reinvigorate the HANDS-ON practice of space systems engineering and project/program management through focused coursework, training opportunities, on-the job learning and special assignments. Prior to March 2005, NASA responsibility for technical workforce development (the program/project manager, systems engineering, discipline engineering, discipline engineering and associated communities) was executed by two parallel organizations. In March 2005 these organizations merged. The resulting program-ILDP-was chartered to implement an integrated competency-based development model capable of enhancing NASA's technical workforce performance as they face the complex challenges of Earth science, space science, aeronautics and human spaceflight missions. Results developed in collaboration with NASA Field Centers are reported on. This work led to definition of the agency's first integrated technical workforce development model known as the Requisite Occupation Competence and Knowledge (the ROCK). Critical processes and products are presented including: 'validation' techniques to guide model development, the Design-A-CUrriculuM (DACUM) process, and creation of the agency's first systems engineering body-of-knowledge. Findings were validated via nine focus groups from industry and government, validated with over 17 space-related organizations, at an estimated cost exceeding $300,000 (US). Masters-level programs and training programs have evolved to address the needs of these practitioner communities based upon these results. The ROCK reintroduced rigor and depth to the practitioner's development in these critical disciplines enabling their ability to take mission concepts from imagination to reality.
Flowers, L.; Baring-Gould, I.
As the United States dramatically expands wind energy deployment, the industry is challenged with developing a skilled workforce and addressing public resistance. Wind Powering America's Wind for Schools project addresses these issues by: Developing Wind Application Centers (WACs) at universities; installing small wind turbines at community "host" schools; and implementing teacher training with interactive curricula at each host school.
Tonso, Michael A; Prematunga, Roshani Kanchana; Norris, Stephen J; Williams, Lloyd; Sands, Natisha; Elsom, Stephen J
The international literature suggests workplace violence in mental health settings is a significant issue, yet little is known about the frequency, nature, severity and health consequences of staff exposure to violence in Australian mental health services. To address this gap, we examined these aspects of workplace violence as reported by mental health services employees in Victoria, Australia. The project used a cross-sectional, exploratory descriptive design. A random sample of 1600 Health and Community Services Union members were invited to complete a survey investigating exposure to violence in the workplace, and related psychological health outcomes. Participants comprised employees from multiple disciplines including nursing, social work, occupational therapy, psychology and administration staff. A total of 411 members responded to the survey (26% response rate). Of the total sample, 83% reported exposure to at least one form of violence in the previous 12 months. The most frequently reported form of violence was verbal abuse (80%) followed by physical violence (34%) and then bullying/mobbing (30%). Almost one in three victims of violence (33%) rated themselves as being in psychological distress, 54% of whom reported being in severe psychological distress. The more forms of violence to which victims were exposed, the greater the frequency of reports of psychological distress. Workplace violence is prevalent in mental health facilities in Victoria. The nature, severity and health impact of this violence represents a serious safety concern for mental health employees. Strategies must be considered and implemented by healthcare management and policy makers to reduce and prevent violence.
Patrick, Rebecca; Kingsley, Jonathan; Capetola, Teresa
Public health practitioners have important roles to play in addressing environmental sustainability imperatives that have an impact on human health. Yet, to date, the extent to which practitioners are willing and able to address these issues is an understudied subject. This article draws on the findings of two qualitative studies involving 49…
Squires, A.; Aiken, L.H.; Heede, K. Van den; Sermeus, W.; Bruyneel, L.; Lindqvist, R.; Schoonhoven, L.; Stromseng, I.; Busse, R.; Brzostek, T.; Ensio, A.; Moreno-Casbas, M.; Rafferty, A.M.; Schubert, M.; Zikos, D.; Matthews, A.
BACKGROUND: As health services research (HSR) expands across the globe, researchers will adopt health services and health worker evaluation instruments developed in one country for use in another. This paper explores the cross-cultural methodological challenges involved in translating HSR in the
Staff working directly with adults' challenging behaviours in learning disability services need to be very good at what they do. They also need to want to do the job. A theory-practice gap exists, however, between what is known about effective, evidence-based approaches and whether and how these are used in person-centred community services. Many frontline staff working with people with the most serious challenging behaviours do not have the skills to implement programmes to change behaviour. This discussion article reviews workforce development in the context of clinical and service guidelines and asks whether the legitimate purview of frontline staff is treating challenging behaviour, managing it or simply coping with it on a daily basis, whilst maintaining the best quality of life possible for service users.
Lagos, Leonel E. [Applied Research Center, Florida International University, 10555 West Flagler St, EC2100, Miami, Florida (United States)
The US Department of Energy Office of Environmental Management (DOE-EM) oversees one of the largest and most technically challenging cleanup programs in the world. The mission of DOE-EM is to complete the safe cleanup of the environmental legacy from five decades of nuclear weapons development and government-sponsored nuclear energy research. Since 1995, Florida International University's Applied Research Center (FIU-ARC) has supported the DOE-EM mission and provided unique research capabilities to address some of these highly technical and difficult challenges. This partnership has allowed FIU-ARC to create a unique infrastructure that is critical for the training and mentoring of science, technology, engineering, and math (STEM) students and has exposed many STEM students to 'hands-on' DOE-EM applied research, supervised by the scientists and engineers at ARC. As a result of this successful partnership between DOE and FIU, DOE requested FIU-ARC to create the DOE-FIU Science and Technology Workforce Development Initiative in 2007. This innovative program was established to create a 'pipeline' of minority STEM students trained and mentored to enter DOE's environmental cleanup workforce. The program was designed to help address DOE's future workforce needs by partnering with academic, government and private companies (DOE contractors) to mentor future minority scientists and engineers in the research, development, and deployment of new technologies and processes addressing DOE's environmental cleanup challenges. Since its inception in 2007, the program has trained and mentored 78 FIU STEM minority students. Although, the program has been in existence for only six years, a total of 75 internships have been conducted at DOE National Laboratories, DOE sites, DOE Headquarters and field offices, and DOE contractors. Over 100 DOE Fellows have participated in the Waste Management (WM) Symposia since 2008 with a total of 84 student
Coto, Mayela; Mora, Sonia; Lykke, Marianne
, a growing number of local companies have been established to provide ICT products and services worldwide. Such development requires a large qualified workforce related to computer science and informatics, with skills in the areas of problem solving, group work, mathematics, business administration......, and foreign languages. In computer engineering, teaching has traditionally been deductive, with lecturers presenting theories and general principles, illustrative examples, practical work, and at the course end tests of students’ ability to do the same kind of reasoning through exams. This approach is very...... common in Costa Rican universities. However, many studies show that problem-based, inductive teaching that present students to real-life questions and realistic case studies is a preferable alternative. Problem-based teaching prepares better the students to complex, real-life problems and work. When...
Stuckless, Teri; Milosevic, Michael; de Metz, Catherine; Parliament, Matthew; Tompkins, Brent; Brundage, Michael
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. A forward calculation model was created and populated with data obtained from national sources. Validation was confirmed using a historical prospective approach. 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. 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. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Adam D. Koon
Full Text Available This article opens a debate about how to think about moving forward with the emerging twin movements of human resources for health (HRH and universal health coverage (UHC. There is sufficient evidence to warrant these movements, but actors and the policy process significantly affect which policies are adopted and how they are implemented. How exactly this occurs in low- and middle-income countries (LMICs is not very well understood. Furthermore, it is not clear whether actors will mobilize for or against the emergent HRH and UHC agendas. Policy analysis should help illuminate potential strategies to account for multiple interests and divergent values in volatile stakeholder environments. We argue that not only should the movement for UHC be paired with current efforts to address the human resources crisis, but also, for both to succeed, we need to know more about how health policy works in LMICs.
Hickson, M; Child, J; Collinson, A
Healthcare is changing and the professions that deliver it need to adapt and change too. The aim of this research was to inform the development of a workforce strategy for Dietetics for 2020-2030. This included an understanding of the drivers for change, the views of stakeholders and recommendations to prepare the profession for the future. The research included three phases: (i) establishing the context which included a literature and document review (environmental scan); (ii) discovering the profession and professional issues using crowd-sourcing technology; and (iii) articulating the vision for the future using appreciative inquiry. The environmental scan described the current status of the dietetic profession, the changing healthcare environment, the context in which dietitians work and what future opportunities exist for the profession. The online conversation facilitated by crowd-sourcing technology asked the question: 'How can dietitians strengthen their future role, influence and impact?' Dietitians and interested stakeholders (726 and 109, respectively) made 6130 contributions. Seven priorities were identified and fed into the appreciative inquiry event. The event bought together 54 dietitians and analysis of the discussions generated five themes: (i) professional identity; (ii) strong foundations-creating structure and direction for the profession; (iii) amplifying visibility and influence; (iv) embracing advances in science and technology; and (v) career advancement and emerging opportunities. A series of recommendations were made for the next steps in moving the workforce to a new future. The future for dietetics looks bright, embracing technology, as well as exploring different ways of working and new opportunities, as this dynamic profession continues to evolve. © 2017 The British Dietetic Association Ltd.
Improving access to appropriate health care, currently inadequate for many Americans, is more complex than merely increasing the projected number of physicians and nurses. Any attainable increase in their numbers will not solve the problem. To bring supply and demand closer, new systems of care are required, leveraging every member of the health care workforce, permitting professionals to provide their unique contributions.To increase supply: Redefine the roles of physicians and nurse practitioners (NPs), assess how much primary care must be delivered by a physician, and provide support from other team members to let the physician deal with complex patients. NPs can deliver much primary care and some specialty care. Care must be delivered in integrated systems permitting new payment models (e.g., salary with bonus) and team-based care as well as maximum use of electronic health records. Teams must make better use of nonprofessionals, such as Grand-Aides, using telephone protocols and portable telemedicine with home visits and online direct reporting of every encounter. The goals are to improve health and reduce unnecessary clinic and emergency department visits, admissions, and readmissions.To decrease demand: Physician payment must foster quality and appropriate patient volume (if accompanied by high patient satisfaction). Patients must be part of the team, work to remain healthy, and reduce inappropriate demand.The nation may not need as many physicians and nurses if the systems can be changed to promote integration, leveraging every member of the workforce to perform at his or her maximum competency.
Lawhead, Pamela B.; Aten, Michelle L.
The Center for GeoSpatial Workforce Development is embarking on a new era in education by developing a repository of dynamic online courseware authored by the foremost industry experts within the remote sensing and GIS industries. Virtual classrooms equipped with the most advanced instructions, computations, communications, course evaluation, and management facilities amplify these courses to enhance the learning environment and provide rapid feedback between instructors and students. The launch of this program included the objective development of the Model Curriculum by an independent consortium of remote sensing industry leaders. The Center's research and development focus on recruiting additional industry experts to develop the technical content of the courseware and then utilize state-of-the-art technology to enhance their material with visually stimulating animations, compelling audio clips and entertaining, interactive exercises intended to reach the broadest audience possible by targeting various learning styles. The courseware will be delivered via various media: Internet, CD-ROM, DVD, and compressed video, that translates into anywhere, anytime delivery of GeoSpatial Information Technology education.
Perry, Lin; Xu, Xiaoyue; Duffield, Christine; Gallagher, Robyn; Nicholls, Rachel; Sibbritt, David
To examine the quality of life of nurses and midwives in New South Wales, Australia and compare values with those of the Australian general population; to determine the influence of workforce, health and work life characteristics on quality of life and its effect on workforce intention to leave. Few studies have examined nurses' and midwives' quality of life and little is known of its effects on workforce longevity. This was a cross-sectional survey conducted in 2014-2015. The "Fit for the Future" electronic survey, delivered to nurses and midwives, examined demographic, work and health-related factors, which were compared with Australian general population normative values for physical and mental components of quality of life (the Short Form-12). Univariate and multivariate logistic regression models assessed associations with workforce intention to leave. Physical and mental component scores, calculated for 4,592 nurses and midwives, revealed significantly higher physical but lower mental component scores than the general population. Physical component scores decreased with increasing age; higher scores were seen in nurses with better health indices and behaviours. Mental well-being scores increased with increasing age; in nurses who reported job satisfaction, no work injury, sleep problems or frequent pain and non-smokers. The odds of intention to leave decreased with increasing mental well-being. Managers and decision-makers should heed study recommendations to implement health promotion strategies for nurses and midwives, aiming to improve mental health, specifically to promote workforce retention. © 2017 John Wiley & Sons Ltd.
Kirk A. Astroth
Full Text Available Positive youth development outcomes are influenced by a competent, highly trained work force that enjoys their work with young people. The youth work field has struggled with how to keep and motivate front line youth workers given the heavy workloads, low pay, lack of recognition and irregular time demands to compete with family responsibilities. Professional development is a key strategy for retaining and motivating youth workers. A model of professional development called the Western 4-H Institute has been developed and held now for two sessions. Results from participants indicate that this strategy can have a positive influence on job satisfaction, competencies, and retention. In fact, only 10 percent of participants had left during the intervening 5 years, and job satisfaction had increased significantly over time. Organizational loyalty among participants is not high, but with early career professionals, they may still be trying to find their niche. A regional training model has shown itself to be effective in supporting 4-H youth professionals and is building a sustainable workforce for the future.
Bertone, Maria Paola; Lurton, Grégoire; Mutombo, Paulin Beya
The financial remuneration of health workers (HWs) is a key concern to address human resources for health challenges. In low-income settings, the exploration of the sources of income available to HWs, their determinants and the livelihoods strategies that those remunerations entail are essential to gain a better understanding of the motivation of the workers and the effects on their performance and on service provision. This is even more relevant in a setting such as the DR Congo, characterized by the inability of the state to provide public services via a well-supported and financed public workforce. Based on a quantitative survey of 1771 HWs in four provinces of the DR Congo, this article looks at the level and the relative importance of each revenue. It finds that Congolese HWs earn their living from a variety of sources and enact different strategies for their financial survival. The main income is represented by the share of user fees for those employed in facilities, and per diems and top-ups from external agencies for those in Health Zone Management Teams (in both cases, with the exception of doctors), while governmental allowances are less relevant. The determinants at individual and facility level of the total income are also modelled, revealing that the distribution of most revenues systematically favours those working in already favourable conditions (urban facilities, administrative positions and positions of authority within facilities). This may impact negatively on the motivation and performance of HWs and on their distribution patters. Finally, our analysis highlights that, as health financing and health workforce reforms modify the livelihood opportunities of HWs, their design and implementation go beyond technical aspects and are unavoidably political. A better consideration of these issues is necessary to propose contextually grounded and politically savvy approaches to reform in the DR Congo. © The Author 2016. Published by Oxford University
Scarborough, Jane; Eliott, Jaklin; Miller, Emma; Aylward, Paul
To suggest ways of increasing the cohesiveness of national primary healthcare strategies and hepatitis C strategies, with the aim of ensuring that all these strategies include ways to address barriers and facilitators to access to primary healthcare and equity for people with hepatitis C. A critical review was conducted of the first national Primary Healthcare System Strategy and Health Workforce Strategy with the concurrent Hepatitis C Strategy. Content relating to provision of healthcare in private general practice was examined, focussing on issues around access and equity. In all strategies, achieving access to care and equity was framed around providing sufficient medical practitioners for particular locations. Equity statements were present in all policies but only the Hepatitis C Strategy identified discrimination as a barrier to equity. Approaches detailed in the Primary Healthcare System Strategy and Health Workforce Strategy regarding current resource allocation, needs assessment and general practitioner incentives were limited to groups defined within these documents and may not identify or meet the needs of people with hepatitis C. Actions in the primary healthcare system and health workforce strategies should be extended to additional groups beyond those listed as priority groups within the strategies. Future hepatitis C strategies should outline appropriate, detailed needs assessment methodologies and specify how actions in the broad strategies can be applied to benefit the primary healthcare needs of people with hepatitis C.
A functional and socially acceptable level of oral health is an integral part of healthy ageing! More teeth, more sophisticated dental technology and increasing co-morbidities of an ageing Australian society will have significant impacts on oral health professionals and their capacities to work within expanded teams of health, education and social organizations. Society is adapting its perspective on the social role of older citizens; replacing its perception of the elderly as an economic social burden, to one of senior citizens as being a respected and active source of social and economic benefit. Maintaining general and oral health for older Australians will bring into sharp focus the need for recognizing and managing not only the biological markers associated with ageing and frailty, but also the potential mediators on health outcomes associated with changing health and social behaviours. Increasing social capital of older Australians through national policy initiatives such as the Living Longer Living Better reforms, and greater involvement of allied health and carers' organizations in oral health education and health promotion will set a new scene for the roles of dental professionals. Issues of equity will drive the service delivery agenda, and a socio-cultural shift to 'consumer-directed' health outcomes will shape the range of services, quality of care and support required by an older Australian population. Formal education and training modules for aged care workers, allied health practitioners and geriatricians will develop. The challenge for the dental profession is the coordination and integration of these changes into new models of dental and general health care.
Full Text Available Abstract Background Kenya, like many other countries in sub-Saharan Africa, has been affected by shortages of health workers in the public sector. Data on the rates and leading reasons for health workers attrition in the public sector are key in developing effective, evidence-based planning and policy on human resources for health. Methods This study analysed data from a human resources health facility survey conducted in 2005 in 52 health centres and 22 public hospitals (including all provincial hospitals across all eight provinces in Kenya. The study looked into the status of attrition rates and the proportion of attrition due to retirement, resignation or death among doctors, clinical officers, nurses and laboratory and pharmacy specialists in surveyed facilities. Results Overall health workers attrition rates from 2004 to 2005 were similar across type of health facility: provincial hospitals lost on average 4% of their health workers, compared to 3% for district hospitals and 5% for health centres. However, there are differences in the patterns of attrition rates by cadre. Attrition among doctors and registered nurses was much higher at the provincial hospitals than at district hospitals or health centres, whereas the opposite pattern was observed for laboratory and pharmacy staff (lost at a higher rate in lower-level facilities. In provincial hospitals, doctors had higher attrition rates than clinical officers, and registered nurses had higher attrition rates than enrolled nurses. In contrast, attrition of enrolled and registered nurses in district hospitals and health centres was similar. The main reason for health worker attrition (all cadres combined at each level of facility was retirement, followed by resignation and death. However, resignation drives attrition among doctors and clinical officers; retirement accounts for the main share of attrition among nurses and pharmacy staff; and death is the primary reason for attrition among
Allen, J. E.; Johnson, A.; Headley, R. K.
The increasing availability of no-cost remote sensing data and improvements in analysis software have presented an unprecedented opportunity for the integration of geospatial technologies into a wide variety of disciplines for learning and teaching at community colleges and Tribal colleges. These technologies magnify the effectiveness of problem solving in agriculture, disaster management, environmental sciences, urbanization monitoring, and multiple other domains for societal benefit. This session will demonstrate the approach and lessons learned by federal and private industry partners leading a professional development program, “Integrated Geospatial Education and Technology Training” (iGETT; http://igett.delmar.edu), 2007-2010. iGETT is funded by the National Science Foundation’s Advanced Technological Education Program, (NSF DUE 0703185). 40 participants were selected from a nationwide pool and received training in how to understand, identify, download, and integrate federal land remote sensing data into existing Geographic Information Systems programs to address specific issues of concern to the local workforce. Each participant has authored a “Learning Unit” that covers at least two weeks of class time. All training resources and Learning Units are publicly available on the iGETT Web site. A follow-on project is under consideration to develop core competencies for the remote sensing technician. Authors: Jeannie Allen, Sigma Space Corp. for NASA Landsat, at Goddard Space Flight Center; Ann Johnson, ESRI Higher Education; Rachel Headley, USGS EROS Land Remote Sensing Program
Mmbuji, Peter; Mukanga, David; Mghamba, Janeth; Ahly, Mohamed; Mosha, Fausta; Azima, Simba; Senga, Sembuche; Moshiro, Candida; Semali, Innocent; Rolle, Italia; Wiktor, Stefan; McQueen, Suzzane; McElroy, Peter; Nsubuga, Peter
The Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) was established in 2008 as a partnership among the Ministry of Health and Social Welfare (MOHSW), Muhimbili University of Health and Allied Sciences, National Institute for Medical Research, and local and international partners. TFELTP was established to strengthen the capacity of MOHSW to conduct public health surveillance and response, manage national disease control and prevention programs, and to enhance public health laboratory support for surveillance, diagnosis, treatment and disease monitoring. TFELTP is a 2-year full-time training program with approximately 25% time spent in class, and 75% in the field. TFELTP offers two tracks leading to an MSc degree in either Applied Epidemiology or, Epidemiology and Laboratory Management. Since 2008, the program has enrolled a total of 33 trainees (23 males, 10 females). Of these, 11 were enrolled in 2008 and 100% graduated in 2010. All 11 graduates of cohort 1 are currently employed in public health positions within the country. Demand for the program as measured by the number of applicants has grown from 28 in 2008 to 56 in 2011. While training the public health leaders of the country, TFELTP has also provided essential service to the country in responding to high-profile disease outbreaks, and evaluating and improving its public health surveillance systems and diseases control programs. TFELTP was involved in the country assessment of the revised International Health Regulations (IHR) core capabilities, development of the Tanzania IHR plan, and incorporation of IHR into the revised Tanzania Integrated Disease Surveillance and Response (IDSR) guidelines. TFELTP is training a competent core group of public health leaders for Tanzania, as well as providing much needed service to the MOHSW in the areas of routine surveillance, outbreak detection and response, and disease program management. However, the immediate challenges that the program must
Williams, Cylie; Miyazaki, Koki; Borkowski, Donna; McKinstry, Carol; Cotchet, Matthew; Haines, Terry
The aim of the present study was to identify and understand the self-rated research capacity and culture of the allied health workforce. METHODS. The present study was a cross-sectional survey. The Research Capacity and Culture tool was disseminated to all Victorian public health allied health departments. General demographic data were also collected, including the presence of an organisational allied health research lead. Five hundred and twenty fully completed surveys were returned by participants; all allied health disciplines and all grades were represented. One hundred and eighty-six participants had an organisational allied health research lead and 432 were located in a metropolitan-based health service. There were significant differences (P organisational and team research skills between those with and without a research lead, together with those in different service locations (metropolitan vs non-metropolitan). Higher self-ratings in individual research skills (P organisational level has a flow-down effect on research capacity and culture.
Quinn, Gwendolyn; Albrecht, Terrance; Marshall, Robert; Akintobi, Tabia Henry
The marketing mindset focuses a practitioner on systematically thinking through key issues before undertaking a health promotion campaign. The Thinking Like a Marketer training, developed by the National Training Collaborative for Social Marketing is a challenging method for health educators and promoters to apply their skills in innovative ways. Focus groups were conducted with former trainees to assess the impact of the training. Additional data were collected from members of the Association of State and Territorial Promotion Directors of Health Promotion and Public Health Education organization through a 10-item elicitation survey. Findings suggest that although participants gained greater sensitivity and appreciation for the social marketing research process, the major barrier to application in the workplace surrounded upper management. On-site technical assistance, mentoring, and follow-up were important training needs identified through the survey and focus groups.
Ramos, Mary M; Sebastian, Rachel A; Murphy, Mary; Oreskovich, Kristin; Condon, Timothy P
Recent attention has focused on the potential for school-based health centers (SBHCs) to provide access points for adolescent substance use care. In 2015, the University of New Mexico began screening, brief intervention, and referral to treatment (SBIRT) training for providers at New Mexico Department of Health (NMDOH)-funded SBHCs across the state. This study assesses baseline knowledge, attitudes, and practices of the New Mexico SBHC provider workforce regarding adolescent substance use and provision of services. In early 2015, the NMDOH administered an SBHC provider workforce survey (N = 118) and achieved a 44.9% response rate. This descriptive analysis includes all survey respondents who self-identified as a primary care or behavioral health provider in an SBHC serving middle or high school students (n = 52). Among respondents, the majority (57.7%) were primary care providers, including nurse practitioners, physicians, and physician assistants. The remaining 42.3% of respondents were master's-level behavioral health providers. Only 44.2% of providers reported practicing the full SBIRT model at their SBHC, and 21.2% reported having received continuing education on SBIRT within the previous 3 years. Most respondents, 84.6%, agreed that it is the responsibility of SBHC providers to screen students for substance use using a standardized tool, and 96.2% agreed that it is the responsibility of the SBHC provider to assess for students' readiness to change. A majority reported self-efficacy in helping students achieve change in their alcohol use, illicit drug use, and prescription drug misuse: 73.1%, 65.4%, and 63.5%, respectively. These results suggest that SBIRT training for New Mexico SBHC providers is timely. The authors identified gaps between recommended SBIRT practices and SBIRT delivery as well as discrepancies between reported provider self-efficacy and actual implementation of the SBIRT model. Further study will determine the effectiveness of efforts to
Pool, Lindsay R; Wagner, Robin M; Scott, Lindsey L; RoyChowdhury, Deepshikha; Berhane, Rediet; Wu, Charles; Pearson, Katrina; Sutton, Jennifer A; Schaffer, Walter T
The U.S. National Institutes of Health (NIH) annually invests approximately $22 billion in biomedical research through its extramural grant programs. Since fiscal year (FY) 2010, all persons involved in research during the previous project year have been required to be listed on the annual grant progress report. These new data have enabled the production of the first-ever census of the NIH-funded extramural research workforce. Data were extracted from All Personnel Reports submitted for NIH grants funded in FY 2009, including position title, months of effort, academic degrees obtained, and personal identifiers. Data were de-duplicated to determine a unique person count. Person-years of effort (PYE) on NIH grants were computed. In FY 2009, NIH funded 50,885 grant projects, which created 313,049 full- and part-time positions spanning all job functions involved in biomedical research. These positions were staffed by 247,457 people at 2,604 institutions. These persons devoted 121,465 PYE to NIH grant-supported research. Research project grants each supported 6 full- or part-time positions, on average. Over 20% of positions were occupied by postdoctoral researchers and graduate and undergraduate students. These baseline data were used to project workforce estimates for FYs 2010-2014 and will serve as a foundation for future research.
Fiona J Charlson
Full Text Available The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010 data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals.
Dodd, Jenny; Saggers, Sherry; Wildy, Helen
The recruitment and retention of allied health workers present challenges for organizations in Australia and internationally. Australia, in common with other developed countries, faces the prospect of a rapidly aging population and the high turnover of younger allied health workers (the majority of whom are female) from employing organizations. Emphases on the individual characteristics of Boomer, Generation X, and Generation Y workers may provide a useful starting base for recruitment and retention strategies, but our study shows that these need to be contextualized within broader political, social, and structural factors that take account of gender and the changing needs of workers over their life span.
Dunn, Michelle C; Bourne, Philip E
This article describes efforts at the National Institutes of Health (NIH) from 2013 to 2016 to train a national workforce in biomedical data science. We provide an analysis of the Big Data to Knowledge (BD2K) training program strengths and weaknesses with an eye toward future directions aimed at any funder and potential funding recipient worldwide. The focus is on extramurally funded programs that have a national or international impact rather than the training of NIH staff, which was addressed by the NIH's internal Data Science Workforce Development Center. From its inception, the major goal of BD2K was to narrow the gap between needed and existing biomedical data science skills. As biomedical research increasingly relies on computational, mathematical, and statistical thinking, supporting the training and education of the workforce of tomorrow requires new emphases on analytical skills. From 2013 to 2016, BD2K jump-started training in this area for all levels, from graduate students to senior researchers.
Velasco, E. E.; Pangman, P.; Jacobs, R. L.
Developed nations face the immediate need to replace the current wave of retiring geoscientists at the same time developing nations need to build an infrastructure to train future geoscientists. But what does a successful geoscientist look like? Recruiters seem to favor candidates from respected universities that pair applied book knowledge with excellent communication skills and the ability to take a multidisciplinary approach to challenges. Students should be global thinking, business minded, and socially aware. The Society of Exploration Geophysicists as a successful global society addresses the needs of a growing diverse membership through an international approach. Student membership has doubled over the past five years to almost 10,000. The Society is building momentum through targeted, yet diverse programs. Students are eager to participate in the unique SEG/Chevron Student Leadership Symposium, SEG/ExxonMobil Student Education Program, Challenge Bowls, Student Expositions, Honorary Lecturer presentations and related events. These are transformative educational opportunities that provide the impetus for expanded and very effective international networking and transfer of knowledge. As SEG's students build on these relationships and newly acquired leadership skills, they affect the scope and breadth of SEG Student Chapter activities. There has been a resulting increase in multi-country field camps. The Geoscientists Without Borders° humanitarian program provides cross-cultural field opportunities that demonstrate how applied geoscience can make a difference in the global society, while providing students with valuable workforce skills that employers seek. These collaborative efforts are facilitated by social media and on-line communities that cause boundaries to dissolve and time zones to become irrelevant.
Murray-García, Jann L; Harrell, Steven; García, Jorge A; Gizzi, Elio; Simms-Mackey, Pamela
Efforts in the field of multicultural education for the health professions have focused on increasing trainees' knowledge base and awareness of other cultures, and on teaching technical communication skills in cross-cultural encounters. Yet to be adequately addressed in training are profound issues of racial bias and the often awkward challenge of cross-racial dialogue, both of which likely play some part in well-documented racial disparities in health care encounters. We seek to establish the need for the skill of dialoguing explicitly with patients, colleagues, and others about race and racism and its implications for patient well-being, for clinical practice, and for the ongoing personal and professional development of health care professionals. We present evidence establishing the need to go beyond training in interview skills that efficiently "extract" relevant cultural and clinical information from patients. This evidence includes concepts from social psychology that include implicit bias, explicit bias, and aversive racism. Aiming to connect the dots of diverse literatures, we believe health professions educators and institutional leaders can play a pivotal role in reducing racial disparities in health care encounters by actively promoting, nurturing, and participating in this dialogue, modeling its value as an indispensable skill and institutional priority.
Marphatia, Akanksha A
Decades of underinvestment in public sectors and in teachers and health workers have adversely affected the health and educational outcomes of women. This is partly explained by a general lack of resources. However, the amount a country can spend on social sectors, including teachers and health workers, is also determined by its macroeconomic framework, which is set in agreement with the International Monetary Fund. There is now ample evidence of how IMF-imposed wage ceilings have constrained the ability of governments to hire adequate numbers of trained professionals and increase investment in social sectors. Though the IMF has recently removed wage ceilings from its basket of conditions, little change has taken place to ensure that women are better supported by macroeconomic policies or, at the least, are less adversely affected. Thus far, the IMF's neoliberal policies have either ignored gender concerns or instrumentalized equity, health, and education to support economic development. Unless macroeconomic policies are more flexible and deliberately take into account the different needs of women and men, social outcomes will continue to be poor and inequitable. Governments must pursue alternative, feminist policies that put the goals of social equity at the center of macroeconomic policy. These policies can facilitate increased investment in education and health care, which are vital measures for achieving gender equality and providing both women and men with the skills and training needed to soften the impact of the current economic crisis.
DOD’s 2013-2018 Workforce Plan 22 functional communities 32 mission-critical occupations (series) Medical Psychology Series (0180) Social Work...Updates. Listen to our Podcasts . Visit GAO on the web at www.gao.gov. Contact: Website: http://www.gao.gov/fraudnet/fraudnet.htm E-mail: fraudnet
..., it was realigned again, into IEED. The purpose of the action under consideration is to return DWD to... Employment Works Program (NEW) program, the Department of Labor's Workforce Investment Act (WIA), and the... of Human Services, which administers social service, welfare assistance, and American Indian...
Kelly, Patrick J.
This report focuses on the 15 states of the West (Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming), their ability to educate minorities, and the resulting impact on their workforces and economies. The foundation of the Western U.S. economy rests on…
Crockett, Elahé T
The National Institutes of Health has recognized a compelling need to train highly qualified individuals and promote diversity in the biomedical/clinical sciences research workforce. In response, we have developed a research-training program known as REPID (Research Education Program to Increase Diversity among Health Researchers) to prepare students/learners to pursue research careers in these fields and address the lack of diversity and health disparities. By inclusion of students/learners from minority and diverse backgrounds, the REPID program aims to provide a research training and enrichment experience through team mentoring to inspire students/learners to pursue research careers in biomedical and health-related fields. Students/learners are recruited from the University campus from a diverse population of undergraduates, graduates, health professionals, and lifelong learners. Our recruits first enroll into an innovative on-line introductory course in Basics and Methods in Biomedical Research that uses a laboratory Tool-Kit (a lab in a box called the My Dr. ET Lab Tool-Kit) to receive the standard basics of research education, e.g., research skills, and lab techniques. The students/learners will also learn about the responsible conduct of research, research concept/design, data recording/analysis, and scientific writing/presentation. The course is followed by a 12-week hands-on research experience during the summer. The students/learners also attend workshops and seminars/conferences. The students/learners receive scholarship to cover stipends, research related expenses, and to attend a scientific conference. The scholarship allows the students/learners to gain knowledge and seize opportunities in biomedical and health-related careers. This is an ongoing program, and during the first three years of the program, fifty-one (51) students/learners have been recruited. Thirty-six (36) have completed their research training, and eighty percent (80%) of them have
Zandniapour, Lily; Conway, Maureen
The benefits of sectoral workforce development programs to the working poor were examined in a 3-year longitudinal study of participants in six sectoral employment training programs across the United States. The programs, which were all designed to serve low-income clients, provided training in a diverse set of industries, including the following:…
Newhauser, Wayne D
The medical physics workforce comprises approximately 24,000 workers worldwide and approximately 8,200 in the United States. The occupation is a recognized, established, and mature profession that is undergoing considerable growth and change, with many of these changes being driven by scientific, technical, and medical advances. Presently, the medical physics workforce is adequate to meet societal needs. However, data are emerging that suggest potential risks of shortages and other problems that could develop within a few years. Some of the governing factors are well established, such as the increasing number of incident cancers thereby increasing workload, while others, such as the future use of radiation treatments and changes in healthcare economic policies, are uncertain and make the future status of the workforce difficult to forecast beyond the next several years. This review examines some of the major factors that govern supply and demand for medical physicists, discusses published projections and their uncertainties, and presents other information that may help to inform short- and long-term planning of various aspects of the future workforce. It includes a description of the general characteristics of the workforce, including information on its size, educational attainment, certification, age distribution, etc. Because the supply of new workers is governed by educational and training pathways, graduate education, post-doctoral training, and residency training are reviewed, along with trends in state and federal support for research and education. Selected professional aspects of the field also are considered, including professional certification and compensation. We speculate on the future outlook of the workforce and provide recommendations regarding future actions pertaining to the future medical physics workforce.
Whelen, A Christian; Kitagawa, Kent
Chronically understaffed public health laboratories depend on a decreasing number of employees who must assume broader responsibilities in order to sustain essential functions for the many clients the laboratories support. Prospective scientists considering a career in public health are often not aware of the requirements associated with working in a laboratory regulated by the Clinical Laboratory Improvement Amendments (CLIA). The purpose of this pilot internship was two-fold; introduce students to operations in a regulated laboratory early enough in their academics so that they could make good career decisions, and evaluate internship methodology as one possible solution to workforce shortages. Four interns were recruited from three different local universities, and were paired with an experienced State Laboratories Division (SLD) staff mentor. Students performed tasks that demonstrated the importance of CLIA regulations for 10-15 hours per week over a 14 week period. Students also attended several directed group sessions on regulatory lab practice and quality systems. Both interns and mentors were surveyed periodically during the semester. Surveys of mentors and interns indicated overall positive experiences. One-on-one pairing of experienced public health professionals and students seems to be a mutually beneficial arrangement. Interns reported that they would participate if the internship was lower paid, unpaid, or for credit only. The internship appeared to be an effective tool to expose students to employment in CLIA-regulated laboratories, and potentially help address public health laboratory staffing shortfalls. Longer term follow up with multiple classes of interns may provide a more informed assessment.
Abas, Melanie A; Nhiwatiwa, Sekai M; Mangezi, Walter; Jack, Helen; Piette, Angharad; Cowan, Frances M; Barley, Elizabeth; Chingono, Alfred; Iversen, Amy; Chibanda, Dixon
Despite the need to improve the quantity and quality of psychiatry training in sub-Saharan Africa (SSA), very little is known about the experiences of psychiatric trainees in the region. This is the first study examining psychiatric trainees in a low-income country in SSA. It was carried out as part of the needs assessment for a unique Medical Education Partnership Initiative (MEPI) programme to find African solutions for medical shortages in Africa. We approached all doctors who had trained in post-graduate psychiatry in Zimbabwe in 2010 and conducted in-depth qualitative interviews with all except one (n = 6). We analysed the data using constant comparison and thematic analysis. Trainees described the apprenticeship model as the programme's primary strength, through providing clinical exposure and role models. Programme weaknesses included shortages in information sources, trainee salaries, trainers, public health education, and in the mental health service. Most respondents were, however, eager to continue practising psychiatry in Zimbabwe, motivated by family ties, national commitment and helping vulnerable, stigmatized individuals. Respondents called for sub-speciality training and for infrastructure and training to do research. Resources need to be made available for psychiatric trainees in more SSA settings to develop public health competencies. However, investment in psychiatry training programmes must balance service provision with trainees' educational needs. Directing investment towards needs identified by trainees may be a cost-effective, context-sensitive way to increase retention and learning outcomes.
Carrasco Victor V
Full Text Available Abstract Introduction One of the components of the Health Observatory for Latin American and the Caribbean (HO-LAC is the design and implementation of metrics for human resources for health. Under the HO-LAC initiative, researchers from nine countries in the region formed the Collaborative Community on Human Resources for Health in Latin America and the Caribbean to identify common metrics applicable to the field of human resources for health (HRH. Case description The case description comprises three stages: a the origins of an initiative in which a non-governmental organization brings together researchers involved in HRH policy in LAC, b a literature search to identify initiatives to develop methods and metrics to assess the HRH field in the region, and c subsequent discussions held by the group of researchers regarding the possibilities of identifying an appropriate set of metrics and indicators to assess HRH throughout the region. Discussion and evaluation A total of 101 documents produced between 1985 and 2008 in the LAC region were identified. Thirty-three of the papers included a variety of measurements comprising counts, percentages, proportions, indicators, averages and metrics, but only 13 were able to fully describe the methods used to identify these metrics and indicators. Of the 33 articles with measurements, 47% addressed labor market issues, 25% were about working conditions, 23% were on HRH training and 5% addressed regulations. Based on these results, through iterative discussions, metrics were defined into three broad categories (training, labor market and working conditions and available sources of information for their estimation were proposed. While only three of the countries have data on working conditions, all countries have sufficient data to measure at least one aspect of HRH training and the HRH labor market. Conclusions Information gleaned from HRH metrics makes it possible to carry out comparisons on a determined
Hinojosa, Jorge A; Pandya, Amit G
The United States is becoming increasingly diverse, and minorities are projected to represent the majority of our population in the near future. Unfortunately, health disparities still exist for these groups, and inequalities have also become evident in the field of dermatology. There is currently a lack of diversity within the dermatology workforce. Potential solutions to these health care disparities include increasing cultural competence for all physicians and improving diversity in the dermatology workforce. ©2016 Frontline Medical Communications.
Ablah, Elizabeth; Biberman, Dorothy A.; Weist, Elizabeth M.; Buekens, Pierre; Bentley, Margaret E.; Burke, Donald; Finnegan, John R.; Flahault, Antoine; Frenk, Julio; Gotsch, Audrey R.; Klag, Michael J.; Lopez, Mario Henry Rodriguez; Nasca, Philip; Shortell, Stephen; Spencer, Harrison C.
Although global health is a recommended content area for the future of education in public health, no standardized global health competency model existed for master-level public health students. Without such a competency model, academic institutions are challenged to ensure that students are able to demonstrate the knowledge, skills, and attitudes (KSAs) needed for successful performance in today's global health workforce. The Association of Schools of Public Health (ASPH) sought to address this need by facilitating the development of a global health competency model through a multistage modified-Delphi process. Practitioners and academic global health experts provided leadership and guidance throughout the competency development process. The resulting product, the Global Health Competency Model 1.1, includes seven domains and 36 competencies. The Global Health Competency Model 1.1 provides a platform for engaging educators, students, and global health employers in discussion of the KSAs needed to improve human health on a global scale. PMID:24445206
Schoenbaum Stephen C
Abstract National planning and management of the physician workforce is a multifaceted, difficult, and even controversial activity. It is an important subset of overall health workforce planning and management, which contributes to a country's having an effective and efficient health care system. This commentary builds on a new survey of specialty considerations by Israeli medical students early in their clinical training, places it in the broader context of health workforce planning, and pro...
Fischer, David Jason; Mack, Melinda
New York's workforce system is a complicated entity that engages nearly a dozen state agencies and myriad funding streams originating at the federal and state levels, and operates on the ground in ten economic development regions, 33 designated workforce investment areas, community-based organizations, labor unions and 62 counties. This report…
Full Text Available Faced with a global shortage of skilled health workers due to attrition, countries are struggling to build and maintain optimum knowledge workforce in healthcare for delivering quality healthcare services. Forces that affect healthcare professionals’ turnover needs to be addressed before a competent uniformly adoptable strategy could be proposed for mitigating the problem. In this study we investigate the effects of the socio–demographic characteristics on attrition of healthcare knowledge workforce in northern parts of India that have a wide gradient of rural and urban belt, taking into account both public and private healthcare organizations. For this purpose healthcare professional attrition tracking survey (HATS was designed. The data has been collected from a random sample of 807 respondents consisting of doctors, nurses, paramedics and administrators to explore the relationships between various factors acting as antecedents in affecting the job satisfaction, commitment and intention of a healthcare professional to stay in the job. Structured questionnaires were utilized as the data collection tools. Descriptive statistics, factor analysis and path analysis were carried out using multiple regression and correlation to propose a model that best explains the theoretical assumption of factors leading to attrition. Six factors of attrition namely compensation and perks, work life balance, sense of accomplishment, work load, need for automation and technology improvement, substandard nature of work have been identified as the main factors with a data reliability of 0.809%. It has also been identified that the intention to shift is a major decision maker that affects attrition and in turn affected by job satisfaction dimensions. Based on the survey response and analysis, a highly possible strategy of utilizing information technology implementation for increasing worker motivation, job satisfaction and commitment to reduce attrition has been
R. K. Suri
Full Text Available Faced with a global shortage of skilled health workers due to attrition, countries are struggling to build and maintain an optimum knowledge workforce in healthcare for delivering quality healthcare services. Forces that affect healthcare professional turnover needs to be addressed before a competent uniformly adoptable strategy could be proposed for mitigating the problem. In this study we investigate the effect of the socio –demographic characteristics on attrition of healthcare knowledge workforce in northern parts of India that have a wide gradient of rural and urban belt, taking into account both public and private healthcare organizations. For this purpose healthcare professional attrition tracking survey (HATS was designed. The data has been collected from a random sample of 807 respondents consisting of doctors, nurses, paramedics and administrators to explore the relationships between various factors acting as antecedents in affecting the job satisfaction, commitment and intention of a healthcare professional to stay in the job. Structured questionnaires were utilized as the data collection tools. Both public and private healthcare organizations in urban and rural areas were covered for the survey. Descriptive statistics and factor analyses using analysis on Rotated Factor Matrix using Principal Components Analysis (PCA in SPSS 16.0 package were carried out. Six factors of attrition namely Compensation and perks, Work Life Balance, Sense of Accomplishment, Work load leading to exhaustion, Need for automation and technology improvement, Break Monotony of Work have been identified as the main factors with a data reliability of 0.809%. Based on the survey response and analysis, a highly possible strategy of utilizing information technology implementation for increasing worker motivation, job satisfaction and commitment to reduce attrition has been proposed.
Full Text Available Abstract Background Bangladesh is identified as one of the countries with severe health worker shortages. However, there is a lack of comprehensive data on human resources for health (HRH in the formal and informal sectors in Bangladesh. This data is essential for developing an HRH policy and plan to meet the changing health needs of the population. This paper attempts to fill in this knowledge gap by using data from a nationally representative sample survey conducted in 2007. Methods The study population in this survey comprised all types of currently active health care providers (HCPs in the formal and informal sectors. The survey used 60 unions/wards from both rural and urban areas (with a comparable average population of approximately 25 000 which were proportionally allocated based on a 'Probability Proportion to Size' sampling technique for the six divisions and distribution areas. A simple free listing was done to make an inventory of the practicing HCPs in each of the sampled areas and cross-checking with community was done for confirmation and to avoid duplication. This exercise yielded the required list of different HCPs by union/ward. Results HCP density was measured per 10 000 population. There were approximately five physicians and two nurses per 10 000, the ratio of nurse to physician being only 0.4. Substantial variation among different divisions was found, with gross imbalance in distribution favouring the urban areas. There were around 12 unqualified village doctors and 11 salespeople at drug retail outlets per 10 000, the latter being uniformly spread across the country. Also, there were twice as many community health workers (CHWs from the non-governmental sector than the government sector and an overwhelming number of traditional birth attendants. The village doctors (predominantly males and the CHWs (predominantly females were mainly concentrated in the rural areas, while the paraprofessionals were concentrated in the urban
Almutairi, Khalid M.
Objectives: To identify, synthesize, and summarize issues and challenges related to the culture and language differences of the health workforce in Saudi Arabia. Methods: A comprehensive systematic review was conducted in May 2014 to locate published articles. Two independent researchers in consultation with several experts used 4 electronic databases (ISI Web of Knowledge, Science Direct, PubMed, and Cochrane) to scrutinize articles published from January 2000 - March 2014. Each of the studies was given a quality assessment rating of weak, moderate, or strong, and was evaluated for methodological soundness using Russell and Gregory’s criteria. Results: The online literature search identified 12 studies that met the inclusion criteria. Lack of knowledge of non-Muslim nurses or culture in Saudi Arabia, difficulties in achieving cultural competence, and culture shock were documented as cultural difference factors. Issues in language difference include the clarity of language use by health care providers in giving information and providing adequate explanation regarding their activities. Conclusion: The available information provided by this review study shows that there is a communication barrier between patients and health care workers such as healthcare workers demonstrate low cultural competency. Despite the fact that the government provides programs for expatriate healthcare workers, there is a need to further improve educational and orientation programs regarding the culture and language in Saudi Arabia. PMID:25828278
Almutairi, Khalid M
To identify, synthesize, and summarize issues and challenges related to the culture and language differences of the health workforce in Saudi Arabia. A comprehensive systematic review was conducted in May 2014 to locate published articles. Two independent researchers in consultation with several experts used 4 electronic databases (ISI Web of Knowledge, Science Direct, PubMed, and Cochrane) to scrutinize articles published from January 2000 - March 2014. Each of the studies was given a quality assessment rating of weak, moderate, or strong, and was evaluated for methodological soundness using Russell and Gregory's criteria. The online literature search identified 12 studies that met the inclusion criteria. Lack of knowledge of non-Muslim nurses or culture in Saudi Arabia, difficulties in achieving cultural competence, and culture shock were documented as cultural difference factors. Issues in language difference include the clarity of language use by health care providers in giving information and providing adequate explanation regarding their activities. The available information provided by this review study shows that there is a communication barrier between patients and health care workers such as healthcare workers demonstrate low cultural competency. Despite the fact that the government provides programs for expatriate healthcare workers, there is a need to further improve educational and orientation programs regarding the culture and language in Saudi Arabia.
McDougle, Leon; Way, David P; Lee, Winona K; Morfin, Jose A; Mavis, Brian E; Matthews, De'Andrea; Latham-Sadler, Brenda A; Clinchot, Daniel M
The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of health care service to the poor and underserved and contribution to health care workforce diversity. We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for health care workforce diversity.
Lynge, Dana Christian; Larson, Eric H
Almost one quarter of America's population and one third of its landmass are defined as rural and served by approximately 20% of the nation's general surgeons. General surgeons are the backbone of the rural health workforce. There is significant maldistribution of general surgeons across regions and different types of rural areas. Rural areas have markedly fewer surgeons per population than the national average. The demography of the rural general surgery workforce differs substantially from the urban general surgery workforce, raising concerns about the extent to which general surgical services can be maintained in rural areas of the United States.
Horney, J A; Davis, M K; Ricchetti-Masterson, K L; MacDonald, P D M
In January 2003, the University of North Carolina Center for Public Health Preparedness established Team Epi-Aid to match graduate student volunteers with state and local health departments to assist with outbreaks and other applied public health projects. This study assessed whether Team Epi-Aid participation by full-time graduate students impacted post-graduation employment, particularly by influencing students to work in governmental public health upon graduation. In September 2010, 223 program alumni were contacted for an online survey and 10 selected for follow-up interviews. Eighty-three Team Epi-Aid alumni answered the survey (response rate = 37 %). Forty-one (49 %) reported participating in at least one activity, with 12/41 (29 %) indicating participation in Team Epi-Aid influenced their job choice following graduation. In 6 months prior to enrolling at UNC, 30 (36 %) reported employment in public health, with 16/30 (53 %) employed in governmental public health. In 6 months following graduation, 34 (41 %) reported employment in public health, with 27 (80 %) employed in governmental public health. Eight alumni completed telephone interviews (response rate = 80 %). Five credited Team Epi-Aid with influencing their post-graduation career. Experience in applied public health through a group such as Team Epi-Aid may influence job choice for public health graduates.
Zhang, Chi; Reichgelt, Han; Rutherfoord, Rebecca H.; Wang, Andy Ju An
Health Information Technology (HIT) professionals are in increasing demand as healthcare providers need help in the adoption and meaningful use of Electronic Health Record (EHR) systems while the HIT industry needs workforce skilled in HIT and EHR development. To respond to this increasing demand, the School of Computing and Software Engineering…
Full Text Available Abstract The impact of increased national wealth, as measured by Gross Domestic Product (GDP, on public health is widely understood, however an equally important but less well-acclaimed relationship exists between improvements in health and the growth of an economy. Communicable diseases such as HIV, TB, Malaria and the Neglected Tropical Diseases (NTDs are impacting many of the world's poorest and most vulnerable populations, and depressing economic development. Sickness and disease has decreased the size and capabilities of the workforce through impeding access to education and suppressing foreign direct investment (FDI. There is clear evidence that by investing in health improvements a significant increase in GDP per capita can be attained in four ways: Firstly, healthier populations are more economically productive; secondly, proactive healthcare leads to decrease in many of the additive healthcare costs associated with lack of care (treating opportunistic infections in the case of HIV for example; thirdly, improved health represents a real economic and developmental outcome in-and-of itself and finally, healthcare spending capitalises on the Keynesian 'economic multiplier' effect. Continued under-investment in health and health systems represent an important threat to our future global prosperity. This editorial calls for a recognition of health as a major engine of economic growth and for commensurate investment in public health, particularly in poor countries.
Popper-Giveon, Ariela; Keshet, Yael; Liberman, Ido
Despite recent attempts at increasing health care workforce diversity, a measure that was found to reduce health disparities, men remain a minority in the traditionally female occupation of nursing. One exception to this observation is the Arab ethnic minority in Israel that includes numerous male nurses. Determining the percentage of Arab male nurses in the Israeli health care system and understanding how they perceive and negotiate their masculinity. We used both quantitative and qualitative methodologies. Quantitative statistics were obtained from the 2011 to 2013 Labor Force Survey conducted by the Israel Central Bureau of Statistics and qualitative data derived from 13 semi-structured, in-depth interviews with Arab nurses working in Israeli public hospitals, conducted during 2014. Nursing constitutes a prominent employment path for Arab men in Israel and is more prominent as an employment path for Arab men than that for Jewish men. A total of 38.6% of all Arab nurses were men and only 7.5% of Jews and others. Quantitative data thus reveal that men do not constitute a minority among Arab nurses. Similarly, qualitative findings show that Arab male nurses do not manifest marginal masculinity but rather demonstrate many elements of hegemonic masculinity. Arab male nurses distinguish themselves and differentiate their roles from those of female nurses, expressing their motives for choosing the nursing profession in terms of hegemonic gender roles for men in Arab society in Israel. Although nursing is a traditionally female occupation, it offers an opportunity for Arab men to demonstrate their masculinity. Arab male nurses choose nursing as a means rather than an end, however, meaning that many of them might not remain in the profession. This observation is significant because of the importance of retaining men from ethnic minorities in nursing, especially in multicultural societies. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Abstract The importance of health workforce provision has gained significance and is now considered one of the most pressing issues worldwide, across all health professions. Against this background, the objectives of the work presented here were to systematically explore and identify contemporary issues surrounding expansion of the global pharmacy workforce in order to assist the International Pharmaceutical Federation working group on the workforce. International peer and non-peer-reviewed literature published between January 1998 and February 2008 was analysed. Articles were collated by performing searches of appropriate databases and reference lists of relevant articles; in addition, key informants were contacted. Information that met specific quality standards and pertained to the pharmacy workforce was extracted to matrices and assigned an evidence grade. Sixty-nine papers were identified for inclusion (48 peer reviewed and 21 non-peer-reviewed. Evaluation of evidence revealed the global pharmacy workforce to be composed of increasing numbers of females who were working fewer hours; this decreased their overall full-time equivalent contribution to the workforce, compared to male pharmacists. Distribution of pharmacists was uneven with respect to location (urban/rural, less-developed/more-developed countries and work sector (private/public. Graduates showed a preference for completing pre-registration training near where they studied as an undergraduate; this was of considerable importance to rural areas. Increases in the number of pharmacy student enrolments and pharmacy schools occurred alongside an expansion in the number and roles of pharmacy technicians. Increased international awareness and support existed for the certification, registration and regulation of pharmacy technicians and accreditation of training courses. The most common factors adding to the demand for pharmacists were increased feminization, clinical governance measures
Lapão, Luís Velez
The digital revolution is gradually transforming our society. What about the effects of digitalization and Internet of Things in healthcare? Among researchers two ideas are dominating, opposing each other. These arguments will be explored and analyzed. A mix-method approach combining literature review with the results from a focus group on eHealth impact on employment is used. Several experts from the WHO and from Health Professional Associations contributed for this analysis. Depending on the type of service it will entail reductions or more need of healthcare workers, yet whatever the scenario medical informatics will play an increasing role.
K.G. Tijdens (Kea); D.H. de Vries (Daniel); S.M. Steinmetz
textabstractBackground: This article represents the first attempt to explore remuneration in Human Resources for Health (HRH), comparing wage levels, ranking and dispersion of 16 HRH occupational groups in 20 countries (Argentina, Belarus, Belgium, Brazil, Chile, Colombia, the Czech Republic, Finlan
Tijdens, K.; de Vries, D.H.; Steinmetz, S.
Background This article represents the first attempt to explore remuneration in Human Resources for Health (HRH), comparing wage levels, ranking and dispersion of 16 HRH occupational groups in 20 countries (Argentina, Belarus, Belgium, Brazil, Chile, Colombia, the Czech Republic, Finland, Germany, I
Tijdens, K.; de Vries, D.H.
This article focuses on remuneration in the Human Resources for Health (HRH), comparing wage levels, ranking and dispersion of 16 HRH occupations in 20 countries (Argentina, Belarus, Belgium, Brazil, Chile, Colombia, Czech Republic, Finland, Germany, India, Mexico, Netherlands, Poland, Russian Feder
Mathur, Manu Raj; Singh, Ankur; Watt, Richard
Dentistry has always been an under-resourced profession. There are three main issues that dentistry is facing in the modern era. Firstly, how to rectify the widely acknowledged geographical imbalance in the demand and supply of dental personnel, secondly, how to provide access to primary dental care to maximum number of people, and thirdly, how to achieve both of these aims within the financial restraints imposed by the central and state governments. The trends of oral diseases have changed significantly in the last 20 years. The two of the most common oral diseases that affect a majority of the population worldwide, namely dental caries and periodontitis, have been proved to be entirely preventable. Even for life-threatening oral diseases like oral cancer, the best possible available treatment is prevention. There is a growing consensus that appropriate skill mix can prove very beneficial in providing these preventive dental care services to the public and aid in achieving the goal of universal oral health coverage. Professions complementary to dentistry (PCD) have been found to be effective in reducing inequalities in oral health, improving access and spreading the messages of health promotion across entire spectrum of socio-economic hierarchy in various studies conducted globally. This commentary provides a review of the effectiveness of skill mix in dentistry and a reflection on how this can be beneficial in achieving universal oral health care in India.
Manu Raj Mathur
Full Text Available Dentistry has always been an under-resourced profession. There are three main issues that dentistry is facing in the modern era. Firstly, how to rectify the widely acknowledged geographical imbalance in the demand and supply of dental personnel, secondly, how to provide access to primary dental care to maximum number of people, and thirdly, how to achieve both of these aims within the financial restraints imposed by the central and state governments. The trends of oral diseases have changed significantly in the last 20 years. The two of the most common oral diseases that affect a majority of the population worldwide, namely dental caries and periodontitis, have been proved to be entirely preventable. Even for life-threatening oral diseases like oral cancer, the best possible available treatment is prevention. There is a growing consensus that appropriate skill mix can prove very beneficial in providing these preventive dental care services to the public and aid in achieving the goal of universal oral health coverage. Professions complementary to dentistry (PCD have been found to be effective in reducing inequalities in oral health, improving access and spreading the messages of health promotion across entire spectrum of socio-economic hierarchy in various studies conducted globally. This commentary provides a review of the effectiveness of skill mix in dentistry and a reflection on how this can be beneficial in achieving universal oral health care in India.
Murray, Corey; Ullman, Ellen
Those following recent employment trends have heard about the nursing shortage. A combination of increased demand and impending retirements means 1 million nurses will be needed in hospitals, homes, and medical facilities by 2018. That's good news for job seekers. But it is not just shortages in nursing. Allied health careers, including…
Green, Geoff; Acres, John; Price, Charles; Tsouros, Agis
The objective of this evaluation was to review the evolution and process of city health development planning (CHDP) in municipalities participating in the Healthy Cities Network organized by the European Region of the World Health Organization. The concept of CHDP combines elements from three theoretical domains: (a) health development, (b) city governance and (c) urban planning. The setting was the 56 cities which participated in Phase III (1998-2002) of the Network. Evidence was gathered from documents either held in WHO archives or made available from Network cities and from interviews with city representatives. CHDPs were the centrepiece of Phase III, evolving from city health plans developed in Phase II. They are strategic documents giving direction to municipalities and partner agencies. Analysis revealed three types of CHDP, reflecting the realpolitik of each city. For many cities, the process of CHDP was as important as the plan itself.
Waltz, Edward C; Maniccia, Dayna M; Bryde, Regina L; Murphy, Kristin; Harris, Brett R; Waldenmaier, Mark N
This article describes lessons learned by the University at Albany Center for Public Health Preparedness (UA-CPHP) in using three technologies to deliver preparedness training for public health professionals in New York State. These three technologies are: 1. Audience response system (ARS, or the "clicker" system)--Purchased to improve engagement of all participants in heterogeneous training audiences, it also markedly reduces staff time while improving training evaluation (cost: $4,500). 2. Satellite broadcast programs--UA-CPHP produced more than 50 broadcasts, which remain available as videostreams and/or podcasts. Viewership of archived programs sometimes surpasses that of the live event (cost estimate: $23,000 to $39,000). 3. Interactive online courses--Seventeen courses have registered more than 44,000 learners worldwide. The Pandemic Influenza course alone has reached more than 16,000 registrants from all 50 U.S. states and at least 56 other countries (cost estimate: $30,000 to $65,000). UA-CPHP's experience as a preparedness training center has confirmed that contemporary technology can be employed to improve and increase the reach of these training efforts. An additional finding was that, quite unintentionally, the intensive use of distance-based educational modalities designed to reach public health practitioners in New York State has afforded UA-CPHP a substantial national and international audience as well, and at no additional cost.
Tinjum, James [Univ. of Wisconsin, Madison, WI (United States)
Significant advances in wind turbine technology and wind turbine power plant capabilities are appearing in the U.S. Sites that only 10 years ago might have been overlooked are being considered for build out. However, the development of a skilled workforce in the engineering fields and construction trades lags the potential market, especially if the industry is expected to site, design, construct, and operate sufficient wind power plant sites to meet the potential for 20% wind energy by 2030. A select few firms have penetrated the engineer-procure-construction (EPC) market of wind power plant construction. Competition and know-how in this market is vital to achieve cost-effective, design-construct solutions. The industry must produce or retrain engineers, contractors, and technicians to meet ambitious goals. Currently, few universities offer undergraduate or graduate classes that teach the basics in designing, building, and maintaining wind power plants that are safe, efficient, and productive.
Hall, Cathy W.; Pinelli, Thomas E.; Brush, Kimberly M.
Participants in this study were student interns and mentors taking part in the 2012, 10- week Langley Aerospace Research Student Scholars (LARSS) summer internship program in Hampton, Virginia. The study examined mentors and student interns' ratings of their preparedness in basic knowledge and skills. The study focused on three primary areas: 1) overall evaluation of knowledge and skills by mentors and interns; 2) male and female interns' perceptions of their own skills in these key areas; and 3) mentors' perceptions of their student interns' knowledge and skills in the same areas by gender. Overall mentors were more positive about their interns' improvement in 12 of 17 areas assessed than were the student interns. There were no significant gender differences in how mentors rated their male and female interns' abilities in these workforce skills, but there were four key areas where female interns rated their own abilities lower than did their male peers: analytical thinking, computational skills, computer skills and technical skills. Implications of these findings are discussed.
Gopinathan, Unni; Lewin, Simon; Glenton, Claire
To identify factors affecting the implementation of large-scale programmes to optimise the health workforce in low- and middle-income countries. We conducted a multicountry case study synthesis. Eligible programmes were identified through consultation with experts and using Internet searches. Programmes were selected purposively to match the inclusion criteria. Programme documents were gathered via Google Scholar and PubMed and from key informants. The SURE Framework - a comprehensive list of factors that may influence the implementation of health system interventions - was used to organise the data. Thematic analysis was used to identify the key issues that emerged from the case studies. Programmes from Brazil, Ethiopia, India, Iran, Malawi, Venezuela and Zimbabwe were selected. Key system-level factors affecting the implementation of the programmes were related to health worker training and continuing education, management and programme support structures, the organisation and delivery of services, community participation, and the sociopolitical environment. Existing weaknesses in health systems may undermine the implementation of large-scale programmes to optimise the health workforce. Changes in the roles and responsibilities of cadres may also, in turn, impact the health system throughout. © 2014 John Wiley & Sons Ltd.
Gilmore Anna B
Full Text Available Abstract Background Casino workers are exposed to high levels of secondhand smoke (SHS at work, yet remain at risk of being excluded from smoke-free legislation around the world. If the prime motivation for smoke-free legislation is the protection of workers, then a workforce experiencing ill-health associated with SHS exposure should not be excluded from legislation. This study aimed to determine the prevalence of respiratory and sensory irritation symptoms among a sample of casino workers, to identify any association between the reporting of symptoms and exposure to SHS at work, and to compare the prevalence of symptoms with that in other workers exposed to SHS. Methods A postal questionnaire survey of 1568 casino workers in London. Using multivariate analysis we identified predictors of respiratory and sensory irritation symptoms. Results 559 workers responded to the questionnaire (response of 36%. 91% of casino workers reported the presence of one or more sensory irritation symptoms in the previous four weeks, while the figure was 84% for respiratory symptoms. The presence of one or more sensory irritation symptoms was most strongly associated with reporting the highest exposure to SHS at work (OR 3.26; 1.72, 6.16. This was also true for reporting the presence of one or more respiratory irritation symptoms (OR 2.24; 1.34, 3.74. Prevalence of irritation symptoms in the casino workers was in general appreciably higher than that reported in studies of bar workers. Conclusion Our research supports the need for comprehensive smoke-free legislation around the world, covering all indoor workplaces including casinos.
Barnett Daniel J
Full Text Available Abstract Background The all-hazards willingness to respond (WTR of local public health personnel is critical to emergency preparedness. This study applied a threat-and efficacy-centered framework to characterize these workers' scenario and jurisdictional response willingness patterns toward a range of naturally-occurring and terrorism-related emergency scenarios. Methods Eight geographically diverse local health department (LHD clusters (four urban and four rural across the U.S. were recruited and administered an online survey about response willingness and related attitudes/beliefs toward four different public health emergency scenarios between April 2009 and June 2010 (66% response rate. Responses were dichotomized and analyzed using generalized linear multilevel mixed model analyses that also account for within-cluster and within-LHD correlations. Results Comparisons of rural to urban LHD workers showed statistically significant odds ratios (ORs for WTR context across scenarios ranging from 1.5 to 2.4. When employees over 40 years old were compared to their younger counterparts, the ORs of WTR ranged from 1.27 to 1.58, and when females were compared to males, the ORs of WTR ranged from 0.57 to 0.61. Across the eight clusters, the percentage of workers indicating they would be unwilling to respond regardless of severity ranged from 14-28% for a weather event; 9-27% for pandemic influenza; 30-56% for a radiological 'dirty' bomb event; and 22-48% for an inhalational anthrax bioterrorism event. Efficacy was consistently identified as an important independent predictor of WTR. Conclusions Response willingness deficits in the local public health workforce pose a threat to all-hazards response capacity and health security. Local public health agencies and their stakeholders may incorporate key findings, including identified scenario-based willingness gaps and the importance of efficacy, as targets of preparedness curriculum development efforts and
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…
Blue, Christine M; Lopez, Naty
In 2009, Minnesota Governor Pawlenty signed into law a bill approving the creation of a new dental team member: the dental therapist. The intent of this legislation was to address oral health disparities by creating a dental professional who would expand access to dental care in Minnesota. This study aimed to describe the characteristics of the first class of dental therapy students at the University of Minnesota and to ascertain the values and motivations that led them to choose a career in dental therapy. Four surveys were used to create the composite profile of the ten students in this first dental therapy class: 1) the California Critical Thinking Skills Test, 2) the Learning Type Measure, 3) the Attitudes Toward Healthcare Survey, and 4) a values and motivation survey that included demographic data. The results of the surveys revealed interacting influences of the students' background, personal self-concept, and environment leading to a career decision to pursue dental therapy.
Roy, Kakoli; Lang, Jason E.; Payne, Rebecca L.; Howard, David H.
Introduction Employers may incur costs related to absenteeism among employees who have chronic diseases or unhealthy behaviors. We examined the association between employee absenteeism and 5 conditions: 3 risk factors (smoking, physical inactivity, and obesity) and 2 chronic diseases (hypertension and diabetes). Methods We identified 5 chronic diseases or risk factors from 2 data sources: MarketScan Health Risk Assessment and the Medical Expenditure Panel Survey (MEPS). Absenteeism was measured as the number of workdays missed because of sickness or injury. We used zero-inflated Poisson regression to estimate excess absenteeism as the difference in the number of days missed from work by those who reported having a risk factor or chronic disease and those who did not. Covariates included demographics (eg, age, education, sex) and employment variables (eg, industry, union membership). We quantified absenteeism costs in 2011 and adjusted them to reflect growth in employment costs to 2015 dollars. Finally, we estimated absenteeism costs for a hypothetical small employer (100 employees) and a hypothetical large employer (1,000 employees). Results Absenteeism estimates ranged from 1 to 2 days per individual per year depending on the risk factor or chronic disease. Except for the physical inactivity and obesity estimates, disease- and risk-factor–specific estimates were similar in MEPS and MarketScan. Absenteeism increased with the number of risk factors or diseases reported. Nationally, each risk factor or disease was associated with annual absenteeism costs greater than $2 billion. Absenteeism costs ranged from $16 to $81 (small employer) and $17 to $286 (large employer) per employee per year. Conclusion Absenteeism costs associated with chronic diseases and health risk factors can be substantial. Employers may incur these costs through lower productivity, and employees could incur costs through lower wages. PMID:27710764
Cicutto, Lisa; Gleason, Melanie; Haas-Howard, Christy; Jenkins-Nygren, Lynn; Labonde, Susan; Patrick, Kathy
School health teams commonly address the needs of students with asthma, which requires specific knowledge and skills. To develop a skilled school health team, a competency-based framework for managing asthma in schools was developed. A modified Delphi with 31 panelists was completed. Consensus (=80% agreement) was reached for all 148 items…
Essary, Alison C; Wade, Nathaniel L
According to the most recent statistics from the National Center for Education Statistics, disparities in enrollment in undergraduate and graduate education are significant and not improving commensurate with the national population. Similarly, only 12% of graduating medical students and 13% of graduating physician assistant students are from underrepresented racial and ethnic groups. Established in 2012 to promote health care transformation at the organization and system levels, the School for the Science of Health Care Delivery is aligned with the university and college missions to create innovative, interdisciplinary curricula that meet the needs of our diverse patient and community populations. Three-year enrollment trends in the program exceed most national benchmarks, particularly among students who identify as Hispanic and American Indian/Alaska Native. The Science of Health Care Delivery program provides students a seamless learning experience that prepares them to be solutions-oriented leaders proficient in the business of health care, change management, innovation, and data-driven decision making. Defined as the study and design of systems, processes, leadership and management used to optimize health care delivery and health for all, the Science of Health Care Delivery will prepare the next generation of creative, diverse, pioneering leaders in health care.
Botchwey, Nisha D; Hobson, Susan E; Dannenberg, Andrew L; Mumford, Karen G; Contant, Cheryl K; McMillan, Tracy E; Jackson, Richard J; Lopez, Russell; Winkle, Curtis
Despite growing evidence of the direct and indirect effects of the built environment on public health, planners, who shape the built environment, and public health professionals, who protect the public's health, rarely interact. Most public health professionals have little experience with urban planners, zoning boards, city councils, and others who make decisions about the built environment. Likewise, few planners understand the health implications of design, land use, or transportation decisions. One strategy for bridging this divide is the development of interdisciplinary courses in planning and public health that address the health implications of the built environment. Professional networking and Internet-based searches in 2007 led to the identification of six primarily graduate-level courses in the U.S. that address the links between the built environment and public health. Common content areas in most of the identified courses included planning and public health histories, health disparities, interdisciplinary approaches, air and water quality, physical activity, social capital, and mental health. Instructors of these courses collaborated on course content, assignments, and evaluations to develop a model curriculum that follows an active learning-centered approach to course design. The proposed model curriculum is adaptable by both planning and public health departments to promote interdisciplinary learning. Results show that students gain planning and public health perspectives through this instruction, benefiting from active-learning opportunities. Faculty implementation of the proposed interdisciplinary model curriculum will help bridge the divide between the built environment and public health and enable both planners and public health professionals to value, create, and promote healthy environments.
Dreachslin, J L; Hunt, P L; Sprainer, E
This paper examines the implications of racial diversity for the self-perceived communication effectiveness of nursing care teams. An RN leads the nursing care team (NCT) and delivers care in collaboration with two or more nonlicensed caregivers. Overlap is intentionally designed into the roles of NCT members and the range of duties the team performs is generally expanded to include functions previously performed by personnel from centralized departments. NCTs are highly reliant on mutual respect and effective communication among team members. Team conflict and miscommunication can be exacerbated by the strong correlation between role on the nursing care team (NCT) and race. Verbatim transcripts of fourteen focus groups from two study hospitals were used to develop a grounded theory of the role that race plays in the self-perceived communication effectiveness of nursing care teams. Two themes that emerged from the focus group discussions constitute the overarching framework within which racially diverse team members evaluate team communication effectiveness: different perspectives and alternative realities. Three additional themes, social isolation, selective perception and stereotypes, that serve as reinforcing factors were also identified, i.e., these factors deepen the conflict and dissatisfaction with team communication that occurs as a natural consequence of the overarching framework of different perspectives and alternative realities. Leadership emerged as a powerful mitigating factor in the model of how race influences the self-perceived communication effectiveness of nursing care teams. Leaders who can transcend racial identity as evidenced by the ability to validate alternative realities and appreciate different perspectives appear to moderate the potential negative effects of racial diversity on team communication processes and strengthen the positive aspects of diversity.
Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public healthThe landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector.
Hannan, T; Brooks, P
Healthcare is considered a service profession and most of what clinicians do is manage information. Thus, information is not a necessary adjunct to care. It is care and effective patient management that require effective management of patients' clinical data. This perspective is supported by the World Health Organisation in its use of the quotation from Gonzalo Vecina Neto, head of the Brazilian National Health Regulatory Agency, 'There is no health without management, and there is no management without information'. This opinion paper discusses how traditional clinical decision-making led 'by the doctor' is unsustainable in the modern era and how e-technologies will facilitate distributed effective decision-making and new divisions of labour across the health workforce.
Department of Health and Children
Workforce planning identifies the composition of the workforce required to deliver health service goals. It encompasses a range of human resource activities aimed at the short, medium and long-term. Workforce planning that is integrated with service and financial planning offers the best opportunity for linking human resource decisions to the strategic goals for the health services. Systems and structures are required to support and develop workforce planning activities
Schwind, Jessica S.; Gilardi, Kirsten V. K.; Beasley, Val R.; Mazet, Jonna A. K.; Smith, Woutrina A.
Objectives: The objectives of this study were to assess whether the Envirovet programme served to increase the number of practising ecosystem health professionals, as well as to measure the lasting professional and personal impact of the programme on participants. Design: Impact programme evaluation. Setting: An emerging strategy among global…
McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C
This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency.
... specific prenatal tests to monitor both the mother's health and fetal health during each trimester. With modern technology, health professionals can Detect birth defects Identify problems that ...
Palazzo, Mary O
The evolution of care delivery from an acute care and inpatient standard to the outpatient setting and health promotion model is generating the need for innovative workforce and infrastructure adjustments to meet the new paradigm of population health management. Successful transformation of the nursing workforce necessitates a positive style of thinking that addresses rational concerns during times of difficult transition. Nurse leaders are called to recognize and appreciate the strengths of the nursing workforce by involving them in the course of change through collaboration, planning, and discussion. One unique way to plan and develop new care delivery models is to adopt the framework used in health facility planning and design for new services, units, or hospitals. This framework is flexible and can be adjusted easily to meet the objectives of a small nursing workforce innovation project or expanded to encompass the needs of a large-scale hospital transformation. Structured questioning further helps the team to identify barriers to care and allows for the development of new concepts that are objective and in accord with evidence-based practice and data. This article explores the advantages and disadvantages of implementing innovative workforce redesign and workforce reduction strategies.
Wright, Kate S; Thomas, Michael W; Durham, Dennis P; Jackson, Lillie M; Porth, Leslie L; Buxton, Mark
In December 2006, Congress passed the Pandemic and All-Hazards Preparedness Act to improve the nation's public health preparedness and response capabilities. It includes the role of Centers for Public Health Preparedness (CPHPs) to establish a competency-based core curriculum and perform evaluation of impact on newly developed materials. The Heartland Center for Public Health Preparedness (HCPHP) at the Saint Louis University School of Public Health is part of the Centers for Disease Control and Prevention national CPHP network and is engaged with state and regional partners in workforce development, preparedness planning, evaluation, and multi-year exercise and training cycles. This includes development, implementation, and evaluation of the HCPHP Exercise Evaluation Training Program to improve the competence and capacity for exercise evaluation and improvement planning. This program is designed to enhance quality improvement and performance measurement capabilities to identify increase of workforce competence over time (maturity).
Sharif, Muhammad U; Elsayed, Mohamed E; Stack, Austin G
Amidst the rising tide of chronic kidney disease (CKD) burden, the global nephrology workforce has failed to expand in order to meet the growing healthcare needs of this vulnerable patient population. In truth, this shortage of nephrologists is seen in many parts of the world, including North America, Europe, Australia, New Zealand, Asia and the African continent. Moreover, expert groups on workforce planning as well as national and international professional organizations predict further reductions in the nephrology workforce over the next decade, with potentially serious implications. Although the full impact of this has not been clearly articulated, what is clear is that the delivery of care to patients with CKD may be threatened in many parts of the world unless effective country-specific workforce strategies are put in place and implemented. Multiple factors are responsible for this apparent shortage in the nephrology workforce and the underpinning reasons may vary across health systems and countries. Potential contributors include the increasing burden of CKD, aging workforce, declining interest in nephrology among trainees, lack of exposure to nephrology among students and residents, rising cost of medical education and specialist training, increasing cultural and ethnic disparities between patients and care providers, increasing reliance on foreign medical graduates, inflexible work schedules, erosion of nephrology practice scope by other specialists, inadequate training, reduced focus on scholarship and research funds, increased demand to meet quality of care standards and the development of new care delivery models. It is apparent from this list that the solution is not simple and that a comprehensive evaluation is required. Consequently, there is an urgent need for all countries to develop a policy framework for the provision of kidney disease services within their health systems, a framework that is based on accurate projections of disease burden, a
Hughes, Charles Anthony; McMenamin, Patrick; Mehta, Vikas; Pillsbury, Harold; Kennedy, David
The number of trained otolaryngologists available is insufficient to supply current and projected US health care needs. The goal of this study was to assess available databases and present accurate data on the current otolaryngology workforce, examine methods for prediction of future health care needs, and explore potential issues with forecasting methods and policy implementation based on these predictions. Retrospective analysis of research databases, public use files, and claims data. The total number of otolaryngologists and current practices in the United States was tabulated using the databases of the American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Board of Otolaryngology, American College of Surgeons, Association of American Medical Colleges, National Center for Health Statistics, and Department of Health and Human Services. Otolaryngologists were identified as surgeons and classified into surgical groups using a combination of AMA primary and secondary self-reported specialties and American Board of Medical Specialties certifications. Data gathered were cross-referenced to rule out duplications to assess total practicing otolaryngologists. Data analyzed included type of practice: 1) academic versus private and 2) general versus specialty; and demographics: 1) urban versus rural, 2) patient age, 3) reason for visit (referral, new, established, surgical follow-up), 4) reason for visit (diagnosis), and 5) payer type. Analysis from the above resources estimates the total number of otolaryngologists practicing in the United States in 2011 to be 12,609, with approximately 10,522 fully trained practicing physicians (9,232-10,654) and 2,087 in training (1,318 residents and 769 fellows/others). Based on 2011 data, workforce projections would place the fully trained and practicing otolaryngology workforce at 11,088 in 2015 and 12,084 in 2025 unless changes in training occur. The AAO-HNS Physicians Resource Committee
Ruiz, Jennifer; Gilleskie, Gary L.; Brown, Patty; Burnett, Bruce; Carbonell, Ruben G.
The critical need for enhancing influenza pandemic preparedness in many developing nations has led the World Health Organization (WHO) and the Biomedical Advanced Research and Development Authority (BARDA), part of the U.S. Department of Health and Human Services (HHS), to develop an international influenza vaccine capacity-building program. Among…
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...
Grover, Atul; Orlowski, Janis M; Erikson, Clese E
There is much debate about the adequacy of the U.S. physician workforce and projections of its future size, distribution and composition. Beginning with 3 observations about the workforce we believe are largely not subject to dispute, we address the debate by providing an overview of the current state of the workforce and Graduate Medical Education in the United States; a brief history of both calls for graduate medical education reform since 1910 and the recent, intense debate about the reliability of workforce projections; and a discussion of the challenges to understanding the physician workforce. We draw 3 concluding observations: (1) Precisely because projections can be unpredictable in their impact on both physician workforce behavior and public policy development, policy makers need to devote more attention to workforce projections, not less. (2) More research devoted specifically to the workforce implications of delivery and payment reforms is strongly needed. (3) Such research must be pursued with a sense of urgency, given the rapid aging of the Baby Boom generation, which will put a disproportionate demand on the nation's physician workforce.
Holloway, Kathy; Baker, Jacqueline; Lumby, Judy
The current global nursing shortage challenges the provision of a well qualified and sustainable health workforce to meet future population health needs. An identified area of concern for New Zealand reaching health policy targets in chronic conditions management and primary health care is an adequate specialist nurse workforce supply. This article explores the New Zealand context underpinning this concern and contends that effective workforce planning would be supported by the development of a single unified framework for specialist nursing practice in New Zealand. A consistent national framework has the potential to support accurate data collection and enable service providers to identify and plan transparent and transferable pathways for specialist nursing service provision and development. Advanced practice nursing frameworks assist in increasing productivity through building an evidence base about advanced practice, enhancing consistency and equity of expertise; supporting a reduction in role duplication; and enabling succession planning and sustainability.
Munga, Michael A; Mwangu, Mughwira A
Although the Human Resources for Health (HRH) crisis is apparently not new in the public health agenda of many countries, not many low and middle income countries are using Primary Health Care (PHC) as a tool for planning and addressing the crisis in a comprehensive manner. The aim of this paper is to appraise the inadequacies of the existing planning approaches in addressing the growing HRH crisis in resource limited settings. A descriptive literature review of selected case studies in middle and low income countries reinforced with the evidence from Tanzania was used. Consultations with experts in the field were also made. In this review, we propose a conceptual framework that describes planning may only be effective if it is structured to embrace the fundamental principles of PHC. We place the core principles of PHC at the centre of HRH planning as we acknowledge its major perspective that the effectiveness of any public health policy depends on the degree to which it envisages to address public health problems multi-dimensionally and comprehensively. The proponents of PHC approach in planning have identified inter-sectoral action and collaboration and comprehensive approach as the two basic principles that policies and plans should accentuate in order to make them effective in realizing their pre-determined goals. Two conclusions are made: Firstly, comprehensive health workforce planning is not widely known and thus not frequently used in HRH planning or analysis of health workforce issues; Secondly, comprehensiveness in HRH planning is important but not sufficient in ensuring that all the ingredients of HRH crisis are eliminated. In order to be effective and sustainable, the approach need to evoke three basic values namely effectiveness, efficiency and equity.
Mascarenhas, Ana Karina; Atchison, Kathryn Ann
Dental professionals are an "underutilized" workforce, when it comes to advocating for prevention and wellness in populations. The goal of this HRSA-funded project is to develop dental public health (DPH) competencies and curriculum for US predoctoral dental and dental hygiene programs. These competencies and accompanying curriculum are designed to better prepare the oral health workforce to meet the needs of the entire population, including the chronically underserved, those challenged by poor health literacy, or communities encountering barriers to accessing oral health care. By increasing the DPH competency of all graduating dental providers, in population-based approaches to preventing oral diseases rather than the existing exclusive focus on treatment, the number of providers who can respond to a population or the public's unmet needs and challenges, both in private practices and publicly supported clinics, will increase. This paper describes the competency development process and the eight competencies that were identified.
Rolfe, Ben; Leshabari, Sebalda; Rutta, Fredrik; Murray, Susan F
The human resource crisis in health care is an important obstacle to attainment of the health-related targets for the Millennium Development Goals. One suggested strategy to alleviate the strain upon government services is to encourage new forms of non-government provision. Detail on implementation and consequences is often lacking, however. This article examines one new element of non-government provision in Tanzania: small-scale independent midwifery practices. A multiple case study analysis over nine districts explored their characteristics, and the drivers and inhibitors acting upon their development since permitted by legislative change. Private midwifery practices were found concentrated in a 'new' workforce of 'later life entrepreneurs': retired, or approaching retirement, government-employed nursing officers. Provision was entirely facility-based due to regulatory requirements, with approximately 60 'maternity homes' located mainly in rural or peri-urban areas. Motivational drivers included fear of poverty, desire to maintain professional status, and an ethos of community service. However, inhibitors to success were multiple. Start-up loans were scarce, business training lacking and registration processes bureaucratic. Cost of set-up and maintenance were prohibitively high, registration required levels of construction and equipping similar to government sector dispensaries. Communities were reluctant to pay for services that they expected from government. Thus, despite offering a quality of basic maternity care comparable to that in government facilities, often in poorly-served areas, most private maternity homes were under-utilized and struggling for sustainability. Because of their location and emphasis on personalized care, small-scale independent practices run by retired midwives could potentially increase rates of skilled attendance at delivery at peripheral level. The model also extends the working life of members of a professional group at a time of
Full Text Available Organizational and individual learning are two different concepts in contemporary
organizational theory. Organizational learning is a difficult concept which needs to be further
elucidated for organizational practitioner at actual work setting; especially in the developing
countries like Pakistan. This paper reviews the literature on organizational learning in
transformational change, and the comparative learning processes in the developed and
developing economies. Furthermore, we are dealing here with the proposed learning cycle in
strategic change process with special reference to the developing countries.
Keywords: Learning cycle, Transformational change, Innovation, Learning Dynamics
Singer, Sara; Meterko, Mark; Baker, Laurence; Gaba, David; Falwell, Alyson; Rosen, Amy
Objective To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. Data Sources/Study Setting Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. Study Design Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. Data Collection We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). Principal Findings We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's α coefficients ranged from 0.50 to 0.89. Conclusions It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes. PMID:17850530
Tyler, Mark; Dymock, Darryl
This occasional paper provides a stocktake of recent developments in continuing professional development for VET practitioners. It explores issues such as industry currency, the debate around a professional association for VET and the Certificate IV in Training and Assessment as the minimum qualification for VET practitioners. Through synthesising…
Shuck, Michael Bradley; Wollard, Karen Kelly
Tomorrow's workforce is seeking more than a paycheck; they want their work to meet their needs for affiliation, meaning, and self-development. Companies willing to meet these demands will capture the enormous profit potential of a workforce of fully engaged workers. This piece explores what engagement is, why it matters, and how human resource…
St. John, Mark; Castori, Pam
This brief presents a third party, external perspective on the Akamai Workforce Initiative (AWI), highlighting some of the contributions of the initiative over the last ten years. AWI is a program that seeks to develop a skilled local STEM workforce to meet the needs of Hawai'i's growing high-tech industry. It began as an internship program…
Oluoch, Tom; Muturi, David; Kiriinya, Rose; Waruru, Anthony; Lanyo, Kevin; Nguni, Robert; Ojwang, James; Waters, Keith P; Richards, Janise
Sub-Saharan Africa (SSA) bears the heaviest burden of the HIV epidemic. Health workers play a critical role in the scale-up of HIV programs. SSA also has the weakest information and communication technology (ICT) infrastructure globally. Implementing interoperable national health information systems (HIS) is a challenge, even in developed countries. Countries in resource-limited settings have yet to demonstrate that interoperable systems can be achieved, and can improve quality of healthcare through enhanced data availability and use in the deployment of the health workforce. We established interoperable HIS integrating a Master Facility List (MFL), District Health Information Software (DHIS2), and Human Resources Information Systems (HRIS) through application programmers interfaces (API). We abstracted data on HIV care, health workers deployment, and health facilities geo-coordinates. Over 95% of data elements were exchanged between the MFL-DHIS and HRIS-DHIS. The correlation between the number of HIV-positive clients and nurses and clinical officers in 2013 was R2=0.251 and R2=0.261 respectively. Wrong MFL codes, data type mis-match and hyphens in legacy data were key causes of data transmission errors. Lack of information exchange standards for aggregate data made programming time-consuming.
Blank, Jos L T; van Hulst, Bart L
Well-trained, well-distributed and productive health workers are crucial for access to high-quality, cost-effective healthcare. Because neither a shortage nor a surplus of health workers is wanted, policymakers use workforce planning models to get information on future labour markets and adjust policies accordingly. A neglected topic of workforce planning models is productivity growth, which has an effect on future demand for labour. However, calculating productivity growth for specific types of input is not as straightforward as it seems. This study shows how to calculate factor technical change (FTC) for specific types of input. The paper first theoretically derives FTCs from technical change in a consistent manner. FTC differs from a ratio of output and input, in that it deals with the multi-input, multi-output character of the production process in the health sector. Furthermore, it takes into account substitution effects between different inputs. An application of the calculation of FTCs is given for the Dutch hospital industry for the period 2003-2011. A translog cost function is estimated and used to calculate technical change and FTC for individual inputs, especially specific labour inputs. The results show that technical change increased by 2.8% per year in Dutch hospitals during 2003-2011. FTC differs amongst the various inputs. The FTC of nursing personnel increased by 3.2% per year, implying that fewer nurses were needed to let demand meet supply on the labour market. Sensitivity analyses show consistent results for the FTC of nurses. Productivity growth, especially of individual outputs, is a neglected topic in workforce planning models. FTC is a productivity measure that is consistent with technical change and accounts for substitution effects. An application to the Dutch hospital industry shows that the FTC of nursing personnel outpaced technical change during 2003-2011. The optimal input mix changed, resulting in fewer nurses being needed to let
Valantine, Hannah A.; Lund, P. Kay; Gammie, Alison E.
The National Institutes of Health (NIH) is committed to attracting, developing, and supporting the best scientists from all groups as an integral part of excellence in training. Biomedical research workforce diversity, capitalizing on the full spectrum of skills, talents, and viewpoints, is essential for solving complex human health challenges.…
Brown, David; Maxwell, Sarah; DeJesus, Edward; Schiraldi, Vincent
This publication is part of a toolkit that examines systemic barriers to achieving economic self-sufficiency for court-involved youth. It highlights 15 exemplary programs in the world of criminal justice for young people. The programs are all based on youth development principles and are guided by a comprehensive set of core principles that view…
Kube, Connie; Dempsey, Sarah J.; Pohlman, Charles
Educational, industry, and state leaders worked together to design a program to meet the training needs of Nebraska's fast-growing ethanol industry. The statewide initiative, guided by Northeast Community College and funded through the President's Community-Based Job Training Grants program, is developing dual-credit, short-term training that…
Baring-Gould, I.; Flowers, L.; Kelly, M.; Barnett, L.; Miles, J.
This paper provides an overview of the Wind for Schools project elements, including a description of host and collegiate school curricula developed for wind energy and the status of the current projects. The paper also provides focused information on how schools, regions, or countries can become involved or implement similar projects to expand the social acceptance and understanding of wind energy.
Like all biomedical research fields, AIDS research needs the broadest diversity of experiences and perspectives among researchers in the field if creative advancements are to be achieved. Mentors and mentoring are the most important vehicles by which the talents of young scientists are developed. However, mentoring as a teaching and learning paradigm is very complex and idiosyncratic, and often inadvertently fails to provide the same quality and quantity of opportunity to aspiring scientists who are 'different' from those doing the mentoring. This article provides a theoretical and practical framework for understanding how differences of race, ethnicity, gender, skin color, social status and other identifiable characteristics can play into scientific development during mentoring 'within the pipeline'. It also serves as a foundation upon which mentoring in AIDS is considered by subsequent papers in this series. Finally, it goes beyond mentoring to propose systematic coaching as an effective complement to research mentoring to promote success, especially for individuals from underrepresented groups.
Carl Irwin; Rakesh Gupta; Richard Turton; GangaRao Hota; Cyril Logar; Tom Ponzurick; Buddy Graham; Walter Alcorn; Jeff Tucker
The Mid-Atlantic Recycling Center for End-of-Life Electronics (MARCEE) was set up in 1999 in response to a call from Congressman Alan Mollohan, who had a strong interest in this subject. A consortium was put together which included the Polymer Alliance Zone (PAZ) of West Virginia, West Virginia University (WVU), DN American and Ecolibrium. The consortium developed a set of objectives and task plans, which included both the research issues of setting up facilities to demanufacture End-of-Life Electronics (EoLE), the economics of the demanufacturing process, and the infrastructure development necessary for a sustainable recycling industry to be established in West Virginia. This report discusses the work of the MARCEE Project Consortium from November 1999 through March 2005. While the body of the report is distributed in hard-copy form the Appendices are being distributed on CD's.
Mel Croucher; Rakesh Gupta; Hota GangaRao; Darran Cairns; Jinzing Wang; Xiaodong Shi; Jason Linnell; Karen Facemyer; Doug Ritchie; Jeff Tucker
The MARCEE Project was established to understand the problems associated with electronics recycling and to develop solutions that would allow an electronics recycling industry to emerge. While not all of the activities have been funded by MARCEE, but through private investment, they would not have occurred had the MARCEE Project not been undertaken. The problems tackled and the results obtained using MARCEE funds are discussed in detail in this report.
Nichols, Barbara L; Davis, Catherine R; Richardson, Donna R
Migration has been a way of life since the beginning of time, with migrants seeking other lands for personal and professional betterment. Today, in an era of globalization, trade agreements and technological advances, an increase in migration is inevitable. All professions have been affected, but the migration of health professionals, particularly nurses, has been the most dramatic. However, the migration of nurses across national and international borders comes with many challenges: systematic tracking of migration flows, harmonization of standards, recognition of professional credentials, fair and equitable distribution of the global health care workforce, and the effect of migration on the health care infrastructure of both source and destination countries. The international migration of nurses to address shortages in developed countries has, in some instances, left source countries with insufficient resources to address their own health care needs. The increasing complexity of health care delivery, aging of the population and the nursing workforce, and the escalating global demand for nurses create on-going challenges for policy makers. Strategically addressing global nursing workforce issues is paramount to sustaining the health of nations.
Callister, Paul; Badkar, Juthika; Didham, Robert
Severe staff and skill shortages within the health systems of developed countries have contributed to increased migration by health professionals. New Zealand stands out among countries in the Organisation for Economic Co-operation and Development in terms of the high level of movements in and out of the country of skilled professionals, including nurses. In New Zealand, much attention has been given to increasing the number of Māori and Pacific nurses as one mechanism for improving Māori and Pacific health. Against a backdrop of the changing characteristics of the New Zealand nursing workforce, this study demonstrates that the globalisation of the nursing workforce is increasing at a faster rate than its localisation (as measured by the growth of the Māori and New Zealand-born Pacific workforces in New Zealand). This challenges the implementation of culturally appropriate nursing programmes based on the matching of nurse and client ethnicities.
Zheng, Jingmin; Li, Jie; Jiang, Xingxing; Zhang, Bin
Township hospitals, the main provider of rural primary healthcare in China, are severely understaffed. International studies on factors influencing rural working are increasing; however, studies on factors affecting the recruitment and retention of health workers in Chinese township hospitals are limited. The current study aims to understand the motivation of health workers and arrive at a systematic framework of pluralistic factors that would help support health workers in terms of receiving posts and remaining in posts in township hospitals. A three-stage integrated quantitative and qualitative methodology was employed. First, a survey on 120 directors of township hospitals was conducted to learn the latest status of health workers in township hospitals and distinguish existing problems. Second, after sending these problems back to the directors, an open-ended pen-and-paper survey was conducted to ask the directors to identify the factors influencing the attraction and retention of health workers in township hospitals. Third, four focus groups were conducted to gauge the underlying reasons. Five problems from the questionnaire survey were recognized, and numbers of thematic factors were identified at the individual, professional, and treatment environment from the pen-and-paper survey and focus group. Similar to other studies, this framing of both non-financial and financial elements affected the attraction and retention of health workers in township hospitals, thereby filling the gap in a Chinese context. Although several factors had been recognized earlier, our findings further highlighted the importance of these factors. Meanwhile, the factors identified in this study were barely explored in literature. This paper identifies and develops multi-faceted factors to call for a bundled package of multidimensional incentives if decision-makers get interested. The evidence-based findings in our study can be used to provide China-specific policy recommendations on how
Sprang, Ginny; Silman, Miriam
Behavioral health professional organizations are in the unique role of aggregating and disseminating information to their membership before, during, and after health-related disasters to promote the integration of behavioral health services into the public health disaster response plan. This article provides a set of 5 principles to direct this undertaking that are based on the current literature and previous evaluation of the online guidance provided by 6 prominent behavioral health professional organizations. These principles use a strengths-based approach to prioritize resilience; underscore the importance of context, collaboration, and coordination; recognize the unique needs of pediatric populations; and guide ongoing training and content development in the area of biopsychosocial responses to health-related disasters. Recognizing important innovations and strides made by the behavioral health organizations noted in a previous study, this article recommends additional areas in which behavioral health professional organizations can contribute to overall pandemic disaster preparedness and response efforts.
Naccarella, Lucio; Osborne, Richard H; Brooks, Peter M
People with chronic complex conditions continue to experience increasing health system fragmentation and poor coordination. To reverse these trends, one solution has been an investment in effective models of care coordination that use a care coordinator workforce. Care coordinators are not a homogenous workforce - but an applied professional role, providing direct and indirect care, and is often undertaken by nurses, allied health professionals, social workers or general practitioners. In Australia, there is no training curriculum nor courses, nor nationally recognised professional quality standards for the care coordinator workforce. With the growing complexity and fragmentation of the health care system, health system literacy - shared understanding of the roles and contributions of the different workforce professions, organisations and systems, among patients and indeed the health workforce is required. Efforts to improve health system literacy among the health workforce are increasing at a policy, practice and research level. However, insufficient evidence exists about what are the health system literacy needs of care coordinators, and what is required for them to be most effective. Key areas to build a health system literate care coordination workforce are presented. Care coordination is more than an optional extra, but one of the only ways we are going to be able to provide equitable health services for people with chronic complex conditions. People with low health literacy require more support with the coordination of their care, therefore we need to build a high performing care coordinator workforce that upholds professional quality standards, and is health literacy responsive.
Fox, Elise B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Edwards, Thomas B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)
The South Carolina solar industry has surged over the past two years, largely due to the implementation of Act 236, and continues to grow at a rapid pace. At the beginning of 2014, there was little more than 3MW total spread across the state, but by the end of 2021, that state solar industry will have grown to over 300MW across all sectors. Prior to this study, there has been little publically available information on the solar industry in SC and throughout the Southeastern US. This makes SC a key case study of an emerging market, enabling the development of regional best practices in order to decrease associated costs and increase deployment.
E. Oluwabunmi Olapade-Olaopa
Full Text Available Recent proposals for re-defining the roles Africa’s health workforce are a continuation of the discussions that have been held since colonial times. The proposals have centred on basing the continent’s healthcare delivery on non-physician clinicians (NPCs who can be quickly trained and widely distributed to treat majority of the common diseases. Whilst seemingly logical, the success of these proposals will depend on the development of clearly defined professional duties for each cadre of healthcare workers (HCW taking the peculiarities of each country into consideration. As such the continent-wide efforts aimed at health-professional curriculum reforms, more effective utilisation of task-shifting as well as the intra – and inter-disciplinary collaborations must be encouraged. Since physicians play a major role in the training mentoring and supervision of physician and nonphysician health-workers alike, the maintenance of the standards of university medical education is central to the success of all health system models. It must also be recognized that, efforts at improving Africa’s health systems can only succeed if the necessary socio-economic, educational, and technological infrastructure are in place.
Blackburn,N.; White, K.; Stegman, M.
The Faculty and Student Teams (FaST) Program, a cooperative effort between the US Department of Energy (DOE) Office of Science and the National Science Foundation (NSF), brings together collaborative research teams composed of a researcher at Brookhaven National Laboratory, and a faculty member with two or three undergraduate students from a college or university. Begun by the Department of Energy in 2000 with the primary goal of building research capacity at a faculty member's home institution, the FaST Program focuses its recruiting efforts on faculty from colleges and universities with limited research facilities and those institutions that serve populations under-represented in the fields of science, engineering and technology, particularly women and minorities. Once assembled, a FaST team spends a summer engaged in hands-on research working alongside a laboratory scientist. This intensely collaborative environment fosters sustainable relationships between the faulty members and BNL that allow faculty members and their BNL colleagues to submit joint proposals to federal agencies, publish papers in peer-reviewed journals, reform local curriculum, and develop new or expand existing research labs at their home institutions.
Chiarella, Mary; Roydhouse, Jessica K
Health workforce planning is a priority for Australian governments at both state and federal levels. Nursing shortages are a significant problem and addressing these shortages is likely to be a component of any workforce plan. This paper looks at the case of hospital nursing and argues that casemix, workforce and management instability inhibit workforce planning for hospital nursing. These issues are related and any efforts to objectively plan the hospital nursing workforce must seek to address them in order to succeed.
Naccarella, Lucio; Osborne, Richard H.; Brooks, Peter M.
People with chronic complex conditions continue to experience increasing health system fragmentation and poor coordination. To reverse these trends, one solution has been an investment in effective models of care coordination that use a care coordinator workforce. Care coordinators...... standards for the care coordinator workforce. With the growing complexity and fragmentation of the health care system, health system literacy - shared understanding of the roles and contributions of the different workforce professions, organisations and systems, among patients and indeed the health...... workforce is required. Efforts to improve health system literacy among the health workforce are increasing at a policy, practice and research level. However, insufficient evidence exists about what are the health system literacy needs of care coordinators, and what is required for them to be most effective...
Finding Your Workforce: The Top 25 Institutions Graduating Latinos in Health Professions and Related Programs by Academic Level. Second in a Series Linking College Completion with U.S. Workforce Needs
Santiago, Deborah A.
The population growth, labor force participation, and educational attainment of Latinos in the U.S. influence the composition of the current and future U.S. society, economy, and workforce. In 2012, the Latino population in the United States is the youngest and fastest growing ethnic group, with the highest level of labor force participation…
Castrucci, Brian C; Leider, Jonathon P; Sellers, Katie
Policy development is recognized as a core function of public health and a core competency in formal public health education. However, relatively little is known nationally about worker perceptions and competencies related to policy development in the governmental public health workforce. To characterize perceived importance and presence or absence of competency gaps related to policy development. As part of the Public Health Workforce Interests and Needs Survey (PH WINS), a nationally representative stratified sample of permanently employed state health agency (SHA) central office staff was created. Descriptive and inferential analyses examined correlates of perceived importance and competency gaps related to policy development. Permanently employed central office employees of SHAs. Analyses focus on 2 self-reported measures of perceived importance and ability related to policy development skills, as well as awareness and perceptions regarding Health in All Policies (HiAP). Seventy-two percent of SHA central office staff (95% confidence interval, 71-73) indicated "influencing policy development" was somewhat or very important to their day-to-day work. Among that group, 35% (95% confidence interval, 34-36) reported that they were unable to perform this or they considered themselves to be a beginner at this skill. Approximately three-fourths of staff indicated "understanding the relationship between a new policy and many types of public health problems" was somewhat or very important, and 30% of those who did said they were unable to perform this skill or were a beginner at it. Nationally, one-half of staff have not heard of HiAP. Among those who have, 86% indicated it was somewhat or very important to public health, and 41% reported they would like to see more emphasis on HiAP. Workforce development, both formal education and on-the-job training, may benefit from placing a greater emphasis on the development of policy skills. HiAP is an important approach to policy
Maria C. Dolce
Full Text Available Nurses are positioned to play a significant role in oral health promotion and disease prevention across the life cycle. Oral health has not been a high priority in nursing practice, and educating nurses about oral health has been inadequate particularly regarding the interrelationship between oral health and overall health. The first step for developing a nursing workforce with core competencies in oral health promotion and disease prevention is to prepare nurse faculty with the requisite knowledge, skills, attitudes, and best practices in oral-systemic health. The purpose of this paper is to present Smiles for Life: A National Oral Health Curriculum as a knowledge framework that nurse faculty can use for faculty enrichment and competency development in oral health across the life cycle. A variety of teaching-learning strategies and resources are provided to assist nurse faculty with integrating oral-systemic health into existing nursing curricula.
Though public health situation in Nepal is under-developed, the public health education and workforce has not been prioritised. Nepal should institutionalise public health education by means of accrediting public health courses, registration of public health graduates in a data bank and increasing job opportunities for public health graduates in various institutions at government sector.
Marjanovic, Sonja; Robin, Enora; Harte, Emma; MacLure, Calum; Walton, Clare; Pickett, James
Objectives To identify research support strategies likely to be effective for strengthening the UK's dementia research landscape and ensuring a sustainable and competitive workforce. Design Interviews and qualitative analysis; systematic internet search to track the careers of 1500 holders of UK doctoral degrees in dementia, awarded during 1970–2013, to examine retention in this research field and provide a proxy profile of the research workforce. Setting and participants 40 interviewees based in the UK, whose primary role is or has been in dementia research (34 individuals), health or social care (3) or research funding (3). Interviewees represented diverse fields, career stages and sectors. Results While the UK has diverse strengths in dementia research, needs persist for multidisciplinary collaboration, investment in care-related research, supporting research-active clinicians and translation of research findings. There is also a need to better support junior and midlevel career opportunities to ensure a sustainable research pipeline and future leadership. From a sample of 1500 UK doctorate holders who completed a dementia-related thesis in 1970–2013, we identified current positions for 829 (55%). 651 (43% of 1500) could be traced and identified as still active in research (any field) and 315 (21%) as active in dementia research. Among recent doctoral graduates, nearly 70% left dementia research within 4–6 years of graduation. Conclusions A dementia research workforce blueprint should consider support for individuals, institutions and networks. A mix of policy interventions are needed, aiming to attract and retain researchers; tackle bottlenecks in career pathways, particularly at early and midcareer stages (eg, scaling-up fellowship opportunities, rising star programmes, bridge-funding, flexible clinical fellowships, leadership training); and encourage research networks (eg, doctoral training centres, succession and sustainability planning
Dugan, Alicia G; Farr, Dana A; Namazi, Sara; Henning, Robert A; Wallace, Kelly N; El Ghaziri, Mazen; Punnett, Laura; Dussetschleger, Jeffrey L; Cherniack, Martin G
Correctional Officers (COs) have among the highest injury rates and poorest health of all the public safety occupations. The HITEC-2 (Health Improvement Through Employee Control-2) study uses Participatory Action Research (PAR) to design and implement interventions to improve health and safety of COs. HITEC-2 compared two different types of participatory program, a CO-only "Design Team" (DT) and "Kaizen Event Teams" (KET) of COs and supervisors, to determine differences in implementation process and outcomes. The Program Evaluation Rating Sheet (PERS) was developed to document and evaluate program implementation. Both programs yielded successful and unsuccessful interventions, dependent upon team-, facility-, organizational, state-, facilitator-, and intervention-level factors. PAR in corrections, and possibly other sectors, depends upon factors including participation, leadership, continuity and timing, resilience, and financial circumstances. The new PERS instrument may be useful in other sectors to assist in assessing intervention success. Am. J. Ind. Med. 59:897-918, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Datz, David; Hallberg, Colleen; Harris, Kathy; Harrison, Lisa; Samples, Patience
Banner Health has long recognized the need to anticipate, beyond the immediate operational realities or even the annual budgeting projection exercises, the necessary workforce needs of the future. Thus, in 2011, Banner implemented a workforce planning model that included structures, processes, and tools for predicting workforce needs, with particular focus on identified critical systemwide practice areas. The model represents the incorporation of labor management tools and processes with more strategic, broad-view, long-term assessment and planning mechanisms. The sequential tying of the workforce planning lifecycle with the organization's strategy and financial planning process supports alignment of goals, objectives, and resource allocation. Collaboration among strategy, finance, human resources, and operations has provided us with the ability to identify critical position groups based on 3-year strategic priorities. By engaging leaders from across the organization, focusing on activities at facility, regional, and system levels, and building in mechanisms for accountability, we are now engaged in continuous evaluations of our delivery models, the competencies and preparations necessary for the staff to effectively function within those delivery models, and developing and implementing action plans designed to ensure adequate numbers of the staff whose competencies will be suited to the work expected of them.
Full Text Available Abstract There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening. With increased travel and urbanization, the threat of emerging diseases of pandemic potential is increasing alongside endemic diseases such as human immunodeficiency virus (HIV, tuberculosis (TB, malaria, and hepatitis virus infections. At the same time, the epidemiologic patterns are shifting, giving rise to a concurrent increase in disease burden due to non-communicable diseases. These diseases can be addressed by public health surveillance and response systems that are operated by competent public health workers in core public health positions at national and sub-national levels with a focus on disease prevention. We describe two ways that health ministries in developing countries could leverage President Obama’s Global Health Initiative (GHI to build public health surveillance and response systems using proven models for public health systems strengthening and to create the public health workforce to operate those systems. We also offer suggestions for how health ministries could strengthen public health systems within the broad health systems strengthening agenda. Existing programs (e.g., the Global Vaccine Alliance [GAVI] and the Global Fund Against Tuberculosis, AIDS, and Malaria [GFTAM] can also adapt their current health systems strengthening programs to build sustainable public health systems.
Sopher, Carrie J; Adamson, Blythe Jane S; Andrasik, Michele P; Flood, Danna M; Wakefield, Steven F; Stoff, David M; Cook, Ryan S; Kublin, James G; Fuchs, Jonathan D
We developed and evaluated a novel National Institutes of Health-sponsored Research and Mentorship Program for African American and Hispanic medical students embedded within the international, multisite HIV Vaccine Trials Network, and explored its impact on scientific knowledge, acquired skills, and future career plans. Scholars conducted social, behavioral, clinical, or laboratory-based research projects with HIV Vaccine Trials Network investigators over 8 to 16 weeks (track 1) or 9 to 12 months (track 2). We conducted an in-depth, mixed-methods evaluation of the first 2 cohorts (2011-2013) to identify program strengths, areas for improvement, and influence on professional development. A pre-post program assessment demonstrated increases in self-reported knowledge, professional skills, and interest in future HIV vaccine research. During in-depth interviews, scholars reported that a supportive, centrally administered program; available funding; and highly involved mentors and staff were keys to the program's early success. A multicomponent, mentored research experience that engages medical students from underrepresented communities and is organized within a clinical trials network may expand the pool of diverse public health scientists. Efforts to sustain scholar interest over time and track career trajectories are warranted.
Fraher, Erin P; Jones, Cheryl B
Nurses are the single largest component of North Carolina's health workforce, and nursing jobs are an essential driver of the state's economic recovery. We propose 5 recommendations for creating a nursing workforce system that, if implemented, would position the state to meet the future health care needs of North Carolinians.
Worm Hansen, Casper
Previous research establishes that the rise in life expectancy during the second half of the twentieth century led to larger, but not wealthier, populations. In terms of the neoclassical growth theory, these findings indicate that the potential positive effects of health on human capital...... and productivity ðTFPÞ are limited. The current paper decomposes this corollary. Specifically, it demonstrates that life expectancy promotes human capital skills, which, according to the neoclassical theory, suggests that the TFP elasticity with respect to health is close to zero....
Worm Hansen, Casper
Previous research establishes that the rise in life expectancy during the second half of the twentieth century led to larger, but not wealthier, populations. In terms of the neoclassical growth theory, these findings indicate that the potential positive effects of health on human capital and prod......Previous research establishes that the rise in life expectancy during the second half of the twentieth century led to larger, but not wealthier, populations. In terms of the neoclassical growth theory, these findings indicate that the potential positive effects of health on human capital...
Background. Female health workers (FHWs), posted at subcentres, each serving a rural population of 3000 to 5000, are the final points of contact between the people and the health system. This study assesses a selected sample of FHWs using the 'managing for performance' framework. Methods. Twenty-two FHWs and their supervisors at five primary health centres near Ahmedabad were purposively selected for this mixed methods study. They were administered a semi-structured questionnaire, which also guided 12 individual interviews and four focus group discussions. Quantitative data were analysed using Epi Info and Excel. Content analysis of the qualitative data was done using Microsoft Word. Results. In spite of increased FHW strength due to recent recruitments, one-third of these FHWs were carrying out additional responsibilities of another FHW or supervisor. Planning of tasks was the most popular activity while the chief demotivating factor at work was meeting targets. Recent trainings have been useful but failed to build specific competence as required. About 37% of routine person-tasks carried out by FHWs were graded below 60 points by supervisors. They rated the FHWs highly for their collaboration with community leaders although FHWs themselves did not consider community leaders to be a helpful resource. Conclusion. Mapping age, skill levels and locations of existing FHWs and soon-to-be retirees would be useful when planning future expansion of the FHW cadre. The natural elasticity of base populations due to migration as well as unpredictability of their work schedules need to be taken into account when monitoring the work performance of FHWs. District training centres need to be developed to provide a wide range of competencies.
Hodge, T; Parkin, N
The contraction of the economy in the United Kingdom and constraints on the National Health Service (NHS) together with new opportunities for the delivery of orthodontic treatment has resulted in an increasing number of dental personnel across the different registrant groups. This article focuses on the changes that have taken place in the orthodontic workforce over the past decade. Although others help deliver orthodontic services such as material suppliers, treatment coordinators and those involved in marketing, this article will restrict itself to informing the reader specifically about which dental registrants are doing what at the clinical interface. How health professionals have developed their skills to undertake the role they play within the team and possible threats arising because of these changes are also discussed.
Heilbrun, Marta E; Bender, Claire E; Truong, Hang B; Bluth, Edward I
Radiologists today are faced with the challenges of maintaining and balancing individual and family health needs and the demands of the workplace. To provide the highest quality and safest care of our patients, a corresponding ethos of support for a healthy workforce is required. There is a paucity of targeted information describing protections for and maintenance of the health of the practicing radiologist, in both private and academic settings. However, a review of existing family and medical leave policies may be helpful to practice leaders and practicing radiologists as a platform for the development of strategic workforce plans. This writing, by members of the ACR Commission on Human Resources, addresses the following areas: (1) medical leave, (2) maternity and/or paternity leave, and (3) disability. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Anderson, Margaret; Maier, Linda; Shepard, Michael
To meet workforce demand and the needs of working or place-bound students, Whatcom Community College developed an online version of its existing face-to-face Physical Therapist Assistant program which became a model for other lab-based health science degrees. This article describes research studies that support the program's practices and includes…
As a country India has to her credit the largest number of medical colleges in the world. More than 40,000 seats of MBBS (Bachelor of Medicine and Bachelor of Surgery) are available annually but only a fraction would enter into primary health care vocation. It is a matter of common perception and also of great concern that a large majority of young Indian doctors are not willing to serve the rural, remote and underserved population. An observation on human resource policies of several developed countries reveals interesting patterns. Beyond willingness and interest of the medical students and young doctors, there are real factors which prohibit their engagement with the health care delivery system in India, especially in the area of primary health care.
Saber, Deborah A
The job satisfaction of registered nurses has been found to be associated with retention, organizational commitment, workforce safety, and cost savings to health care organizations. Satisfaction of the workforce is vital because nursing turnover can be detrimental for a labor force that is growing older. However, the summation of the most important variables that are linked to job satisfaction has been difficult to discern in part because the workforce includes 3 main generations (ie, Baby Boomers, Gen Xers, and Millennials) with unique work values that drive their job satisfiers. This article provides a review of existing literature to examine the differences in variables that are linked to job satisfaction that exist between the generational cohorts. Differences in stress sources, need for work-life balance, and compensation are discussed. The knowledge about generationally driven variables that influence job satisfaction can help managers develop strategies to maintain a diverse nursing workforce.
Winkfield, Karen M; Flowers, Christopher R; Patel, Jyoti D; Rodriguez, Gladys; Robinson, Patricia; Agarwal, Amit; Pierce, Lori; Brawley, Otis W; Mitchell, Edith P; Head-Smith, Kimberly T; Wollins, Dana S; Hayes, Daniel F
In December 2016, the American Society of Clinical Oncology (ASCO) Board of Directors approved the ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce. Developed through a multistakeholder effort led by the ASCO Health Disparities Committee, the purpose of the plan is to guide the formal efforts of ASCO in this area over the next three years (2017 to 2020). There are three primary goals: (1) to establish a longitudinal pathway for increasing workforce diversity, (2) to enhance ASCO leadership diversity, and (3) to integrate a focus on diversity across ASCO programs and policies. Improving quality cancer care in the United States requires the recruitment of oncology professionals from diverse backgrounds. The ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce is designed to enhance existing programs and create new opportunities that will move us closer to the vision of achieving an oncology workforce that reflects the demographics of the US population it serves.
Jafarey Sadiqua N
knowledge of MNCH with only 6% scoring more than 70%. All three cadres of health care providers performed poorly in the resuscitation skill and only 50% were able to demonstrate steps of immediate newborn care. The MOs performed far better in counselling skills compare to the LHWs. Only 50 per cent of LHWs could secure competency scale in this critical component of skills assessment. Conclusions All three cadres of health care providers performed well below competency levels for MNCH knowledge and skills. Standardized training and counselling modules, tailored to the needs and resources at district level need to be developed and implemented. This evaluation highlighted the need for periodic assessment of health worker training and skills to address gaps and develop targeted continuing education modules. To achieve MDG4 and 5 goals, it is imperative that such deficiencies are identified and addressed.
This presentation was given at the Minority Environmental Leadership Development Initiative (MELDI) National Summit on Diversity in the Environmental Field at the University of Michigan on August 30, 2005. The presentation was an outline of how it is like to work at an EPA resea...
Marfelt, Mikkel Mouritz
Due to advancements in technology and the expansion of companies onto a global level, organizations have become increasingly aware of the need to understand and manage diverse workforces; that is, the need to understand and manage differences among employees across borders (such as geographical......, cultural, professional, etc.). This PhD dissertation studies this phenomenon, ‘a diverse workforce’, in a large Scandinavian pharmaceutical company. The dissertation follows the Diverse and Global Workforce (DGW) project, a ‘headquarter centric’ and strategic corporate initiative to address the rapid...... global expansion of the company workforce....
Kibwana, Sharon; Woldemariam, Damtew; Misganaw, Awoke; Teshome, Mihereteab; Akalu, Leulayehu; Kols, Adrienne; Kim, Young Mi; Mengistu, Samuel; van Roosmalen, Jos; Stekelenburg, Jelle
BACKGROUND: Efforts to address shortages of health workers in low-resource settings have focused on rapidly increasing the number of higher education programs for health workers. This study examines selected competencies achieved by graduating Bachelor of Science and nurse anesthetist students in
Kibwana, Sharon; Woldemariam, Damtew; Misganaw, Awoke; Teshome, Mihereteab; Akalu, Leulayehu; Kols, Adrienne; Kim, Young Mi; Mengistu, Samuel; van Roosmalen, Jos; Stekelenburg, Jelle
BACKGROUND: Efforts to address shortages of health workers in low-resource settings have focused on rapidly increasing the number of higher education programs for health workers. This study examines selected competencies achieved by graduating Bachelor of Science and nurse anesthetist students in Et
Squires, Allison; Beltrán-Sánchez, Hiram
Research that links macro-level socioeconomic development variables to health care human resources workforce composition is scarce at best. The purpose of this study was to explore the links between nonnursing factors and nursing workforce composition through a secondary, descriptive analysis of year 2000, publicly available national nursing human resources data from Mexico. Building on previous research, the authors conducted multiple robust regression analysis by federal typing of nursing human resources from 31 Mexican states against macro-level socioeconomic development variables. Average education in a state was significantly associated in predicting all types of formally educated nurses in Mexico. Other results suggest that macro-level indicators have a different association with each type of nurse. Context may play a greater role in determining nursing workforce composition than previously thought. Further studies may help to explain differences both within and between countries.
Fraher, Erin P
In 2015, the Institute of Medicine's Committee for Assessing Progress on Implementing the Future of Nursing recommendations noted that little progress has been made in building the data infrastructure needed to support nursing workforce policy. This article outlines a case study from North Carolina to demonstrate the value of collecting, analyzing, and disseminating state-level workforce data. Data were derived from licensure renewal information gathered by the North Carolina Board of Nursing and housed at the North Carolina Health Professions Data System at the University of North Carolina at Chapel Hill. State-level licensure data can be used to inform discussions about access to care, evaluate progress on increasing the number of baccalaureate nurses, monitor how well the ethnic and racial diversity in the nursing workforce match the population, and investigate the educational and career trajectories of licensed practical nurses and registered nurses. At the core of the IOM's recommendations is an assumption that we will be able to measure progress toward a "Future of Nursing" in which 80% of the nursing workforce has a BSN or higher, the racial and ethnic diversity of the workforce matches that of the population, and nurses currently employed in the workforce are increasing their education levels through lifelong learning. Without data, we will not know how fast we are reaching these goals or even when we have attained them. This article provides concrete examples of how a state can use licensure data to inform nursing workforce policy. Copyright © 2016 Elsevier Inc. All rights reserved.
Faller, Marcia; Gogek, Jim
The powerful transformation in the health care industry is reshaping not only patient care delivery and the business of health care but also demanding new strategies from vendors who support the health care system. These new strategies may be most evident in workforce solutions and health care staffing services. Consolidation of the health care industry has created increased demand for these types of services. Accommodating a changing workforce and related pressures resulting from health care industry transformation has produced major change within the workforce solutions and staffing services sector. The effect of the growth strategy of mergers, acquisitions, and organic development has revealed organizational opportunities such as expanding capacity for placing physicians, nurses, and allied professionals, among other workforce solutions. This article shares insights into workforce challenges and solutions throughout the health care industry.
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.
Arheart, Kristopher L; Fleming, Lora E; Lee, David J; Leblanc, William G; Caban-Martinez, Alberto J; Ocasio, Manuel A; McCollister, Kathryn E; Christ, Sharon L; Clarke, Tainya; Kachan, Diana; Davila, Evelyn P; Fernandez, Cristina A
Through use of a nationally representative database, we examined the variability in both self-rated health and overall mortality risk within occupations across the National Occupational Research Agenda (NORA) Industry Sectors, as well as between the occupations within the NORA Industry sectors. Using multiple waves of the National Health Interview Survey (NHIS) representing an estimated 119,343,749 US workers per year from 1986 to 2004, age-adjusted self-rated health and overall mortality rates were examined by occupation and by NORA Industry Sector. There was considerable variability in the prevalence rate of age-adjusted self-rated poor/fair health and overall mortality rates for all US workers. The variability was greatest when examining these data by the Industry Sectors. In addition, we identified an overall pattern of increased poor/fair self-reported health and increased mortality rates concentrated among particular occupations and particular Industry Sectors. This study suggests that using occupational categories within and across Industry Sectors would improve the characterization of the health status and health disparities of many subpopulations of workers within these Industry Sectors. Copyright © 2011 Wiley-Liss, Inc.
Climate change presents the biggest threat to human health in the 21st century. However, many public health leaders feel ill equipped to face the challenges of climate change and have been unable to make climate change a priority in service development. I explore how to achieve a regionally responsive whole-of-systems approach to climate change in the key operational areas of a health service: service governance and culture, service delivery, workforce development, asset management, and financing. The relative neglect of implementation science means that policymakers need to be proactive about sourcing and developing models and processes to make health services ready for climate change. Health research funding agencies should urgently prioritize applied, regionally responsive health services research for a future of climate change.
Tobi, Patrick; George, Gavin; Schmidt, Elena; Renton, Adrian
To investigate the effect of scaling up antiretroviral treatment (ART) on the working environment and motivation of health workers in South Africa; and to suggest strategies to minimize negative effects and maximise positive effects. Exploratory interviews with health managers and senior clinical staff were used to identify locally relevant work environment indicators. A self-reported Likert scale questionnaire was administered to a randomly selected cohort of 269 health professionals at health facilities in KwaZulu Natal and Western Cape provinces of South Africa that included ART delivery sites. The cohort was disaggregated into ART and non-ART groups and differences between the two compared with Fisher's exact test and the non-parametric Mann-Whitney U-test. The ART sub-cohort reported: (i) a lighter workload (P = 0.013), (ii) higher level of staffing (P = 0.010), (iii) lower sickness absence (P = 0.032), (iv) higher overall job satisfaction (P = 0.010), (v) poorer physical state of their work premises (P = 0.003), and (vi) higher staff turnover (P = 0.036). Conclusion Scale-up affects the work environment in ways that influence workers' motivation both positively and negatively. A net negative balance is likely to drive staff out-migration, undermine the quality of care and compromise the capacity of the programme to achieve significant scale. As health workers are the most important element of the health system, a comprehensive and systematic understanding of scale-up impacts on their working conditions and motivation needs to be an integral part of any delivery strategy.
Panikkar, Bindu; Woodin, Mark A; Brugge, Doug; Hyatt, Raymond; Gute, David M
This study estimates job-related risks among common low wage occupations (cleaning, construction, food service, cashier/baggers, and factory workers) held by predominantly Haitian, El Salvadorian, and Brazilian immigrants living or working in Somerville, Massachusetts. A community-based cross-sectional survey on immigrant occupational health was conducted between 2006 and 2009 and logistic regression was used to assess the job-related risks among the most common low wage occupations. Construction workers reported significantly higher health risks, and lower access to occupational health services than the other occupations. Compared to cashier/baggers, the reference population in this study, cleaners reported significantly lower access to health and safety and work training and no knowledge of workers' compensation. Factory workers reported significantly lower work training compared to cashier/baggers. Food service workers reported the least access to doctors compared to the other occupations. We found significant variability in risks among different low wage immigrant occupations. The type of occupation independently contributed to varying levels of risks among these jobs. We believe our findings to be conservative and recommend additional inquiry aimed at assuring the representativeness of our findings. © 2013 Wiley Periodicals, Inc.
In health care today, scientific and technological frontiers are expanding at unprecedented rates, even as economic and financial pressures shrink profit margins, intensify competition, and constrain the funds available for investment. Therefore, the world today has more economic, and social opportunities for people than 10 or 100 years since globalization has created a new ground somewhat characterized by rapid economic transformation, deregulation of national markets by new trade regimes, amazing transport, electronic communication possibilities and high turnover of foreign investment and capital flow as well as skilled labor. These trends can easily mask great inequalities in developing countries such as importation and spreading of infectious and non-communicable diseases; miniaturization of movement of medical technology; health sector trades management driven by economics without consideration to the social and health aspects and its effects, increasing health inequalities and their economic and social burden creation; multinational companies' cheap labor employment promotion in widening income differentials; and others. As a matter of fact, all these factors are major determinants of ill health. Health authorities of developing countries have to strengthen their regulatory framework in order to ensure that national health systems derive maximum benefit in terms of equity, quality and efficiency, while reducing potential social cost to a minimum generated risky side of globalization.
past, some hiring decisions made by DOD components using the Defense Acquisition Workforce Development Fund exceeded initial 2010 career field...contracting and engineering career fields are largely the result of high attrition rates and difficulty in hiring qualified personnel. Despite these...revised career field goals or issued guidance on the use of the Defense Acquisition Workforce Development Fund to guide future hiring decisions . In
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
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. Copyright © 2015 by the American Academy of Pediatrics.
Narang, Akhil; Sinha, Shashank S.; Rajagopalan, Bharath; Ijioma, Nkechinyere N.; Jayaram, Natalie; Kithcart, Aaron P.; Tanguturi, Varsha K.; Cullen, Michael W.
As the burden of cardiovascular disease in the United States continues to increase, uncertainty remains on how well-equipped the cardiovascular workforce is to meet the challenges that lie ahead. In a time when health care is rapidly shifting, numerous factors affect the supply and demand of the cardiovascular workforce. This Council Commentary critically examines several factors that influence the cardiovascular workforce. These include current workforce demographics and projections, evolving health care and practice environments, and the increasing burden of cardiovascular disease. Finally, we propose 3 strategies to optimize the workforce. These focus on cardiovascular disease prevention, the effective utilization of the cardiovascular care team, and alterations to the training pathway for cardiologists. PMID:27712782
Dobmeyer, Anne C; Hunter, Christopher L; Corso, Meghan L; Nielsen, Matthew K; Corso, Kent A; Polizzi, Nicholas C; Earles, Jay E
The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense's experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed.
Vigersky, Robert A; Fish, Lisa; Hogan, Paul; Stewart, Andrew; Kutler, Stephanie; Ladenson, Paul W; McDermott, Michael; Hupart, Kenneth H
Many changes in health care delivery, health legislation, and the physician workforce that affect the supply and demand for endocrinology services have occurred since the first published workforce study of adult endocrinologists in 2003. The objective of the study was to assess the current adult endocrinology workforce data and provide the first analysis of the pediatric endocrinology workforce and to project the supply of and demand for endocrinologists through 2025. A workforce model was developed from an analysis of proprietary and publicly available databases, consultation with a technical expert panel, and the results of an online survey of board-certified endocrinologists. The Endocrine Society commissioned The Lewin Group to estimate current supply and to project gaps between supply and demand for endocrinologists. A technical expert panel of senior endocrinologists provided context, clinical information, and direction. The following were measured: 1) the current adult and pediatric endocrinology workforce and the supply of and demand for endocrinologists through 2025 and 2) the number of additional entrants into the endocrinology work pool that would be required to close the gap between supply and demand. Currently there is a shortage of approximately 1500 adult and 100 pediatric full-time equivalent endocrinologists. The gap for adult endocrinologists will expand to 2700 without an increase in the number of fellows trained. An increase in the prevalence of diabetes mellitus further expands the demand for adult endocrinologists. The gap can be closed in 5 and 10 years by increasing the number of fellowship positions by 14.4% and 5.5% per year, respectively. The gap between supply and demand for pediatric endocrinologists will close by 2016, and thereafter an excess supply over demand will develop at the current rate of new entrants into the work force. There are insufficient adult endocrinologists to satisfy current and future demand. A number of proactive
Gaden, Michael D. [Transuranic Waste Processing Center, Lenoir City, TN 37771 (United States); Wastren Advantage Inc. (United States)
Likert, Covey, and a number of others studying and researching highly effective organizations have found that performing functions such as problem-solving, decision-making, safety analysis, planning, and continuous improvement as close to the working floor level as possible results in greater buy-in, feelings of ownership by the workers, and more effective use of resources. Empowering the workforce does several things: 1) people put more effort and thought into work for which they feel ownership, 2) the information they use for planning, analysis, problem-solving,and decision-making is more accurate, 3) these functions are performed in a more timely manner, and 4) the results of these functions have more credibility with those who must implement them. This act of delegation and empowerment also allows management more time to perform functions they are uniquely trained and qualified to perform, such as strategic planning, staff development, succession planning, and organizational improvement. To achieve this state in an organization, however, requires a very open, transparent culture in which accurate, timely, relevant, candid, and inoffensive communication flourishes, a situation that does not currently exist in a majority of organizations. (authors)
Approaches to Working with Children, Young People and Families for Traveller, Irish Traveller, Gypsy, Roma and Show People Communities. A Literature Review Report for the Children's Workforce Development Council
Robinson, Mark; Martin, Kerry
The Children's Workforce Development Council (CWDC) commissioned this literature review as the first part of a project exploring issues around and approaches to working with Travellers, Irish Travellers, Gypsies, Roma and Showpeople, and the support, training and other programs available to staff involved. The project is intended to contribute to…
Dever, Greg; Finau, Sitaleki; Kuartei, Stevenson; Durand, A Mark; Rykken, David; Yano, Victor; Untalan, Pedro; Withy, Kelley; Tellei, Patrick; Baravilala, Wame; Pierantozzi, Sandra; Tellei, Jullie
The Palau Area Health Education Center (AHEC)--a program of the University of Hawaii's John A. Burns School of Medicine (JABSOM) and based at Palau Community College--was established in 2001 in response to the recommendations of the 1998 Institute of Medicine (IOM) report--Pacific Partnerships for Health--Charting a New Course for the 21st Century1. One of IOM's core recommendations was to promote the training of the primary health care workforce among the U.S.-Associated Pacific Islands. Since its inception in 2001, the Palau AHEC has coordinated overall 37 postgraduate and undergraduate courses in General Practice and Public Health taught by the University of Auckland Faculty of Medicine and Health Sciences and the Fiji School of Medicine's School of Public Health and Primary Care (SPH&PC) in Palau, Yap State, and the Republic of the Marshall Islands. Currently 139 physicians, nurses, health administrators, and environmental health workers are registered as active students in Palau (58), Yap State (22), and the RMI (59). Notably, the Palau AHEC and the SPH&PC have worked in an innovative partnership with the Palau Ministry of Health to operationalize the MOH's public health work plan to implement a comprehensive community health survey of all 4,376 households in Palau, interviewing 79% of the total population, to determine Palau's health indicators. To accomplish this, the SPH&PC developed and taught a curriculum for Palau physicians and public health nurses on how to design the survey, gather, and analyze data in order to develop and implement appropriately responsive intervention and treatment programs to address Palau's old and newer morbidities. In early FY2005, two other Micronesian AHECs--the Yap State and Commonwealth of the Northern Mariana Islands AHECs--were funded through JABSOM administered grants which will also address the primary care training needs of Micronesia's remote and isolated health workforce.
How much does disease depress development in human capital and income around the world? I discuss a range of micro evidence, which finds that health is both human capital itself and an input to producing other forms of human capital. I use a standard model to integrate these results, and suggest a re-interpretation of much of the micro literature. I then discuss the aggregate implications of micro estimates, but note the complications in extrapolating to general equilibrium, especially because of health's effect on population size. I also review the macro evidence on this topic, which consists of either cross-country comparisons or measuring responses to health shocks. Micro estimates are 1-2 orders of magnitude smaller than the cross-country relationship, but nevertheless imply high benefit-to-cost ratios from improving certain forms of health.
Stahlman, E.J.; Oens, M.A.; Lewis, R.E.
The Pacific Northwest Laboratory (PNL) was tasked by the US Department of Energy Albuquerque Field Office (DOE-AL) to develop a workforce assessment and transition planning tool to support integrated decision making at a single DOE installation. The planning tool permits coordinated, integrated workforce planning to manage growth, decline, or transition within a DOE installation. The tool enhances the links and provides commonality between strategic, programmatic, and operations planners and human resources. Successful development and subsequent complex-wide implementation of the model also will facilitate planning at the national level by enforcing a consistent format on data that are now collected by installations in corporate-specific formats that are not amenable to national-level analyses. The workforce assessment and transition planning tool, the Workforce Transition Modeling Environment (WFTME), consists of two components: the Workforce Transition Model and the Workforce Budget Constraint Model. The Workforce Transition Model, the preponderant of the two, assists decision makers identify and evaluate alternatives for transitioning the current workforce to meet the skills required to support projected workforce requirements. The Workforce Budget Constraint Model helps estimate the number of personnel that will be affected by a given workforce budget increase or decrease and assists in identifying how the corresponding hirings or layoffs should be distributed across the Common Occupation Classification System (COCS) occupations. This user`s guide describes the use and operation of the WFTME. This includes the functions of modifying data and running models, interpreting output reports, and an approach for using the WFTME to evaluate various workforce transition scenarios.
Phillips, Jennan A; Miltner, Rebecca
To discuss selected work hazards and safety concerns for aging nurses. Greater numbers of older nurses remain in the workforce. Projections suggest that one-third of the nursing workforce will be over age 50 years by 2015. Employers will struggle to find ways to protect the health and safety of their aging workforce and prevent a massive loss of intellectual and human resources when these experienced nurses exit the workforce. Review of recent relevant literature in English language journals. Repetitive motion injuries, fatigue and slips, trips and falls are three major work hazards older nurses face. We discuss several factors for each hazard, including: the normal physiological aging effects of diminished strength, hearing and vision; workplace variables of work schedules, noise and clutter; and personal characteristics of sleep disturbances, overexertion and fatigue. Inconclusive evidence exists to guide best practices for designing safe workplace environments and shift patterns for nursing work. There are at least two areas administrators can reduce work hazards for older workers: (1) modification of the workplace, and (2) creating the infrastructure to support the aging workforce to encourage healthy behaviours. © 2014 John Wiley & Sons Ltd.
Sullivan, Marlysa; Leach, Matthew; Snow, James; Moonaz, Steffany
To describe the personal, professional, practice, service and consumer characteristics of the North American yoga therapy workforce. Cross-sectional, descriptive survey developed and informed by the contemporary workforce literature. A link to the e-survey was distributed to members of the International Association of Yoga Therapists. 367 members responded (∼20% of eligible participants). Most were aged 40-69 years (88%) and female (91%). Almost half (42%) identified as a "seasoned yoga therapist" and few (9%) graduated from an accredited 800-h yoga therapy program. An average of 8h/week was spent in clinical practice with many (41%) earning an annual income of yoga therapy. Practice was informed by twenty different styles of yoga. Urban (39%) and suburban (38.1%) regions were the most common locations of practice. Most therapists conducted therapeutic yoga classes (91%) and 1:1 sessions (94%), with more than half delivering 1-10 therapeutic classes/month (53%) and 1-10 1:1 sessions/month (52%). Conditions seen most frequently were anxiety (77%), back/neck pain (77%) and joint pain/stiffness (67%). While yoga therapists shared demographic characteristics with other complementary and integrative health (CIH) providers, they tended to work less and earn less than their CIH counterparts. Yoga therapists were less likely to work in rural settings, possibly contributing to the underutilization of yoga in underserved populations. Improving access to yoga therapy services, identifying common core components across the various styles of yoga, and building a stronger evidence-base for key health indications may increase acceptance of, and demand for, yoga therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.
Yip, C H; Taib, N A
Breast cancer is one of the leading cancers world-wide. While the incidence in developing countries is lower than in developed countries, the mortality is much higher. Of the estimated 1 600 000 new cases of breast cancer globally in 2012, 794 000 were in the more developed world compared to 883 000 in the less developed world; however, there were 198 000 deaths in the more developed world compared to 324 000 in the less developed world (data from Globocan 2012, IARC). Survival from breast cancer depends on two main factors--early detection and optimal treatment. In developing countries, women present with late stages of disease. The barriers to early detection are physical, such as geographical isolation, financial as well as psychosocial, including lack of education, belief in traditional medicine and lack of autonomous decision-making in the male-dominated societies that prevail in the developing world. There are virtually no population-based breast cancer screening programs in developing countries. However, before any screening program can be implemented, there must be facilities to treat the cancers that are detected. Inadequate access to optimal treatment of breast cancer remains a problem. Lack of specialist manpower, facilities and anticancer drugs contribute to the suboptimal care that a woman with breast cancer in a low-income country receives. International groups such as the Breast Health Global Initiative were set up to develop economically feasible, clinical practice guidelines for breast cancer management to improve breast health outcomes in countries with limited resources.
Board on Agriculture and Natural Resources; Board on Higher Education and Workforce; Division on Earth and Life Studies; Policy and Global Affairs; National Research Council
In a study of the issues related to the veterinary medical workforce, including demographics, workforce supply, trends affecting job availability, and capacity of the educational system to fill future...
Birch, Stephen; Kephart, George; Murphy, Gail Tomblin; O'Brien-Pallas, Linda; Alder, Rob; MacKenzie, Adrian
Health human resources planning is generally based on estimating the effects of demographic change on the supply of and requirements for healthcare services. In this article, we develop and apply an extended analytical framework that incorporates explicitly population health needs, levels of service to respond to health needs, and provider productivity as additional variables in determining the future requirements for the levels and mix of healthcare providers. Because the model derives requirements for providers directly from the requirements for services, it can be applied to a wide range of different provider types and practice structures including the public health workforce. By identifying the separate determinants of provider requirements, the analytical framework avoids the "illusions of necessity" that have generated continuous increases in provider requirements. Moreover, the framework enables policy makers to evaluate the basis of, and justification for, increases in the numbers of provider and increases in education and training programs as a method of increasing supply. A broad range of policy instruments is identified for responding to gaps between estimated future requirements for care and the estimated future capacity of the healthcare workforce.
How much does disease depress development in human capital and income around the world? I discuss a range of micro evidence, which finds that health is both human capital itself and an input to producing other forms of human capital. I use a standard model to integrate these results, and suggest a re-interpretation of much of the micro literature. I then discuss the aggregate implications of micro estimates, but note the complications in extrapolating to general equilibrium, especially because of health’s effect on population size. I also review the macro evidence on this topic, which consists of either cross-country comparisons or measuring responses to health shocks. Micro estimates are 1–2 orders of magnitude smaller than the cross-country relationship, but nevertheless imply high benefit-to-cost ratios from improving certain forms of health. PMID:24147187
Leadership is the capacity to help transform a vision of the future into reality. Individuals who can and will exercise leadership are like a river's current--a part past where we now stand, a part yet to come. We have an ongoing need to remember and to look toward the next "generation." A key responsibility of those here now, is to mentor and to create structures for mentoring, in order to maximize the flow and effectiveness of tomorrow's leaders. When recruiting organizational leaders, the recruitment and interview process must seek individuals who in addition to technical competence, also have demonstrated leadership in their prior work and activities. To exercise effective leadership, we must work to know who we are, how we relate to others, and the environment around us. "Servant leadership" is a perspective held by many throughout the rural health community and offers a key set attributes of leadership useful to rural health. To implement the Institute of Medicine's recommendations in Through Collaboration: the Future of Rural Health, we must develop leaders skilled in collaboration, both internal to their organization and across organizations. The National Advisory Committee on Rural Health and Human Services had it right when they said to the Secretary and to the rest of us, "the best way to honor Jim is to consciously work to help develop the next generation of rural health leaders." There are, of course, a multitude of leadership institutes, programs, and courses throughout America; this is not a call for yet another separate entity. But it is a call to each of us in rural health to assure that we are deliberate in how we identify "emerging leaders from and for rural communities and provide them with the training and resources to play a lead role in ensuring access to quality healthcare in their states and communities." Let's get started.
Reid, Bernie; Kane, Kay; Curran, Carol
District nursing services in Northern Ireland face increasing demands and challenges which may be responded to by effective and efficient workforce planning and development. The aim of this paper is to critically analyse district nursing workforce planning and development methods, in an attempt to find a suitable method for Northern Ireland. A systematic analysis of the literature reveals four methods: professional judgement; population-based health needs; caseload analysis and dependency-acuity. Each method has strengths and weaknesses. Professional judgement offers a 'belt and braces' approach but lacks sensitivity to fluctuating patient numbers. Population-based health needs methods develop staffing algorithms that reflect deprivation and geographical spread, but are poorly understood by district nurses. Caseload analysis promotes equitable workloads but poorly performing district nursing localities may continue if benchmarking processes only consider local data. Dependency-acuity methods provide a means of equalizing and prioritizing workload but are prone to district nurses overstating factors in patient dependency or understating carers' capability. In summary a mixed method approach is advocated to evaluate and adjust the size and mix of district nursing teams using empirically determined patient dependency and activity-based variables based on the population's health needs.
Pugh, Judith D; Twigg, Diane E; Martin, Tracy L; Rai, Tapan
the ongoing attrition of the midwifery workforce frustrates future workforce planning and the provision of maternity services in Western Australia. This project determined factors contributing to the intention of the midwives to move jobs and/or leave the profession. a cross-sectional survey approach was taken for this descriptive research utilising a self-administered questionnaire developed by the Nursing and Midwifery Office, Department of Health, Western Australia. public and private health sectors in Western Australia, April-May 2010. 1,600 midwives employed in the public and private health sectors throughout Western Australia were invited to participate: 712 responded (44.5%), one-fifth of the state's registered midwives. most midwives worked part-time in a clinical role in public hospitals. Almost half intended moving jobs within 5 years and/or leaving midwifery. Excluding midwives of retirement age, the most common reasons for intending to move jobs were family commitments, working conditions and role dissatisfaction. Those intending to leave midwifery cited work-life balance, career change and family commitments. Midwives thought addressing the following issues would improve midwifery retention: flexible work arrangements, remuneration, staffing and caseload, workplace culture, professional development and models of care. retaining the midwifery workforce requires attention to workforce practices particularly flexible work arrangements and workloads; models of care to strengthen midwives' relationships with clients and colleagues; and accessible professional development. a review of workplace practices at unit and institution levels is urgently required in Western Australia so that midwives can achieve work-life balance and practice to the full extent of their professional role. These changes are necessary to forestall premature retirement of skilled and experienced midwives from the profession and workforce churn. Crown Copyright © 2012. Published by
Science Literacy, and the Innovation Workforce in America : In compiling this document, Bayer has identified key intersections of thought, belief...System t " The Animal Kingdom includes: Birds, Mammal, ano Reptiles Under the Sea includes: Deep Sea Exploration, Middle Sea, and The Shallows
Boehm, Jackie; Cordier, Reinie; Thomas, Yvonne; Tanner, Bronwyn; Salata, Karen
Student retention at regional universities is important in addressing regional and remote workforce shortages. Students attending regional universities are more likely to work in regional areas. First year experience at university plays a key role in student retention. This study aimed to explore factors influencing the first year experience of occupational therapy students at a regional Australian university. Surveys were administered to 58 second year occupational therapy students in the first week of second year. Data were analysed using descriptive statistics, inferential statistics (Pearson χ(2) ; Spearman rho) and summarising descriptive responses. An Australian regional university. Second year undergraduate occupational therapy students. Factors influencing students' decisions to study and continue studying occupational therapy; factors enhancing first year experience of university. Fifty-four students completed the survey (93.1%). A quarter (25.9%) of students considered leaving the course during the first year. The primary influence for continuing was the teaching and learning experience. Most valued supports were orientation week (36.7%) and the first year coordinator (36.7%). The importance of the first year experience in retaining occupational therapy students is highlighted. Engagement with other students and staff and academic support are important factors in facilitating student retention. It is important to understand the unique factors influencing students' decisions, particularly those from regional and remote areas, to enter and continue in tertiary education to assist in implementing supports and strategies to improve student retention. © 2015 National Rural Health Alliance Inc.
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...
Goldman, Charles A.; Butterfield, Lindsay; Lavery, Diana; Miller, Trey; Daugherty, Lindsay; Beleche, Trinidad; Han, Bing
In May 2013, the Texas Legislature passed House Bill 1296, requiring a report on Texas's future workforce needs that would help inform decisions to develop or expand postsecondary education programs. Educators and policymakers in Texas and elsewhere have a wide variety of quantitative and qualitative workforce information available for planning…
Brocklehurst, Paul; Tickle, Martin
Background: The two most common models of workforce planning are the "stock and flow" and the demographic approach. The former balances future losses from a system against recruitment and retention, whilst the latter simply "grosses up" current provision based on changes to population demographics. However, such approaches…
Mason, Julie L.; Johnston, Elizabeth; Berndt, Sam; Segal, Katie; Lei, Ming; Wiest, Jonathan S.
The United States has experienced an unsustainable increase of the biomedical research workforce over the past 3 decades. This expansion has led to a myriad of consequences, including an imbalance in the number of researchers and available tenure-track faculty positions, extended postdoctoral training periods, increasing age of investigators at first U.S. National Institutes of Health R01 grant, and exodus of talented individuals seeking careers beyond traditional academe. Without accurate data on the biomedical research labor market, challenges will remain in resolving these problems and in advising trainees of viable career options and the skills necessary to be productive in their careers. We analyzed workforce trends, integrating both traditional labor market information and real-time job data. We generated a profile of the current biomedical research workforce, performed labor gap analyses of occupations in the workforce at regional and national levels, and assessed skill transferability between core and complementary occupations. We conclude that although supply into the workforce and the number of job postings for occupations within that workforce have grown over the past decade, supply continues to outstrip demand. Moreover, we identify practical skill sets from real-time job postings to optimally equip trainees for an array of careers to effectively meet future workforce demand.—Mason, J. L., Johnston, E., Berndt, S., Segal, K., Lei, M., Wiest, J. S. Labor and skills gap analysis of the biomedical research workforce. PMID:27075242
Pálsdóttir, Björg; Neusy, André-Jacques
Medically underserved communities suffer a high burden of morbidity and mortality, increasing with remoteness where access to health services is limited. Major challenges are the overall shortage and maldistribution of the health workforce. There is a lack of understanding of how academic institutions can best contribute to addressing these health inequities. A new international collaborative of health professions schools, Training for Health Equity Network, is developing and disseminating evidence, challenging assumptions, and developing tools that support health profession institutions striving to meet the health and health workforce needs of underserved communities.
Arosemena, Farah A; Fox, Laila; Lichtveld, Maureen Y
Gulf Coast women are especially vulnerable to the effects of disaster and for many this vulnerability is compounded by existing poor health-related quality of life. Post-Hurricane Isaac, a baseline survey battery utilizing the Reproductive Health Assessment After Disasters (RHAD) Toolkit, the Medical Outcomes Study Social Support Survey, and the Edinburgh Postnatal Depression Scale were used quantitatively to assess reproductive health risks, services, and outcomes and to explore the psychosocial effects of disaster among pregnant and postpartum women aged 18-45 years (N=300). The pilot study included trained community health workers and patient navigators to implement a community needs assessment in Southeast Louisiana. The community health navigation corps administered RHAD and the brief psychosocial battery to gain a closer understanding of post-disaster reproductive health needs. Findings demonstrate the importance of making a transition from patient navigation into disaster management in order to reduce fragmentation in health care systems and to implement innovative approaches in survey methodology.
The health promotion and health education literature has references to health counselling. Yet, beyond the field of health, coaching has become a popular method to enhance and facilitate individual and group performance in business, sports, and personal areas of life. This paper focuses on the recent development of health coaching by practitioners…
The health promotion and health education literature has references to health counselling. Yet, beyond the field of health, coaching has become a popular method to enhance and facilitate individual and group performance in business, sports, and personal areas of life. This paper focuses on the recent development of health coaching by practitioners…
Andriole, Dorothy A; Jeffe, Donna B; Schechtman, Kenneth B
We sought to determine the extent to which recent increases in levels of gender and racial diversity in the overall resident-physician workforce were evident among core-surgical specialty resident workforces. Chi-square tests for trend assessed the importance of changes from 1996 to 2004 in proportions of women and African Americans in the surgery-resident workforce. Surgery-resident trends were compared with overall resident workforce trends using two-tailed t-tests to compare regression slopes that quantified rates of change over time. Chi-square tests assessed differences between proportions of women and African Americans in the current overall board-certified workforce and their proportions in the surgery board-certified workforce. From 1996 to 2004, proportions of women increased in all seven surgical specialties studied. Compared with the overall trend toward increasing proportions of women in the resident workforce, the trend in one surgical specialty was larger (obstetrics/gynecology, p 0.05), and two were smaller (each p 0.05). Proportions of African Americans decreased in three specialties (each p workforce, except obstetrics/gynecology, remained lower than in the overall board-certified workforce (each p workforces have persisted since 1996 and will likely perpetuate ongoing surgery board-certified workforce disparities.
白思敏; 欧阳静; 张建华; 许强; 杨良佩; 叶庆; 朱朝刚
目的：探讨新疆克拉玛依市2006-2010年医疗机构提供医疗卫生服务以及社会发展情况，测算2011-2015年医疗机构的卫生技术人员数量和机构，为合理配置与规划医疗机构的发展提供有效的依据。方法根据2006-2010的卫生服务需求数据，利用等维灰数递补动态模型预测2011-2015年的卫生服务需求数据，再利用卫生服务需求法计算2011-2015年的医生数，最后利用相应的指标推算其他人员的数据量。结果根据卫生服务需求法测算2011年克市医疗卫生机构总人数应为3508名，其中医生926名、护士1111名，2015年为3663名，其中医生967名、护士1160名；截止2010年底卫生人员是2987名，与2011年测算的卫生人员总数相差521名，卫生技术人员2010年数量与2015年测算的卫生技术人员相差643名。结论克市医疗机构卫生人员总量不足，卫生人员结构不合理，工勤人员比例偏高，其他卫生技术人员比例偏低；2011-2015年克市卫生技术人才引进工作压力大。%Objective The number and structure of health care workforce in health care facilities over 2011 to 2015 in Karamay were predicted to provide the information of the rational allocation and scientific plan-ning for health care facilities′development,by analyzing the condition of health services provided by health care facilities and social development from 2006 to 2010 in Karamay.Methods Based on health services de-mand data during 2006 to 2010,a dimension gray recurrence dynamic model was developed to predict the health services demand from 2011 to 2015 in Karamay.Subsequently the calculation method of health serv-ices demand was used to estimate the number of physicians.Finally the corresponding indices were applied to obtain the number of the other workers.Results The estimated total number of health care workforce by 2011 was 3508,and among whom physicians and nurses were 926 and 1 111,respectively
Hays, Richard; Bowles, Sarah; Brown, Terry; Lawler, Anthony; Vickers, James
Tasmania established its medical programme in 1965 to produce graduates to address medical workforce recruitment challenges. Many Tasmanian graduates work in Tasmania, but workforce problems continue. This paper reports the workforce outcomes of the first 42 graduating cohorts. A database for all University of Tasmania medical graduates from the years 1970 to 2011 was developed by combining information from university, registration and local workforce survey databases. A total of 2012 doctors graduated from 1971 to 2011 and 1707 (85%) were registered, most commonly in general practice (45.8%), medicine (13%), anaesthetics (7.9%), surgery (7.5%), psychiatry (4.3%), emergency medicine (35, 3.5%), paediatrics (3.4%) and pathology (3.3%). While 41.9% worked in Tasmania, they comprised 35.6% of the local workforce and were clustered around the two larger cities. The proportion entering general practice has fallen since 1980s. The contribution of the Tasmanian medical programme is substantial but appears less than other regional medical schools. Relatively few work in smaller communities, particularly in specialties other than general practice. Lifestyle choices and the availability of training opportunities and career positions might be contributing factors. The medical school has established clinical schools in rural communities, promoted admission of rural applicants and increased rural clinical placement opportunities, with some early signs of success. The Tasmanian medical programme is important in this regional, island economy, but the rural and remote communities have not benefited as much as the two larger cities. Sustaining a regional workforce mission over time might require frequent adjustments to admissions and curriculum processes. © 2017 National Rural Health Alliance Inc.
Covell, Christine L; Primeau, Marie-Douce; Kilpatrick, Kelley; St-Pierre, Isabelle
Global trends in migration accompanied with recent changes to the immigrant selection process may have influenced the demographic and human capital characteristics of internationally educated nurses (IENs) in Canada and in turn the assistance required to facilitate their workforce integration. This study aimed to describe the demographic and human capital profile of IENs in Canada, to explore recent changes to the profile, and to identify predictors of IENs' workforce integration. A cross-sectional, descriptive, correlational survey design was used. Eligible IENs were immigrants, registered and employed as regulated nurses in Canada. Data were collected in 2014 via online and paper questionnaires. Descriptive statistics were used to examine the data by year of immigration. Logistic regression modeling was employed to identify predictors of IENs' workforce integration measured as passing the licensure exam to acquire professional recertification and securing employment. The sample consisted of 2280 IENs, representative of all Canadian provincial jurisdictions. Since changes to the immigrant selection process in 2002, the IEN population in Canada has become more racially diverse with greater numbers emigrating from developing countries. Recent arrivals (after 2002) had high levels of human capital (knowledge, professional experience, language proficiency). Some, but not all, benefited from the formal and informal assistance available to facilitate their workforce integration. Professional experience and help studying significantly predicted if IENs passed the licensure exam on their first attempt. Bridging program participation and assistance from social networks in Canada were significant predictors if IENs had difficulty securing employment. Nurses will continue to migrate from a wide variety of countries throughout the world that have dissimilar nursing education and health systems. Thus, IENs are not a homogenous group, and a "one size fits all" model may not be
Clithero, Amy; Ross, Simone Jacquelyn; Middleton, Lyn; Reeve, Carole; Neusy, Andre-Jacques
Health professionals providing health-care services must have the relevant competencies and clinical experiences needed to improve population health outcomes in different contexts. Current models of health profession education often fail to produce a fit-for-purpose workforce ready and willing to provide relevant, quality care to underserved communities. Evidence is emerging that community-engaged and socially accountable health workforce education, i.e., aligned with priority health needs, produces a workforce ready and willing to work in partnership with underserved regions. This model of education fosters greater affiliation between education and service delivery systems and requires institutions to measure graduate outcomes and institutional impact. The Training for Health Equity Network (THEnet), a partnership of socially accountable health workforce education institutions, has developed and tested a Social Accountability Framework for Health Workforce Education (the Framework) and toolkit to improve alignment of health workforce education with outcomes to assess how well education institutions meet the needs of the communities they serve. The Framework links education and service delivery creating a continuous quality improvement feedback loop to ensure that education addresses needs and maximizes impact on the quality of service delivery. The Framework also provides a unifying set of guidelines for health workforce policy and planning, accreditation, education, research, and service delivery. A key element to ensuring consistent high quality service delivery is an appropriately trained and equitably distributed workforce. An effective and comprehensive mechanism for evaluation is the method of CQI which links the design, implementation, accreditation, and evaluation of health workforce education with health service delivery and health outcomes measurement. PMID:28289678
Roman, Leah A
For health promotion professionals, social media offers many ways to engage with a broader range of colleagues; participate in professional development events; promote expertise, products, or services; and learn about career-enhancing opportunities such as funding and fellowships. Previous work has recommended "building networking into what you are already doing." This article provides updated and new social media resources, as well as practical examples and strategies to promote effective use of social media. Social media offers health promotion professionals cost-effective opportunities to enhance their career by building communities of practice, participating in professional development events, and enriching classroom learning. Developing the skills necessary to use social media for networking is important in the public health workforce, especially as social media is increasingly used in academic and practice settings.
of key acquisition personnel including providing appropriate compensation and other forms of incentives • Inability to couple rewards to performance...against incentives • Gerald Ledford and Barry Gerhart in “Negative Effects of Extrinsic Rewards and Intrinsic Motivation: More Smoke Than Fire” argue...May 13, 2015 Innovation in Workforce Incentives Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection
Indoor and Outdoor Air Pollution- related Health Problem in Ethiopia: Review of Related ... Review of Climate Change and Health in Ethiopia: Status and Gap Analysis ... Health Effects of Environmental Exposures, Occupational Hazards and ...
Davidson, P L; Nakazono, T T; Carreon, D C; Gutierrez, J J; Shahedi, S; Andersen, R M
The USA dental education programmes are facing challenges similar to those confronting countries around the globe, particularly amongst the industrialised nations. The purpose of this study was to evaluate the educational programmes of 15 USA dental schools to determine their impact on improving workforce diversity and oral health care access. The study investigates the predictors of public service plans of dental school seniors in Pipeline and non-Pipeline Program dental schools. We analysed baseline and post-intervention data collected in the American Dental Education Association (ADEA) Annual Survey of Dental School Seniors and a set of contextual variables. Public service plans (dependent variable) was predicted by four types of independent variables: intervention, contextual, community-based dental education (CBDE), and student characteristics. Findings from the study show that access to a state or federally sponsored loan repayment program was the most significant predictor of public service plans and that increasing educational debt was the most significant barrier. In the short-term we may be able to sustain the USA loan repayment programs to motivate senior dental students to provide public service to address the oral health care access crisis. However, in the long-term, a new workforce development initiative will be required to transform dental education and practice, modelled after the well-respected licensure programmes for Physician Assistants and/or Advanced Practice Registered Nurses, to expand oral health care access, particularly amongst vulnerable population subgroups, such as low-income children and families.
Guruvadoo, Eranna K.
Recently, the Workforce and Diversity Management Office at KSC have launched a major initiative to develop and implement a competency/skill approach to Human Resource management. As the competency/skill dictionary is being elaborated, the need for a competency-based workforce-planning model is recognized. A proof of concept for such a model is presented using a multidimensional data model that can provide the data infrastructure necessary to drive intelligent decision support systems for workforce planing. The components of competency-driven workforce planning model are explained. The data model is presented and several schemes that would support the workforce-planning model are presented. Some directions and recommendations for future work are given.
Manduca, C. A.; Bralower, T. J.; Blockstein, D.; Keane, C. M.; Kirk, K. B.; Schejbal, D.; Wilson, C. E.
work takes place both inside and outside of the classroom and occurs as a progression throughout the course of study. Professional skills were recognized as an area where outcomes could be strengthened. The challenge faced by geoscience programs is developing pathways into the workforce for students who bring different skills and interests to their studies. Workforce data suggest that in the past only 30% of undergraduate graduates have remained in the geosciences indicating that geoscience programs are playing an important role in developing the workforce beyond the geosciences. A collection of program descriptions describes what is known about career pathways from the programs represented at the workshop.
Heimburger, Douglas C; Warner, Tokesha L; Carothers, Catherine Lem; Blevins, Meridith; Thomas, Yolanda; Gardner, Pierce; Primack, Aron; Vermund, Sten H
Between 2004 and 2012, the National Institutes of Health Fogarty International Clinical Research Scholars (FICRS) Program provided 1-year mentored research training at low- and middle-income country sites for American and international health science doctoral students. We describe the centralized application process, US applicant characteristics, and predictors of selection/enrollment. FICRS received 1,084 applicants representing many health professions and biomedical disciplines at 132 US academic institutions; 219 students from 72 institutions were accepted and enrolled. Medical/osteopathic students comprised 88.9% of applicants and 85.8% of enrollees. Applicants from institutions with higher applicant numbers were two times as likely to be selected. In 2012, FICRS was decentralized among 20 institutions in five consortia (Global Health Fellows), with autonomous selection processes that emphasize post-doctoral trainees. If academia, government, or charitable foundations offer future opportunities to health professions students for international research, the FICRS experience predicts that they can attract substantial numbers of motivated trainees from diverse backgrounds.
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.
Cabral, Jorge; Dussault, Gilles; Buchan, James; Ferrinho, Paulo
The health services system of Timor-Leste (T-L) will, by 2015, add 800 physicians, most of them trained in Cuba, to the 233 employed by the national health system in 2010-2011. The need for more physicians is not in discussion: poor health indicators, low coverage and utilization of services, and poor quality of services are well documented in T-L. However, the choice of this scaling-up, with a relatively narrow focus on the medical workforce, needs to be assessed for its relevance to the health profile of the country, for its comprehensiveness in terms of other complementary measures needed to make it effective. This article discusses the potential effects of the rapid scaling-up of the medical workforce, and the organizational capacity needed to monitor the process and eventually mitigate any deleterious consequences. The analysis is based on a review of documentation collected on site (T-L) and on interviews with key-informants conducted in 2011. We stress that any workforce scaling-up is not simply a matter of increasing numbers of professionals, but should combine improved training, distribution, working conditions, management and motivation, as a means towards better performing health services' systems. This is a major challenge in a context of limited organizational and managerial capacity, underdeveloped information systems, limited training and research capacity, and dependency on foreign aid and technical assistance. Potential risks are associated with funding the additional costs of recruiting more personnel, associated expenditures on infrastructure, equipment and consumables, the impact on current staff mix, and the expected increased demand for services. We conclude that failing to manage effectively the forthcoming "great leap forward" will have long term effects: formal policies and plans for the balanced development of the health workforce, as well as strengthened institutions are urgently needed.
General Services Administration — This is the Federal Acquisition Institute's (FAI's) Annual demographic report on the Federal acquisition workforce, showing trends by occupational series, employment...
General Services Administration — This is the Federal Acquisition Institute's (FAI's) Annual demographic report on the Federal acquisition workforce, showing trends by occupational series, employment...