Workforce

Abstract: The current nursing shortage, high hospital nurse job dissatisfac- tion, and reports of uneven quality of hospital care are not uniquely American phenomena. This paper presents reports from 43,000 nurses from more than 700 hospitals in the United States, Canada, England, Scotland, and Germany in 1998-1999. Nurses in countries with distinctly different health care systems report similar shortcomings in their work environments and the quality of hospital care. While the competence of and relation between nurses and physi- cians appear satisfactory, core problems in work design and workforce manage- ment threaten the provision of care. Resolving these issues, which are amena- ble to managerial intervention, is essential to preserving patient safety and care of consistently high quality.

Abstract: In this analysis of the global workforce, the Joint Learning Initiative-a consortium of more than 100 health leaders-proposes that mobilisation and strengthening of human resources for health, neglected yet critical, is central to combating health crises in some of the world's poorest countries and for building sustainable health systems in all countries. Nearly all countries are challenged by worker shortage, skill mix imbalance, maldistribution, negative work environment, and weak knowledge base. Especially in the poorest countries, the workforce is under assault by HIV/AIDS, out-migration, and inadequate investment. Effective country strategies should be backed by international reinforcement. Ultimately, the crisis in human resources is a shared problem requiring shared responsibility for cooperative action. Alliances for action are recommended to strengthen the performance of all existing actors while expanding space and energy for fresh actors.

Abstract: Using data from a unique nationally representative sample of businesses, the Educational Quality of the Workforce National Employers Survey (EQW-NES), matched with the Bureau of the Census' Longitudinal Research Database (LRD), we examine the impact of workplace practices, information technology and human capital investments on productivity. We estimate an augmented Cobb Douglas production function with both cross section and panel data covering the period of 1987-1993 using both within and GMM estimators. We find that what is associated with higher productivity is not so much whether or not an employer adopts a particular work practice but rather how that work practice is actually implemented within the establishment. We also find that those unionized establishments that have adopted what have been called new or transformed' industrial relations practices that promote joint decision making coupled with incentive based compensation have higher productivity than other similar non-union plants maintain more traditional labor management relations have lower productivity. We also find that the higher the average educational level of production workers or the greater the proportion of non-managerial workers who use computers, the higher is plant productivity.

Abstract: In the last decade, education and training (ET) reform has become a major issue in many of the world's industrial powers. One theme which runs throughout these reform initiatives is the need to adapt ET systems to the changing economic environment. These changes include: the increasing integration of world markets, the shift in mass manufacturing towards newly developed nations and the rapid development of new technologies, most notably information technologies. Education and training are seen to play a crucial role in restoring or maintaining international competitiveness, both on the macro-level by easing the transition of the workforce into new industries, and at the micro-level, where firms producing high quality, specialized goods and services require a well-qualified workforce capable of rapid adjustment in the work process and continual product innovation. This paper will highlight the need for policy-makers and academics to take account of the two-way nature of the relationship between ET and the economy.

Abstract: Context: Numerous policy and research reports call for leadership to build quality work environments, implement new models of care, and bring health and wellbeing to an exhausted and stretched nursing workforce. Rarely do they indicate how leadership should be enacted, or examine whether some forms of leadership may lead to negative outcomes. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. Methods: The search strategy of this multidisciplinary systematic review included 10 electronic databases. Published, quantitative studies that examined leadership behaviours and outcomes for nurses and organizations were included. Quality assessments, data extractions and analysis were completed on all included studies. Findings: 34,664 titles and abstracts were screened resulting in 53 included studies. Using content analysis, 64 outcomes were grouped into five categories: staff satisfaction with work, role and pay, staff relationships with work, staff health and wellbeing, work environment factors, and productivity and effectiveness. Distinctive patterns between relational and task focused leadership styles and their outcomes for nurses and their work environments emerged from our analysis. For example, 24 studies reported that leadership styles focused on people and relationships (transformational, resonant, supportive, and consideration) were associated with higher nurse job satisfaction, whereas 10 studies found that leadership styles focused on tasks (dissonant, instrumental and management by exception) were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. Conclusion: Our results document evidence of various forms of leadership and their differential effects on the nursing workforce and work environments. Leadership focused on task completion alone is not sufficient to achieve optimum outcomes for the nursing workforce. Efforts by organizations and individuals to encourage and develop transformational and relational leadership are needed to enhance nurse satisfaction, recruitment, retention, and healthy work environments, particularly in this current and worsening nursing shortage.