Showing papers on "Workforce published in 2013"

Primary Care: America's Health in a New Era

Abstract: 1 Front Matter 2 Summary 3 Introduction 4 Defining Primary Care 5 The Value of Primary Care 6 The Nature of Primary Care 7 The Delivery of Primary Care 8 The Primary Care Workforce 9 Education and Training for Primary Care 10 Research and Evaluation in Primary Care 11 Implementation Strategy 12 Appendixes 13 A Site Visits 14 B Public Hearing 15 C Workshops 16 D Mental Health Care in the Primary Care Setting 17 E Life in the Kaleidodscope: The Impact of Managed Care on the U.S. Health Care Workforce and a New Model for the Delivery of Primary Care 18 F Integrating Our Primary Care and Public Health Systems: A Formula for Improving Community and Population Health 19 G Committee Biographies 20 Index

Increasing Persistence of College Students in STEM

Abstract: A 2012 report by the President's Council of Advisors on Science and Technology (PCAST) predicts that the U.S. workforce will suffer a deficit of one million college graduates in science, technology, engineering, and mathematics (STEM) over the next decade ( 1 ). The report calls for addressing the shortfall by increasing retention of college students in STEM. But many academic leaders have not responded aggressively to workforce needs by implementing measures that increase retention. Some of this nonaction is likely due to lack of knowledge about proven retention strategies.

The strength of primary care in Europe: an international comparative study

Abstract: Background A suitable definition of primary care to capture the variety of prevailing international organisation and service-delivery models is lacking. Aim Evaluation of strength of primary care in Europe. Design and setting International comparative cross-sectional study performed in 2009–2010, involving 27 EU member states, plus Iceland, Norway, Switzerland, and Turkey. Method Outcome measures covered three dimensions of primary care structure: primary care governance, economic conditions of primary care, and primary care workforce development; and four dimensions of primary care service-delivery process: accessibility, comprehensiveness, continuity, and coordination of primary care. The primary care dimensions were operationalised by a total of 77 indicators for which data were collected in 31 countries. Data sources included national and international literature, governmental publications, statistical databases, and experts’ consultations. Results Countries with relatively strong primary care are Belgium, Denmark, Estonia, Finland, Lithuania, the Netherlands, Portugal, Slovenia, Spain, and the UK. Countries either have many primary care policies and regulations in place, combined with good financial coverage and resources, and adequate primary care workforce conditions, or have consistently only few of these primary care structures in place. There is no correlation between the access, continuity, coordination, and comprehensiveness of primary care of countries. Conclusion Variation is shown in the strength of primary care across Europe, indicating a discrepancy in the responsibility given to primary care in national and international policy initiatives and the needed investments in primary care to solve, for example, future shortages of workforce. Countries are consistent in their primary care focus on all important structure dimensions. Countries need to improve their primary care information infrastructure to facilitate primary care performance management.

Supply and demand analysis of the current and future US neurology workforce

Abstract: Objective: This study estimates current and projects future neurologist supply and demand under alternative scenarios nationally and by state from 2012 through 2025. Methods: A microsimulation supply model simulates likely career choices of individual neurologists, taking into account the number of new neurologists trained each year and changing demographics of the neurology workforce. A microsimulation demand model simulates utilization of neurology services for each individual in a representative sample of the population in each state and for the United States as a whole. Demand projections reflect increased prevalence of neurologic conditions associated with population growth and aging, and expanded coverage under health care reform. Results: The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists. Demand for neurologists is projected to increase from ∼18,180 in 2012 (11% shortfall) to 21,440 by 2025 (19% shortfall). This includes an increased demand of 520 full-time equivalent neurologists starting in 2014 from expanded medical insurance coverage associated with the Patient Protection and Affordable Care Act. Conclusions: In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future.

Understanding Compassion Satisfaction, Compassion Fatigue and Burnout: a survey of the hospice palliative care workforce.

Abstract: Background:Despite the increasingly crucial role of the healthcare workforce and volunteers working in hospice and palliative care (HPC), very little is known about factors that promote or limit the positive outcomes associated with practicing compassion.Aim:The purpose of this study was to: 1) understand the complex relationships among Compassion Satisfaction, Compassion Fatigue and Burnout within the hospice and palliative care workforce and 2) explore how key practice characteristics – practice status, professional affiliation, and principal institution – interact with the measured constructs of Compassion Satisfaction, Compassion Fatigue and Burnout.Design:Self-reported measures of Compassion Satisfaction, Compassion Fatigue and Burnout, using validated scales, as well as questions to describe socio-demographic profiles and key practice characteristics were obtained.Setting/participants:A national survey of HPC workers, comprising clinical, administrative, allied health workers and volunteers, was com...

Challenges and opportunities in cancer control in Africa: a perspective from the African Organisation for Research and Training in Cancer

Abstract: Summary Sub-Saharan Africa has a disproportionate burden of disease and faces a major public-health challenge from non-communicable diseases. Although infectious diseases continue to afflict Africa, the proportion of the overall disease burden in sub-Saharan Africa attributable to cancer is rising. The region is predicted to have a greater than 85% increase in cancer burden by 2030. Approaches to minimise the burden of cancer in sub-Saharan Africa in the past few years have had little success because of low awareness of the cancer burden and a poor understanding of the potential for cancer prevention. Success will not be easy, and will need partnerships and bridges to be built across countries, economies, and professions. A strategic approach to cancer control in sub-Saharan Africa is needed to build on what works there and what is unique to the region. It should ideally be situated within strong, robust, and sustainable health-care systems that offer quality health care to all people, irrespective of their social or economic standing. However, to achieve this will need new leadership, critical thinking, investment, and understanding. We discuss the present situation in sub-Saharan Africa and propose ideas to advance cancer control in the region, including the areas of cancer awareness, advocacy, research, workforce, care, training, and funding.

A systematic literature review of nurse shortage and the intention to leave.

Abstract: chan z.c.y., tam w.s., lung m.k.y., wong w.y. & chau c.w. (2013) Journal of Nursing Management 21, 605–613 A systematic literature review of nurse shortage and the intention to leave Aim To present the findings of a literature review regarding nurses’ intention to leave their employment or the profession. Background The nursing shortage is a problem that is being experienced worldwide. It is a problem that, left unresolved, could have a serious impact on the provision of quality health care. Understanding the reasons why nurses leave their employment or the profession is imperative if efforts to increase retention are to be successful. Evaluation Electronic databases were systematically searched to identify English research reports about nurses’ intention to leave their employment or the profession. Key results concerning the issue were extracted and synthesized. Key issues The diversified measurement instruments, samples and levels of intention to leave caused difficulties in the attempt to compare or synthesize findings. The factors influencing nurses’ intention to leave were identified and categorized into organizational and individual factors. Conclusions The reasons that trigger nurses’ intention to leave are complex and are influenced by organizational and individual factors. Further studies should be conducted to investigate how external factors such as job opportunities correlate with nurses’ intention to leave. Implications for nursing management The review provides insight that can be useful in designing and implementing strategies to maintain a sustainable workforce in nursing.

Times are Changing: Gender and Generation at Work and at Home in the USA

Abstract: Times are changing for Americans in the workplace and at home. The US workforce not only looks different today than it did three decades ago as a result of increased participation by women — but it is also different in more subtle, less visible ways. In this chapter, we identify emerging trends showing that women are, for the first time, on a par with men in their desire to advance to jobs with more responsibility, while converging gender roles at work and at home have left men experiencing more work-family conflict than women.

Sustaining innovation and improvement in the treatment of childhood cancer: lessons from high-income countries

Abstract: Cancer in children and adolescents is rare and biologically very different from cancer in adults. It accounts for 1·4% of all cancers worldwide, although this proportion ranges from 0·5% in Europe to 4·8% in Africa, largely because of differences in age composition and life expectancy. In high-income countries, survival from childhood cancer has reached 80% through a continuous focus on the integration of clinical research into front-line care for nearly all children affected by malignant disease. However, further improvement must entail new biology-driven approaches, since optimisation of conventional treatments has in many cases reached its limits. In many instances, such approaches can only be achieved through international collaborative research, since rare cancers are being subdivided into increasingly smaller subgroups on the basis of their molecular characteristics. The long-term effect of anticancer treatment on quality of life must also be taken into account because more than one in 1000 adults in high-income countries are thought to be survivors of cancer in childhood or adolescence. The introduction of drugs that are less toxic and more targeted than those currently used necessitates a partnership between clinical and translational researchers, the pharmaceutical industry, drug regulators, and patients and their families. This therapeutic alliance will ensure that efforts are focused on the unmet clinical needs of young people with cancer. Most children with cancer live in low-income and middle-income countries, and these countries account for 94% of all deaths from cancer in people aged 0-14 years. The immediate priority for these children is to improve access to an affordable, best standard of care in each country. Every country should have a national cancer plan that recognises the unique demographic characteristics and care needs of young people with cancer. Centralisation of the complex components of treatment of these rare diseases is essential to improve survival, accelerate research, and train the future specialist workforce. Referral routes and care pathways must take account of the large geographical distances between many patients' homes and treatment centres, and the economic, cultural, and linguistic diversity of the populations served.

The Underside of the Silver Tsunami — Older Adults and Mental Health Care

Abstract: By 2030, the United States will have less than one geriatric psychiatrist per 6000 older adults with mental health or substance-use disorders. Perhaps innovations in other types of workforce expansion, use of technology, and federal policy can help to fill the gap.

Mental health affects future employment as job loss affects mental health: findings from a longitudinal population study

Abstract: Workforce participation is a key feature of public mental health and social inclusion policies across the globe, and often a therapeutic goal in treatment settings. Understanding the reciprocal relationship between participation and mental health has been limited by inadequate research methods. This is the first study to simultaneously examine and contrast the relative effects of unemployment on mental health and mental health on employment status in a single general population sample. Data were from working-age respondents (20 to 55 years at baseline) who completed nine waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey (N=7176). Cross-lagged path analyses were used to test the lagged and concurrent associations between unemployment and mental health over time, adjusting for sociodemographic characteristics. Mental health was shown to be both a consequence of and risk factor for unemployment. Thus, the poorer mental health observed amongst people who are not working is attributable to both the impact of unemployment and existing mental health problems. While the strength of these two effects was similar for women, the results for men suggested that the effect of unemployment on subsequent mental health was weaker than the effect of mental health on subsequent risk of unemployment. Disentangling the reciprocal links between mental health and workforce participation is central to the development and success of clinical goals and health and social policies that aim to promote either aspect. This study demonstrates that both effects are important and supports concurrent responses to prevent a cycle of disadvantage and entrenched social exclusion.

Spillovers from High-Skill Consumption to Low-Skill Labor Markets

Abstract: The least-skilled workforce in the United States is disproportionally employed in the provision of time-intensive services that can be thought of as market substitutes for home production activities. At the same time, skilled workers, with their high opportunity cost of time, spend a larger fraction of their budget in these services. Given the skill asymmetry between consumers and providers in this market, product demand shifts—such as those arising when relative skilled wages increase—should boost relative labor demand for the least-skilled workforce. We estimate that this channel may explain one-third of the growth of employment of noncollege workers in low-skill services in the 1990s.

Can Business Schools Make Students Culturally Competent? Effects of Cross-Cultural Management Courses on Cultural Intelligence

Abstract: The rapid increase in courses dealing with cross-cultural management (CCM), brought about by economies' globalization and increased workforce mobility motivated us to examine the impact of cross-cu...

Barriers to Successful Implementation of STEM Education

Abstract: The implementation of STEM education in schools across the globe is to prepare the future workforce with strong scientific and mathematical backgrounds to enhance skills development across STEM disciplines. However, for STEM education to achieve its goals and objectives, addressing the barriers to STEM education should start by fixing the problems at the elementary, junior and senior high school levels; the grassroots and potential feeders to colleges and universities. Since many nations including the United States of America is in dire need of the workforce with adequate preparation in science and mathematics to help address the nation’s economy that is in shambles, the barriers to its successful implementation should be identified and addressed. In this paper, (a) the definition of STEM education and (b) some barriers to successful implementation of STEM education are discussed and elaborated.

The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?

Abstract: At least 5.6 million to 8 million--nearly one in five--older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.

Monitoring service delivery for universal health coverage: the Service Availability and Readiness Assessment

Abstract: Objective To describe the Service Availability and Readiness Assessment (SARA) and the results of its implementation in six countries across three continents. Methods The SARA is a comprehensive approach for assessing and monitoring health service availability and the readiness of facilities to deliver health-care interventions, with a standardized set of indicators that cover all main programmes. Standardized data-collection instruments are used to gather information on a defined set of selected tracer items from public and private health facilities through a facility sample survey or census. Results from assessments in six countries are shown. Findings The results highlight important gaps in service delivery that are obstacles to universal access to health services. Considerable variation was found within and across countries in the distribution of health facility infrastructure and workforce and in the types of services offered. Weaknesses in laboratory diagnostic capacities and gaps in essential medicines and commodities were common across all countries. Conclusion The SARA fills an important information gap in monitoring health system performance and universal health coverage by providing objective and regular information on all major health programmes that feeds into country planning cycles.

Economic Crisis, Quality of Work, and Social Integration: The European Experience

Abstract: 1. Economic Crisis, the Quality of Work and Social Integration: Issues and Context 2. Economic Crisis and Employment Change: The Great Regression 3. Distribution in the Downturn 4. Continuing Training in Times of Economic Crisis 5. Job Control, Work Intensity and Work Stress 6. Job Insecurity and the Peripheral Workforce 7. Work-Life Conflict and Economic Change 8. Economic Downturn and Work Motivation 9. Unemployment and Subjective Well-being 10. Economic Crisis, Political Legitimacy and Social Cohesion 11. Economic Crisis, Country Variations and Institutional Structure

Men in nursing.

Abstract: This literature review examines the ability of the nursing profession to recruit and retain men in nursing schools and in the nursing workforce. The authors consider such educational barriers as role stress, discrimination, and stereotyping, and explore questions of male touch and the capacity of men to care. In identifying challenges faced by men entering or working in a profession in which women predominate, the authors hope to promote actions on the part of nurse leaders, educators, and researchers that may address issues of sex bias and promote greater sexual diversity within nursing.

WHO 2010 Global Policy Recommendations Interpretation:Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention

Abstract: The shortage of health workforce in rural and remote areas has been commonly concerned by every country around the word.It is one of world health issues,challenging the aspirations of achieving equity.In this regard,WHO developed the Global Policy Recommendations to improve the accessibility of the health workforce in rural and remote areas through improved retention.his article focuses on the key steps of the policy guideline developed from evidence-based medicine methodology and from angle of guideline development,mainly about background,issues,evidence retrieval and selection,quality grading of evidence,and the forming of recommendation plan,in order to further explore how to correctly understand,obtain,evaluate and apply currently available research evidence,and how to use the GRADE system to make scientiic and feasible recommendations in the decision-making process,emphasizing the importance of evidence and the GRADE system in the evidence-based health decision-making.

Patient Characteristics and Variability in Adherence and Competence in Cognitive-Behavioral Therapy for Panic Disorder.

Abstract: Although associations with outcome have been inconsistent, therapist adherence and competence continues to garner attention, particularly within the context of increasing interest in the dissemination, implementation, and sustainability of evidence-based treatments. To date, research on therapist adherence and competence has focused on average levels across therapists. With a few exceptions, research has failed to address multiple sources of variability in adherence and competence, identify important factors that might account for variability, or take these sources of variability into account when examining associations with symptom change. Objective (a) statistically demonstrate between- and within-therapist variability in adherence and competence ratings and examine patient characteristics as predictors of this variability and (b) examine the relationship between adherence/competence and symptom change.

United States of America: health system review

Abstract: This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time.

Is it Just a Bad Class? Assessing the Long‐term Stability of Estimated Teacher Performance

Abstract: A number of teacher workforce policies implicitly assume that job performance is a relatively stable attribute within teachers. We use longitudinal data on 5th grade teachers in North Carolina to assess this using value-added measures (VAMs) of job performance. We find that there is a permanent component of teacher performance that is stable in teachers over long periods—implying that workforce policies selecting teachers based on VAMs could effectively improve student achievement. But importantly, our time series model suggests that the permanent component of performance is considerably smaller than that which is often used to estimate workforce policy impacts.

Motivated to Adapt? The Role of Public Service Motivation as Employees Face Organizational Change

Abstract: Researchers concerned with organizational change have consistently emphasized the role that the work environment plays in employee acceptance of change Underexamined in the public management literature, however, is the role that employee values, particularly public service motivation (PSM), may play in employee acceptance of change Some scholars have noted a positive correlation between employee PSM and organizational change efforts; this article extends this work by attempting to isolate the mechanisms that explain this relationship Using data from a survey of employees in a city undergoing a reorganization and reduction in workforce, the authors find that only employees who scored high on a single dimension of PSM—self-sacrifice—were more likely than others to support organizational change Rather than support changes for their potential to improve public service, this finding suggests that employees with higher PSM may simply be less likely to resist changes that might disadvantage them personally