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Horvat CM, Hamilton MF, Hall MW, McGuire JK, Mink RB. Child Health Needs and the Pediatric Critical Care Medicine Workforce: 2020-2040. Pediatrics 2024; 153:e2023063678G. [PMID: 38300003 DOI: 10.1542/peds.2023-063678g] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
This article, focused on the current and future pediatric critical care medicine (PCCM) workforce, is part of a supplement in Pediatrics anticipating the future supply of the pediatric subspecialty workforce. It draws on information available in the literature, data from the American Board of Pediatrics, and findings from a model that estimates the future supply of pediatric subspecialists developed by the American Board of Pediatrics Foundation in collaboration with the Carolina Workforce Research Center at the University of North Carolina at Chapel Hill's Cecil G. Sheps Center for Health Services Research and Strategic Modeling and Analysis Ltd. A brief history of the field of PCCM is provided, followed by an in-depth examination of the current PCCM workforce and a subsequent evaluation of workforce forecasts from 2020 to 2040. Under baseline conditions, the PCCM workforce is expected to increase by 105% during the forecasted period, more than any other pediatric subspecialty. Forecasts are modeled under a variety of multifactorial conditions meant to simulate the effects of changes to the supply of PCCM subspecialists, with only modest changes observed. Future PCCM workforce demand is unclear, although some suggest an oversupply may exist and that market forces may correct this. The findings generate important questions regarding the future state of the PCCM workforce and should be used to guide trainees considering a PCCM career, subspecialty leaders responsible for hosting training programs, staffing ICUs, and governing bodies that oversee training program accreditation and subspecialist certification.
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Affiliation(s)
| | | | - Mark W Hall
- Nationwide Children's Hospital, Columbus, Ohio
| | | | - Richard B Mink
- The Lundquist Institute for Biomedical Innovation at Harbor, University of California Los Angeles Medical Center, Torrance, California
- David Geffen School of Medicine at UCLA, Torrance, CA
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202
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Blumenthal DM. Increasing Clinical Complexity-Implications for Care Delivery, Payment Models, and the Health Care Workforce. JAMA Intern Med 2024; 184:192-193. [PMID: 38190150 DOI: 10.1001/jamainternmed.2023.7407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Affiliation(s)
- Daniel M Blumenthal
- Cardiology Division, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
- Novocardia Division, Cardiovascular Associates of America, Celebration, Florida
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203
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Hewitt L, Dadich A, Hartz DL, Dahlen HG. Midwifery group practice workforce in Australia: A cross-sectional survey of midwives and managers. Women Birth 2024; 37:206-214. [PMID: 37726186 DOI: 10.1016/j.wombi.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/25/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Despite robust evidence on the benefits of midwifery group practice (MGP), there remains difficulties with implementing and sustaining the model. However, contemporary data on the MGP workforce and how each model has been operationalised are limited. This constrains an understanding of the factors that help or hinder implementation and sustainability of MGP. AIM To describe the characteristics of Australian MGPs and the factors that help or hinder sustainability. METHODS A national cross-sectional survey was undertaken in Australia between March 2021 and July 2022, inclusive. Quantitative data were analysed using descriptive analysis while qualitative data were analysed using content analysis. FINDINGS Of 669 survey responses, 579 were midwives and 90 were managers. The mean years of experience for clinical midwives was eight years, and 47.8% (almost twice the national average) completed a Bachelor of Midwifery (BMid). Half (50.2%) the models provided care for women of all risk. Midwives resigned from MGP because of the MGP work conditions (30%) and how the service was managed or supported (12.7%). Managers resigned from MGP because of role changes, conflict with their manager, and limited support. Almost half (42.6%) of MGP managers also managed other areas, leading to heavy workloads, competing demands, and burnout. CONCLUSION The BMid appears to be a common educational pathway for MGP midwives, and many MGP services are providing care to women with complexities. Flexible practice agreements, organisational support and appropriate workloads are vital for recruitment, retention, and sustainability of MGP.
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Affiliation(s)
- Leonie Hewitt
- School of Nursing and Midwifery Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Ann Dadich
- School of Business Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Donna L Hartz
- School of Nursing and Midwifery Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Hannah G Dahlen
- School of Nursing and Midwifery Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
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204
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Slotala L. [Internationalization as an innovation in long-term care]. Z Gerontol Geriatr 2024; 57:27-31. [PMID: 38231210 DOI: 10.1007/s00391-023-02279-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/18/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Long-term care in Germany is undergoing a process of internationalization. Against the backdrop of a growing need for skilled workers, personnel are also increasingly being recruited from abroad. OBJECTIVE The article analyzes the relevance of immigration of skilled workers for the labor market and derives the needs for innovation on the side of companies. MATERIAL AND METHODS Selected results of the professional recognition statistics are presented and literature-supported innovation needs are worked out. RESULTS AND CONCLUSION Significant innovation needs lie in the areas of implementation of recognition procedures, operational integration measures and approaches to municipal cooperation.
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Affiliation(s)
- Lukas Slotala
- Fakultät Angewandte Sozialwissenschaften, Technische Hochschule Würzburg-Schweinfurt, Münzstr. 12, 97070, Würzburg, Deutschland.
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205
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Abstract
Child abuse pediatrics (CAP) subspecialists evaluate, diagnose, and treat children when abuse or neglect is suspected. Despite the high rates of child maltreatment across the United States, CAP remains the smallest pediatric subspecialty. The CAP workforce faces numerous challenges, including few fellows entering the field, decreased financial compensation compared with other fields of medicine, and threats to workforce retention, including secondary trauma and harmful exposure in the media. A microsimulation model that estimates the future of the US CAP workforce over the next 20 years shows that, although the number of child abuse pediatricians in the field is expected to increase, the growth is smaller than that of every other pediatric subspecialty. In addition to the low overall CAP workforce in the United States, other workforce issues include the need to increase CAP subspecialists who are underrepresented in medicine and unequal geographic distribution across the country. To meet the medical needs of suspected victims of maltreatment, especially in CAP-underserved areas, many children are evaluated by providers who are not board-certified in CAP, such as general pediatricians, family medicine physicians, emergency medicine physicians, and advanced practice providers, whose CAP experience and training may vary. Current child abuse pediatricians should continue introducing the field to medical students and residents, especially those who identify as underrepresented in medicine or are from CAP-underserved areas, and offer mentorship, continuing education, and oversight to non-CAP physicians meeting this population's medical needs.
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Affiliation(s)
- Brett Slingsby
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Angela Bachim
- Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Laurel K Leslie
- American Board of Pediatrics, Chapel Hill, North Carolina
- Tufts University School of Medicine, Boston, Massachusetts
| | - Mary E Moffatt
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri
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206
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Pit SW, Horstmanshof L, Moehead A, Hayes O, Schache V, Parkinson L. International Standards for Dementia Workforce Education and Training: A Scoping Review. Gerontologist 2024; 64:gnad023. [PMID: 37071967 PMCID: PMC10825835 DOI: 10.1093/geront/gnad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The increasing number of people with dementia requires transparency and quality dementia education, training, and care. This scoping review aimed to determine the key elements of national or state-wide standards on dementia education and training that could underpin the development of international standards for dementia workforce training and education. RESEARCH DESIGN AND METHODS The English-language peer-reviewed and gray literature were searched (2010-20). Key search domains were training, workforce, standards/frameworks, and dementia. RESULTS Thirteen standards were identified from the United Kingdom (n = 5), the United States (n = 4), Australia (n = 3), and Ireland (n = 1). Most standards focused on training health care professionals with some including people in customer-centric settings, people living with dementia, and informal carers or the general community. Seventeen training topics were identified in 10 or more of the 13 standards. Cultural safety, rural issues, health care professional self-care, digital literacy, and health promotion topics were less commonly reported. The barriers to standards implementation were lack of organizational support, lack of access to relevant training, low staff literacy, lack of funding, high staff turnover, ineffective past program cycles, and inconsistent service delivery. Enablers included a strong implementation plan, funding, strength of partnerships, and building on previous work. DISCUSSION AND IMPLICATIONS The U.K. Dementia Skills and Core Training Standard, the Irish Department of Health Dementia Together, and the National Health Services Scotland Standard are the recommended strongest standards for underpinning the development of international standards. It is essential that training standards are tailored to the needs of the consumer, worker, and regions.
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Affiliation(s)
- Sabrina Winona Pit
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- School of Medicine, Western Sydney University, Lismore, New South Wales, Australia
| | | | - Anne Moehead
- Dementia Inclusive Ballina, Ballina, New South Wales, Australia
| | - Oliver Hayes
- University of Melbourne, Melbourne, Victoria, Australia
| | - Valerie Schache
- Dementia Alliance International, Ballina, New South Wales, Australia
| | - Lynne Parkinson
- School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia
- Olivia May Consulting, Gladstone, Queensland, Australia
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207
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Abstract
This article evaluates the pediatric cardiology (PC) workforce and forecasts its future supply. Produced as part of a supplement in Pediatrics, this effort represents a collaboration among the American Board of Pediatrics Foundation, the University of North Carolina at Chapel Hill's Carolina Health Workforce Research Center, the Strategic Modeling and Analysis Ltd., and members of the pediatric subspecialty community. PC is a complex subspecialty including care from fetal life through adulthood and in practice settings that range from the outpatient clinic to procedural settings to the cardiac ICU. Complex subdisciplines include imaging, electrophysiology, heart failure, and interventional and critical care. Using American Board of Pediatrics data, US Census Bureau data, and data from the modeling project, projections were created to model the subspecialty workforce through 2040. Across all modeling scenarios considered, there is considerable projected growth in the supply of pediatric cardiologists by 2040. However, there is significant regional variation in the projected supply of trainees relative to demand in terms of local population growth, with evidence of a likely mismatch between areas surrounding training centers versus areas of greatest workforce need. In addition, this article highlights areas for future focus, including efforts to attract more residents to the subspecialty in general, particularly underrepresented minority members; increased support, more part-time career options, and improved academic career advancement for women in PC; and the development of better "real-time" workforce data to guide trainees and training programs in decisions regarding sub-subspecialty job availability.
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Affiliation(s)
- Lowell H. Frank
- Division of Cardiology, Children’s National Hospital, Washington, District of Columbia
| | - Julie Glickstein
- Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, New York
| | - David W. Brown
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts
| | - Richard B. Mink
- David Geffen School of Medicine at the University of California Los Angeles, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles Medical Center, Torrance
| | - Robert D. Ross
- Division of Cardiology, Children’s Hospital of Michigan, Detroit, Michigan
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208
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Danylak S, Walsh LJ, Zafar S. Measuring ergonomic interventions and prevention programs for reducing musculoskeletal injury risk in the dental workforce: A systematic review. J Dent Educ 2024; 88:128-141. [PMID: 37990449 DOI: 10.1002/jdd.13403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 09/05/2023] [Accepted: 10/20/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE Pain from musculoskeletal disorders (MSD) is experienced by all types of dental clinicians, leading to forced reduction of work capacity and premature retirement. Prolonged static posture is a major contributor to MSD in dentistry. Currently, there is no uniform ergonomic training in dentistry to prevent MSD. This systematic review explored and summarized methods and technologies for baseline and ongoing measurements of ergonomic intervention and prevention programs for reducing postural risk and for prevention of MSDs. METHODS The review was conducted in accordance with PRISMA guidelines. The literature search included PUBMED, Embase, CINAHL and the Cochrane Library, and identified relevant observational, experimental, quasi-experimental, research, and intervention studies. Quality was rated using a validated standardized instrument. RESULTS A total of 20 studies were included, of which 4 were rated as being of the high quality. Methods ranged from observers to motion sensors. Ten studies focused used established measuring tools (PAI, RULA, REBA), while nine studies focused on effectiveness of alternative methods of measurement. One study identified ISO standard 11226 for baseline comparisons. Evolving technologies were found to be suitable for baseline measurements of posture, and for feedback for developing sustainable postural behaviors. No studies measured ongoing postural performance improvement. CONCLUSIONS This systematic review adds to current evidence for the expanded and improved use of early training and testing of postural competence to reduce MSD risk among dental professionals. Further studies using technologies to assess the impacts of ergonomic training and testing among dental professionals are warranted.
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Affiliation(s)
- Stefan Danylak
- School of Dentistry, The University of Queensland, Brisbane, Brisbane, QLD, Australia
| | - Laurence J Walsh
- School of Dentistry, The University of Queensland, Brisbane, Brisbane, QLD, Australia
| | - Sobia Zafar
- School of Dentistry, The University of Queensland, Brisbane, Brisbane, QLD, Australia
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209
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Nandiwada DR, Farkas AH, Nikiforova T, Leung PB, Donovan AK, Killian K, Thomas ML, Singh MK, Gallagher B, Callender DM. Exploring Models of Exposure to Primary Care Careers in Training: a Narrative Review. J Gen Intern Med 2024; 39:277-282. [PMID: 37989819 PMCID: PMC10853099 DOI: 10.1007/s11606-023-08532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023]
Abstract
Multiple models of clinical exposure to primary care exist within undergraduate medical education (UME) and graduate medical education (GME). In this narrative review, we explore the evidence behind these different models of exposure, their alignment with positive promoters of primary care careers, and the pros and cons of each. Without positive exposure to primary care during training, sustaining the future primary care work force becomes increasingly challenging. Here, we explore multiple models of clinical exposure in UME, including longitudinal integrated clerkships, primary care tracks, and primary care clerkships. Within GME, we will review the impact of primary care tracks, Area Health Education Centers, block scheduling models, and continuity clinic scheduling models. The goal of this narrative review is to allow educators to think broadly and intentionally about the array of models to develop positive primary care experiences and perceptions in training, ultimately sustaining the primary care workforce.
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Affiliation(s)
- D Rani Nandiwada
- Perelman School of Medicine, University of Pennsylvania, 51 North 39Th Street, MAB 102, Philadelphia, PA, 19104, USA
| | - Amy H Farkas
- Milwaukee VA Medical Center, 5000 W National Ave, Milwaukee, WI, 53211, USA
| | - Tanya Nikiforova
- Division of General Internal Medicine, UPMC Montefiore Hospital, 9 West 921, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Peggy B Leung
- Weill Cornell Internal Medicine Associates, 505 East 70Th St, HT-4, New York, NY, 10021, USA
| | - Anna K Donovan
- Division of General Internal Medicine, UPMC Montefiore Hospital, 9 West 930, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Katherine Killian
- Weill Cornell Internal Medicine, 178 East 85Th Street, Floor 2, New York, NY, 10028, USA
| | - Mary L Thomas
- University of Tennessee, 920 Madison Ave, Suite 531, Memphis, TN, 38163, USA
| | - Mamta K Singh
- Case Western Reserve University, VA Northeast Ohio Healthcare System, 1620 Magnolia Drive, Administrative Building, RM 5M678, Cleveland, OH, 44106, USA
| | | | - David M Callender
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA.
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210
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Naik H, Murray TM, Khan M, Daly-Grafstein D, Liu G, Kassen BO, Onrot J, Sutherland JM, Staples JA. Population-Based Trends in Complexity of Hospital Inpatients. JAMA Intern Med 2024; 184:183-192. [PMID: 38190179 PMCID: PMC10775081 DOI: 10.1001/jamainternmed.2023.7410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/11/2023] [Indexed: 01/09/2024]
Abstract
Importance Clinical experience suggests that hospital inpatients have become more complex over time, but few studies have evaluated this impression. Objective To assess whether there has been an increase in measures of hospital inpatient complexity over a 15-year period. Design, Setting and Participants This cohort study used population-based administrative health data from nonelective hospitalizations from April 1, 2002, to January 31, 2017, to describe trends in the complexity of inpatients in British Columbia, Canada. Hospitalizations were included for individuals 18 years and older and for which the most responsible diagnosis did not correspond to pregnancy, childbirth, the puerperal period, or the perinatal period. Data analysis was performed from July to November 2023. Exposure The passage of time (15-year study interval). Main Outcomes and Measures Measures of complexity included patient characteristics at the time of admission (eg, advanced age, multimorbidity, polypharmacy, recent hospitalization), features of the index hospitalization (eg, admission via the emergency department, multiple acute medical problems, use of intensive care, prolonged length of stay, in-hospital adverse events, in-hospital death), and 30-day outcomes after hospital discharge (eg, unplanned readmission, all-cause mortality). Logistic regression was used to estimate the relative change in each measure of complexity over the entire 15-year study interval. Results The final study cohort included 3 367 463 nonelective acute care hospital admissions occurring among 1 272 444 unique individuals (median [IQR] age, 66 [48-79] years; 49.1% female and 50.8% male individuals). Relative to the beginning of the study interval, inpatients at the end of the study interval were more likely to have been admitted via the emergency department (odds ratio [OR], 2.74; 95% CI, 2.71-2.77), to have multimorbidity (OR, 1.50; 95% CI, 1.47-1.53) and polypharmacy (OR, 1.82; 95% CI, 1.78-1.85) at presentation, to receive treatment for 5 or more acute medical issues (OR, 2.06; 95% CI, 2.02-2.09), and to experience an in-hospital adverse event (OR, 1.20; 95% CI, 1.19-1.22). The likelihood of an intensive care unit stay and of in-hospital death declined over the study interval (OR, 0.96; 95% CI, 0.95-0.97, and OR, 0.81; 95% CI, 0.80-0.83, respectively), but the risks of unplanned readmission and death in the 30 days after discharge increased (OR, 1.14; 95% CI, 1.12-1.16, and OR, 1.28; 95% CI, 1.25-1.31, respectively). Conclusions and Relevance By most measures, hospital inpatients have become more complex over time. Health system planning should account for these trends.
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Affiliation(s)
- Hiten Naik
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Tyler M. Murray
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mayesha Khan
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Daniel Daly-Grafstein
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Statistics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Guiping Liu
- Center for Health Services and Policy Research (CHSPR), School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Barry O. Kassen
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jake Onrot
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jason M. Sutherland
- Center for Health Services and Policy Research (CHSPR), School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada
| | - John A. Staples
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation (C2E2), Vancouver, British Columbia, Canada
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211
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Aye T, Boney CM, Orr CJ, Leonard MB, Leslie LK, Allen DB. Child Health Needs and the Pediatric Endocrinology Workforce: 2020-2040. Pediatrics 2024; 153:e2023063678J. [PMID: 38300000 DOI: 10.1542/peds.2023-063678j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
The pediatric endocrinology (PE) workforce in the United States is struggling to sustain an adequate, let alone optimal, workforce capacity. This article, one of a series of articles in a supplement to Pediatrics, focuses on the pediatric subspecialty workforce and furthers previous evaluations of the US PE workforce to model the current and future clinical PE workforce and its geographic distribution. The article first discusses the children presenting to PE care teams, reviews the current state of the PE subspecialty workforce, and presents projected headcount and clinical workforce equivalents at the national, census region, and census division level on the basis of a subspecialty workforce supply model through 2040. It concludes by discussing the educational and training, clinical practice, policy, and future workforce research implications of the data presented. Data presented in this article are available from the American Board of Pediatrics, the National Resident Matching Program, and the subspecialty workforce supply model. Aging, part-time appointments, and unbalanced geographic distribution of providers diminish the PE workforce capacity. In addition, limited exposure, financial concerns, and lifestyle perceptions may impact trainees. Additional workforce challenges are the subspecialty's increasingly complex cases and breadth of conditions treated, reliance on international medical graduates to fill fellowship slots, and high relative proportion of research careers. The recent limitations on pediatric endocrinologists providing gender-affirming care may also impact the geographic distribution of the subspecialty's workforce. Deliberate actions need to be taken now to continue serving the needs of children.
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Affiliation(s)
- Tandy Aye
- Division of Pediatric Endocrinology
- Stanford University School of Medicine, Stanford, California
| | - Charlotte M Boney
- Division of Pediatric Endocrinology, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts
| | - Colin J Orr
- Division of General Pediatrics and Adolescent Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mary B Leonard
- Stanford University School of Medicine, Stanford, California
| | | | - David B Allen
- Division of Pediatric Endocrinology and Diabetes, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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212
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Patel VR, Liu M, Byrne JP, Haynes AB, Ibrahim AM. Surgeon Supply by County-Level Rurality and Social Vulnerability From 2010 to 2020. JAMA Surg 2024; 159:223-225. [PMID: 38019482 PMCID: PMC10687707 DOI: 10.1001/jamasurg.2023.5632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/24/2023] [Indexed: 11/30/2023]
Abstract
This cross-sectional study examines the surgical workforce in all counties across the US from 2010 to 2020.
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Affiliation(s)
| | - Michael Liu
- Harvard Medical School, Boston, Massachusetts
| | - James P. Byrne
- Division of Acute Care Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Andrew M. Ibrahim
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor
- Taubman College of Architecture and Urban Planning, University of Michigan, Ann Arbor
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213
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Coad B, Joekes K, Rudnicka A, Frost A, Tatton-Brown K, Snape K. Massive open online courses (MOOCs) in genomic variant interpretation: An innovative education strategy for the growing genetic counselor workforce. J Genet Couns 2024; 33:142-150. [PMID: 38013198 DOI: 10.1002/jgc4.1837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 10/02/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023]
Abstract
The growth in genomic testing in healthcare requires a highly trained specialist workforce to ensure evidence based clinical germline variant interpretation. Genetic counselors form a core part of the clinical genomics multidisciplinary team (MDT) and represent a growing workforce participating in variant interpretation from data analysis to the patient consultation. Standardized, high-quality variant interpretation training for Genetic Counselors has historically been ad hoc and variable, with existing programs lacking capacity to reach the entire workforce. To address the requirement for scalable variant interpretation training for genomics healthcare professionals (HCPs), two Massive Open Online Courses (MOOCs) were developed. We analyzed the data from 17 Genetic counselors, as part of an evaluation cohort completing the first run of these MOOCs. Overall genetic counselors enjoyed the courses, felt they were clinically relevant and would recommend them to colleagues. Common challenges amongst the genetic counseling workforces included utilizing relevant databases and finding time in the workday to complete training. These findings suggest MOOCs could be an acceptable option to ensure a consistent and transferrable high standard of training, complimentary to existing curricula. They also hold the potential to facilitate large-scale education to update the genetic counseling workforce when changes in variant interpretation guidance occur.
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Affiliation(s)
- Beth Coad
- St George's University of London, London, UK
| | | | | | - Amy Frost
- Genomics Education Programme, Health Education England, London, UK
| | | | - Katie Snape
- St George's University of London, London, UK
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214
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Howard J, Houry D. Protecting the Mental Health and Well-Being of the Nation's Health Workforce. Am J Public Health 2024; 114:137-141. [PMID: 38354354 PMCID: PMC10916729 DOI: 10.2105/ajph.2023.307475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 02/16/2024]
Affiliation(s)
- John Howard
- John Howard is the director of the National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention in the Department of Health and Human Services, Washington, DC. Debra Houry is the deputy director for program and science and the chief medical officer at the Centers for Disease Control and Prevention in the Department of Health and Human Services, Atlanta, GA
| | - Debra Houry
- John Howard is the director of the National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention in the Department of Health and Human Services, Washington, DC. Debra Houry is the deputy director for program and science and the chief medical officer at the Centers for Disease Control and Prevention in the Department of Health and Human Services, Atlanta, GA
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Jia S, Shang H. Utilizing green financing in developing green HRM resources for carbon neutrality: presenting multidimensional perspectives of China. Environ Sci Pollut Res Int 2024; 31:8798-8811. [PMID: 38180647 DOI: 10.1007/s11356-023-31560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024]
Abstract
This study examines how green finance may encourage the development of green human resource management (HRM) solutions to help China achieve carbon neutrality. For an empirical estimate, the Chinese data is subjected to DEA analysis, Tobit regression, and a sensitivity analysis model. The findings highlight the significance of green finance in the creation of green HRM solutions that aid firms in enhancing their environmental performance, boosting employee happiness, and getting them closer to their carbon neutrality goals. With the use of tools like green bonds and sustainable investment funds, businesses may raise capital for sustainability projects and encourage the adoption of environmentally responsible HRM practices. Moreover, the study results discussed the need to incorporate environmental sustainability considerations into HRM plans, enabling organizations to cultivate a sustainable culture and engage employees in supporting carbon neutrality through green practices in talent acquisition, training and development, performance management, and employee engagement. Incorporating environmental sustainability into HRM processes, boosting stakeholder involvement, and looking into new funding methods are all points emphasized in the study, which aims to enhance the uptake of green HRM initiatives.
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Affiliation(s)
- Shaowei Jia
- School of Economics and Management, East China University of Technology, NanChang, 330000, China
| | - Hongjiang Shang
- Department of Economic Management, Hebei Vocational University of Technology and Engineering, XingTai, 054000, China.
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216
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Johnson JH, Alexander GR. Confronting the Nursing Profession's Workforce Challenges: Embracing Iceberg Demographics. Creat Nurs 2024; 30:58-64. [PMID: 38304938 DOI: 10.1177/10784535241229448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
U.S. Supreme Court rulings on reproductive rights and affirmative action inadvertently present the nursing profession with a propitious opportunity to capitalize on the nation's rich mosaic of iceberg demographic identities-inherited and acquired traits that may not be visibly apparent-to address imminent challenges such as worker shortages and other perplexities within the workplace milieu.
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Affiliation(s)
- James H Johnson
- Kenan-Flagler Business School, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - G Rumay Alexander
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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217
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Fisher K, Depczynski J, Mitchell E, Smith A. Factors influencing nursing and allied health recent graduates' rural versus urban preferred principal place of practice: A cross-sectional data linkage study. Aust J Rural Health 2024; 32:117-128. [PMID: 38014427 DOI: 10.1111/ajr.13069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/11/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Disparities between metropolitan and non-metropolitan health workforce must be addressed to reduce inequities in health care access. Understanding factors affecting early career practitioners' choice of practice location can inform workforce planning. OBJECTIVE To investigate influences on rural practice location preferences of recent graduates. DESIGN Cross-sectional analysis linked university enrolment, Graduate Outcomes Survey (GOS) and Australian Health Professional Regulation Agency (Ahpra) principal place of practice (PPP) for 2018 and 2019 nursing and allied health graduates from two Australian universities. Chi-squared tests and logistic regression compared rural versus urban PPP and locational preference. FINDINGS Of 2979 graduates, 1295 (43.5%) completed the GOS, with 63.7% (n = 825) working in their profession and 84.0% of those (n = 693) in their preferred location. Ahpra PPP data were extracted for 669 (81.1%) of those working in their profession. Most reported influences were 'proximity to family/friends' (48.5%), 'lifestyle of the area' (41.7%) and 'opportunity for career advancement' (40.7%). Factors most influential for rural PPP were 'cost of accommodation/housing' (OR = 2.26, 95% CI = 1.23-4.17) and 'being approached by an employer' (OR = 2.10, 95% CI = 1.12-3.92). Having an urban PPP was most influenced by 'spouse/partners employment/career' (OR = 0.53, 95% CI = 0.30-0.93) and 'proximity to family/friends' (OR = 0.41, 95% CI = 0.24-0.72). DISCUSSION While the findings add strength to the understanding that graduates who originated from a rural area are most likely to take up rural practice in their preferred location, varied social and professional factors are influential on decision-making. CONCLUSIONS It is imperative to recruit students from non-metropolitan regions into health professional degrees, as well as addressing other influences on choice of practice location.
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Affiliation(s)
- Karin Fisher
- University of Newcastle Department of Rural Health, Tamworth, New South Wales, Australia
| | - Julie Depczynski
- University of Newcastle Department of Rural Health, Moree, New South Wales, Australia
| | - Eleanor Mitchell
- Monash University Department of Rural Health, Clayton, Victoria, Australia
| | - Anthony Smith
- University of Newcastle Department of Rural Health, Taree, New South Wales, Australia
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218
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Calderon M, Parekh VI. Time to move past midnight census: Adopting modern methods to guide hospital medicine staffing. J Hosp Med 2024; 19:149-150. [PMID: 38146815 DOI: 10.1002/jhm.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 12/27/2023]
Affiliation(s)
- Marcus Calderon
- Division of Hospital Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Vikas I Parekh
- Division of Hospital Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- University of Michigan Health, Ann Arbor, Michigan, USA
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219
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Patterson DG, Shipman SA, Pollack SW, Andrilla CHA, Schmitz D, Evans DV, Peterson LE, Longenecker R. Growing a rural family physician workforce: The contributions of rural background and rural place of residency training. Health Serv Res 2024; 59:e14168. [PMID: 37161614 PMCID: PMC10771894 DOI: 10.1111/1475-6773.14168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE To determine the distinct influences of rural background and rural residency training on rural practice choice among family physicians. DATA SOURCES AND STUDY SETTING We used a subset of The RTT Collaborative rural residency list and longitudinal data on family physicians from the American Board of Family Medicine National Graduate Survey (NGS; three cohorts, 2016-2018) and American Medical College Application Service (AMCAS). STUDY DESIGN We conducted a logistic regression, computing predictive marginals to assess associations of background and residency location with physician practice location 3 years post-residency. DATA COLLECTION/EXTRACTION METHODS We merged NGS data with residency type-rural or urban-and practice location with AMCAS data on rural background. PRINCIPAL FINDINGS Family physicians from a rural background were more likely to choose rural practice (39.2%, 95% CI = 35.8, 42.5) than those from an urban background (13.8%, 95% CI = 12.5, 15.0); 50.9% (95% CI = 43.0, 58.8) of trainees in rural residencies chose rural practice, compared with 18.0% (95% CI = 16.8, 19.2) of urban trainees. CONCLUSIONS Increasing rural programs for training residents from both rural and urban backgrounds, as well as recruiting more rural students to medical education, could increase the number of rural family physicians.
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Affiliation(s)
- Davis G. Patterson
- Department of Family MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - Scott A. Shipman
- Department of Clinical Research and Public HealthCreighton UniversityOmahaNebraskaUSA
| | - Samantha W. Pollack
- Department of Family MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - C. Holly A. Andrilla
- Department of Family MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - David Schmitz
- School of Medicine and Health SciencesUniversity of North DakotaGrand ForksNorth DakotaUSA
| | - David V. Evans
- Department of Family MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
| | | | - Randall Longenecker
- Heritage College of Osteopathic MedicineOhio UniversityBridgewaterVirginiaUSA
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220
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Stephens EH, Romano JC, Carpenter AJ, Yang SC, LaPar DJ, Fuller S. Workforce and Training Implications of the 2022 Congenital Heart Surgery Practice Survey. Ann Thorac Surg 2024; 117:282-284. [PMID: 37866647 DOI: 10.1016/j.athoracsur.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Affiliation(s)
| | - Jennifer C Romano
- Department of Cardiac Surgery, CS Mott Children's Hospital, Ann Arbor, Michigan
| | - Andrea J Carpenter
- Division of Thoracic Surgery, University of Texas, Health Science Center at San Antonio, San Antonio, Texas
| | - Stephen C Yang
- Division of Thoracic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Damien J LaPar
- Department of Cardiovascular Surgery, UTHealth Houston Children's Heart Institute, Houston, Texas
| | - Stephanie Fuller
- Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
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221
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Liu XL, Nic Giolla Easpaig B, Garti I, Bressington D, Wang T, Wikander L, Tan JYB. Improving success and retention of undergraduate nursing students from rural and remote Australia: A multimethod study protocol. Nurse Educ Pract 2024; 75:103876. [PMID: 38266568 DOI: 10.1016/j.nepr.2024.103876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/06/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
AIM The aim of the proposed research is to develop, pilot and evaluate a novel, bespoke intervention with in-built consideration of the factors influencing attrition and barriers to retention for rural and remote undergraduate nursing students. BACKGROUND There are high rates of attrition in nursing students with rural and remote backgrounds in Australia. However, there is a lack of understanding of what enables or impedes these students to progress in their studies and the strategies available to support them to become part of the nursing workforce. Addressing these gaps is critical to informing the efforts of those involved in nursing education, training and workforce planning. DESIGN A multi-methods study. METHOD A project involving a multi-methods approach will be undertaken at an Australian higher education institution. In the first exploratory study, interviews and student cohort data will be used to understand attrition and retention, influencing factors and barriers to retention among rural and remote undergraduate nursing students. Findings from this study will be used to guide the development and implementation of a novel tailored student support service targeted to increase retention for this cohort. In the final evaluation study, the attrition and retention outcomes of participating students will be examined via interviews, surveys and existing cohort retention data. EXPECTED RESULTS The study will provide insights into the factors that can shape the retention experiences of rural and remote undergraduate nursing students and generate much needed evidence concerning what Higher Education Institutions can do to support the retention for this specific student cohort.
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Affiliation(s)
- Xian-Liang Liu
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong SAR, China.
| | - Bróna Nic Giolla Easpaig
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia
| | - Isabella Garti
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia
| | - Daniel Bressington
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia
| | - Tao Wang
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia
| | - Lolita Wikander
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia
| | - Jing-Yu Benjamin Tan
- School of Nursing and Midwifery, University of Southern Queensland, Ipswich Campus, 11 Salisbury Rd, Ipswich, QLD 4305, Australia
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222
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Orr CJ, McCartha E, Vinci RJ, Mink RB, Leonard MB, Bissell M, Gaona AR, Leslie LK. Projecting the Future Pediatric Subspecialty Workforce: Summary and Recommendations. Pediatrics 2024; 153:e2023063678T. [PMID: 38300012 DOI: 10.1542/peds.2023-063678t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
This article summarizes the findings of a Pediatrics supplement addressing the United States workforce for 15 pediatric subspecialties. It includes results from a microsimulation model projecting supply through 2040; growth is forecasted to be uneven across the subspecialties with worsening geographic maldistribution. Although each subspecialty has unique characteristics, commonalities include (1) the changing demographics and healthcare needs of children, including mental health; (2) poor outcomes for children experiencing adverse social drivers of health, including racism; and (3) dependence on other subspecialties. Common healthcare delivery challenges include (1) physician shortages for some subspecialties; (2) misalignment between locations of training programs and subspecialists and areas of projected child population growth; (3) tension between increasing subsubspecialization to address rare diseases and general subspecialty care; (4) the need to expand clinical reach through collaboration with other physicians and advanced practice providers; (5) the lack of parity between Medicare, which funds much of adult care, and Medicaid, which funds over half of pediatric subspecialty care; and (6) low compensation of pediatric subspecialists compared with adult subspecialists. Overall, subspecialists identified the lack of a central authority to monitor and inform child healthcare provided by pediatric subspecialists as a challenge. Future research on the pediatric subspecialty workforce and the children it serves will be necessary to ensure these children's needs are met. Together, these articles provide overarching and subspecialty-specific recommendations to improve training, recruitment, and retention of a diverse workforce, implement innovative models of care, drive policy changes, and advise future research.
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Affiliation(s)
- Colin J Orr
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Emily McCartha
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert J Vinci
- Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Richard B Mink
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
| | - Mary B Leonard
- Stanford University School of Medicine, Stanford, California
| | - Mary Bissell
- Child Focus, Washington, District of Columbia
- Georgetown University Law Center, Georgetown University, Washington, District of Columbia
| | - Adriana R Gaona
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Laurel K Leslie
- American Board of Pediatrics, Chapel Hill, North Carolina
- Tufts University School of Medicine, Boston, Massachusetts
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223
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Kelly MS, Cataldi JR, Schlaudecker EP, Shah SS, Vinci RJ, Myers AL. Child Health Needs and the Pediatric Infectious Diseases Workforce: 2020-2040. Pediatrics 2024; 153:e2023063678N. [PMID: 38300015 PMCID: PMC10852198 DOI: 10.1542/peds.2023-063678n] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
Pediatric infectious diseases (PID) physicians prevent and treat childhood infections through clinical care, research, public health, education, antimicrobial stewardship, and infection prevention. This article is part of an American Board of Pediatrics Foundation-sponsored supplement investigating the future of the pediatric subspecialty workforce. The article offers context to findings from a modeling analysis estimating the supply of PID subspecialists in the United States between 2020 and 2040. It provides an overview of children cared for by PID subspecialists, reviews the current state of the PID workforce, and discusses the projected headcount and clinical workforce equivalents of PID subspecialists at the national, census region, and census division levels over this 2-decade period. The article concludes by discussing the education and training, clinical practice, policy, and research implications of the data presented. Adjusting for population growth, the PID workforce is projected to grow more slowly than most other pediatric subspecialties and geographic disparities in access to PID care are expected to worsen. In models considering alternative scenarios, decreases in the number of fellows and time spent in clinical care significantly affect the PID workforce. Notably, model assumptions may not adequately account for potential threats to the PID workforce, including a declining number of fellows entering training and the unknown impact of the COVID-19 pandemic and future emerging infections on workforce attrition. Changes to education and training, clinical care, and policy are needed to ensure the PID workforce can meet the future needs of US children.
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Affiliation(s)
- Matthew S. Kelly
- Department of Pediatrics, Division of Infectious Diseases, Duke University, Durham, North Carolina
| | - Jessica R. Cataldi
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado
| | - Elizabeth P. Schlaudecker
- Division of Infectious Diseases
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Samir S. Shah
- Division of Infectious Diseases
- Division of Hospital Medicine, Cincinnati Children’s Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Robert J. Vinci
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
| | - Angela L. Myers
- Division of Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
- University of Missouri – Kansas City
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224
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Matthews RP, Hyde RL, McLachlan HL, Llewelyn F, Forster DA. Midwifery workforce challenges in Victoria, Australia. A cross-sectional study of maternity managers. Women Birth 2024; 37:144-152. [PMID: 37553273 DOI: 10.1016/j.wombi.2023.07.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND In Australia, there is a lack of accurate data on midwifery workforce staffing and skill mix, which in turn hinders workforce policy and planning. AIM To describe the current staffing levels of the midwifery workforce in Victoria, Australia, explore workforce challenges and assess the impact of COVID-19 pandemic on staffing. DESIGN Cross-sectional. METHODS Midwifery managers in all public and private maternity services in Victoria, Australia were invited to complete a survey exploring midwifery staffing numbers and adequacy. Topics explored included midwifery turnover, recruitment, and skill mix. Descriptive statistics were used. FINDINGS The survey was open March to October 2021, and 56 % (38/68) of managers responded. Of these, 76 % reported inadequate midwifery staff levels, with deficits ranging from one to 19 estimated Full-Time Equivalent (EFT) midwives, with a combined total deficit of 135 EFT. In the 12 months prior to the survey, 73 % of services had found it difficult to recruit midwives, with increased difficulty during the COVID-19 pandemic. Managers were concerned about retaining and recruiting 'experienced' midwives due to an ageing workforce and high turnover due to work/life imbalance and job dissatisfaction. These issues have led to a predominantly early career midwifery workforce and created concern about skill mix. CONCLUSION Victorian maternity services have a midwifery workforce shortage and are experiencing significant skill mix issues. The pandemic has exacerbated these considerable gaps in the workforce. Urgent implementation of retention and recruitment schemes are needed, along with strategies to improve the working conditions for the current workforce.
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Affiliation(s)
- Robyn P Matthews
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia.
| | - Rebecca L Hyde
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
| | - Helen L McLachlan
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
| | - Fleur Llewelyn
- The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
| | - Della A Forster
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; The Royal Women's Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia
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Dosis A, Husnoo N, Roney S, Hendry C, Bonner C, Kronberga M, Moran E, Ninh V, Jha A, Grey T, Saha AK. A census of general surgery consultants in England and Wales: implications for the current and future surgical workforce. Ann R Coll Surg Engl 2024; 106:150-159. [PMID: 37489525 PMCID: PMC10830335 DOI: 10.1308/rcsann.2023.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION This study aimed to describe the composition of the current general surgical consultant body in England and Wales and quantify levels of inequality within it as well as describe future workforce challenges. METHODS This is an observational study of all general surgical departments in England and Wales. Consultant general surgeons were identified and data regarding their gender, country of undergraduate medical education, subspecialty and private practice were recorded. RESULTS Of the 2,682 consultant general surgeons in England and Wales identified for this study, just 17% are women, with gender inequality most marked in university teaching hospitals and among certain subspecialties. Almost 40% of consultants did not obtain their primary undergraduate degree in the United Kingdom and there are considerably fewer surgeons who studied abroad in university teaching hospitals. Over 40% of current general surgical consultants have been qualified for more than three decades and there is no equivalent sized group of younger consultants. CONCLUSIONS There remains considerable gender and racial inequality in the consultant general surgical workforce, with pockets of a lack of diversity within university or teaching hospital surgical departments and some subspecialties. The proportion of surgeons in their fourth decade of clinical practice represents the largest group of current practising consultants, which points towards an impending workforce crisis should senior clinicians seek to reduce activity or consider taking early retirement.
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Affiliation(s)
- A Dosis
- Yorkshire and the Humber Deanery, UK
| | - N Husnoo
- University of Sheffield & Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - S Roney
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | | | - C Bonner
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - M Kronberga
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - E Moran
- Yorkshire and the Humber Deanery, UK
| | - V Ninh
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - A Jha
- South Tees Hospitals NHS Foundation Trust, UK
| | - T Grey
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - AK Saha
- Calderdale and Huddersfield NHS Foundation Trust, UK
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Schwartz RL, Hamlin SK, Vozzella GM, Randle LN, Klahn S, Maris GJ, Waterman AD. Utilizing Telenursing to Supplement Acute Care Nursing in an Era of Workforce Shortages: A Feasibility Pilot. Comput Inform Nurs 2024; 42:151-157. [PMID: 38252545 DOI: 10.1097/cin.0000000000001097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Hospitals are experiencing a nursing shortage crisis that is expected to worsen over the next decade. Acute care settings, which manage the care of very complex patients, need innovations that lessen nurses' workload burden while ensuring safe patient care and outcomes. Thus, a pilot study was conducted to evaluate the feasibility of implementing a large-scale acute care telenurse program, where a hospital-employed telenurse would complete admission and discharge processes for hospitalized patients virtually. In 3 months, almost 9000 (67%) of patient admissions and discharges were conducted by an acute care telenurse, saving the bedside nurse an average of 45 minutes for each admission and discharge. Preliminary benefits to the program included more uninterrupted time with patients, more complete hospital admission and discharge documentation, and positive patient and nurse feedback about the program.
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Affiliation(s)
- Roberta L Schwartz
- Author Affiliations: Administration (Drs Schwartz and Vozzella and Ms Maris); Center for Nursing Research, Education and Practice (Dr Hamlin); Virtual Medicine Department (Ms Randle and Mr Klahn); J. C. Walter Jr. Transplant Center and Department of Surgery (Dr Waterman), Houston Methodist, TX
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227
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Noah TL, Boyer D, Davis SD, Vinci RJ, Oermann CM. Child Health and the Pediatric Pulmonology Workforce: 2020-2040. Pediatrics 2024; 153:e2023063678Q. [PMID: 38300006 DOI: 10.1542/peds.2023-063678q] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
There is concern as to whether the supply of pediatric pulmonology (PULM) subspecialists will be adequate to meet future demand. As part of an American Board of Pediatrics (ABP) Foundation-sponsored supplement investigating the future of the pediatric subspecialty workforce, this article assesses the current PULM clinical workforce and estimates the clinical workforce supply in the United States through 2040. The current workforce was assessed using ABP certification and Maintenance of Certification data, and a workforce supply model evaluating population growth, clinical effort, and geographic trends was developed after incorporating ABP data. Findings demonstrate that the number of pediatric pulmonologists has gradually increased over the past decade, and the ratio of subspecialists to children is likely to increase another 20% to 40% over the next 2 decades, although absolute numbers remain small. Geographic variation in access will persist in some regions. The proportion of women in the discipline has increased, but the proportion of pediatric pulmonologists from underrepresented in medicine backgrounds still lags behind the general population. Based on current trends, the PULM clinical workforce appears equipped to meet both population growth and the modest increase in demand for clinical services speculated to occur because of changes in the subspecialty's clinical portfolio. However, several factors could inhibit growth, and geographic maldistribution may continue to impact care access. Efforts to address variation in access and demographic diversity in the field are warranted. This article concludes by discussing the training, clinical practice, policy, and future workforce research implications of the data presented.
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Affiliation(s)
- Terry L Noah
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Debra Boyer
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Stephanie D Davis
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert J Vinci
- Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Christopher M Oermann
- University of Missouri-Kansas City School of Medicine; Children's Mercy Kansas City, Kansas City, Missouri
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Abstract
This article is part of an American Board of Pediatrics Foundation-sponsored effort to analyze and forecast the pediatric subspecialty workforce between 2020 and 2040. Herein, an overview of the current pediatric gastroenterology workforce is provided, including demographics, work characteristics, and geographic distribution of practitioners. Brief context is provided on the changing nature of current practice models and the increasing prevalence of some commonly seen disorders. On the basis of a rigorous microsimulation workforce projection model, projected changes from 2020 to 2040 in the number of pediatric gastroenterologists and clinical workforce equivalents in the United States are presented. The article closes with a brief discussion of training, clinical practice, policy, and future workforce research implications of the data presented. This data-driven analysis suggests that the field of pediatric gastroenterology will continue to grow in scope and complexity, propelled by scientific advances and the increasing prevalence of many disorders relevant to the discipline. The workforce is projected to double by 2040, a growth rate faster than most other pediatric subspecialties. Disparities in care related to geography, race, and ethnicity are among the most significant challenges for the years ahead. Changes to training and education, incentives to meet the needs of underserved populations, and new multidisciplinary models for health care delivery will be necessary to optimally meet the volume, diversity, and complexity of children with gastroenterological diseases in the years ahead.
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Affiliation(s)
- Cary G Sauer
- Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - John A Barnard
- Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio
| | - Robert J Vinci
- Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Jennifer A Strople
- Department of Pediatrics, Northwestern Feinberg School of Medicine, Chicago, Illinois
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229
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Bacci JL, Pollack SW, Skillman SM, Odegard PS, Danielson JH, Frogner BK. Impact of the COVID-19 Pandemic on the Community Pharmacy Workforce. Med Care Res Rev 2024; 81:39-48. [PMID: 37830446 DOI: 10.1177/10775587231204101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
This study sought to describe the impact of the COVID-19 pandemic on community pharmacy practice and its workforce. Interviews were conducted with 18 key informants from pharmacy associations and community pharmacists representing chain and independent pharmacy organizations across the United States from January to May 2022. Interview notes were analyzed using a rapid content analysis approach. Four themes resulted: (a) patient care at community pharmacies focused on fulfilling COVID-19 response needs; (b) pharmacists' history as immunizers and scope of practice expansions facilitated COVID-19 response efforts; (c) workforce supply shortages impeded COVID-19 response efforts and contributed to burnout; and (d) maintaining community pharmacy workforce's readiness will be critical to future emergency preparedness and response efforts. Formalizing scope of practice expansion policies and reimbursement pathways deployed during the COVID-19 pandemic could facilitate the community pharmacy workforce's ability to address ongoing public health needs and respond to future public health emergencies.
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230
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Thompson E, Senek M, Ryan T. Analysis of a nursing survey: Reasons for compromised quality of care in inpatient mental health wards. Int J Ment Health Nurs 2024; 33:52-61. [PMID: 37654077 DOI: 10.1111/inm.13216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 09/02/2023]
Abstract
Current evidence suggests understaffing is related to poor quality and missed care in a global context, but this relationship is complex. There is also a research gap for quality in mental health care in the United Kingdom that includes a wider set of patient outcomes. This paper aims to investigate RMN's perception of quality of care on their last shift, their self-reported reasons for compromised care and potential impact on patient outcomes. A mixed methods approach, we used descriptive statistics to create a framework within which to qualitatively analyse data from the 2017 Royal College of Nursing (RCN) employment survey to consider the complex relationship between understaffing and care quality. We established three themes: 'Understaffing', 'Professional Code Expectations and Moral Distress' and 'Management'. In line with the current evidence; lack of resources and understaffing were consistently present throughout. Nurses also felt pressure from the Nursing and Midwifery Council (NMC) code of conduct which in turn instilled shame and fear for their registration when they were unable to achieve the standards expected. This was further exacerbated by poor management and supervision; leading nurses to reflect on poor outcomes for patients which compromised not only legal rights but safety of patients and staff alike. We conclude that focusing on staffing numbers alone is unlikely to improve care quality.
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Affiliation(s)
- Elissa Thompson
- Division of Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - Michela Senek
- University of Sheffield, Sheffield University/Strategic Research Alliance, Sheffield, UK
| | - Tony Ryan
- University of Sheffield, Sheffield University/Strategic Research Alliance, Sheffield, UK
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231
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Rivara FP, Gonzalez-Del-Rey J, Forrest CB. The Pediatric Subspecialty Physician Workforce. JAMA Pediatr 2024; 178:107-108. [PMID: 38109094 DOI: 10.1001/jamapediatrics.2023.5235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
This Viewpoint summarizes strategic goals and recommendations from the National Academies of Sciences, Engineering, and Medicine for the improvement of pediatric subspecialty care.
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232
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Braithwaite J, Fisher G. Beyond the aspirational: creating the future of health care in Australia. Intern Med J 2024; 54:342-347. [PMID: 37926972 DOI: 10.1111/imj.16286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
The context of health care in Australia is shifting very rapidly; more chronic diseases, budgetary stress and the constant threat of the next pandemic and climate change mean that patterns of disease and care are changing, and the workforce is under pressure. Health systems have learned to respond as best they can, but there are many challenges and opportunities for the Australian health care system to plan and implement an evidence-based and sustainable approach to health care delivery in the next decade. To support this approach, many peak bodies and authoritative agencies, such as the Australian government in their 2022 Strengthening Medicare Taskforce Report, have described laudable visions for health care, but no one has laid out a tangible blueprint for whole-of-system change. Here, we outline nine strategies that span principles of integrated, value-based care, with a focus on prevention and quality, the development of a skilled workforce and health-literate population and the use of emerging technologies such as genomics and artificial intelligence. These strategies form a potential path for the Australian health care system to meet the changing requirements of the current decade and take the aspirational visions of the future of health care into an improved, patient-based health system that delivers care in line with best practices.
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Affiliation(s)
- Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Georgia Fisher
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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233
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Roush K. Symposium Addresses Continuing Issues of Burnout Among Nurses. Am J Nurs 2024; 124:12. [PMID: 38270407 DOI: 10.1097/01.naj.0001006640.94260.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Experts discussed staffing, wellness, and workplace safety.
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234
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Boston-Fleischhauer C. Building an Evidence-Based Foundation for Virtual Nursing. J Nurs Adm 2024; 54:77-78. [PMID: 38261640 DOI: 10.1097/nna.0000000000001385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Virtual nursing is viewed as a key strategy to support safe, effective staffing in acute care amid continued RN workforce challenges. Consensus has not been reached on the optimal model that can drive highly impactful results for virtual nursing. Research is needed on the most effective strategies to optimize the role of the virtual nurse. In addition, nurse leaders need evidence to confirm which virtual models are the most strongly positioned to impact staff and patient satisfaction, quality, labor costs, and length of stay.
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Affiliation(s)
- Carol Boston-Fleischhauer
- Author Affiliation: Senior Vice President/Chief Clinical Officer, Banyan Medical Solutions, Omaha, Nebraska
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235
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Russell H, Hord J, Orr CJ, Moerdler S. Child Health and the Pediatric Hematology-Oncology Workforce: 2020-2040. Pediatrics 2024; 153:e2023063678L. [PMID: 38299998 DOI: 10.1542/peds.2023-063678l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
Pediatric hematology-oncology (PHO) is 1 of the oldest recognized pediatric subspecialities. PHO physicians care for infants, children, adolescents, and young adults with all types of cancer and nonmalignant blood conditions, in many cases temporarily assuming the role of a primary care physician because of the complexity and intensity of treatment. However, the number of clinically active PHO subspecialists needed to care for children in the United States remains unknown. Recent papers suggest a potential oversaturation of PHO physicians in some geographic areas. This article is part of a Pediatrics supplement focused on projecting the future supply of the pediatric subspecialty workforce. It draws on information available in the literature, data from the American Board of Pediatrics, and findings from a new microsimulation model estimating the future supply of pediatric subspecialists through 2040. The model predicts a workforce growth in PHO subspecialists of 66% by 2040. Alternative scenarios, including changes in clinical time and fellowship size, resulted in a difference in growth of ±18% from baseline. The model also forecasts significant geographic maldistribution. For example, the current workforce is concentrated in the Northeast Census region and the model predicts the New England Census division will have a 2.9-fold higher clinical workforce equivalent per 100 000 children aged 0 to 18 years than the Mountain Census division by 2040. These findings suggest potential opportunities to improve the PHO subspecialty workforce and the outcomes and experiences of its patient population through educational changes, practice initiatives, policy interventions, and dedicated research.
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Affiliation(s)
- Heidi Russell
- University of Texas Health Houston School of Public Health, Department of Management, Policy and Community Health, Houston, Texas
| | - Jeffrey Hord
- Akron Children's Hospital, Pediatric Hematology-Oncology, Akron, Ohio
| | - Colin J Orr
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Scott Moerdler
- Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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236
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Fields EL, Louis-Jacques J, Kas-Osoka O, Holland-Hall C, Richardson LP, Ott M, Leslie LK, Pitts SAB. Child Health Needs and the Adolescent Medicine Workforce Supply: 2020-2040. Pediatrics 2024; 153:e2023063678D. [PMID: 38300009 DOI: 10.1542/peds.2023-063678d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
Adolescent medicine (AM) subspecialists provide primary, subspecialty, and consultative care to adolescents and young adults (AYAs). Given insufficient numbers of AM subspecialists to care for all AYAs, the workforce supports AYAs health care capacity through education, research, advocacy, and the development of policies and programs sensitive to their unique needs. A modeling project funded by the American Board of Pediatrics Foundation was developed to forecast the pediatric subspecialty workforce in the United States from 2020 to 2040 on the basis of current trends in each subspecialty. The model predicts workforce supply at baseline and across alternative scenarios, and reports results in headcount and headcount adjusted for percentage of time spent in clinical care, termed "clinical workforce equivalent." For the AM subspecialty, several scenarios were considered that modified the number of fellows and/or clinical time. The baseline model predicted low growth nationally (27% and 13% increase in total AM subspecialists and AM subspecialists per 100 000 children, respectively) and declines in AM workforce relative to population growth in census divisions with existing geographic workforce disparities. In the alternative scenarios, fellow number and clinical time changes did not significantly change predictions relative to the baseline model, but a 12.5% decrease in fellows predicted a 40% reduction in the workforce from baseline with a widening of geographic workforce disparities. On the basis of the expansive clinical and nonclinical roles of AM subspecialists and these forecasted workforce challenges, significant educational, practice, and policy changes will be necessary to bolster the supply of well-trained clinicians addressing the dynamic health care needs of AYAs.
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Affiliation(s)
| | | | - Oriaku Kas-Osoka
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Cynthia Holland-Hall
- Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Laura P Richardson
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Mary Ott
- Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Sarah A B Pitts
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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237
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Onywera H, Ondoa P, Nfii F, Ogwell A, Kebede Y, Christoffels A, Tessema SK. Boosting pathogen genomics and bioinformatics workforce in Africa. Lancet Infect Dis 2024; 24:e106-e112. [PMID: 37778362 DOI: 10.1016/s1473-3099(23)00394-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/02/2023] [Accepted: 06/16/2023] [Indexed: 10/03/2023]
Abstract
Next-generation sequencing (NGS) of genomic data has established its fundamental value in public health surveillance, research and development, and precision medicine. In Africa, severe shortages of competent experts in genomics and bioinformatics, few opportunities for research, and inadequate genomic infrastructure have had a knock-on effect on the use of NGS technologies for research and public health practice. Several reasons-ranging from poor funding, inadequate infrastructure for training and practice, to brain drain-might partly account for the scarcity of genomics and bioinformatics expertise in the region. In recognition of these shortcomings and the importance of NGS genomic data, which was amplified during the COVID-19 pandemic in mid-2021, the Africa Centres for Disease Control and Prevention (Africa CDC) through the Africa Pathogen Genomics Initiative began building and expanding Africa's workforce in pathogen surveillance. By the end of 2022, the Africa CDC in collaboration with its partners and centres of excellence had trained 413 personnel, mostly from public health institutions, in 53 (96%) of 55 African Union Member States. Although this training has increased genomics, bioinformatics, and genomic epidemiology literacy, and genomic-informed pathogen surveillance, there is still a need for a strategic and sustainable public health workforce development in Africa.
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Affiliation(s)
- Harris Onywera
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Pascale Ondoa
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia; Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, Netherlands
| | - Faith Nfii
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Ahmed Ogwell
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Yenew Kebede
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Alan Christoffels
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia; South African National Bioinformatics Institute, South African Medical Research Council, Bioinformatics Unit, University of the Western Cape, Cape Town, South Africa
| | - Sofonias K Tessema
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia.
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238
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O'Gara B, Hutchinson AMN, Watt J, Rees-Lee J. Sexual harassment in the healthcare workforce: what next? Br J Surg 2024; 111:znae004. [PMID: 38298066 DOI: 10.1093/bjs/znae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/08/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024]
Affiliation(s)
- Bijal O'Gara
- Torbay and South Devon NHS Foundation Trust, Torquay, Devon, UK
| | | | - Jonathan Watt
- Torbay and South Devon NHS Foundation Trust, Torquay, Devon, UK
- Digital Futures Lab, Horizon Centre, Torbay and South Devon NHS Foundation Trust, Torquay, Devon, UK
| | - Jacqueline Rees-Lee
- Torbay and South Devon NHS Foundation Trust, Torquay, Devon, UK
- Digital Futures Lab, Horizon Centre, Torbay and South Devon NHS Foundation Trust, Torquay, Devon, UK
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239
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Schoenberg NE, Robinson J, McGladrey M, Cassis LA, Conwell D, Pearson KJ, Tannock LR, Wilcock D, White S. Promoting a more diverse and inclusive research workforce through the research scholars program. BMC Med Educ 2024; 24:98. [PMID: 38291425 PMCID: PMC10829238 DOI: 10.1186/s12909-024-05075-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Novel and comprehensive approaches are needed to address shortcomings in the diversity and inclusiveness of the scientific workforce. In response to this need and informed by multiple programs and data sources, we created the Research Scholars Program (RSP). The RSP is a yearlong program for early-career faculty with an overall objective to overcome barriers to the academic success, retention, progression, and promotion of groups underrepresented in biomedical and behavioral research. The goal of the RSP is to increase research confidence and productivity, build a supportive research community, and reduce isolation by providing personal and group research enrichment to junior faculty through professional development, mentorship, and networking. METHODS We adapted evidence-based approaches for our institutional context and vetted the RSP across our campus. The resulting RSP consists of three main elements: (1) five levels of Mosaic Mentorship; (2) group and tailored professional development programming; and (3) scientific and social networking. To determine the potential of the RSP to improve research confidence critical to success, we used a modified shortened version of the Clinical Research Appraisal Inventory (CRAI-12) to assess participants' confidence in performing a variety of research tasks before and after program participation. We collected information about retention, promotion, and grants submitted and awarded. Additionally, we conducted semi-structured exit interviews with each scholar after program participation to identify programmatic strengths and areas for improvement. Data for Cohorts 1 and 2 (N = 12) were analyzed. RESULTS Our assessment finds, with one exception, increasing confidence in participants' research skills across all items, ranging from 0.4 (4.7%) to 2.6 (40.6%). In their exit interviews, the Research Scholars (RS) described their improved productivity and increased sense of belonging and support from others. Research Scholars noted numerous components of the RSP as strengths, including the Mosaic Mentorship model, professional development programming, and opportunities for both informal and formal interactions. Respondents identified time pressure, a lack of feedback, and unclear expectations of the various mentorship roles as areas in which the program can improve. CONCLUSION Preliminary findings indicate that the RSP is successful in building the research confidence of underrepresented and disadvantaged early-career faculty. While this report focuses on the development and protocol of the RSP, additional cohorts and data will provide the evidence base to support dissemination as a national model of research professional development. Such programming is critical to ensure sustainable support structures, institutional networks, infrastructure, and resources that will improve discovery and equity through inclusive excellence.
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Affiliation(s)
- Nancy E Schoenberg
- Department of Behavioral Science, College of Medicine; and Associate Vice President for Research, Center for Health Equity Transformation, Office of the Vice President for Research at the University of Kentucky, Suite 460 Healthy Kentucky Research Building, 760 Press Avenue, Lexington, KY, 40536-0679, USA.
| | - Jimmy Robinson
- Department of Sociology, Center for Health Equity Transformation, College of Arts & Sciences at the University of Kentucky, Suite 460 Healthy Kentucky Research Building, 760 Press Avenue, Lexington, KY, 40536-0679, USA
| | - Margaret McGladrey
- Center for Innovation in Population Health and Department of Health Management and Policy, College of Public Health at the University of Kentucky, 111 Washington Ave Suite 205B, Lexington, KY, 40508, USA
| | - Lisa A Cassis
- Department of Pharmacology and Nutritional Science, College of Medicine at the University of Kentucky, 311 Main Building, Lexington, KY, 40506-0032, USA
| | - Darwin Conwell
- Department of Internal Medicine, College of Medicine at the University of Kentucky, 301 C.T. Wethington Building, 900 Limestone St, Lexington, KY, 40536-0200, USA
| | - Kevin J Pearson
- Department of Pharmacology and Nutritional Science, College of Medicine at the University of Kentucky, 591 C.T. Wethington Building, 900 S. Limestone St, Lexington, KY, 40536-0200, USA
| | - Lisa R Tannock
- Department of Internal Medicine, College of Medicine at the University of Kentucky. Address: C. T, Wethington Building, 900 S. Limestone St, Lexington, KY, 40536-0200, USA
| | - Donna Wilcock
- Alzheimer's Disease Research, Department of Neurology at Indianapolis University School of Medicine, GHE 4700, NEUR, Indianapolis, 46202-3082, USA
| | - Stephanie White
- College of Medicine at the University of Kentucky, 800 Rose St, Lexington, KY, 40536, USA
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240
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Workman B, Fulk F, Carreón T, Nabors L. Implementation of an Awareness Level Training to Prepare the Workforce for Future Infectious Disease Outbreaks. Disaster Med Public Health Prep 2024; 18:e9. [PMID: 38287864 DOI: 10.1017/dmp.2024.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
OBJECTIVE The COVID-19 pandemic underscores the need for workforce awareness-level training for infectious disease outbreaks. A training program was created and evaluated to provide strategies for emergency preparedness as well as worker health and safety during a disease outbreak. METHODS Participants (N = 292) completed instructor-led synchronous online training modules between January 2022 and February 2023. Training covered 5 areas: vaccine awareness, infectious disease transmission and prevention, pandemic awareness, and inapparent infections, as well as workplace controls to reduce or remove hazards. Participants completed a survey before and after training to assess knowledge change in the five areas. Chi-square analyses assessed how predictors were related to knowledge change. RESULTS Overall, an increase in knowledge was observed between pre- (80.9%) and post-training (92.7%). Participants from small businesses, with less work experience, and in non-health care roles were under-informed. Knowledge of disease transmission and prevention improved for non-health care professions and workers with less experience. All participants gained knowledge in identifying and ranking safeguards to protect workers from injuries and illness at job sites. CONCLUSIONS Training improved employee knowledge about safe work practices and pandemic preparedness. Studies should continue to evaluate the effectiveness of preparedness training to prepare the workforce for infectious disease outbreaks and pandemics.
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Affiliation(s)
- Brandon Workman
- Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Health Promotion and Education, School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, Ohio, USA
| | - Florence Fulk
- Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Tania Carreón
- Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- World Trade Center Health Program, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Laura Nabors
- Health Promotion and Education, School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, Ohio, USA
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241
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Ahmed IA, Kariuki J, Mathu D, Onteri S, Macharia A, Mwai J, Otambo P, Wanjihia V, Mutai J, Mokua S, Nyandieka L, Echoka E, Njomo D, Bukania Z. Health systems' capacity in availability of human resource for health towards implementation of Universal Health Coverage in Kenya. PLoS One 2024; 19:e0297438. [PMID: 38289943 PMCID: PMC10826929 DOI: 10.1371/journal.pone.0297438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
INTRODUCTION Kenya faces significant challenges related to health worker shortages, low retention rates, and the equitable distribution of Human Resource for Health (HRH). The Ministry of Health (MOH) in Kenya has established HRH norms and standards that define the minimum requirements for healthcare providers and infrastructure at various levels of the health system. The study assessed on the progress of Universal Health Coverage (UHC) piloting on Human Resource for Health in the country. METHODS The study utilized a Convergent-Parallel-Mixed-Methods design, incorporating both quantitative and qualitative approaches. The study sampled diverse population groups and randomly selected health facilities. Four UHC pilot counties are paired with two non-UHC pilot counties, one neighboring county and the second county with a geographically distant and does not share a border with any UHC pilot counties. Stratification based on ownership and level was performed, and the required number of facilities per stratum was determined using the square root allocation method. Data on the availability of human resources for health was collected using a customized Kenya Service Availability and Readiness Assessment Mapping (SARAM) tool facilitated by KoBo ToolKitTM open-source software. Data quality checks and validation were conducted, and the HRH general service availability index was measured on availability of Nurses, Clinician, Nutritionist, Laboratory technologist and Pharmacist which is a minimum requirement across all levels of health facilities. Statistical analyses were performed using IBM SPSS version 27 and comparisons between UHC pilot counties and non-UHC counties where significance threshold was established at p < 0.05. Qualitative data collected using focus group discussions and in-depth interview guides. Ethical approval and research permits were obtained, and written informed consent was obtained from all participants. RESULTS The study assessed 746 health facilities with a response rate of 94.3%. Public health facilities accounted for 75% of the sample. The overall healthcare professional availability index score was 17.2%. There was no significant difference in health workers' availability between UHC pilot counties and non-UHC pilot counties at P = 0.834. Public health facilities had a lower index score of 14.7% compared to non-public facilities at 27.0%. Rural areas had the highest staffing shortages, with only 11.1% meeting staffing norms, compared to 31.8% in urban areas and 30.4% in peri-urban areas. Availability of health workers increased with the advancement of The Kenya Essential Package for Health (KEPH Level), with all Level 2 facilities across counties failing to meet MOH staffing norms (0.0%) except Taita Taveta at 8.3%. Among specific cadres, nursing had the highest availability index at 93.2%, followed by clinical officers at 52.3% and laboratory professionals at 55.2%. The least available professions were nutritionists at 21.6% and pharmacist personnel at 33.0%. This result is corroborated by qualitative verbatim. CONCLUSION The study findings highlight crucial challenges in healthcare professional availability and distribution in Kenya. The UHC pilot program has not effectively enhanced healthcare facilities to meet the standards for staffing, calling for additional interventions. Rural areas face a pronounced shortage of healthcare workers, necessitating efforts to attract and retain professionals in these regions. Public facilities have lower availability compared to private facilities, raising concerns about accessibility and quality of care provided. Primary healthcare facilities have lower availability than secondary facilities, emphasizing the need to address shortages at the community level. Disparities in the availability of different healthcare cadres must be addressed to meet diverse healthcare needs. Overall, comprehensive interventions are urgently needed to improve access to quality healthcare services and address workforce challenges.
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Affiliation(s)
- Ismail Adow Ahmed
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - James Kariuki
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - David Mathu
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Stephen Onteri
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Antony Macharia
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Judy Mwai
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Priscah Otambo
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Violet Wanjihia
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Joseph Mutai
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Sharon Mokua
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Lilian Nyandieka
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Elizabeth Echoka
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
| | - Doris Njomo
- Kenya Medical Research Institute Kenya, Eastern and Southern Africa Centre of International Parasite Control, Nairobi, Kenya
| | - Zipporah Bukania
- Centre for Public Health Research, Kenya Medical Research Institute Kenya, Nairobi, Kenya
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242
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Lanada JA, Culligan K. The experiences of internationally educated nurses who joined the nursing workforce in England. Br J Nurs 2024; 33:78-84. [PMID: 38271032 DOI: 10.12968/bjon.2024.33.2.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVES There is limited literature on the experiences of internationally educated nurses (IENs) who have joined NHS trusts in England in the past 20 years. The objectives of this integrative review included exploring and analysing the experiences of IENs in the NHS in England and identifying the cultural, pastoral and training needs of IENs during their first 2 years working in England and providing research-informed recommendations to better support IENs. DESIGN An integrative review of primary research studies using quantitative, qualitative, and mixed methods of data collection. Data source: CINAHL, British Nursing Index and Google Scholar. RESULTS Nine articles met the inclusion criteria for this integrative review. All articles contributed to the findings of three main analytical themes: expectations, challenges and belongingness. CONCLUSION Limited research fully met the search criteria. This was concerning since IENs have been working in the NHS for decades, yet so few primary studies have been conducted into their experiences. The findings were in line with previous studies, which found that IENs faced challenges both in the workplace and in settling into an English way of life, and often reported feeling that they were not treated equally to their English counterparts. This integrative review raises issues and increases awareness of how the NHS in England can better support IENs transitioning into their new life and ways of working, to further aid recruitment and retention of the international nursing workforce.
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Affiliation(s)
- Jose Ariel Lanada
- NOTSSCaN Divisional Lead for Practice Development and Education, Oxford University Hospitals NHS Foundation Trust, and Doctor of Education Candidate, Oxford Brookes University
| | - Kate Culligan
- Practice Development and Education Lead, Oxford University Hospitals NHS Foundation Trust and Doctor of Nursing Student, Oxford Brookes University
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243
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Dushyanthen S, Choo D, Perrier M, Gray K, Capurro D, Pires D, Chapman BE, Hart GK, Huckvale K, Chapman WW, Lyons K. Designing an Interprofessional Online Course to Foster Learning Health Systems. Stud Health Technol Inform 2024; 310:1241-1245. [PMID: 38270013 DOI: 10.3233/shti231163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
The Learning Health Systems (LHS) framework demonstrates the potential for iterative interrogation of health data in real time and implementation of insights into practice. Yet, the lack of appropriately skilled workforce results in an inability to leverage existing data to design innovative solutions. We developed a tailored professional development program to foster a skilled workforce. The short course is wholly online, for interdisciplinary professionals working in the digital health arena. To transform healthcare systems, the workforce needs an understanding of LHS principles, data driven approaches, and the need for diversly skilled learning communities that can tackle these complex problems together.
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Affiliation(s)
- Sathana Dushyanthen
- Centre for Digital Transformation of Health, University of Melbourne, Australia
| | - Dawn Choo
- Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Meg Perrier
- Centre for Digital Transformation of Health, University of Melbourne, Australia
| | - Kathleen Gray
- Centre for Digital Transformation of Health, University of Melbourne, Australia
- School of Computing and Information Systems, University of Melbourne, Australia
| | - Daniel Capurro
- Centre for Digital Transformation of Health, University of Melbourne, Australia
- School of Computing and Information Systems, University of Melbourne, Australia
| | - Douglas Pires
- Centre for Digital Transformation of Health, University of Melbourne, Australia
- School of Computing and Information Systems, University of Melbourne, Australia
| | - Brian E Chapman
- School of Computing and Information Systems, University of Melbourne, Australia
| | - Graeme K Hart
- Centre for Digital Transformation of Health, University of Melbourne, Australia
| | - Kit Huckvale
- Centre for Digital Transformation of Health, University of Melbourne, Australia
| | - Wendy W Chapman
- Centre for Digital Transformation of Health, University of Melbourne, Australia
| | - Kayley Lyons
- Centre for Digital Transformation of Health, University of Melbourne, Australia
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244
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Kubota K, Seki T, Miyake K, Okada M, Nishio K, Ohe K. Providing Practical Knowledge and Skills to Handle Real-World Data? Lessons Learned from Med RWD Program. Stud Health Technol Inform 2024; 310:1540-1541. [PMID: 38269735 DOI: 10.3233/shti231283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Both lectures and hands-on education are essential for the development of human resources that can use real-world data (RWD). The University of Tokyo has launched a new hybrid-style RWD educational program entitled "Medical Real World Data Utilization Human Resource Development Project" from FY2019 onwards. We present an overview of the overall picture of the project, including the development process of the educational program and the challenges associated with it.
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245
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Meehan R. Health Informatics Workforce in the Digital Health Ecosystem. Stud Health Technol Inform 2024; 310:1226-1230. [PMID: 38270010 DOI: 10.3233/shti231160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Workforce development needs to align with the healthcare data ecosystem emerging from digital transformation in healthcare. Careers for health informaticists are emerging as translational agents between clinicians and data scientists. Digital tools and mechanisms in healthcare, through electronic health records (EHR), devices, capabilities including artificial intelligence (AI), machine learning (ML), interoperability and health information exchange (HIE) allow clinicians and stakeholders to capture, store, access and use health data and information in ways unseen in years past, creating a new digital health ecosystem. This transformation is evolving both technologies and the strategies to influence health outcomes. Careers in health informatics are now part of this data ecosystem, and it is important to examine the current status and its implications for job seekers and for workforce development.
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Affiliation(s)
- Rebecca Meehan
- School of Information, Kent State University, Kent, OH, USA
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246
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Fenton SH, Mustata Wilson G. Building a More Diverse Public Health Informatics Workforce: Preliminary Results. Stud Health Technol Inform 2024; 310:1231-1235. [PMID: 38270011 DOI: 10.3233/shti231161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
The US public health infrastructure has been historically underfunded, a condition that was exacerbated by the COVID-19 pandemic. This was especially noted in the area of public health informatics. It was also acknowledged that the lack of a diverse public health workforce made it more difficult to address biases and disparities effectively. In 2021 the Office of the National Coordinator awarded $73 million to 10 awardees to develop public health informatics and technology (PHIT) workforce training. The Gaining Equity in Training for Public Health Informatics and Technology (GET PHIT) award utilizes various methods to train and engage minority and underserved populations in the field of public health informatics. Evaluations of the bootcamps and internships to date have shown generally positive results, both in terms of skills acquired and overall experiences. These results indicate that integrating the fields of public health and data science in non-degree, short-term experiences can have positive outcomes.
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Affiliation(s)
- Susan H Fenton
- The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Gabriela Mustata Wilson
- Multi-Interprofessional Center for Health Informatics, The University of Texas at Arlington, Arlington, TX. USA
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247
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Henderson MC, Aminololama-Shakeri S. Options for Building a Diverse Health Care Workforce. JAMA 2024; 331:357-358. [PMID: 38261054 DOI: 10.1001/jama.2023.23397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Affiliation(s)
- Mark C Henderson
- Department of Internal Medicine, University of California, Davis, Sacramento
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248
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Lee M, Kim SE, Jeong JH, Park YH, Han HW. Development of service standards and manpower calculation criteria for hospital clinical pharmacies in South Korea: a survey-based study. BMC Health Serv Res 2024; 24:118. [PMID: 38254141 PMCID: PMC10802065 DOI: 10.1186/s12913-023-10530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND After the revision of the Korean Pharmaceutical Affairs Act, the certification of specialized pharmacists is scheduled to be legally recognized in 2023. Considering that the specialized pharmacist certification was developed based on the working model of hospital clinical pharmacists, it is necessary to establish standards for clinical pharmacists in hospitals and to calculate appropriate manpower. Through this study, we aim to establish practical standards for clinical pharmacists and propose a method for calculating staffing levels based on an investigation of actual workloads. METHODS This survey-based study consisted of two phases. In the first phase, a literature review was conducted to establish standards for clinical pharmacy services, and tasks in relevant literature were classified to identify clinical pharmacy service tasks that are applicable to the practice of Korean hospitals. Additionally, a preliminary survey was conducted to investigate the essential tasks. In the second phase of the investigation, a multicenter survey was conducted targeting pharmacists in facilities with more than 1,000 beds to explore their perceptions and actual workloads related to tasks. RESULTS According to the standards for clinical pharmacists in Korea, clinical pharmacy services consist of a total of 23 tasks, of which 16 have been identified as essential tasks. Essential tasks accounted for 93% of the total tasks in clinical pharmacy services. The average full-time equivalent (FTE) through workload calculation was 2.5 ± 1.9 for each field, while the FTE allocated to actual practice was 2.1 ± 1.6. The distribution of each type of clinical pharmacy service was as follows: 77% for medication therapy management, 13% for medication education, 8% for multidisciplinary team activities, and 3% for medication use evaluation. CONCLUSION This study identified essential tasks common to clinical pharmacy services across different healthcare institutions. However, the FTE of clinical pharmacists in actual practice was insufficient compared to the required amount. In order to establish and expand clinical pharmacy services in a hospital, it is necessary to ensure an adequate workforce for essential tasks.
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Affiliation(s)
- Mirinae Lee
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea
| | - Seung-Eun Kim
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea
| | - Jee-Hye Jeong
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea
| | - Yoon-Hee Park
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea
| | - Hye-Won Han
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea.
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249
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Looi MK. The European healthcare workforce crisis: how bad is it? BMJ 2024; 384:q8. [PMID: 38242581 DOI: 10.1136/bmj.q8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
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250
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Chiou PZ, Herring RP, Oh J, Medina E. Health impacts in pathology workforce during mergers and acquisitions (M&A). J Clin Pathol 2024; 77:98-104. [PMID: 37914381 DOI: 10.1136/jcp-2023-209124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/22/2023] [Indexed: 11/03/2023]
Abstract
AIMS To compare burn-out in laboratory professionals (LPs) with exposure to consolidation to those without, and to investigate the role of social support as a moderator in the exposure to mergers and acquisitions (M&A). METHODS Surveys were sent to the clinical LPs, including 732 with exposure to M&A and 819 without. The dependent variable was burn-out, and the independent variable was exposure to M&A. In investigating the role of social support in exposure group, a logistic regression was used with education, time since M&A, gender, merger types, practice setting, lab hierarchy and race as covariates. RESULTS Exposure to M&A was associated with higher levels of burn-out (p<0.05). In logistic regression of the workforce exposed to M&A, the odds for LP developing a high level of burn-out are lowered by 7.1% for every unit of increase in social support (OR 0.93; 95% CI 0.88 to 0.98; p=0.004). CONCLUSION LPs exposed to M&A are more likely to experience higher levels of burn-out but having social support can protect against burn-out, which has policy implications for leadership managing laboratories in times of M&A.
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Affiliation(s)
- Paul Zone Chiou
- Clinical Laboratory Science, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - R Patti Herring
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Jisoo Oh
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Ernest Medina
- Loma Linda University School of Public Health, Loma Linda, California, USA
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