1
|
Royster J, Meyer JA, Cunningham MC, Hall K, Patel K, McCall TC, Alford AA. Local public health under threat: Harassment faced by local health department leaders during the COVID-19 pandemic. Public Health Pract (Oxf) 2024; 7:100468. [PMID: 38328527 PMCID: PMC10847788 DOI: 10.1016/j.puhip.2024.100468] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 12/27/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
Background Prior to the COVID-19 pandemic, local health departments (LHDs) faced several challenges including underfunding and understaffing. COVID-19 exacerbated these challenges and introduced new ones, including harassment of the agency, staff, and leadership. The objective of this study was to qualitatively understand the experiences and impact of harassment faced by LHDs during the pandemic and provide recommendations to prevent future harassment. Study design A qualitative study was conducted utilizing focus groups for data collection. Methods LHDs were sampled from the 2022 National Profile of Local Health Departments (Profile) study to ensure diversity in LHD size. Four virtual focus groups were conducted in Fall 2022 with a total of 16 LHD leaders surveyed in Profile, who were still in their positions. Focus group transcripts were then coded by two independent coders and analyzed using thematic analysis. Findings Four common domains arose from the data: aggravating factors of harassment, content and formats of harassment, protective factors, and effects on individuals and on the workforce. Conclusion Findings suggest that harassment was pervasive with many forms and impacts on the LHD leaders and workforce overall. Recommendations are proposed for the local as well as federal partners because the public health system is threatened without immediate, substantial, and coordinated solutions to address harassment and offer protection.
Collapse
Affiliation(s)
- Jordan Royster
- National Association of County and City Health Officials, Washington, DC, USA
| | | | | | - Kellie Hall
- National Association of County and City Health Officials, Washington, DC, USA
| | - Krishna Patel
- National Association of County and City Health Officials, Washington, DC, USA
| | - Timothy C. McCall
- National Association of County and City Health Officials, Washington, DC, USA
- The George Washington University, Washington, DC, USA
| | - Aaron A. Alford
- National Association of County and City Health Officials, Washington, DC, USA
| |
Collapse
|
2
|
Blankart CR, De Gani SM, Crimlisk H, Desmedt M, Bauer B, Doyle G. Health literacy, governance and systems leadership contribute to the implementation of the One Health approach: a virtuous circle. Health Policy 2024; 143:105042. [PMID: 38518391 DOI: 10.1016/j.healthpol.2024.105042] [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: 08/01/2023] [Revised: 02/12/2024] [Accepted: 03/11/2024] [Indexed: 03/24/2024]
Abstract
One Health is an important approach to addressing health threats and promoting health through interdisciplinary health, policy, legislation and leadership research to achieve better human and animal health and better outcomes for the planet. The Covid-19 pandemic has triggered an urgent awareness of the need to develop innovative integrative solutions to address root causes of such threats to health, which requires collaboration across disciplines and amongst different sectors and communities. We explore how achieving the Quadripartite Organizations' One Health Joint Plan of Action can be supported by the concepts of 'One Health literacy' and 'One Health governance' and promote both academic and policy dialogue. We show how One Health literacy and One Health governance influence and reinforce each other, while an interdisciplinary systems leadership approach acts as a catalyst and mechanism for understanding and enacting change. Based on our understanding of how these elements influence the implementation of the One Health approach, we describe a model for considering how external triggering events such as the Covid-19 pandemic may prompt a virtuous circle whereby exposure to and exploration of One Health issues may lead to improved One Health literacy and to better governance. We close with recommendations to international organisations, national governments and to leaders in policy, research and practice to enhance their influence on society, the planetary environment, health and well-being.
Collapse
Affiliation(s)
- Carl Rudolf Blankart
- KPM Center for Public Management, University of Bern, Freiburgstr. 3, 3010 Bern, Switzerland; Swiss Institute for Translational and Entrepreneurial Medicine (sitem-insel), Freiburgstr. 3, 3010 Bern, Switzerland; Multidisciplinary Center for Infectious Diseases (MCID), University of Bern, Hallerstrasse 6, 3012 Bern, Switzerland.
| | - Saskia Maria De Gani
- Careum Center for Health Literacy, Careum Foundation, 8032 Zürich, Switzerland; Careum School of Health, Kalaidos University of Applied Sciences, 8006 Zürich, Switzerland
| | - Helen Crimlisk
- Sheffield Health and Social Care NHS Foundation Trust, Centre Court, Atlas Way, Sheffield S47QQ, United Kingdom; Faculty of Medicine and Population Health, University of Sheffield, Beech Hill Rd, Sheffield S102RX, United Kingdom; Royal College of Psychiatrists, 21 Prescot St, London E18BB, United Kingdom
| | - Mario Desmedt
- Swiss Nurse Leaders, Haus der Akademien, Laupenstrasse 7, P.O. Box, 3001 Bern, Switzerland
| | - Birgit Bauer
- Data Saves Lives Germany, c/o european digital health academy gGmbH, Mohnblumenweg 1, 93326 Abensberg, Germany
| | - Gerardine Doyle
- UCD College of Business, University College Dublin, Belfield, Dublin 4, Ireland; UCD Geary Institute for Public Policy, University College Dublin, Belfield, Dublin 4, Ireland
| |
Collapse
|
3
|
Farsaci L, Fleming P, Almirall-Sanchez A, O'Donoghue C, Thomas S. Understanding the legacies of shocks on health system performance: Exploring Ireland's management of recent crises and its implications for policy. Health Policy 2024; 143:105063. [PMID: 38583364 DOI: 10.1016/j.healthpol.2024.105063] [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: 11/16/2023] [Revised: 02/26/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
This paper contrasts the Irish experience of the 2008 economic crisis and the Covid-19 pandemic, and the health system responses to these shocks, from the perspective of health system leaders working across both time periods. Based on semi-structured interviews with seven senior national and international officials, the research presented here forms the qualitative component of RESTORE, a five-year research project examining health system resilience and reform, funded through the Health Research Board's Research Leader Award in Ireland. Findings indicate that the financial crisis deeply impacted the Irish health system in relation to infrastructure and capacity, service delivery and workforce. Due to these legacy issues, Ireland's health system was in a relatively weak position when faced with the Covid-19 pandemic but the system proved adaptive and innovative during this time. Furthermore, the pandemic proved to be a catalyst for positive change, providing opportunities for long-term reform, alongside an immediate response to the crisis. This was facilitated by increased funding, a devolution in decision-making structures and a political commitment to the health system. Exploring lessons from the Irish response to these crises provides a case study for developing appropriate policy responses around financing and resource allocation, fostering support for healthcare among political leaders and policy makers, and preparing for future shocks. Furthermore, examining these experiences facilitates understanding around the impact of each crisis on the health system, exploring options for addressing legacy issues and considering practical steps to improve health system performance.
Collapse
Affiliation(s)
- Liz Farsaci
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, 3-4 Foster Place, Dublin 2, Ireland.
| | - Padraic Fleming
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, 3-4 Foster Place, Dublin 2, Ireland
| | - Arianna Almirall-Sanchez
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, 3-4 Foster Place, Dublin 2, Ireland
| | - Catherine O'Donoghue
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, 3-4 Foster Place, Dublin 2, Ireland
| | - Steve Thomas
- Edward Kennedy Professor of Health Policy and Management, School of Medicine, Trinity College Dublin, 3-4 Foster Place, Dublin 2, Ireland
| |
Collapse
|
4
|
Conway N, Chisholm O. Building a Competency Framework to Integrate Inter-disciplinary Precision Medicine Capabilities into the Medical Technology and Pharmaceutical Industry. Ther Innov Regul Sci 2024; 58:567-577. [PMID: 38491262 PMCID: PMC11043185 DOI: 10.1007/s43441-024-00626-5] [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: 08/22/2023] [Accepted: 02/04/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Integration of precision medicine (PM) competencies across the Medical Technology and Pharmaceutical industry is critical to enable industry professionals to understand and develop the skills needed to navigate the opportunities arising from rapid scientific and technological innovation in PM. Our objective was to identify the key competency domains required by industry professionals to enable them to upskill themselves in PM-related aspects of their roles. METHODS A desktop research review of current literature, curriculum, and healthcare trends identified a core set of domains and subdomains related to PM competencies that were consistent across multiple disciplines and competency frameworks. A survey was used to confirm the applicability of these domains to the cross-functional and multi-disciplinary work practices of industry professionals. Companies were requested to trial the domains to determine their relevance in practice and feedback was obtained. RESULTS Four PM-relevant domains were identified from the literature review: medical science and technology; translational and clinical application; governance and regulation and professional practice. Survey results refined these domains, and case studies within companies confirmed the potential for this framework to be used as an adjunct to current role specific competency frameworks to provide a specific focus on needed PM capabilities. CONCLUSION The framework was well accepted by local industry as a supplement to role specific competency frameworks to provide a structure on how to integrate new and evolving technologies into their current workforce development planning and build a continuous learning and cross-disciplinary mindset.
Collapse
Affiliation(s)
- Nicholette Conway
- GenomePlus Pty Ltd, Sydney, Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Orin Chisholm
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| |
Collapse
|
5
|
Emil S, Langer JC, Blair G, Aspirot A, Brisseau G, Hancock BJ. The Canadian Pediatric Surgery Workforce: A 10-year Prospective Assessment. J Pediatr Surg 2024; 59:757-762. [PMID: 38395684 DOI: 10.1016/j.jpedsurg.2024.01.026] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The Canadian Association of Paediatric Surgeons launched a 10-year prospective assessment of the Canadian pediatric surgery workforce and training environment, beginning in 2013. The results of the first 5 years (2013-2017) were previously published. Here, we present the results of the last 5 years (2018-2022), and the cumulative results of the past decade. METHODS With IRB approval, a web-based survey was sent to all pediatric surgery division chiefs in Canada each year (2013-2022). The survey gathered workforce data on pediatric surgery practices, as well as data regarding fellowship graduates from Canadian training programs. RESULTS Complete responses were received from all 18 divisions (100% response rate). Over the decade studied, the number of pediatric surgeons and full-time equivalent positions increased from 73 to 81, and 65 to 82, respectively. Thirty positions were vacated (15 retirement, 6 new Canadian practice, 8 leaving Canada, 1 other), and 38 were filled (20 new Canadian fellowship graduates, 8 Canadian surgeons moving from other sites in Canada, 10 surgeons coming from outside Canada). Seventy-five fellows completed training eligible for North American certification, including 34 Canadians, 31 Americans, and 10 non-North American foreign nationals (9 of whom left North America after training). The proportion of Canadian graduates who desired, but could not find, a Canadian position improved from 44% in the first 5 years to 20% in the second 5 years. CONCLUSIONS The Canadian pediatric surgery workforce has experienced a modest increase over a decade. A mismatch still exists between Canadian pediatric surgery graduates and attending staff positions, but the situation has improved during the last 5 years. TYPE OF STUDY Survey. LEVEL OF EVIDENCE: 5
Collapse
Affiliation(s)
- Sherif Emil
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
| | - Jacob C Langer
- Division of Pediatric General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Geoffrey Blair
- Division of Pediatric Surgery, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Ann Aspirot
- Division of Pediatric Surgery, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Guy Brisseau
- Division of Pediatric Surgery, Sidra Medicine, Doha, Qatar
| | - B J Hancock
- Division of Pediatric Surgery, Children's Hospital of Winnipeg, Winnipeg, Manitoba, Canada
| |
Collapse
|
6
|
Huang A, Cooke SM, Garsden C, Behne C, Borkoles E. Transitioning to sustainable, climate-resilient healthcare: insights from a health service staff survey in Australia. BMC Health Serv Res 2024; 24:475. [PMID: 38627700 PMCID: PMC11022411 DOI: 10.1186/s12913-024-10882-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND More than 80 countries, including Australia, have made commitments to deliver climate-resilient and low carbon healthcare. Understanding how healthcare workers view their own and their organization's efforts to achieve sustainable and climate-resilient healthcare practice is vital to inform strategies to accelerate that transition. METHODS We conducted an online staff survey in a large state government hospital-and-health-service organisation in Queensland, Australia, to ascertain attitudes and practices towards environmentally sustainable, climate-resilient healthcare, and views about the organizational support necessary to achieve these goals in their workplace. RESULTS From 301 participants showed staff strongly support implementing sustainable and climate-resilient healthcare but require significantly more organizational support. Participants identified three categories of organizational support as necessary for the transition to environmentally sustainable and climate-resilient health services and systems: (1) practical support to make sustainability easier in the workplace (e.g. waste, energy, water, procurement, food, transport etc.); (2) training and education to equip them for 21st century planetary health challenges; and (3) embedding sustainability as 'business as usual' in healthcare culture and systems. CONCLUSIONS The research provides new insight into health workforce views on how organizations should support them to realize climate and sustainability goals. This research has implications for those planning, managing, implementing, and educating for, the transition to environmentally sustainable and climate-resilient health services and systems in Queensland, Australia, and in similar health systems internationally.
Collapse
Affiliation(s)
| | | | - Christine Garsden
- Sunshine Coast Hospital and Health Service, Queensland Health, Sunshine Coast, Australia
| | | | - Erika Borkoles
- Griffith Business School, Griffith University, Brisbane, Australia
| |
Collapse
|
7
|
Kuruc Poje D, Fitzpatrick RW, Stevens C, Machin C, Underhill J, Horák P, Batista A, Süle A, Miljković N, Plesan C, Kohl S, Marzal Lopez G. Investigation of the hospital pharmacy profession in Europe. Eur J Hosp Pharm 2024:ejhpharm-2023-004066. [PMID: 38604616 DOI: 10.1136/ejhpharm-2023-004066] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/17/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE From 1995, the European Association of Hospital Pharmacists (EAHP) has regularly investigated the progress of the hospital pharmacy profession in Europe, and identified key barriers and drivers of this. The most recent 'Investigation of the Hospital Pharmacy Profession in Europe' was conducted from November 2022 to March 2023. METHODS The online questionnaire was sent to all hospital pharmacies in EAHP member countries. The investigation was drafted using the same questions as the 2015 baseline survey. Where possible and relevant, responses were compared with the data from previous surveys that monitored the implementation of the EAHP statements. Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, UK analysed the data. RESULTS The overall number of responses was 653, with a better response rate of 19% compared with 14% in 2018 statements survey. The findings indicated that participating hospital pharmacies have similar characteristics to previous surveys. Section 1 (Introductory statements and governance), section 2 (Selection, procurement and distribution), section 3 (Production and compounding), section 5 (Patient safety and quality assurance) questions were generally answered positively, with results ranging from 52% to 90%. However, results for section 4 (Clinical pharmacy services) returned lower levels of positivity, with responses from 8 of the 15 questions being less than 60%. When asked what is preventing hospital pharmacists from achieving implementation of these activities, most answers were limited capacity, not considered to be a priority by managers, or other healthcare professionals do this. The last section focused on self-assessment and action planning, with fewer than 50% of positive responses; COVID-19 preparedness and vaccines with mixed positive and negative responses. Furthermore, implementation of the falsified medicines directive impacted the medication handling processes in 50% or more of the answers. Regarding sustainability, the majority (59%) of respondents felt a greater focus should be on sustainability from an organisational or management perspective. CONCLUSION Results offer valuable insights into the hospital pharmacy profession throughout Europe. While there have been improvements in certain areas, challenges remain, particularly in implementing clinical pharmacy services. The findings provide a foundation for further dialogue, advocacy, and strategic planning to advance the role of hospital pharmacists and enhance patient care in Europe's healthcare systems.
Collapse
Affiliation(s)
- Darija Kuruc Poje
- Hospital Pharmacy, General Hospital Dr Tomislav Bardek, Koprivnica, Europe, Croatia
- European Association of Hospital Pharmacists, Brussels, Belgium
| | - Raymond William Fitzpatrick
- Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, Staffordshire, UK
| | - Claire Stevens
- Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, Staffordshire, UK
| | - Carl Machin
- Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, Staffordshire, UK
| | - Jonathan Underhill
- Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, Staffordshire, UK
| | - Petr Horák
- Hospital Pharmacy, University Hospital Motol, Prague, Czech Republic
| | - Aida Batista
- Unidade Hospitalar do Médio Ave EPE, Santo Tirso, Porto, Portugal
| | - András Süle
- European Association of Hospital Pharmacists, Brussels, Belgium
- Department of Pharmacy, Peterfy Korhaz-Rendelointezet es Manninger Jeno Orszagos Traumatologiai Intezet, Budapest, Hungary
| | - Nenad Miljković
- European Association of Hospital Pharmacists, Brussels, Belgium
- Hospital Pharmacy, Institute of Orthopaedics Banjica, Belgrade, Serbia
| | - Claudia Plesan
- Oncology Center Drobeta Turnu Severin, Drobeta-Turnu Severin, Romania
| | - Stephanie Kohl
- European Association of Hospital Pharmacists, Brussels, Belgium
| | | |
Collapse
|
8
|
Hodgson NR, Kwun R, Gorbatkin C, Davies J, Fisher J. Emergency department responses to nursing shortages. Int J Emerg Med 2024; 17:51. [PMID: 38580916 PMCID: PMC10996074 DOI: 10.1186/s12245-024-00628-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 03/28/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic exacerbated the nursing shortage, which is predicted to continue to worsen with significant numbers of nurses planning to retire within the next 5 years. There remains a lack of published information regarding recommended interventions for emergency departments (EDs) facing a sudden nursing shortage. METHODS We queried emergency department leaders from the American College of Emergency Physicians to examine the impact of nursing shortages on EDs and to gather real-world interventions employed to mitigate the effects of the shortage. RESULTS Most respondents (98.5%) reported nursing shortages, with 83.3% describing prolonged shortages lasting more than 12 months, with negative impacts such as misses/near-misses (93.9%) and increasing left without being seen rates (90.9%). ED leaders reported a range of interventions, including operational flow changes, utilizing alternative staff to fill nurse roles, recruitment of new nurses, and retention strategies for existing nurses. They employed temporary and permanent pay increases as well as efforts to improve the ED work environment and techniques to hire new nurses from atypical pipelines. CONCLUSION We report a patchwork of solutions ED leaders utilized which may have variable efficacy among different EDs; personalization is essential when selecting interventions during a sudden nursing shortage.
Collapse
Affiliation(s)
- Nicole R Hodgson
- Department of Emergency Medicine, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
| | - Richard Kwun
- Department of Emergency Medicine, Swedish Medical Center, Issaquah, WA, USA
| | - Chad Gorbatkin
- Department of Emergency Medicine, Madigan Army Medical Center, JBLM, Lakewood, WA, USA
| | - Jeanie Davies
- American College of Emergency Physicians, Irving, TX, USA
| | | |
Collapse
|
9
|
Bruyneel A, Bouckaert N, Pirson M, Sermeus W, Van den Heede K. Unfinished nursing care in intensive care units and the mediating role of the association between nurse working environment, and quality of care and nurses' wellbeing. Intensive Crit Care Nurs 2024; 81:103596. [PMID: 38043435 DOI: 10.1016/j.iccn.2023.103596] [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: 02/10/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES Unfinished care refers to the situation in which nurses are forced to delay or omit necessary nursing care. The objectives was: 1) to measure the prevalence of unfinished nursing care in intensive care units during the COVID-19 pandemic; 2) to examine whether unfinished nursing care has a mediating role in the relationship between nurse working environment and nurse-perceived quality of care and risk of burnout among nurses. DESIGN A national cross-sectional survey. SETTING Seventy-five intensive care units in Belgium (December 2021 to February 2022). MAIN OUTCOME MEASURES The Practice Environment Scale of the Nursing Work Index was used to measure the work environment. The perception of quality and safety of care was evaluated via a Likert-type scale. The risk of burnout was assessed using the Maslach Burnout Inventory scale. RESULTS A total of 2,183 nurse responses were included (response rate of 47.8%). Seventy-six percent of nurses reported at least one unfinished nursing care activity during their last shift. The staffing and resource adequacy subdimension of the Practice Environment Scale of the Nursing Work Index had the strongest correlation with unfinished nursing care. An increase in unfinished nursing care led to significantly lower perceived quality and safety of care and an increase in high risk of burnout. Unfinished nursing care appears to be a mediating factor for the association between staffing and resource adequacy and the quality and safety of care perceived by nurses and risk of burnout. CONCLUSIONS Unfinished nursing care, which is highly related to staffing and resource adequacy, is associated with increased odds of nurses being at risk of burnout and reporting a lower level of perceived quality of care. IMPLICATIONS FOR CLINICAL PRACTICE The monitoring of unfinished nursing care in the intensive care unit is an important early indicator of problems related to adequate staffing levels, the well-being of nurses, and the perceived quality of care.
Collapse
Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.
| | | | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Walter Sermeus
- KU Leuven Institute for Healthcare Policy, Leuven, Belgium
| | - Koen Van den Heede
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium; KU Leuven Institute for Healthcare Policy, Leuven, Belgium
| |
Collapse
|
10
|
El Ansari W, Arafa M, Shah R, Harraz A, Shokeir A, Zohdy W, Savira M, Agarwal A. Pushing the Boundaries for Evidenced-Based Practice: Can Online Training Enhance Andrology Research Capacity Worldwide? An Exploration of the Barriers and Enablers - The Global Andrology Forum. World J Mens Health 2024; 42:394-407. [PMID: 37635339 PMCID: PMC10949034 DOI: 10.5534/wjmh.230084] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/23/2023] [Indexed: 08/29/2023] Open
Abstract
PURPOSE This is the first study to design and assess a research capacity building (RCB) specifically tailored for clinical and non-clinical andrology practitioners worldwide. We appraised: 1) the barriers and enablers to research among these practitioners; 2) attendees' satisfaction with the webinar; and 3) research knowledge acquisition as a result of the webinar (before/after quiz). MATERIALS AND METHODS A online RCB webinar was designed, comprising two presentations in research design and systematic review/meta-analysis (SR/MA). An online survey using validated published questionnaires assessed the three above-stated objectives. Paired t-test compared the means of the pre- and post-webinar scores. Subgroup analysis was performed on the participants' professional background, sex, and number of years in practice. RESULTS A total of 237 participants attended the webinar, of which 184 completed the survey and are included in the current analysis. Male participants were about double the females and 60.9% were from Asian countries. The most common research enablers were to publish scientific papers (14.8%) and to develop research (14.7%) or new skills (12.7%). The most common barriers were the lack of training in research (12.4%), training in research software (11.8%), and time for research (11.8%). Satisfaction with the webinar was considerably high (86.3%-88.4%) for the different features of the webinar. Compared to the pre-webinar knowledge level, there were significant improvements in participants' research knowledge acquisition after the webinar in terms of the total score for the quiz (13.7±4.31 vs. 21.5±4.7), as well as the scores for the study design (7.12±2.37 vs. 11.5±2.69) and SR/MA sessions (6.63±2.63 vs. 9.93±2.49) (p<0.001 for each). CONCLUSIONS Clinical and non-clinical andrology webinar attendees recognized the importance of research and exhibited a range of research skills, knowledge and experience. There were significant improvements in the participants' knowledge and understanding of the components of scientific research. We propose an RCB model that can be implemented and further modeled by organizations with similar academic research goals.
Collapse
Affiliation(s)
- Walid El Ansari
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Department of Postgarduate Medcial Education, College of Medicine, Qatar University, Doha, Qatar
- Department of Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Andrology, Cairo University, Cairo, Egypt
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Rupin Shah
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Ahmed Harraz
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt
- Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
- Sabah Al Ahmad Urology Center, Kuwait City, Kuwait
| | - Ahmed Shokeir
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt
| | - Wael Zohdy
- Department of Andrology, Cairo University, Cairo, Egypt
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Missy Savira
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Ashok Agarwal
- Global Andrology Forum, Moreland Hills, OH, USA
- Cleveland Clinic, Cleveland, OH, USA.
| |
Collapse
|
11
|
Collazo A, Walcher CM, Campbell KM. Underrepresented in medicine (URiM) faculty development: Trends in biomedical database publication. J Natl Med Assoc 2024; 116:165-169. [PMID: 38220585 DOI: 10.1016/j.jnma.2024.01.005] [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: 08/06/2023] [Revised: 10/03/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Biomedical databases create an educational platform that allows institutions to share innovations and research discoveries. Identifying literature in biomedical databases that inform the faculty development experiences of faculty underrepresented in medicine (URiM) can help institutions identify resources to promote career advancement for this group. The authors sought to determine biomedical database trends in publications related to faculty development experiences of URiM faculty over the last twenty years. METHODS An electronic search for literature published between January 2003 to Dec 2022 was conducted in the databases CINAHL, PubMed, Scopus, and PsycInfo using keywords underrepresented minority, faculty development, career development, professional development, academic medicine, and workforce in the title, abstract, or body of the manuscript. Growth rates were calculated for each database. The statistical significance difference in median numbers of publication per database was evaluated using Krusksal Wallis and Dunn's test post hoc. RESULTS Search results found 1516 publications over the twenty-year period. Scopus published the most literature with 1,372 publications with a mean number of 68.6 per year (SD 83.47). Both Scopus and PubMed had increased growth rates at 41% and 25%, respectively. There were statistically significant differences in median publication numbers between Scopus, CINAHL, and PsycInfo (p < 0.001) but not PubMed (p 0.062). CONCLUSION Trends in publications related to URiM faculty development have increased over the last twenty years, most noted in the Scopus and PubMed biomedical databases.
Collapse
Affiliation(s)
- Ashley Collazo
- University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123, United States
| | - Christen M Walcher
- University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123, United States
| | - Kendall M Campbell
- University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123, United States.
| |
Collapse
|
12
|
Castedo de Martell S, Wilkerson JM, Howell J, Brown HS, Ranjit N, Holleran Steiker L, McCurdy SA. The peer to career pipeline: An observational study of peer worker trainee characteristics and training completion likelihood. J Subst Use Addict Treat 2024; 159:209287. [PMID: 38160878 PMCID: PMC10947928 DOI: 10.1016/j.josat.2023.209287] [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: 04/25/2023] [Revised: 11/06/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Peer recovery support services (PRSS) for substance use disorder (SUD) are a flexible and evidence-based intervention employed across multiple settings and for a variety of populations. These services have expanded over the past two decades, but there is little research on recruitment and training of prospective peer workers - the peer to career pipeline. This study observed training outcomes for applicants to a peer worker scholarship program in Texas. METHODS A total of 448 participants provided baseline personal history information, and a subset of participants (n = 239) completed optional psychosocial surveys. Logistic regression analysis tested associations of personal history and psychosocial variables with three training stage completion outcomes: classroom training completion, placement at an internship site, and full certification. RESULTS The greatest decline in advancement between stages occurred in the transition between classroom training (78.1 % of participants completed) and internship placement (43.3 % of participants completed). Participants were diverse in terms of race/ethnicity and life experiences salient to the peer worker role, but Hispanic/Latinx peer workers were under-represented. Past work with a SUD peer worker, age, and having a bachelor's degree were each positively associated with training stage completion across multiple models, while having basic technological access, being a woman, and veteran status were each positively associated with training stage completion in only one model. Years since recovery initiation date, non-monosexual orientation, White race, and quality of life were each negatively associated with training stage completion in only one model. CONCLUSIONS The existing peer workforce may be a key source of recruitment for new peer workers; thus retention of existing workers is key to ensuring continued expansion of these services. Additional support may be required to recruit and retain younger peer worker trainees, men trainees, Hispanic/Latinx trainees, trainees who lack basic technological access, or trainees without bachelor's degrees. Unanswered questions about the peer workforce remain and must be addressed to ensure that an appropriately diverse workforce is recruited, that disparities in training outcomes are minimized or prevented, and that existing peer workers are well-supported.
Collapse
Affiliation(s)
- Sierra Castedo de Martell
- The University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin, Suite 1880, Houston, TX 77030, USA; Chestnut Health Systems, 1003 Martin Luther King Jr. Dr., Bloomington, IL 61701, USA.
| | - J Michael Wilkerson
- The University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin, Suite 1880, Houston, TX 77030, USA.
| | | | - H Shelton Brown
- The University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin, Suite 1880, Houston, TX 77030, USA.
| | - Nalini Ranjit
- The University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin, Suite 1880, Houston, TX 77030, USA.
| | - Lori Holleran Steiker
- The University of Texas at Austin, Steve Hicks School of Social Work and School of Undergraduate Studies, 110 Inner Campus Drive, Austin, TX 78705, USA.
| | - Sheryl A McCurdy
- The University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin, Suite 1880, Houston, TX 77030, USA.
| |
Collapse
|
13
|
Camarano J, Lefever D, Kandregula S, Abushehab N, Benzil D, Huntoon K, Mazzola C, McGuire L, Heary R, Parr A, Hussain N, Perez-Cruet M, Shuer L, Stacy J, Guthikonda B. Utilization of Locum Tenens in Neurosurgery. World Neurosurg 2024; 184:e274-e281. [PMID: 38296044 DOI: 10.1016/j.wneu.2024.01.109] [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: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Despite its rising popularity, little has been described about locum tenens employment (locums) in neurosurgery. This study provides the first nationwide overview of the locums neurosurgery experience. METHODS An anonymous online survey examined practice characteristics of respondents, extent of and satisfaction with locums, motivations for pursuing locums, case volumes, agencies used, compensation, and positive/negative aspects of experiences. Responses were collected between November 2020 and February 2021. RESULTS Response rate for the 1852 neurosurgeons who opened the survey request was 4.9%; 36 of 91 respondents had previously worked locums and were commonly motivated by compensation or transitioning to new jobs or retirement. In our response group, 92% of locums respondents had taken more than one position and 47% had taken more than 10. Neurosurgeons performing <200 cases/year were significantly more likely to have also worked locums than those performing >200 cases/year (41.6% locums, 12.7% non-locums, P = 0.001). Responses showed that 69% of locums respondents earned $2000-$2999/day and 16% earned >$3500/day. Nearly 78% of locums respondents were satisfied with their experience(s) and 86% would take another future locums position. Being in practice for >15 years was significantly associated with satisfaction with locums (P = 0.03). Reported flaws included unfamiliarity with hospitals, limited continuity of care, credentialing burdens, and inadequate travel compensation. CONCLUSIONS Locums is utilized by neurosurgeons across multiple practice types and may serve to complement workloads or "fill in gaps" between longer-term employment. Overall, locums neurosurgeons are well compensated, and the majority are satisfied with their experience(s). Inevitably, flaws still exist with locums employment, which may be the focus of organized efforts aiming to improve the experience.
Collapse
Affiliation(s)
- Joseph Camarano
- Department of Neurosurgery, LSU Health Shreveport, Shreveport, Louisiana, USA.
| | - Devon Lefever
- Department of Neurosurgery, LSU Health Shreveport, Shreveport, Louisiana, USA
| | - Sandeep Kandregula
- Department of Neurosurgery, LSU Health Shreveport, Shreveport, Louisiana, USA
| | - Nimer Abushehab
- Department of Neurosurgery, LSU Health Shreveport, Shreveport, Louisiana, USA
| | - Deborah Benzil
- Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA; Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Kristin Huntoon
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Catherine Mazzola
- Division of Pediatric Neurological Surgery, Goryeb Children's Hospital, Morristown, New Jersey, USA
| | - Laura McGuire
- Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago Illinois, USA; Department of Neurological Surgery, University of Illinois Chicago, Chicago Illinois, USA
| | - Robert Heary
- Department of Neurological Surgery, New Jersey Medical School, Newark, New Jersey, USA
| | - Ann Parr
- Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Namath Hussain
- Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, California, USA
| | | | - Lawrence Shuer
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jason Stacy
- Division of Neurosurgery, North Mississippi Medical Center, Tupelo, Mississippi, USA
| | - Bharat Guthikonda
- Department of Neurosurgery, LSU Health Shreveport, Shreveport, Louisiana, USA
| |
Collapse
|
14
|
Dowling M, Pape E, Geese F, Van Hecke A, Bryant-Lukosius D, Cerón MC, Fernández-Ortega P, Marquez-Doren F, Ward A, Semple C, King T, Glarcher M, Drury A. Advanced Practice Nursing Titles and Roles in Cancer Care: A Scoping Review. Semin Oncol Nurs 2024:151627. [PMID: 38556366 DOI: 10.1016/j.soncn.2024.151627] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES Advanced practice nursing roles in cancer care are diverse and exist across the cancer care continuum. However, the titles used and the scope of practice differ across countries. This diversity is likely to be misleading to patients and influence nurses' contribution to health care. An understanding of the current state of advanced practice nursing roles in cancer care internationally is needed to inform opportunities for future role development and enhance cancer nursing career pathways. METHODS This scoping review included a systematic search of four databases: MEDLINE, CINAHL, PsycINFO, and Academic Search Complete. Independent screening for papers meeting the review's inclusion criteria was undertaken using online screening software. Data extraction, coding, and mapping were undertaken in NVivo 12. RESULTS Of the 13,409 records identified, 108 met the review's inclusion criteria. A variety of roles in cancer care settings were described. The United States and the United Kingdom had the most titles for advanced practice nursing roles. Tumor-specific roles were described and integrated into different phases of the cancer care continuum. Trends in continuing professional development for advanced practice nurses in cancer care included the rise in Fellowship programs in the United States and practice-based education in the United Kingdom. CONCLUSIONS The differences in advanced practice nursing roles in cancer care allow regional and institutional variation to meet the needs of patient populations and health care system demands. However, a lack of clarity surrounding titles and roles results in confusion and underutilization of these nurses' highly specialized skill sets. IMPLICATIONS FOR NURSING PRACTICE Incongruence in titles and scope of practice internationally will ultimately result in a merging of roles. There is a need for international agreement on education requirements for advanced practice nursing roles to promote career pathways.
Collapse
Affiliation(s)
- Maura Dowling
- School of Nursing and Midwifery, University of Galway, Ireland.
| | - Eva Pape
- Cancer Center, Ghent University Hospital, Belgium; Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium and Ghent University Hospital, Centre for Nursing Expertise, Belgium
| | - Franziska Geese
- Department of Nursing, Clinical Practice Development and Digitalisation, Bern University Hospital, Inselspital, Insel Gruppe, Switzerland
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium and Ghent University Hospital, Centre for Nursing Expertise, Belgium; Nursing Department, Ghent University Hospital, Belgium
| | - Denise Bryant-Lukosius
- School of Nursing and Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - M Consuelo Cerón
- Escuela de Enfermería, Facultad de Enfermería y Obstetricia, Universidad de los Andes-Chile
| | - Paz Fernández-Ortega
- Catalan Institute of Oncology and Faculty of Nursing, University of Barcelona, Spain
| | - Francisca Marquez-Doren
- School of Nursing, PAHO Collaborating Center, Pontificia Universidad Católica de Chile and School of Nursing Pontificia Universidad Católica de Chile, PAHO Collaborating Center and Sigma Chapter Alfa Beta Ómicron
| | - Ashleigh Ward
- School of Medicine, Dentistry and Nursing College of Medicine, Veterinary and Life Sciences, University of Glasgow, Scotland; NHS Forth Valley, Stirling, UK
| | - Cherith Semple
- Institute of Nursing and Health Research, Ulster University / Cancer Services, South Eastern Health and Social Care Trust, Belfast, Northern Ireland
| | - Tracy King
- Cancer Care Research Unit (CCRU) Susan Wakil School of Nursing and Midwifery, The University of Sydney, Australia; Institute of Haematology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Manela Glarcher
- Institute of Nursing Science, Paracelsus Medical University, Salzburg, Austria
| | - Amanda Drury
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Ireland
| |
Collapse
|
15
|
Lawson McLean A, Vetrano IG, Lawson McLean AC, Conti A, Mertens P, Müther M, Nemir J, Peschillo S, Santacroce A, Sarica C, Tuleasca C, Zoia C, Régis J. Revitalizing neurosurgical frontiers: The EANS frontiers in neurosurgery committee's strategic framework. Brain Spine 2024; 4:102794. [PMID: 38601776 PMCID: PMC11004717 DOI: 10.1016/j.bas.2024.102794] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/12/2024]
Abstract
Introduction The field of neurosurgery faces challenges with the increasing involvement of other medical specialties in areas traditionally led by neurosurgeons. This paper examines the implications of this development for neurosurgical practice and patient care, with a focus on specialized areas like pain management, peripheral nerve surgery, and stereotactic radiosurgery. Research question To assess the implications of the expanded scope of other specialties for neurosurgical practice and to consider the response of the EANS Frontiers in Neurosurgery Committee to these challenges. Materials and methods Analysis of recent trends in neurosurgery, including the shift in various procedures to other specialties, demographic challenges, and the emergence of minimally invasive techniques. This analysis draws on relevant literature and the initiatives of the Frontiers in Neurosurgery Committee. Results We explore a possible decrease in neurosurgical involvement in certain areas, which may have implications for patient care and access to specialized neurosurgical interventions. The Frontiers in Neurosurgery Committee's role in addressing these concerns is highlighted, particularly in terms of training, education, research, and networking for neurosurgeons, especially those early in their careers. Discussion and conclusion The potential decrease in neurosurgical involvement in certain specialties warrants attention. This paper emphasizes the importance of carefully considered responses by neurosurgical societies, such as the EANS, to ensure neurosurgeons continue to play a vital role in managing neurological diseases. Emphasis on ongoing education, integration of minimally invasive techniques, and multidisciplinary collaboration is essential for maintaining the field's competence and quality in patient care.
Collapse
Affiliation(s)
- Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
| | - Ignazio G. Vetrano
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna C. Lawson McLean
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
| | - Alfredo Conti
- UOC Neurochirurgia, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Patrick Mertens
- Department of Neurosurgery, University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, University Lyon 1, Lyon, France
| | - Michael Müther
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Jakob Nemir
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
| | - Simone Peschillo
- Endovascular Neurosurgery, Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Antonio Santacroce
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
- Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
- European Radiosurgery Center Munich, Munich, Germany
| | - Can Sarica
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontatio, Canada
| | - Constantin Tuleasca
- Lausanne University Hospital (CHUV), Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland
- University of Lausanne (UNIL), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
| | - Cesare Zoia
- UOC Neurochirurgia, Ospedale Moriggia Pelascini, Gravedona e Uniti, Italy
| | - Jean Régis
- Aix Marseille University, Department of Functional Neurosurgery, CHU Timone, Marseille, France
| | - EANS Frontiers in Neurosurgery Committee
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena University Hospital, Jena, Germany
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- UOC Neurochirurgia, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Alma Mater Studiorum Università di Bologna, Bologna, Italy
- Department of Neurosurgery, University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, University Lyon 1, Lyon, France
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, Zagreb, Croatia
- Endovascular Neurosurgery, Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
- Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
- European Radiosurgery Center Munich, Munich, Germany
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontatio, Canada
- Lausanne University Hospital (CHUV), Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland
- University of Lausanne (UNIL), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
- UOC Neurochirurgia, Ospedale Moriggia Pelascini, Gravedona e Uniti, Italy
- Aix Marseille University, Department of Functional Neurosurgery, CHU Timone, Marseille, France
| |
Collapse
|
16
|
Hall EW, Sarwary S, Reynolds A, Przedworski J, Newby-Kew A, Camp K, Ku JH, Snowden JM. Development of a University-Government Partnership for Public Health Response and Workforce Development in the State of Oregon. J Community Health 2024:10.1007/s10900-024-01352-7. [PMID: 38491319 DOI: 10.1007/s10900-024-01352-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
The COVID-19 pandemic exposed and exacerbated a public health workforce shortage and national strategies have called for the development of clear occupational pathways for students to enter the public health workforce and meaningful public health careers. In response to the immediate need for public health workers during the pandemic, several universities and academic hospitals rapidly mobilized students and employees and partnered with local or state health departments. However, many of those partnerships were based on short-term volunteer effort to support critical COVID-19 public health efforts. In this article, we document the development of Oregon's Public Health Practice Team, a student, staff, and faculty workforce developed at the Oregon Health & Science University-Portland State University (OHSU-PSU) School of Public Health in close collaboration with the Oregon Health Authority (OHA). This project contributed significant effort to several phases of Oregon's statewide public health response to COVID-19, and over time developed into a lasting, multi-purpose, inter-agency collaborative public health practice program. Health equity has been centered at every stage of this work. We describe the phases of the partnership development, the current team structure and operations, and highlight key challenges and lessons learned. This provides a case-study of how an innovative and flexible university-government partnership can contribute to immediate pandemic response needs, and also support ongoing public health responses to emerging needs, while contributing to the development of a skilled and diverse public health workforce.
Collapse
Affiliation(s)
- Eric W Hall
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA.
| | - Shabir Sarwary
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA
| | - Amelia Reynolds
- Health Security, Preparedness and Response Program, Public Health Division, Oregon Health Authority, Portland, OR, USA
| | | | - Abigail Newby-Kew
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA
| | - Karen Camp
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA
| | - Jennifer H Ku
- Department of Research & Evaluation, Kaiser Permanente Southern California, California, USA
| | - Jonathan M Snowden
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA
| |
Collapse
|
17
|
Svensson I, Bridges J, Ellis J, Brady N, Dello S, Hooft J, Kleine J, Kohnen D, Lehane E, Lindqvist R, Maier CB, Mc Carthy VJC, Strømseng Sjetne I, Eriksson LE, Smeds Alenius L. Laying the foundations for implementing Magnet principles in hospitals in Europe: A qualitative analysis. Int J Nurs Stud 2024; 154:104754. [PMID: 38522183 DOI: 10.1016/j.ijnurstu.2024.104754] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Magnet hospitals, a concept developed in the U.S., have been associated with improved nurse recruitment and retention, and better patient outcomes. Magnet principles may be useful to address workforce challenges in European hospitals, but they have not been implemented or evaluated on a large scale in the European hospital context. OBJECTIVE This study aims to explore the initial phase of implementing Magnet principles in 11 acute care hospitals in six European countries. The specific objectives of the study were to investigate the type of work that characterises the early phase of implementation and how implementation leaders engage with their context. METHODS A multinational qualitative study was conducted, with data from 23 semi-structured, one-to-one interviews with implementation leaders in 11 acute care hospitals in six European countries. Thematic analyses guided the analysis of data. FINDINGS Three themes of core work processes during the early phase of implementing Magnet principles in European hospitals were identified. The first theme, 'Creating space for Magnet', describes how work was directed towards creating both political and organisational space for the project. The second theme, 'Framing to fit: understanding and interpreting Magnet principles', describes the translational work to understand what the Magnet model entails and how it relates to the local hospital context. Finally, the third theme, 'Calibrating speed and dose', describes the strategic work of considering internal and external factors to adjust the process of implementation. CONCLUSIONS The first phase of implementation was characterised by conceptual and relational work; translating the Magnet concepts, considering the fit into existing structures and practices and making space for Magnet in the local context. Understanding the local context played an important role in shaping and guiding the navigation of professional and organisational tensions. Hospitals employed diverse strategies to either emphasise or downplay the role of nurses and nursing to facilitate progress in the implementation.
Collapse
Affiliation(s)
- Ingrid Svensson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
| | - Jackie Bridges
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Jaimie Ellis
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Noeleen Brady
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Simon Dello
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium
| | - Jonathan Hooft
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium
| | - Joan Kleine
- Department of Healthcare Management, Technical University of Berlin, Berlin, Germany
| | - Dorothea Kohnen
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium; Occupational & Organisational Psychology and Professional Learning, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium
| | - Elaine Lehane
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Rikard Lindqvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Claudia B Maier
- Department of Healthcare Management, Technical University of Berlin, Berlin, Germany
| | | | - Ingeborg Strømseng Sjetne
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway; Lovisenberg Diakonale Sykehus, Oslo, Norway
| | - Lars E Eriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; School of Health and Psychological Sciences, City, University of London, London, United Kingdom; Medical Unit Infectious Diseases, Karolinska University Hospital, Huddinge, Sweden
| | - Lisa Smeds Alenius
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
18
|
Arunogiri S, Lubman D, Foulds J. Addiction Medicine and Psychiatry Workforce Training and Planning across Australia and New Zealand: Commentary on "Education and Training in Addiction Medicine and Psychology across Europe: a EUFAS Survey". Eur Addict Res 2024:1-4. [PMID: 38467117 DOI: 10.1159/000536560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/17/2024] [Indexed: 03/13/2024]
Affiliation(s)
- Shalini Arunogiri
- Monash Addiction Research Centre and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Dan Lubman
- Monash Addiction Research Centre and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - James Foulds
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| |
Collapse
|
19
|
Gillan C, Magliozzi A, Savelli L, Cornacchione P. Early engagement: The value of MRIT student externs in supporting recruitment, retention, and the future of the medical imaging professions. J Med Imaging Radiat Sci 2024:S1939-8654(24)00028-6. [PMID: 38461058 DOI: 10.1016/j.jmir.2024.02.015] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/11/2024]
Abstract
The healthcare system faces critical challenges in recruitment and retention due to increased patient volumes, post-pandemic recovery needs, and a departing experienced workforce. The concept of an 'extern' role, increasingly explored in professions such as nursing, allows healthcare students to take on paid employment in assistive roles in settings relevant to their future profession. The cornerstone of such an initiative is to bridge academic learning with practical clinical support, engaging the future of the workforce in a safe and meaningful way. METHODS An extern program was piloted at a major urban multi-site medical imaging department beginning in 2022. Over three cohort years, it has explored two types of extern roles (junior and clinical) across three entry-to-practice MRIT disciplines - radiological technology, nuclear medicine and molecular imaging, and ultrasound. In developing roles, compliance with legislative regulations, considerations in defining roles and eligibility criteria, and aligning work commitment with student learning schedules were paramount in informing the program's structure and success. Seventy-three candidates applied to related roles and 34 externs were hired. BENEFITS/CHALLENGES Benefits to the program include engagement in clinical and administrative tasks, facilitation of departmental efficiency, and support for the existing workforce. Specific tasks for clinical externs included supporting staff in patient transfers and positioning, cleaning and restocking rooms, triaging patients and demands, calling inpatients and coordinating porters, and monitoring patients and schedules. For junior externs, tasks involved record-keeping, curating teaching cases, and supporting billing code reviews and quality control exercises like lead apron testing. IMPACTS/OUTCOMES The program's value in shaping the future of healthcare professions has been recognized, particularly in enhancing student transition into practice and increasing recruitment opportunities for the host site. Staff overtime hours were reduced, and new graduates who had worked as externs were more quickly able to work autonomously following hire. The program was mutually beneficial to existing staff and future professionals, reinforcing the workforce without sacrificing the higher level learning achieved through university-based preparation for practice.
Collapse
Affiliation(s)
- C Gillan
- Joint Department of Medical Imaging, University Health Network, Toronto Canada; Department of Radiation Oncology, University of Toronto, Toronto Canada; Department of Medical Imaging, University of Toronto, Toronto Canada.
| | - A Magliozzi
- Department of Radiation Oncology, University of Toronto, Toronto Canada; Michener Institute of Education at UHN, Toronto Canada
| | - L Savelli
- Joint Department of Medical Imaging, University Health Network, Toronto Canada
| | - P Cornacchione
- Joint Department of Medical Imaging, University Health Network, Toronto Canada
| |
Collapse
|
20
|
Bradley F, Hammond M, Braund R. Career outlook and satisfaction in the presence of workload intensification-a survey of early career pharmacists. Int J Pharm Pract 2024; 32:164-169. [PMID: 38180803 DOI: 10.1093/ijpp/riad084] [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: 03/02/2023] [Accepted: 11/12/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND The demographics of the pharmacy workforce is changing with an increased proportion of pharmacists less than 30 years old (early career pharmacists-ECPs). In parallel, the profession has experienced workload intensification and workforce attrition. It is important to understand ECPs career satisfaction to retain this section of the pharmacy profession. OBJECTIVES This study aimed to collect data on the current career satisfaction of ECPs, and identify workplace factors that were most important to this group. Further, to use these findings to inform sector recommendations. METHODS A steering group of ECPs in Aotearoa New Zealand developed a survey based on one used previously. An invitation email was sent to all pharmacists who had been registered for less than 10 years and were members of the Pharmaceutical Society of New Zealand. RESULTS A total of 1418 ECPs were identified and invited to participate, and responses were received by 416 of these. While 90% believe that they are making a useful contribution to the health of their patients, over half are unhappy and discontented, with over a third dissatisfied with their careers. A large proportion (44%) were considering leaving the profession in the next 5 years. The top three factors for career satisfaction were ability to progress and learn new skills, the people they work with, and the remuneration. CONCLUSIONS This study provides a starting point for understanding the current environment and level of dissatisfaction of young pharmacists. There are several areas of concern that need to be addressed if a strong vibrant viable pharmacy profession is to be achieved.
Collapse
Affiliation(s)
- Fiona Bradley
- The Pharmaceutical Society of New Zealand, PO Box 11640, Wellington, New Zealand
| | - Michael Hammond
- Te Whatu Ora-Health New Zealand, PO Box 93-503, Auckland/Waitematā, New Zealand
- New Zealand Pharmacovigilance Centre, University of Otago, PO Box 913, Dunedin, New Zealand
| | - Rhiannon Braund
- The Pharmaceutical Society of New Zealand, PO Box 11640, Wellington, New Zealand
- New Zealand Pharmacovigilance Centre, University of Otago, PO Box 913, Dunedin, New Zealand
| |
Collapse
|
21
|
Blake H, Mancini H, Coyne E, Cooper J, Stanulewicz-Buckley N. Workforce wellbeing centres and their positive role for wellbeing and presenteeism in healthcare workers during the COVID-19 pandemic: secondary analysis of COVID-Well data. BMC Health Serv Res 2024; 24:302. [PMID: 38448919 PMCID: PMC10918935 DOI: 10.1186/s12913-024-10730-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/15/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Supported wellbeing centres established during the COVID-19 pandemic provided high quality rest spaces and access to peer-to-peer psychological first aid for healthcare workers (HCWs). The centres were well accessed and valued by HCWs, but their relationship with wellbeing and job-related factors is not well established. The aim of this study was to explore the relationship between wellbeing centre use, HCWs wellbeing and job-related factors (job stressfulness, job satisfaction, presenteeism, turnover intentions). METHODS Secondary analysis of data from 819 HCWs from an acute hospital trust who completed an online survey in April-July 2020, as part of the COVID-Well study. Measures included the Warwick Edinburgh Mental Wellbeing Scale, and four single-item global measures of job stressfulness, job satisfaction, presenteeism and turnover intentions. ANCOVA models and regression analyses were conducted on these data. RESULTS HCWs who had not accessed the wellbeing centres had lower wellbeing (β = 0.12, p < .001), higher job stressfulness (β = - 0.22, p < .001), lower job satisfaction (β = 0.39, p < .001), higher presenteeism (β = - 0.22, p < .001) and were of younger age (β = 0.09, p = .002). Centre use was associated with wellbeing irrespective of job stressfulness. Those reporting presenteeism and who accessed the centre (M = 3.30, SE = 0.04) had higher wellbeing than those who accessed the centre but did not report presenteeism (M = 3.06, SE = 0.04) (F(1, 791) = 18.65, p < .001, ηp2 = 0.02). Centre use was not significantly associated with turnover intentions (B = - 0.30, p = .13; Wald = 2.26; odds = 0.74), while job stress and job satisfaction showed significant effects. CONCLUSIONS Accessing wellbeing centres was associated with higher wellbeing of HCWs, particularly for those reporting presenteeism. Therefore, the centres may have provided greatest respite and restoration for those present at work but not in optimal health. Younger workers were disproportionately affected in terms of wellbeing, and targeted support for this population is needed. Strategies to decrease presenteeism and maximise job satisfaction are urgently required. Healthcare organisations should provide rest spaces and psychological support to HCWs for the long-term, as part of a systems-wide approach to improving workforce health and wellbeing.
Collapse
Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
| | - Helen Mancini
- Human Resources, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Emma Coyne
- Clinical Psychology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joanne Cooper
- Nursing and Midwifery, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | |
Collapse
|
22
|
Ko CH, Chien LN, Chiu YT, Hsu HH, Wong HF, Chan WP. Demands for medical imaging and workforce Size: A nationwide population-based Study, 2000-2020. Eur J Radiol 2024; 172:111330. [PMID: 38290203 DOI: 10.1016/j.ejrad.2024.111330] [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: 07/13/2023] [Revised: 12/22/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE The aim of this study was to investigate associations between workforce and workload among radiologists in Taiwan. MATERIALS AND METHODS Data for the period 2000-2020 describing the demand for imaging services and radiologists have been obtained from databases and statistical reports of the Ministry of Health and Welfare. The future demand for radiologists was based on Taiwanese people aged 40 and over. RESULTS The workforce of Taiwan's radiologists has increased by 6 % annually over the past 20 years (from 450 to 993), performing 2125, 3202 and 3620 monthly examinations (mainly conventional radiography and CT) in medical centers, regional hospitals and district hospitals. Between 2000 and 2020, the use of CT and MRI increased by more than 3.5 times. Demand for interventional radiology also increased by 1.77 times, 2.25 times, and 5 times, respectively. To maintain this volume of services in 2040, at least 1168 radiologists are needed, about 1.18 times more in 2020. CONCLUSION Taiwan has 2.4 to 2.9 times fewer radiologists than the United States and 3 times fewer than Europe, while the annual workload is approximately 2 to 3.4 times greater than that of the United States and 1.4 to 2.5 times greater than that of the United Kingdom. This report may serve as a reference for policy makers who address the challenges of the growing workload among radiologists in countries of similar situations.
Collapse
Affiliation(s)
- Chih-Hsiang Ko
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Li-Nien Chien
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei City 11221, Taiwan
| | - Yu-Ting Chiu
- School of Health Care Administration, College of Management, Taipei Medical University, New Taipei City 235, Taiwan
| | - Hsian-He Hsu
- Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei 11490, Taiwan
| | - Ho-Fai Wong
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333423, Taiwan
| | - Wing P Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
| |
Collapse
|
23
|
Kenner C, Boykova M. Neonatal Nursing Care from a Global Perspective. Crit Care Nurs Clin North Am 2024; 36:147-156. [PMID: 38296372 DOI: 10.1016/j.cnc.2023.08.005] [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: 02/15/2024]
Abstract
Neonatal nurses play an essential role in small and sick newborn care. In the last few years, especially during the pandemic, neonatal mortality stayed relatively static. Recognition is growing that neonatal nurses represent a specialty that requires unique, consistent, competency-based training and education to provide the best possible care. The Council of International Neonatal Nurses, Inc collaborates with many global stakeholders to raise the standards of neonatal nursing care, especially in Africa.
Collapse
Affiliation(s)
- Carole Kenner
- Council of International Neonatal Nurses, Inc. (COINN); School of Nursing & Health Sciences, The College of New Jersey.
| | - Marina Boykova
- Council of International Neonatal Nurses, Inc. (COINN); School of Nursing and Health Sciences, Holy Family University, 9801 Frankford Avenue, Philadelphia, PA 19114, USA
| |
Collapse
|
24
|
Harris IM, McNeilly H, Ward DJ, Sitch AJ, Parry J, Greenfield S. The Clinical Teaching Fellow role: exploring expectations and experiences. BMC Med Educ 2024; 24:213. [PMID: 38429703 PMCID: PMC10908057 DOI: 10.1186/s12909-024-05207-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Many UK junior doctors are now taking a year out of the traditional training pathway, usually before specialty training, and some choose to work as a clinical teaching fellow (CTF). CTFs primarily have responsibility for delivering hospital-based teaching to undergraduate medical students. Only a very small amount of literature is available regarding CTF posts, none of which has explored why doctors choose to undertake the role and their expectations of the job. This study aimed to explore the expectations and experiences of CTFs employed at NHS hospital Trusts in the West Midlands. METHODS CTFs working in Trusts in the West Midlands region registered as students on the Education for Healthcare Professionals Post Graduate Certificate course at the University of Birmingham in August 2019 took part in a survey and a focus group. RESULTS Twenty-eight CTFs participated in the survey and ten participated in the focus group. In the survey, participants reported choosing a CTF role due to an interest in teaching, wanting time out of training, and being unsure of which specialty to choose. Expectations for the year in post were directly related to reasons for choosing the role with participants expecting to develop teaching skills, and have a break from usual clinical work and rotations. The focus group identified five main themes relating to experiences starting their job, time pressures and challenges faced in post, how CTF jobs differed between Trusts, and future career plans. Broadly, participants reported enjoying their year in a post at a mid-year point but identified particular challenges such as difficulties in starting the role and facing time pressures in their day-to-day work. CONCLUSION This study has provided a valuable insight into the CTF role and why doctors choose a CTF post and some of the challenges experienced, adding to the sparse amount of literature. Understanding post holders' experiences may contribute to optimisation of the role. Those employing CTFs should consider ensuring a formal handover process is in place between outgoing and incoming CTFs, having a lead person at their Trust responsible for evaluating changes suggested by CTFs, and the balance of contractual duties and personal development time.
Collapse
Affiliation(s)
| | - Heather McNeilly
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Derek J Ward
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Alice J Sitch
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Jayne Parry
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
25
|
Blease C, Worthen A, Torous J. Psychiatrists' experiences and opinions of generative artificial intelligence in mental healthcare: An online mixed methods survey. Psychiatry Res 2024; 333:115724. [PMID: 38244285 DOI: 10.1016/j.psychres.2024.115724] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/22/2024]
Abstract
Following the launch of ChatGPT in November 2022, interest in large language model (LLM)-powered chatbots has surged with increasing focus on the clinical potential of these tools. Missing from this discussion, however, are the perspectives of physicians. The current study aimed to explore psychiatrists' experiences and opinions on this new generation of chatbots in mental health care. An online survey including both quantitative and qualitative responses was distributed to a non-probability sample of psychiatrists affiliated with the American Psychiatric Association. Findings revealed 44 % of psychiatrists had used OpenAI's ChatGPT-3.5 and 33 % had used GPT-4.0 "to assist with answering clinical questions." Administrative tasks were cited as a major benefit of these tools: 70 % somewhat agreed/agreed "documentation will be/is more efficient". Three in four psychiatrists (75 %) somewhat agreed/agreed "the majority of their patients will consult these tools before first seeing a doctor". Nine in ten somewhat agreed/agreed that clinicians need more support/training in understanding these tools. Open-ended responses reflected these opinions but respondents also expressed divergent opinions on the value of generative AI in clinical practice, including its impact on the future of the profession.
Collapse
Affiliation(s)
- Charlotte Blease
- Participatory eHeath and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppala, Sweden; Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, -Harvard Medical School, Boston, MA 02115, USA.
| | | | - John Torous
- Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, -Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
26
|
Pan WW, Young KZ, Johnson MW, Young BK. Workforce separation among ophthalmologists before and during the COVID-19 pandemic. Graefes Arch Clin Exp Ophthalmol 2024; 262:1005-1007. [PMID: 37728753 DOI: 10.1007/s00417-023-06228-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/17/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023] Open
Affiliation(s)
- Warren W Pan
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Kelly Z Young
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mark W Johnson
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin K Young
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA.
| |
Collapse
|
27
|
Griffiths P, Turner L, Lown J, Sanders J. Evidence on the use of Birthrate Plus® to guide safe staffing in maternity services - A systematic scoping review. Women Birth 2024; 37:317-324. [PMID: 38007331 DOI: 10.1016/j.wombi.2023.11.003] [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: 05/10/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Birthrate Plus® is a widely used tool that informs decisions about the number of midwifery staff needed to provide safe and high quality care in maternity services. Evidence about the effectiveness, validity, reliability, and feasibility of tools such as this is needed. OBJECTIVE To identify, describe and analyse the available evidence supporting the use of Birthrate Plus. METHODS We searched PubMed, Medline, CINAHL, Google Scholar, Scopus, Academic Search, British Library Ethos, Directory of Open Access Journals and Science Direct. Studies were eligible if they reported empirical data relevant to the validity, reliability, or useability of Birthrate Plus or if they measured the impact on staffing levels, outcomes, costs or provided a comparison with other methods. RESULTS 23 sources of evidence were identified and reviewed. We found no prospective intervention studies on the use of Birthrate Plus to demonstrate outcomes for mothers, babies or staff wellbeing. Nor did we find studies comparing the tool to other methods or addressing resource use. Most of the evidence was descriptive, focussing on the use of the tool or the results of Birthrate Plus assessments. There is some evidence of the reliability of application of categories within the tool, the ability of the tool to detect variation in demand and to highlight staff shortages. CONCLUSIONS In terms of traditional hierarchies of evidence, the evidence for Birthrate Plus is weak. There is a need for more independent research or simulation using real world data to understand how the tool performs in the current context of midwifery practice.
Collapse
Affiliation(s)
- Peter Griffiths
- School of Health Sciences, University of Southampton, National Institute for Health Research Applied Research Centre (Wessex), Southampton, England, UK
| | - Lesley Turner
- School of Health Sciences, University of Southampton, Southampton, England, UK.
| | - Jenny Lown
- Portsmouth Hospitals University NHS Trust, Portsmouth, England, UK
| | | |
Collapse
|
28
|
Merrill K, Cervantes D, Hebden JN, Pogorzelska-Maziarz M, Piatek D, Monsees E, Hessels A. Infection preventionists in public health, consultant and academic roles: Results from the 2020 APIC MegaSurvey. Am J Infect Control 2024; 52:261-266. [PMID: 37689123 DOI: 10.1016/j.ajic.2023.09.001] [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: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Infection preventionists (IPs) work and practice in a variety of roles across many practice settings. While the health care-based IP role has been well studied, less is known about IPs who work in public health, consultant, and academic roles. METHODS Data were collected as a subset of the Association for Professionals in Infection Prevention and Control and Epidemiology 2020 MegaSurvey. Descriptive and bivariate analyses were performed to compare the responses of 147 IPs working in public health, consulting, or academic roles. RESULTS Respondents identified their primary IP role as public health (40%), consulting (39%), or academic (21%). Most were White and non-Hispanic females working in long-term care, acute care, and outpatient settings. Most had over 11 years of experience in health care before IP, with nursing being the most common. More consultants were certified in infection control (74%). While half of the respondents in public health reported being certified in infection control, and a third had 6 or more years of experience in infection prevention and control, they reported the lowest annual salary and satisfaction with total compensation. DISCUSSION These findings highlight the characteristics and contributions of infection prevention and control in nontraditional roles and settings. Certification and fair compensation are crucial factors for professional development and job satisfaction. CONCLUSIONS These insights can guide future education, recruitment, and retention strategies for IPs in public health, consulting, and academic roles.
Collapse
Affiliation(s)
- Katreena Merrill
- Brigham Young University, College of Nursing, Provo, UT; Intermountain Health - St. George Regional Hospital, Nursing Administration, St. George, UT.
| | - Diana Cervantes
- School of Public Health, Department of Biostatistics and Epidemiology, The University of North Texas Health Science Center, Fort Worth, TX
| | - Joan N Hebden
- University of Maryland School of Medicine Department of Epidemiology and Public Health, Baltimore, MD
| | | | - Dana Piatek
- Pennsylvania Department of Health, Harrisburg, PA
| | - Elizabeth Monsees
- Children's Mercy, Infection Prevention & Antimicrobial/Diagnostic Stewardship Integration, Service & Performance, University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Amanda Hessels
- Columbia University, School of Nursing, New York, NY; Hackensack Meridian Health, Department of Nursing Research, Edison, NJ; Consulting Professionals, Inc., Bradenton, FL
| |
Collapse
|
29
|
McCallum-Hee BI, Mukwada G. Navigating the 2021 ACPSEM ROMP workforce model: insights from a single institution. Phys Eng Sci Med 2024:10.1007/s13246-024-01406-z. [PMID: 38421582 DOI: 10.1007/s13246-024-01406-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
Workforce modelling for Radiation Oncology Medical Physicists (ROMPs) is evolving and challenging, prompting the development of the 2021 Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) ROMP Workforce (ARW) Model. In the exploration of this model at Sir Charles Gairdner Hospital, a comprehensive productivity exercise was conducted to obtain a detailed breakdown of ROMP time at a granular level. The results provide valuable insights into ROMP activities and enabled an evaluation of ARW Model calculations. The findings also capture the changing ROMP role as evidenced by an increasing involvement in consultation and advisory tasks with other professionals in the field. They also suggest that CyberKnife QA time requirements in the data utilised by the model may need to be revised. This study emphasises features inherent in the model, that need to be understood if the model is to be applied correctly.
Collapse
Affiliation(s)
- Broderick Ivan McCallum-Hee
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, 6009, Nedlands, WA, Australia.
- School of Physics, Mathematics and Computing, The University of Western Australia, 6009, Crawley, WA, Australia.
| | - Godfrey Mukwada
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, 6009, Nedlands, WA, Australia
- School of Physics, Mathematics and Computing, The University of Western Australia, 6009, Crawley, WA, Australia
| |
Collapse
|
30
|
Fredericks-Younger J, Feldman CA, Allareddy V, Funkhouser E, McBurnie M, Meyerowitz C, Ragusa P, Chapman-Greene J, Coker M, Fine D, Gennaro ML, Subramanian G. Pragmatic Return to Effective Dental Infection Control through Triage and Testing (PREDICT): an observational, feasibility study to improve dental office safety. Pilot Feasibility Stud 2024; 10:44. [PMID: 38419131 PMCID: PMC10900666 DOI: 10.1186/s40814-024-01471-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, there was a substantial interruption of care, with patients and workers fearful to return to the dental office. As dental practice creates a highly aerosolized environment, the potential for spread of airborne illness is magnified. As a means to increase safety and mitigate risk, pre-visit testing for SARS-CoV-2 has the potential to minimize disease transmission in dental offices. The Pragmatic Return to Effective Dental Infection Control through Testing (PREDICT) Feasibility Study examined the logistics and impact of two different testing mechanisms (laboratory-based PCR viral testing and point-of-care antigen testing) in dental offices. METHODS Dental healthcare workers (DHCWs) and patients in four dental offices within the National Dental Practice-based Research Network participated in this prospective study. In addition to electronic surveys, participants in two offices completed POC testing, while participants in two offices used lab-based PCR methods to detect SARS-CoV-2 infection. Analysis was limited to descriptive measures, with median and interquartile ranges reported for Likert scale responses and mean and standard deviation for continuous variables. RESULTS Of the total 72 enrolled, 28 DHCWs and 41 patients completed the protocol. Two patients (4.9%) tested positive prior to their visit, while 2 DHCWs (12.5%) tested positive for SARS-CoV-2 infection at the start of the study. DHCWs and patients shared similar degree of concern (69% and 63%, respectively) for contracting COVID-19 from patients, while patients feared contracting COVID-19 from DHCWs less (49%). Descriptive statistics calculations revealed that saliva, tongue epithelial cells, and nasal swabs were the most desirable specimen collection method; both testing (LAB and POC) protocols took similar amounts of total time to complete; and DHCWs and patients reported feeling more comfortable when both groups were tested. CONCLUSIONS While a larger-scale, network study is necessary for generalizability of results, this feasibility study suggests that SARS-CoV-2 testing can be effectively implemented into dental practice workflows and positively impact perception of safety for DHCWs and patients. As new virulent infectious diseases emerge, preparing dental personnel to employ an entire toolbox of risk mitigation strategies, including testing, may have the potential to decrease dental practice closure time, maintaining continuity of dental care services for patients. TRIAL REGISTRATION ClinicalTrials.gov: NCT05123742.
Collapse
Affiliation(s)
- Janine Fredericks-Younger
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA.
| | - Cecile A Feldman
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
- School of Public Health, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | | | | | - MaryAnn McBurnie
- Kaiser Permanente, Center for Health Research, Portland, OR, USA
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, Rochester, USA
| | - Pat Ragusa
- Eastman Institute for Oral Health, University of Rochester, Rochester, USA
| | - Julie Chapman-Greene
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | - Modupe Coker
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | - Daniel Fine
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | - Maria Laura Gennaro
- New Jersey Medical School, PHRI Center, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | - Gayathri Subramanian
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| |
Collapse
|
31
|
Dos Santos Sixel TR, Bernardo D, de Almeida Medeiros A, Bousquat A, Dos Santos Mota PH, Schmitt ACB. The rehabilitation workforce in Brazil. Arch Public Health 2024; 82:25. [PMID: 38409101 PMCID: PMC10895827 DOI: 10.1186/s13690-024-01249-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/06/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The surge in individuals facing functional impairments has heightened the demand for rehabilitation services. Understanding the distribution of the rehabilitation workforce is pivotal for effective health system planning to address the population's health needs. OBJECTIVE To investigate the spatial and temporal dispersion of physical therapists, speech therapists, psychologists and occupational therapists across various tiers of care within Brazil's Unified Health System and its regions. METHOD This is an ecological time series study on the supply of rehabilitation professionals. Data were obtained from the National Register of Health Establishments from 2007 to 2020. The density of professionals was calculated per 10,000 inhabitants annually for Brazil and its five regions. The Joinpoint regression model was used to analyze the temporal trends of the density of professionals, considering a 95% confidence interval. RESULTS In 2020, the most notable concentrations of psychologists, speech therapists, and occupational therapists in Brazil were observed in the domain of Specialized Health Care, with densities of 0.60, 0.20, and 0.16 professionals per 10,000 inhabitants, respectively. Conversely, the highest density of physical therapists was found within Hospital Health Care, with a density of 1.19 professionals per 10,000 inhabitants. Notably, variations in professional dispersion across different regions were apparent. Primary Health Care exhibited the highest density of professionals in the Northeast region, while the Southern region accounted for the highest densities in all professional categories within Specialized Health Care. The southeast region exhibited the largest workforce within Hospital Health Care. A marked upsurge in professional availability was noted across all categories, notably in the occupational therapy sector within hospital care (AAPC: 30.8), despite its initial low density. CONCLUSION The implementation of public health policies played a significant role in the expansion of the rehabilitation workforce at all three levels of care in Brazil and its various regions from 2007 to 2020. Consequently, regional disparities and densities of professionals have emerged, mirroring patterns observed in low-income countries.
Collapse
Affiliation(s)
- Taciana Rocha Dos Santos Sixel
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Debora Bernardo
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
| | | | - Aylene Bousquat
- Department of Politics, Management and Health, Faculty of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | | | - Ana Carolina Basso Schmitt
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
32
|
Wilding A, Sutton M, Agboraw E, Munford L, Wilson P. Geographic inequalities in need and provision of social prescribing link workers. Br J Gen Pract 2024:BJGP.2023.0602. [PMID: 38359951 DOI: 10.3399/bjgp.2023.0602] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Long-term health conditions are major challenges for care systems. Social prescribing link workers have been introduced via Primary Care Networks (PCNs) across England since 2019 to address the wider determinants of health by connecting individuals to activities, groups, or services within their local community. AIM To assess whether the rollout of social prescribing link workers was in areas with the highest need. DESIGN AND SETTING A retrospective study of social prescribing link workers in England from 2019 to 2023. METHOD We combined workforce, population, survey, and area-level data at the PCN-level from April 2020 to October 2023. We measured population need prior to the rollout of link workers using reported lack of support from local services in the 2019 GP Patient Survey. To assess if rollout reflected need, we used linear regression to relate provision of link workers (measured by full-time equivalent (FTE) per 10,000 patients) in each quarter to population need for support. RESULTS Populations in urban, more deprived areas and with higher proportions of minority ethnicities had the highest reported lack of support. Geographically these were in the North West and London. Initially, there was no association between need and provision; then from July 2022, this became negative and significant. By October 2023, a 10-percentage point higher need for support was associated with a 0.035 (95%CI(-0.634 to -0.066)) lower FTE per 10,000 patients. CONCLUSION Rollout of link workers has not been sufficiently targeted at areas with the highest need. Future deployments should be targeted at those areas.
Collapse
Affiliation(s)
- Anna Wilding
- The University of Manchester, Manchester, United Kingdom
| | - Matthew Sutton
- The University of Manchester, Manchester, United Kingdom
| | | | - Luke Munford
- The University of Manchester, Manchester, United Kingdom
| | - Paul Wilson
- The University of Manchester, Centre for Primary Care and Health Services Research | School of Health Sciences, Manchester, United Kingdom
| |
Collapse
|
33
|
Petravić L, Bajec B, Burger E, Tiefengraber E, Slavec A, Strnad M. Emergency physician personnel crisis: a survey on attitudes of new generations in Slovenia. BMC Emerg Med 2024; 24:25. [PMID: 38355454 PMCID: PMC10865631 DOI: 10.1186/s12873-024-00940-z] [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: 11/22/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Emergency departments globally are overburdened, and emergency medicine residency is losing popularity among students and physicians. This raises concerns about the collapse of a life-saving system. Our goal was to identify the key workforce reasoning and question medical staff employment behavior. METHODS This was a prospective cross-sectional study. In December 2022, medical students and pre-residency doctors in Slovenia were invited to complete a web-based questionnaire. The data were analyzed using T-test, chi-square test, Mann‒Whitney-Wilcoxon tests, and principal component analysis. Open-ended questions were hand-categorized. RESULTS There were 686 participatns who clicked on the first page and 436 of those finished the survey. 4% of participants gave a clear positive response, while 11% responded positively regarding their decision to pursue emergency medicine residency. The popularity of emergency medicine decreases significantly among recent medical school graduates upon their initial employment. People who choose emergency medicine are less concerned about its complexity and pressure compared to others. Most respondents preferred 12-hour shift lengths. The preferred base salary range for residents was I$ 3623-4529, and for specialists, it was I$ 5435-6341. The sample's primary personal priorities are achieving a satisfactory work-life balance, earning respect from colleagues, and engaging in academic activities. Factors that attract individuals to choose emergency medicine include high hourly wages, establishment of standards and norms, and reduced working hours. CONCLUSIONS Our findings indicate that enhancing compensation, establishing achievable standards and norms, facilitating a beneficial work-life equilibrium, providing assistance with initial property acquisition, stimulating participation in deficit residency programs, fostering collegiality among peers, restricting the duration of shifts, and enabling pension accrual may be imperative in attracting more individuals to pursue emergency medicine residency.
Collapse
Affiliation(s)
- Luka Petravić
- Center for Emergency Medicine, University Medical Center Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia.
| | - Boštjan Bajec
- Department of Psychology, Faculty of Arts, University of Ljubljana, Aškerčeva 2, 1000, Ljubljana, Slovenia
| | - Evgenija Burger
- Faculty of Mathematics and Physics, University of Ljubljana, Jadranska ulica 19, 1000, Ljubljana, Slovenia
| | - Eva Tiefengraber
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia
| | - Ana Slavec
- InnoRenew CoE, Livade 6a, 6310, Izola, Slovenia
- Department of Applied Natural Sciences, University of Primorska, Glagoljaška 8, 6000, Koper, Slovenia
| | - Matej Strnad
- Center for Emergency Medicine, University Medical Center Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia
- Community healthcare center dr. Adolf Drolca, Prehospital unit, Ulica talcev 9, 2000, Maribor, Slovenia
| |
Collapse
|
34
|
March MK, Dennis SM, Caruana S, Mahony C, Elliott JM, Polley S, Thomas B, Lin C, Harmer AR. Boosting inpatient exercise after hip fracture using an alternative workforce: a mixed methods implementation evaluation. BMC Geriatr 2024; 24:149. [PMID: 38350882 PMCID: PMC10865645 DOI: 10.1186/s12877-024-04730-x] [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: 04/25/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Hip fracture has a devastating impact on individuals and is an increasing burden for health systems and society. Compared to usual care, increased physiotherapy provision has demonstrated efficacy in improving patient and health service outcomes in this population. However, physiotherapy workforce challenges prevent sustained implementation. METHODS Our aim was to evaluate the safety, feasibility, acceptability, effectiveness and implementation cost of thrice daily physiotherapy for patients in the acute care setting after hip fracture at two public hospitals. We added twice-daily exercise implemented by an alternative workforce, to usual care consisting of daily mobility practice by a physiotherapist. Sites identified their preferred alternative workforce, with pre-registration physiotherapy students and allied health assistants chosen. We used a mixed methods approach, using the Consolidated Framework for Implementation Research (CFIR) as a determinant framework to guide implementation planning and data collection. We compared hospital length of stay data to a reference cohort. RESULTS We recruited 25 patients during the study period. Acute care hospital length of stay decreased from 11 days in the reference cohort to 8 days in the BOOST cohort (mean difference - 3.3 days, 95%CI -5.4 to -1.2 days, p = 0.003). Intervention fidelity was 72% indicating feasibility, no safety concerns were attributed to the intervention, and uptake was 96% of all eligible patients. The intervention was acceptable to patients, carers and healthcare providers. This intervention was cost-effective from the acute orthopaedic service perspective. CONCLUSION Higher daily frequency of physiotherapy can be safely, feasibly and effectively implemented by an alternative workforce for patients in the acute care setting following hip fracture surgery.
Collapse
Affiliation(s)
- Marie K March
- Physiotherapy Department, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia.
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
| | - Sarah M Dennis
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- South Western Sydney Local Health District, Liverpool, NSW, Australia
- Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Sarah Caruana
- Physiotherapy Department, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia
| | - Christopher Mahony
- Physiotherapy Department, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW, Australia
| | - James M Elliott
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- The Kolling Institute, St Leonards, NSW, Australia
| | - Stephanie Polley
- Department of Rehabilitation and Aged Care, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia
- Department of Aged Care, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW, Australia
| | - Bijoy Thomas
- Department of Orthopaedic Surgery, Blacktown Mt Druitt Hospital, Western Sydney Local Health District, Blacktown, NSW, Australia
| | - Charlie Lin
- Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW, Australia
| | - Alison R Harmer
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
35
|
Ross P, Sheldrake J, Ilic D, Watterson J, Berkovic D, Pilcher D, Udy A, Hodgson CL. An exploration of intensive care nurses' perceptions of workload in providing extracorporeal membrane oxygenation (ECMO) support: A descriptive qualitative study. Aust Crit Care 2024:S1036-7314(23)00199-6. [PMID: 38355389 DOI: 10.1016/j.aucc.2023.12.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/16/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND There is increasing use of extracorporeal membrane oxygenation (ECMO) in intensive care, where nurses provide the majority of the required ongoing care of cannulas, circuit, and console. Limited evidence currently exists that details nursing perspectives, experiences, and challenges with workload in the provision of ECMO care. OBJECTIVE The objective of this study was to investigate intensive care nurses' perceptions of workload in providing specialist ECMO therapy and care in a high-volume ECMO centre. METHODS The study used a qualitative descriptive methodology through semistructured interviews. Data were analysed using an inductive thematic analysis approach following Braun and Clarke's iterative process. This study was conducted in an intensive care unit within an Australian public, quaternary, university-affiliated hospital, which provides specialist state-wide service for ECMO. FINDINGS Thirty ECMO-specialist trained intensive care nurses were interviewed. This study identified three key themes: (i) opportunity; (ii) knowledge and responsibilities; and (iii) systems and structures impacting on intensive care nurses' workload in providing ECMO supportive therapy. CONCLUSIONS Intensive care nurses require advanced clinical and critical thinking skills. Intensive care nurses are motivated and engaged to learn and acquire ECMO skills and competency as part of their ongoing professional development. Providing bedside ECMO management requires constant monitoring and surveillance from nurses to care for the one of the most critically unwell patient populations in the intensive care unit setting. As such, ECMO nursing services require a suitably trained and educated workforce of intensive care trained nurses. ECMO services provide clinical development opportunities for nurses, increase their scope of practice, and create advanced practice-specialist roles.
Collapse
Affiliation(s)
- Paul Ross
- Department of Intensive Care, Alfred Health, Commercial Road, Melbourne, VIC, 3004, Australia; School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, VIC, Australia.
| | - Jayne Sheldrake
- Department of Intensive Care, Alfred Health, Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Dragan Ilic
- School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, VIC, Australia.
| | - Jason Watterson
- Department of Intensive Care, Frankston Hospital, Peninsula Health, Frankston, VIC, 3199, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, VIC, Australia.
| | - Danielle Berkovic
- School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, VIC, Australia.
| | - David Pilcher
- Department of Intensive Care, Alfred Health, Commercial Road, Melbourne, VIC, 3004, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, VIC, Australia.
| | - Andrew Udy
- Department of Intensive Care, Alfred Health, Commercial Road, Melbourne, VIC, 3004, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, VIC, Australia.
| | - Carol L Hodgson
- Department of Intensive Care, Alfred Health, Commercial Road, Melbourne, VIC, 3004, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, VIC, Australia.
| |
Collapse
|
36
|
Repullo Labrador JR, Freire Campo JM. [Pay for performance in public directly managed healthcare centers. Part 2: The Spanish National Health System. SESPAS Report 2024]. Gac Sanit 2024:S0213-9111(24)00015-3. [PMID: 38413322 DOI: 10.1016/j.gaceta.2024.102368] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/30/2023] [Accepted: 01/17/2024] [Indexed: 02/29/2024]
Abstract
In Spain, the compensation model for statutory health personnel is complex, heterogeneous, and more oriented to rewarding complementary functions and activities, than to paying for the actual performance in the position of employee. The various attempts to incorporate incentives have been distorted by a civil service egalitarianist culture, and weak systemic governance. External attractors (private practice, etc.) for healthcare professionals are becoming more important and neutralize many intramural incentives. There are few prospects of relevant or general changes, since the main actors involved are reforms-averse; but some environmental factors can lead to incremental improvements in employment contracts, in the information available to improve benchmarking, and in the creation of islands of good clinical governance and management. The economic scenario, increasingly concerned about inflationary trends and sustainability risks, may have a revitalizing effect of some governance and management reforms.
Collapse
|
37
|
Repullo Labrador JR, Freire Campo JM. [Pay for performance in public directly managed healthcare centers. Part 1: General framework. SESPAS Report 2024]. Gac Sanit 2024; 38:102367. [PMID: 38413323 DOI: 10.1016/j.gaceta.2024.102367] [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: 07/28/2023] [Revised: 12/30/2023] [Accepted: 01/17/2024] [Indexed: 02/29/2024]
Abstract
Assessing and compensating performance in professional organizations is extremely difficult in direct public management settings of health services. Performance assessment is technically complex and, more so, with multiplicity of principals influencing goal setting. Incentives are a lever to generate directionality and motivation, both structural (for attracting and retaining workers) and specific ones (rewarding performance and directing behavior towards institutional goals). Incentives influence the behavior of workers in various ways, and their effectiveness seams weak and controversial in publicly run health services. To overcome the problems of deciding and evaluating performance, both good governance models and the revitalization of contractual management are required. To improve the effectiveness of incentive models, it is convenient to: 1) widen the conceptual framework of incentives, to incorporate the structural aspects of employment contract and payment; 2) improve the designs from a greater understanding of the determinants of motivation; and 3) broaden the lens to survey the extra-mural factors that alter the behavior of workers, trying to counter them.
Collapse
|
38
|
de Saxe Zerden L, Ware OD, Lombardi BN, Lombardi BM. Harm reduction workforce, behavioral health, and service delivery in the USA: a cross-sectional study. Harm Reduct J 2024; 21:36. [PMID: 38336662 PMCID: PMC10858514 DOI: 10.1186/s12954-024-00952-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Despite recent financial and policy support for harm reduction in the USA, information on the types of workers within organizations who design, implement, and actualize harm reduction services remains nascent. Little is known about how variability in the harm reduction workforce impacts referrals and linkages to other community supports. This exploratory mixed-methods study asked: (1) Who constitutes the harm reduction workforce? (2) Who provides behavioral health services within harm reduction organizations? (3) Are referral services offered and by whom? (4) Do referrals differ by type of harm reduction worker? METHODS Purposive sampling techniques were used to distribute an electronic survey to U.S.-based harm reduction organizations. Descriptive statistics were conducted. Multivariate binary logistic regression models examined the associations (a) between the odds of the referral processes at harm reduction organizations and (b) between the provision of behavioral health services and distinct types of organizational staff. Qualitative data were analyzed using a hybrid approach of inductive and thematic analysis. RESULTS Data from 41 states and Washington, D.C. were collected (N = 168; 48% response rate). Four primary types of workers were identified: community health/peer specialists (87%); medical/nursing staff (55%); behavioral health (49%); and others (34%). About 43% of organizations had a formal referral process; among these, only 32% had follow-up protocols. Qualitative findings highlighted the broad spectrum of behavioral health services offered and a broad behavioral health workforce heavily reliant on peers. Unadjusted results from multivariate models found that harm reduction organizations were more than 5 times more likely (95% CI [1.91, 13.38]) to have a formal referral process and 6 times more likely (95% CI [1.74, 21.52]) to have follow-up processes when behavioral health services were offered. Organizations were more than two times more likely (95% CI [1.09, 4.46]) to have a formal referral process and 2.36 (95% CI [1.11, 5.0]) times more likely to have follow-up processes for referrals when behavioral health providers were included. CONCLUSIONS The composition of the harm reduction workforce is occupationally diverse. Understanding the types of services offered, as well as the workforce who provides those services, offers valuable insights into staffing and service delivery needs of frontline organizations working to reduce morbidity and mortality among those who use substances. Workforce considerations within U.S.-based harm reduction organizations are increasingly important as harm reduction services continue to expand.
Collapse
Affiliation(s)
- Lisa de Saxe Zerden
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St. CB #3550, Chapel Hill, NC, 27599, USA.
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Orrin D Ware
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St. CB #3550, Chapel Hill, NC, 27599, USA
| | - Brooke N Lombardi
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Brianna M Lombardi
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St. CB #3550, Chapel Hill, NC, 27599, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| |
Collapse
|
39
|
Hwang GM, Kulwatno J, Cruz TH, Chen D, Ajisafe T, Monaco JD, Nitkin R, George SM, Lucas C, Zehnder SM, Zhang LT. NSF DARE-transforming modeling in neurorehabilitation: perspectives and opportunities from US funding agencies. J Neuroeng Rehabil 2024; 21:17. [PMID: 38310271 PMCID: PMC10837948 DOI: 10.1186/s12984-024-01308-x] [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: 06/25/2023] [Accepted: 01/24/2024] [Indexed: 02/05/2024] Open
Abstract
In recognition of the importance and timeliness of computational models for accelerating progress in neurorehabilitation, the U.S. National Science Foundation (NSF) and the National Institutes of Health (NIH) sponsored a conference in March 2023 at the University of Southern California that drew global participation from engineers, scientists, clinicians, and trainees. This commentary highlights promising applications of computational models to understand neurorehabilitation ("Using computational models to understand complex mechanisms in neurorehabilitation" section), improve rehabilitation care in the context of digital twin frameworks ("Using computational models to improve delivery and implementation of rehabilitation care" section), and empower future interdisciplinary workforces to deliver higher-quality clinical care using computational models ("Using computational models in neurorehabilitation requires an interdisciplinary workforce" section). The authors describe near-term gaps and opportunities, all of which encourage interdisciplinary team science. Four major opportunities were identified including (1) deciphering the relationship between engineering figures of merit-a term commonly used by engineers to objectively quantify the performance of a device, system, method, or material relative to existing state of the art-and clinical outcome measures, (2) validating computational models from engineering and patient perspectives, (3) creating and curating datasets that are made publicly accessible, and (4) developing new transdisciplinary frameworks, theories, and models that incorporate the complexities of the nervous and musculoskeletal systems. This commentary summarizes U.S. funding opportunities by two Federal agencies that support computational research in neurorehabilitation. The NSF has funding programs that support high-risk/high-reward research proposals on computational methods in neurorehabilitation informed by theory- and data-driven approaches. The NIH supports the development of new interventions and therapies for a wide range of nervous system injuries and impairments informed by the field of computational modeling. The conference materials can be found at https://dare2023.usc.edu/ .
Collapse
Affiliation(s)
- Grace M Hwang
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Rockville, MD, 20852, USA.
| | - Jonathan Kulwatno
- Directorate for Engineering, National Science Foundation, 2415 Eisenhower Avenue, Alexandria, VA, 22314, USA
| | - Theresa H Cruz
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20817, USA
| | - Daofen Chen
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Rockville, MD, 20852, USA
| | - Toyin Ajisafe
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20817, USA
| | - Joseph D Monaco
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Rockville, MD, 20852, USA
| | - Ralph Nitkin
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20817, USA
| | - Stephanie M George
- Directorate for Engineering, National Science Foundation, 2415 Eisenhower Avenue, Alexandria, VA, 22314, USA
| | - Carol Lucas
- Directorate for Engineering, National Science Foundation, 2415 Eisenhower Avenue, Alexandria, VA, 22314, USA
| | - Steven M Zehnder
- Directorate for Engineering, National Science Foundation, 2415 Eisenhower Avenue, Alexandria, VA, 22314, USA
| | - Lucy T Zhang
- Directorate for Engineering, National Science Foundation, 2415 Eisenhower Avenue, Alexandria, VA, 22314, USA
| |
Collapse
|
40
|
Kwee TC, Roest C, Yakar D. Is radiology's future without medical images? Eur J Radiol 2024; 171:111296. [PMID: 38224634 DOI: 10.1016/j.ejrad.2024.111296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/07/2024] [Indexed: 01/17/2024]
Affiliation(s)
- Thomas C Kwee
- Medical Imaging Center, Department of Radiology, University Medical Center Groningen, University of Groningen, The Netherlands.
| | - Christian Roest
- Medical Imaging Center, Department of Radiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Derya Yakar
- Medical Imaging Center, Department of Radiology, University Medical Center Groningen, University of Groningen, The Netherlands
| |
Collapse
|
41
|
Durston A, Chapman J, Marshall D, Mason L. Patterns of major trauma admissions to a level 1 trauma centre: A five year database analysis. Injury 2024; 55:111237. [PMID: 38096747 DOI: 10.1016/j.injury.2023.111237] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 01/29/2024]
Abstract
INTRODUCTION It is only in recent years that major trauma systems and networks have been operating in the UK. High-quality data is available from the Trauma Audit and Research Network (TARN) database, enabling regional analysis. Our aim was to analyse Trauma Team Activations within the Cheshire and Merseyside major trauma network and discuss the implications of these data on resource allocation, training and trauma prevention. METHODS A retrospective analysis was performed for all patients requiring Trauma Team Activation (TTA) at a category one adult Major Trauma Centre (MTC) who were submitted to the TARN database from the 1st January 2015 to the 1st January 2020. Data collected included the date and time of arrival, location of injury and Injury Severity Score (ISS) in addition to routine demographic data. Dates of major sporting events and school holidays were obtained. RESULTS 4811 patients were identified. The median age was 57 years; 65.8 % were male. The mean frequency of TTAs was 18.5 per week. Patterns identified include annual peaks during the summer months, October and December, weekly peaks on Thursdays and Sundays and daily peaks between 16:00 and 23:59 with 45.0 % of TTAs occurring between these hours. There were 5.9 additional TTAs per week during the Isle of Man TT races. The median ISS increased from 14 to 23 for TT race TTAs and from 14 to 36 for Manx Grand Prix TTAs. Those injured during the TT races were twice as likely to require surgery and those injured during the MGP required five additional days in intensive care. School holidays did not independently affect major trauma volumes. CONCLUSIONS Major trauma in Cheshire and Merseyside did follow distinct patterns according to calendar month, day and time. Major motorsport increased trauma volumes and severity; school holidays did not. Such analysis could enable Major Trauma Centres to tailor the supply of trauma services to meet a predictable local demand for the benefit of our staff and patients.
Collapse
Affiliation(s)
- Abigail Durston
- Department of Trauma and Orthopaedics, Aneurin Bevan University Health Board, Royal Gwent Hospital, Cardiff Rd, Newport NP20 2UB, United Kingdom.
| | - James Chapman
- Department of Trauma and Orthopaedics, Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool, Merseyside L7 8XP, United Kingdom; School of Medicine, Faculty of Health and Life Sciences, University of Liverpool, Cedar House, Ashton Street, Liverpool, L69 3GE, United Kingdom
| | - Daniel Marshall
- Department of Trauma and Orthopaedics, Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool, Merseyside L7 8XP, United Kingdom
| | - Lyndon Mason
- Department of Trauma and Orthopaedics, Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool, Merseyside L7 8XP, United Kingdom; School of Medicine, Faculty of Health and Life Sciences, University of Liverpool, Cedar House, Ashton Street, Liverpool, L69 3GE, United Kingdom
| |
Collapse
|
42
|
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.
Collapse
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
| |
Collapse
|
43
|
Arnold R, van Teijlingen E, Way S, Mahato P. 'I might have cried in the changing room, but I still went to work'. Maternity staff balancing roles, responsibilities, and emotions of work and home during COVID-19: An appreciative inquiry. Women Birth 2024; 37:128-136. [PMID: 37567851 DOI: 10.1016/j.wombi.2023.07.128] [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: 11/22/2022] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023]
Abstract
PROBLEM Knowing how to help staff thrive and remain in practice in maternity services. BACKGROUND A chronic shortage of staff in maternity services in the United Kingdom and high levels of stress and burnout in midwifery and medical staff. PURPOSE To understand how to support and enhance the wellbeing of staff in a small UK maternity service. METHODS An appreciative inquiry using interviews with n = 39 maternity staff and n = 4 group discussions exploring meaningful experiences, values and factors that helped their wellbeing. RESULTS Staff members were highly motivated, managing a complex melee of emotions and responsibilities including challenges to professional confidence, mental health, family situation, and conflict between work-life roles. Despite staff shortages, a demanding workload, professional and personal turmoil, and the pandemic participants still found meaning in their work and relationships. DISCUSSION A 'whole person' approach provided insight into the multiple stressors and emotional demands staff faced. It also revealed staff resourcefulness in managing their professional and personal roles. They invested in relationships with women but were also aware of their limits - the need to be self-caring, employ strategies to switch-off, set boundaries or keep a protective distance. CONCLUSION Staff wellbeing initiatives, and research into wellbeing, would benefit from adopting a holistic approach that incorporates home and family with work. Research on emotion regulation strategies could provide insights into managing roles, responsibilities, and the emotional demands of working in maternity services. Emotion regulation strategies could be included in midwifery and obstetric training.
Collapse
Affiliation(s)
- Rachel Arnold
- Centre for Midwifery and Women's Health, Bournemouth University, Bournemouth, UK.
| | - Edwin van Teijlingen
- Centre for Midwifery and Women's Health, Bournemouth University, Bournemouth, UK
| | - Susan Way
- Centre for Midwifery and Women's Health, Bournemouth University, Bournemouth, UK
| | - Preeti Mahato
- Department of Health Studies, Royal Holloway University of London, London, UK
| |
Collapse
|
44
|
Hobson G, Dennis N. "I can't be dealing with this brain fog": A workplace focus group study investigating factors underpinning the menopausal experience for NHS staff. Maturitas 2024; 180:107889. [PMID: 38029510 DOI: 10.1016/j.maturitas.2023.107889] [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: 06/29/2023] [Revised: 10/27/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES Multiple studies highlight that individuals undergoing menopause are not receiving sufficient support at work. An improved menopausal experience in the workplace has been found to be associated with increased job satisfaction, increased economic participation and reduced absenteeism. This work was undertaken to explore the impact of menopause on the working lives of NHS staff working in Wales, with specific emphasis on their experience of menopausal symptoms and management strategies in the workplace. STUDY DESIGN This was a qualitative study using semi-structured focus groups and thematic analysis. 14 women working in the NHS in Wales attended four focus groups, lasting up to 1.5 h. Stem questions focused on participants' positive and negative experiences in the workplace, and their receipt of support. Transcripts were analysed using the framework approach. RESULTS Three major themes were identified: experiences of menopausal symptoms and symptom management, the impact of menopause on work and the impact of work on the menopause. Menopause symptom experience in the workplace was multifaceted and varied, depending on factors such as ongoing or past symptom experience, expectations, social support and effectiveness of management strategies. Inconsistent information was highlighted as a reason why some participants felt confused both about the symptoms that they could attribute to the menopause and the management strategies available to them. A variety of symptom management strategies had been used by participants, including hormone replacement therapy, flexible working hours, working from home, changes to uniform, peer support and lifestyle changes, with varying levels of success. Some women were reticent to ask for support at work even though they felt the workplace response was likely to be supportive. Almost all the women felt that they had to persuade their GP to prescribe HRT and felt that their doctors were too reticent in prescribing this treatment. CONCLUSIONS Employers have a key role in supporting their staff experiencing menopausal symptoms, and such support has the potential to reduce sickness absence and boost retention. Based on the findings we recommend creating an open culture to break down taboos; protected time for peer support around shared experiences and effective symptom management techniques; and maximising the impact of non-menopause-specific policies such as flexible working to help all staff manage fatigue and become more productive in their roles.
Collapse
|
45
|
Ho NT, Tran MT, Tran CTD, Vanderbloemen L, Pham TT, Hoang LB, Nguyen QV, Dorn J, Trevisan M, Shu XO, Le LC. Prevalence of metabolic syndrome among Vietnamese adult employees. Nutr Metab Cardiovasc Dis 2024; 34:326-333. [PMID: 38000991 DOI: 10.1016/j.numecd.2023.10.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/11/2023] [Accepted: 10/01/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MtS) is associated with increased risk of many health disorders, especially cardiovascular diseases. In Vietnam, study examining MtS is meager and especially lacking for the workforce. We estimated the prevalence of MtS and its associated factors among Vietnamese employees. METHODS AND RESULTS We analyzed secondary data of annual health check of employees of 300 Vietnamese companies from the Vinmec Healthcare System. We used three definitions for MtS: International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and NCEP ATP III-Asia. Of 57,997 participants evaluated, 48.5 % were males and 66.2 % were younger than 40 years old. The unadjusted MtS prevalence was 8.4 % (IDF), 10.2 % (NCEP ATP III), and 16.0 % (NCEP ATP III-Asia). The age-sex adjusted prevalence of MtS (NCEP ATP III-Asia) was 21.8 % (95 % confidence interval (CI): 21.4 %, 22.2 %). MtS prevalence increased with age, reached 49.6 % for age ≥60. The aging related increase was more remarkable in females than males (prevalence ratio (PR) (95 % CI) for age ≥60 comparing to age <30 years old in males vs. females was 4.0 (3.6, 4.3) vs. 20.1 (17.7, 22.9)). High blood triglyceride (83.4 %) and abdominal obesity (74.5 %) were the predominant contributors to MtS. CONCLUSION In this relatively young Vietnamese working population, 16 % had MtS with high triglyceride and abdominal obesity being the predominant contributors. These findings emphasize the need for developing effective high triglyceride and abdominal obesity prevention and control programs to curb the emerging epidemic of metabolic disorders in the workforce.
Collapse
Affiliation(s)
- Nhan T Ho
- Vinmec-VinUni Institute of Immunology (VIVI), Vinmec Healthcare System, 458 Minh Khai, Vinh Tuy, Hai Ba Trung, Hanoi, Viet Nam.
| | - Mo T Tran
- College of Health Sciences, VinUniversity, Hanoi, Viet Nam.
| | - Chi T D Tran
- College of Health Sciences, VinUniversity, Hanoi, Viet Nam; Vinmec-VinUni Institute of Immunology (VIVI), Vinmec Healthcare System, Hanoi, Viet Nam.
| | - Laura Vanderbloemen
- Imperial College London, Department of Primary Care and Public Health, UK; School of Health, Sport and Bioscience, University of East London, UK.
| | - Tung T Pham
- College of Health Sciences, VinUniversity, Hanoi, Viet Nam; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Research Advancement Consortium in Health, Hanoi, Viet Nam; Hanoi Medical University, Hanoi, Viet Nam.
| | - Long B Hoang
- College of Health Sciences, VinUniversity, Hanoi, Viet Nam; Institute of Gastroenterology and Hepatology, Hanoi, Viet Nam; Research Advancement Consortium in Health, Hanoi, Viet Nam.
| | | | - Joan Dorn
- College of Health Sciences, VinUniversity, Hanoi, Viet Nam.
| | | | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Tennessee, USA.
| | - Linh C Le
- College of Health Sciences, VinUniversity, Hanoi, Viet Nam.
| |
Collapse
|
46
|
Berry DM, Adams LM, Vytla SP. Vaccine hesitancy and hesitant adoption among nursing students in Texas. Prev Med Rep 2024; 38:102612. [PMID: 38375178 PMCID: PMC10874835 DOI: 10.1016/j.pmedr.2024.102612] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/21/2024] Open
Abstract
Background As the state facing the second-largest nursing workforce shortage in the U.S. and low vaccination rates among residents early in the pandemic, Texas provided a unique opportunity to examine vaccine hesitancy and hesitant adoption among nursing students in an environment where state-level executive orders prohibited mandatory vaccinations. Methods The purpose of this study was to describe the level of vaccine hesitancy and hesitant adoption among nursing students in the state of Texas. We used a convenient, opt-in, online survey of nursing students conducted between mid-April and mid-June 2022. The survey was distributed to all pre-licensure nursing programs in Texas. Results The majority of survey respondents (n = 599) were between the ages of 18-28 (68 %), female (88 %) and white (57 %). Most received at least one dose of the COVID-19 vaccination (84 %). Of those receiving the vaccine, a high proportion (82 %) were identified as hesitant adopters. Respondents cited concerns about side effects (57 %) most frequently as the reason for vaccine hesitancy. Conclusion Given the worldwide nursing shortage, factors potentially impacting the future workforce, such as vaccine hesitancy and hesitant adoption, must be closely monitored. More research is needed to understand the concerns of nursing students and the motivations of hesitant and non-hesitant adopters.
Collapse
Affiliation(s)
- Devon M. Berry
- 3380 College Park Drive, Suite 400, The Woodlands, TX 77384, USA
| | | | | |
Collapse
|
47
|
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.
Collapse
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
| |
Collapse
|
48
|
Courtwright SE, Turi E, Barr EA, Burns JC, Gigli KH, Bennett CR, Sonney J, Francis L, Poghosyan L. Facilitators and Barriers to Pediatric Nurse Practitioner Practice in the United States: A Systematic Review. J Pediatr Health Care 2024:S0891-5245(23)00365-6. [PMID: 38284964 DOI: 10.1016/j.pedhc.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION The pediatric nurse practitioner (PNP) workforce was designed to improve child health equity. We aimed to systematically review the evidence on facilitators and barriers to PNP practice. METHOD We included empirical studies on PNP practice in the United States and excluded studies with non-identifiable PNP data. We applied Joanna Briggs Institute tools to appraise studies and applied critical interpretive synthesis principles to synthesize. RESULTS The final sample is 26 studies, mostly published before 2013 and observational. Prescriptive privileges, training program availability, organizational climate, and telehealth are facilitators. Mandated physician supervision, reduced pediatric curricula, geographically disparate training programs, and poor data infrastructure are barriers. The sample is limited by a moderate to high risk of bias. DISCUSSION Evidence suggests modifiable factors impact PNP practice and could have important implications for child health equity. We offer a theoretical model to guide robust research studying the PNP workforce and health equity.
Collapse
|
49
|
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.
Collapse
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.
| |
Collapse
|
50
|
O'Kelly F, t'Hoen LA, Banuelos Marco B, Lammers RJM, Sforza S, Hiess M, Bindi E, Baydilli N, Donmez MI, Paraboschi I, Atwa A, Spinoit AF, Haid B, Silay S. Pathways to paediatric urology subspecialisation: a study of casemix, incumbent attitudes and opinions. World J Urol 2024; 42:34. [PMID: 38217728 PMCID: PMC10787691 DOI: 10.1007/s00345-023-04743-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 10/20/2023] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVE To identify any self-reported differences or attitudes towards certification, publication, or practice patterns between adult urology and paediatric general surgery-trained paediatric urology providers. There are no known published differences in clinical/operative/research outcomes in either group. METHODS An 18-item cross-sectional survey was compiled through the EAU Young Academic Urologists (YAU) office and disseminated to a trans-Atlantic convenience sample of current practising paediatric urologists. This was created using a mini-Delphi method to provide current semi-quantitative data relating to current opinions and attitudes of this cohort. RESULTS A total of 228 respondents completed the survey, with female respondents representing 37% and 34% for urology and paediatric general surgery, respectively. Nearly 90% overall respondents felt that a full 2-year paediatric fellowship program was very important and 94% endorsed a collaborative dedicated paediatric urology on call service, with 92% supporting the joint development of transitional care. Urology managed higher numbers of bedwetting (p = 0.04), bladder bowel dysfunction (p = 0.02), endourological procedures (p = 0.04), and robotics (p = 0.04). Paediatric general surgery managed higher numbers of laparoscopic reconstruction (p = 0.03), and posterior urethral valve ablation (p = 0.002). CONCLUSION This study represents the first time that a cross-sectional cohort of paediatric urologists from different training backgrounds were compared to assess their productivity, practice patterns and attitudes. Paediatric urology is in a unique position to have two contributing specialities, with the ability to provide optimal transitional and lifelong care. We believe that there should be a strong emphasis on collaboration and to remove any historically-created barriers under policies of equity, diversity and inclusivity.
Collapse
Affiliation(s)
- F O'Kelly
- Division of Paediatric Urology, Beacon Hospital, University College Dublin, Dublin, Ireland.
| | - L A t'Hoen
- Department of Pediatric Urology, Erasmus MC University Medical Center, Rotterdam-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - B Banuelos Marco
- Department of Urology, University Hospital El Clinico, Madrid, Spain
| | - R J M Lammers
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands
| | - S Sforza
- Paediatric Urology, Meyer Children Hospital, University of Florence, Florence, Italy
| | - M Hiess
- Department of Pediatric Urology, Hospital of the Sisters of Charity Linz, Linz, Austria
| | - E Bindi
- Department of Pediatric Surgery, AOU Delle Marche, Ospedale Pediatrico G Salesi, Ancona, Italy
| | - N Baydilli
- Department of Pediatric Urology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - M I Donmez
- Division of Pediatric Urology, Department of Urology, İstanbul University İstanbul Faculty of Medicine, Istanbul, Turkey
| | - I Paraboschi
- Department of Pediatric Urology, IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Atwa
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - A F Spinoit
- Department of Urology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - B Haid
- Department of Pediatric Urology, Hospital of the Sisters of Charity Linz, Linz, Austria
| | - S Silay
- Department of Urology, Biruni University, Istanbul, Turkey
| |
Collapse
|