Browsing by Subject "Workforce"
Now showing 1 - 11 of 11
Results Per Page
Sort Options
Item Open Access Evaluation of lay health workers on quality of care in the inpatient setting.(PloS one, 2023-01) Basnight, Ramona; Berry, Peter; Capes, Kellie; Pearce, Sherri; Thompson, Julie; Allen, Deborah H; Granger, Bradi B; Reynolds, Staci SAims
To evaluate the impact of a lay health worker support role in the inpatient setting.Background
Healthcare systems are facing critical nursing and nurse assistant staffing shortages. These disciplines can be challenging to recruit and retain, leading healthcare leaders to identify innovative staffing models. Whereas lay health workers have been used in the community and low-income setting, there is scant evidence of their use in the inpatient setting. We implemented a lay health worker role, called Patient Attendant Service Aides (PASAs), on two medical/surgical units at a community hospital.Methods
A pre/post-implementation design was used for this study. An online survey was provided to nurses, nursing assistants, and PASAs on the two medical/surgical units to assess their satisfaction and perceptions of the role. Nursing quality metrics, patient satisfaction, and nursing and nursing assistant turnover were evaluated before and after implementing the role.Results
The online survey showed that nurses and nursing assistants felt that PASAs helped offload their workload, allowing them to focus on nursing-related tasks. PASAs felt supported by the team and believed they were making a meaningful contribution to the unit. There were slight improvements in patient satisfaction, although not significant. There was a significant improvement in nursing turnover on Unit A, from 71.1% to 21.6% (p = 0.009).Conclusions
This is one of the first studies to evaluate the use of lay health workers in the inpatient setting; we found this role to be a feasible way to offload tasks from clinical staff. This role may serve as a pathway for workforce development, as several PASAs are now enrolled in nursing assistant training. Nurse managers may consider using lay health workers in the inpatient setting as they face severe clinical staff shortages.Item Open Access Fulfilling the Specialist Neurosurgery Workforce Needs in Africa: a SWOT Analysis of Training Programs and Projection Towards 2030(2021) Ukachukwu, Alvan-Emeka KelechiBackground/ObjectivesAfrica has only 1% of the global neurosurgery workforce, despite having 14% of the global population and 15% of the global neurosurgical disease burden. Also, neurosurgical training is hampered by paucity of training institutions, dearth of training faculty, and deficiency of optimal training resources. The study appraises the current specialist neurosurgical workforce in Africa, evaluates the major neurosurgery training programs, and projects the 2030 workforce capacity using current growth trends. Methods The study involved systematic and gray literature search, with quantitative analysis of retrospective data on the neurosurgery workforce, qualitative evaluation of the major neurosurgery training programs for their strength, weaknesses, opportunities, and threats, and projection modeling of the workforce capacity up to year 2030. Results 1,974 neurosurgeons serve 1.3 billion people (density 0.15/100,000; ratio 1:678,740), in Africa, with the majority (1,271; 64.39%) in North Africa. There are 106 specialist neurosurgery training institutions in 26 African countries, with North Africa having 52 (49.05%) of the training centers. Training is heterogenous, with the major programs being the West African College of Surgeons (WACS) - 24 centers across 7 countries, and the College of Surgeons of East, Central and Southern Africa (COSECSA) - 17 centers in 8 countries. At the current linear growth rate of 74.2 neurosurgeons/year or exponential growth rate of 6.81% per annum, Africa will have 2,716 - 3,813 neurosurgeons by 2030, with a deficit of 4,795 - 11,953 neurosurgeons. The continent requires a scale-up of its linear growth rate to 663.4 - 1269.5 neurosurgeons/year, or exponential growth rate to 15.87% - 22.21% per annum to meet its needs. While North African countries will likely meet their 2030 workforce requirements, sub-Saharan African countries will have significant workforce deficits. Conclusion Despite a recent surge in neurosurgery residency training, the current state of Africa’s neurosurgery workforce is dire, and many countries will be unable to meet their workforce requirements by 2030 at current growth trends. A significant scale-up of the neurosurgery workforce is required in order to meet these targets.
Item Open Access Increased labor losses and decreased adaptation potential in a warmer world.(Nature communications, 2021-12) Parsons, Luke A; Shindell, Drew; Tigchelaar, Michelle; Zhang, Yuqiang; Spector, June TWorking in hot and potentially humid conditions creates health and well-being risks that will increase as the planet warms. It has been proposed that workers could adapt to increasing temperatures by moving labor from midday to cooler hours. Here, we use reanalysis data to show that in the current climate approximately 30% of global heavy labor losses in the workday could be recovered by moving labor from the hottest hours of the day. However, we show that this particular workshift adaptation potential is lost at a rate of about 2% per degree of global warming as early morning heat exposure rises to unsafe levels for continuous work, with worker productivity losses accelerating under higher warming levels. These findings emphasize the importance of finding alternative adaptation mechanisms to keep workers safe, as well as the importance of limiting global warming.Item Open Access Maternity Units in Rural Hospitals in North Carolina: Successful Models for Staffing and Structure.(Southern medical journal, 2021-02) Carlough, Martha; Chetwynd, Ellen; Muthler, Sarah; Page, CristenObjectives
Almost 15% of all US births occur in rural hospitals, yet rural hospitals are closing at an alarming rate because of shortages of delivering clinicians, nurses, and anesthesia support. We describe maternity staffing patterns in successful rural hospitals across North Carolina.Methods
All of the hospitals in the state with ≤200 beds and active maternity units were surveyed. Hospitals were categorized into three sizes: critical access hospitals (CAHs) had ≤25 acute staffed hospital beds, small rural hospitals had ≤100 beds without being defined as CAHs, and intermediate rural hospitals had 101 to 200 beds. Qualitative data were collected at a selection of study hospitals during site visits. Eighteen hospitals were surveyed. Site visits were completed at 8 of the surveyed hospitals.Results
Nurses in CAHs were more likely to float to other units when Labor and Delivery did not have patients and nursing management was more likely to assist on Labor and Delivery when patient census was high. Anesthesia staffing patterns varied but certified nurse anesthetists were highly used. CAHs were almost twice as likely to accept patients choosing a trial of labor after cesarean section (CS) than larger hospitals, but CS rates were similar across all hospital types. Hospitals with only obstetricians as delivering providers had the highest CS rate (32%). The types of hospitals with the lowest CS rates were the hospitals with only family physicians (24%) or high proportions of certified nurse midwives (22%).Conclusions
Innovative staffing models, including family physicians, nurse midwives, and nurse anesthetists, are critical for the survival of rural hospitals that provide vital maternity services in underserved areas.Item Open Access Perceptions of Institutional Support for "Second Victims" Are Associated with Safety Culture and Workforce Well-Being.(Joint Commission journal on quality and patient safety, 2021-05) Sexton, J Bryan; Adair, Kathryn C; Profit, Jochen; Milne, Judy; McCulloh, Marie; Scott, Sue; Frankel, AllanObjective
This study was performed to determine whether health care worker (HCW) assessments of good institutional support for second victims were associated with institutional safety culture and workforce well-being.Methods
HCWs' awareness of work colleagues emotionally traumatized by an unanticipated clinical event (second victims), their perceptions of level of institutional support for such colleagues, safety culture, and workforce well-being were assessed using a cross-sectional survey (SCORE [Safety, Communication, Operational Reliability, and Engagement] survey). Safety culture scores and workforce well-being scores were compared across work settings with high (top quartile) and low (bottom quartile) perceptions of second victim support.Results
Of the 10,627 respondents (81.5% response rate), 36.3% knew at least one work colleague who had been traumatized by an unanticipated clinical event. Across 396 work settings, the percentage of respondents agreeing (slightly or strongly) that second victims receive appropriate support ranged from 0% to 100%. Across all respondents, significant correlations between perceived support for second victims and all SCORE domains (Improvement Readiness, Local Leadership, Teamwork Climate, Safety Climate, Emotional Exhaustion, Burnout Climate, and Work-Life Balance) were found. The 24.9% of respondents who knew an actual second victim and reported inadequate institutional support were significantly more negative in their assessments of safety culture and well-being than the 42.2% who reported adequate institutional support.Conclusion
Perceived institutional support for second victims was associated with a better safety culture and lower emotional exhaustion. Investment in programs to support second victims may improve overall safety culture and HCW well-being.Item Open Access Projecting the effects of long-term care policy on the labor market participation of primary informal family caregivers of elderly with disability: insights from a dynamic simulation model.(BMC geriatrics, 2016-03-23) Ansah, John P; Matchar, David B; Malhotra, Rahul; Love, Sean R; Liu, Chang; Do, YoungBackground
Using Singapore as a case study, this paper aims to understand the effects of the current long-term care policy and various alternative policy options on the labor market participation of primary informal family caregivers of elderly with disability.Methods
A model of the long-term care system in Singapore was developed using System Dynamics methodology.Results
Under the current long-term care policy, by 2030, 6.9 percent of primary informal family caregivers (0.34 percent of the domestic labor supply) are expected to withdraw from the labor market. Alternative policy options reduce primary informal family caregiver labor market withdrawal; however, the number of workers required to scale up long-term care services is greater than the number of caregivers who can be expected to return to the labor market.Conclusions
Policymakers may face a dilemma between admitting more foreign workers to provide long-term care services and depending on primary informal family caregivers.Item Open Access Safety Culture and Workforce Well-Being Associations with Positive Leadership WalkRounds.(Joint Commission journal on quality and patient safety, 2021-07) Sexton, J Bryan; Adair, Kathryn C; Profit, Jochen; Bae, Jonathan; Rehder, Kyle J; Gosselin, Tracy; Milne, Judy; Leonard, Michael; Frankel, AllanBackground
Interventions to decrease burnout and increase well-being in health care workers (HCWs) and improve organizational safety culture are urgently needed. This study was conducted to determine the association between Positive Leadership WalkRounds (PosWR), an organizational practice in which leaders conduct rounds and ask staff about what is going well, and HCW well-being and organizational safety culture.Methods
This study was conducted in a large academic health care system in which senior leaders were encouraged to conduct PosWR. The researchers used data from a routine cross-sectional survey of clinical and nonclinical HCWs, which included a question about recall of exposure of HCWs to PosWR: "Do senior leaders ask for information about what is going well in this work setting (e.g., people who deserve special recognition for going above and beyond, celebration of successes, etc.)?"-along with measures of well-being and safety culture. T-tests compared work settings in the first and fourth quartiles for PosWR exposure across SCORE (Safety, Communication, Operational Reliability, and Engagement) domains of safety culture and workforce well-being.Results
Electronic surveys were returned by 10,627 out of 13,040 possible respondents (response rate 81.5%) from 396 work settings. Exposure to PosWR was reported by 63.1% of respondents overall, with a mean of 63.4% (standard deviation = 20.0) across work settings. Exposure to PosWR was most commonly reported by HCWs in leadership roles (83.8%). Compared to work settings in the fourth (< 50%) quartile for PosWR exposure, those in the first (> 88%) quartile revealed a higher percentage of respondents reporting good patient safety norms (49.6% vs. 69.6%, p < 0.001); good readiness to engage in quality improvement activities (60.6% vs. 76.6%, p < 0.001); good leadership accessibility and feedback behavior (51.9% vs. 67.2%, p < 0.001); good teamwork norms (36.8% vs. 52.7%, p < 0.001); and good work-life balance norms (61.9% vs. 68.9%, p = 0.003). Compared to the fourth quartile, the first quartile had a lower percentage of respondents reporting emotional exhaustion in themselves (45.9% vs. 32.4%, p < 0.001), and in their colleagues (60.5% vs. 47.7%, p < 0.001).Conclusion
Exposure to PosWR was associated with better HCW well-being and safety culture.Item Open Access Should You Stay or Should You Go? Strategies for stabilizing your current job or migrating to a new career if it’s time to leave.(Emergency Physicians Monthly) Severance, HarryItem Open Access Standardization, workforce development and advocacy in cell and gene therapies: a summary of the 2020 Regenerative Medicine InterCHANGE.(Cytotherapy, 2021-10) McNiece, Ian K; Wacker, Kara K; Kurtzberg, Joanne; Warkentin, Phyllis ICell and gene therapy is a promising and disruptive new field of medicine for diseases lacking effective treatments. Collaboration among stakeholders has become critically important as investigators, health care providers, manufacturers, couriers, data registries, regulators and payers all become more invested in the success of this field. Many organizations have collaborated with each other to increase clarity, advocate for improvements and share lessons learned. These efforts appear to be making an impact, although the potential for duplicative efforts could slow progress. The second Regenerative Medicine InterCHANGE, hosted by the Foundation for the Accreditation of Cellular Therapy, took place at the Phacilitate Leaders World/World Stem Cell Summit conference in Miami, Florida, on January 24, 2020. Participants from several organizations outlined needs to advance cell and gene therapies. Efforts to address these include standardization, workforce development and advocacy. This article summarizes the major challenges and opportunities discussed during the InterCHANGE.Item Open Access Surgical Team Stability and Risk of Sharps-Related Blood and Body Fluid Exposures During Surgical Procedures.(Infection control and hospital epidemiology, 2016-05) Myers, Douglas J; Lipscomb, Hester J; Epling, Carol; Hunt, Debra; Richardson, William; Smith-Lovin, Lynn; Dement, John MObjective
To explore whether surgical teams with greater stability among their members (ie, members have worked together more in the past) experience lower rates of sharps-related percutaneous blood and body fluid exposures (BBFE) during surgical procedures.Design
A 10-year retrospective cohort study.Setting
A single large academic teaching hospital.Participants
Surgical teams participating in surgical procedures (n=333,073) performed during 2001-2010 and 2,113 reported percutaneous BBFE were analyzed.Methods
A social network measure (referred to as the team stability index) was used to quantify the extent to which surgical team members worked together in the previous 6 months. Poisson regression was used to examine the effect of team stability on the risk of BBFE while controlling for procedure characteristics and accounting for procedure duration. Separate regression models were generated for percutaneous BBFE involving suture needles and those involving other surgical devices. RESULTS The team stability index was associated with the risk of percutaneous BBFE (adjusted rate ratio, 0.93 [95% CI, 0.88-0.97]). However, the association was stronger for percutaneous BBFE involving devices other than suture needles (adjusted rate ratio, 0.92 [95% CI, 0.85-0.99]) than for exposures involving suture needles (0.96 [0.88-1.04]).Conclusions
Greater team stability may reduce the risk of percutaneous BBFE during surgical procedures, particularly for exposures involving devices other than suture needles. Additional research should be conducted on the basis of primary data gathered specifically to measure qualities of relationships among surgical team personnel.Item Open Access The impact of nurse staffing on falls performance within a health care system: A descriptive study.(Journal of nursing management, 2022-04) Cooke, Melissa; de la Fuente, Margarita; Stringfield, Candice; Sullivan, Kelly; Brassil, Robert; Thompson, Julie; Allen, Deborah H; Granger, Bradi B; Reynolds, Staci SAim
The purpose of this study was to examine the impact of nurse staffing on inpatient falls performance across a multi-hospital system.Background
Evidence to support which staffing variables influence fall performance so that health care organizations can better allocate resources is lacking.Method
A descriptive study design was used to analyse the impact of nurse staffing and falls performance, with units dichotomized as either high or low performing based on national benchmarking data. The impact was evaluated using 10 nurse staffing variables.Results
A total of nine units were included (five high and four low performing). Higher performing units showed less use of sitters and travellers, had fewer overtime hours worked by nurses, and employed more expert-level clinical nurses and combined nursing assistant/health unit coordinator positions, than lower performing units.Conclusion
Findings provide evidence of how staffing variables affect a unit's falls performance. While significant relationships were found, further evaluation is needed to explore the relationship of staffing variables and quality outcomes.Implications for nursing management
Nursing managers may consider trying to reduce use of sitters and travellers, and utilize innovative staffing models, such as using combined nursing assistant/health unit coordinator positions, to help improve their falls performance.