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Health Workforce (health + workforce)
Kinds of Health Workforce Selected AbstractsImproving oral healthcare delivery systems through workforce innovations: an introductionJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2010Elizabeth A. Mertz PhD Abstract The objective of this paper is to describe the purpose, rationale and key elements of the special issue, Improving Oral Healthcare Delivery Systems through Workforce Innovations. The purpose of the special issue is to further develop ideas presented at the 2009 Institute of Medicine (IOM) workshop, Sufficiency of the U.S. Oral Health Workforce in the Coming Decade. Using the IOM discussions as their starting point, the authors evaluate oral health care delivery system performance for specific populations' needs and explore the roles that the workforce can play in improving the care delivery model. The contributing articles provide a broad framework for stimulating and evaluating innovation and change in the oral health care delivery system. The articles in this special issue point to many deficits in the current oral health care delivery system and provide compelling arguments and proposals for improvements. The issues presented and solutions recommended are not entirely new, but add to a growing body of work that is of critical importance given the context of wider health care reform. [source] Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban AreasTHE JOURNAL OF RURAL HEALTH, Issue 1 2006Laura-Mae Baldwin MD ABSTRACT:,Context: Ensuring an adequate mental health provider supply in rural and urban areas requires accessible methods of identifying provider types, practice locations, and practice productivity. Purpose: To identify mental health shortage areas using existing licensing and survey data. Methods: The 1998-1999 Washington State Department of Health files on credentialed health professionals linked with results of a licensure renewal survey, 1990 US Census data, and the results of the 1990-1992 National Comorbidity Survey were used to calculate supply and requirements for mental health services in 2 types of geographic units in Washington state,61 rural and urban core health service areas and 13 larger mental health regions. Both the number of 9 types of mental health professionals and their full-time equivalents (FTEs) per 100,000 population measured supply in the health service areas and mental health regions. Findings: Notable shortages of mental health providers existed throughout the state, especially in rural areas. Urban areas had 3 times the psychiatrist FTEs per 100,000 and more than 1.5 times the nonpsychiatrist mental health provider FTEs per 100,000 as rural areas. More than 80% of rural health service areas had at least 10% fewer psychiatrist FTEs and nonpsychiatrist mental health provider FTEs than the state ratio (10.4 FTEs per 100,000 and 306.5 FTEs per 100,000, respectively). Ten of the 13 mental health regions were more than 10% below the state ratio of psychiatrist FTEs per 100,000. Conclusions: States gathering a minimum database at licensure renewal can identify area-specific mental health care shortages for use in program planning. [source] Are clinical practical guidelines (CPGs) useful for health services and health workforce planning?DIABETIC MEDICINE, Issue 5 2010A critique of diabetes CPGs Diabet. Med. 27, 570,577 (2010) Abstract Aims, Chronic disease management is increasingly informed by clinical practice guidelines (CPGs). However, their implementation requires not only knowledge of guideline content by clinicians and practice processes that support implementation, but also a health workforce with the capacity to deliver care consistent with CPGs. This has a health services planning as well as a health workforce dimension. However, it is not known whether CPGs are described in a way that can inform health services and health workforce planning and potentially drive better quality care. This study aimed to ascertain whether CPGs are useful for health service and health workforce planning. Methods, This question was explored taking diabetes mellitus as a case study. A systematic search of Medline, EMBASE, CINAHL and Scopus was carried out to identify all CPGs relating to the management of diabetes mellitus in the primary healthcare setting. The search was limited to guidelines published in the English language between 2003 and 2009. The quality of guidelines was assessed against a subset of criteria set by the Appraisal of Guidelines for Research and Evaluation (AGREE) collaboration. Results, Seventy-five diabetes-related CPGs were identified, of which 27 met the inclusion criteria. In terms of quality, many guidelines adopted evidence-based recommendations for diabetes care (59%) and most were endorsed by national authorities (70%). With regards to coverage of 17 identified subpopulations, guidelines were generally selective in the populations they covered. Whilst many provided adequate coverage of common complications and comorbidities, approaches to management for those with reduced capacity for effective diabetes self-care were largely absent, except for indigenous populations. Conclusions, Clinical practice guidelines are potentially useful for health services and health workforce planning, but would be more valuable for this purpose if they contained more detail about care protocols and specific skills and competencies, especially for subpopulations who would be expected to have reduced capacity for effective self-care. If service planning ignores these subgroups that tend to require more resource-intensive management, underprovision of services is likely. [source] Staff shortages in the mental health workforce: the case of the disappearing approved social workerHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2005Peter Huxley PhD Abstract Approved social worker (ASW) numbers in England and Wales were compared on the basis of two national surveys conducted in 1992 and 2002. These data were supplemented by reports published by the Employers' Organisation in the intervening years. Although raw numbers suggested a modest absolute increase over this time, rates of ASWs per 100 000 population declined by over 50%. Possible explanations for this dramatic fall are explored. The authors conclude that specific and targeted action needs to be taken by the government and public sector employers to determine the numbers of mental health social workers needed in modernised community mental health services. [source] Global Government Health Partners' Forum 2006: eighteen months laterINTERNATIONAL NURSING REVIEW, Issue 2 2010J. Foster rn FOSTER J., GUISINGER V., GRAHAM A., HUTCHCRAFT L. & SALMON M. (2010) Global Government Health Partners' Forum 2006: eighteen months later. International Nursing Review57, 173,179 Background:, The challenge of global health worker shortages, particularly among nurses, has been the topic of numerous forums over the last several years. Nevertheless, there has been little attention given to the roles of government chief nursing and medical officers as key partners in addressing health worker shortages. This partnership and its potential impact on the adequacy of the global health workforce was the focus of the most recent Global Government Health Partners (GGHP) Forum held in November 2006 in Atlanta, Georgia, USA. This forum was uniquely designed to create a context for government chief nursing officers and chief medical officers to engage in a joint learning and planning experience focused on positioning their leadership to impact health workforce issues. Aim:, This article describes an 18-month follow-up evaluation of the outcomes of the GGHP. The purpose of the evaluation was to assess the impact of the forum experience on the actions of participants based on the country-level plans they produced at the forum. This important feedback is intended to inform the design of future partnered global forums and gain insights into the utility of forum-based action plans. The evaluation process itself has served as an opportunity for the engagement of university faculty, students and staff in a global service learning experience. Conclusion:, The outcomes of this evaluation indicate that important progress has been made by countries whose leadership was involved in the forum, and was also an important learning activity for those participating in the conduct of the study. [source] Community health practitioner's practice guideline for a changing health care: Korean contributionJOURNAL OF CLINICAL NURSING, Issue 8 2009Il Sun Ko Aims and objectives., The specific aims of the study were (1) to identify community residents' health problems and community health practitioners' activities, (2) to explore community health practitioners' perception of the practice guidelines and (3) to provide recommendations for the development of a new practice guideline in the future. Background., Community health practitioners in Korea are recognised as a critical component of the public health workforce in rural areas. Community health practitioners are registered nurses with six months special training, who have the chief responsibility of delivering primary health care to remote or isolated communities. Although there has been numerous changes in focus of community health practitioners practice over the two decades, community health practitioners guidelines have never been updated since being first developed in 1981. Design., This investigation employed a cross-sectional survey and focus group interview. Methods., The samples included two different groups: 1003 community health practitioners participated in a survey and a group of 12 community health practitioners participated in a focus group interview. A measure of perception of the guideline was developed from Mansfield's work. Goolsby's criteria were revised and used to guide the focus group interview. Results., The participants recognised that the role of community health practitioners is in a process of transition and expect to use well developed guidelines that will allow an appropriate response to the needs of the community. Community health practitioners are generally supportive of practice guidelines although they report various contextual, social and resource barriers to the use of practice guidelines. Finally, the researchers have provided recommendations for the development of new community health practitioners practice guidelines. Conclusion., A newly developed community health practitioners guideline should assist in articulating new roles and responsibilities in the practice of community health practitioners and establish a foundation for knowledge, skills and training necessary for them to work independently. Relevance to clinical practice., New services made available for under-recognised health problems may be a direct outcome of newly developed guidelines. [source] Nursing work and the use of nursing timeJOURNAL OF CLINICAL NURSING, Issue 24 2008Christine Duffield Aim., To find that changes in models of service delivery together with the dynamic nature of the contemporary health care context have changed the direction and focus of nurses' work. The aim of this paper is to explore some of the drivers for change and their impact and recommend a way forward to optimising nurses' work in the hospital environment. Background., The healthcare workplace has been transformed over the past 20 years in response to economic and service pressures. However, some of these reforms have had undesirable consequences for nurses' work in hospitals and the use of their time and skills. Results., As the pace and complexity of hospital care increases, nursing work is expanding at both ends of the complexity continuum. Nurses often undertake tasks which less qualified staff could do while at the other end of the continuum, are unable to use their high level skills and expertise. This inefficiency in the use of nursing time may also impact negatively on patient outcomes. Conclusions., Nurses' work that does not directly contribute to patient care, engage higher order cognitive skills or provide opportunity for role expansion may decrease retention of well-qualified and highly skilled nurses in the health workforce. Relevance to clinical practice., In this climate of nursing shortages, we need to use nurses in a cost-effective but also, intellectually satisfying manner, to achieve a sustainable nursing workforce. [source] Review of small rural health services in Victoria: how does the nursing-medical division of labour affect access to emergency care?JOURNAL OF CLINICAL NURSING, Issue 12 2008Elise Sullivan Aims., This paper is based on a review of the Australian and International literature relating to the nursing-medical division of labour. It also explores how the division of labour affects patient access to emergency care in small rural health services in Victoria, Australia. Background., The paper describes the future Australian health workforce and the implications for rural Victoria. The concept of division of labour and how it relates to nursing and medicine is critically reviewed. Two forms of division of labour emerge , traditional and negotiated division of labour. Key themes are drawn from the literature that describes the impact of a traditional form of division of labour in a rural context. Methods., This paper is based on a review of the Australian and international literature, including grey literature, on the subject of rural emergency services, professional boundaries and roles, division of labour, professional relationships and power and the Australian health workforce. Results., In Australia, the contracting workforce means that traditional divisions of labour between health professionals cannot be sustained without reducing access to emergency care in rural Victoria. A traditional division of labour results in rural health services that are vulnerable to slight shifts in the medical workforce, unsafe services and recruitment and retention problems. A negotiated form of division of labour provides a practical alternative. Conclusion., A division of labour that is negotiated between doctors and nurses and supported by a legal and clinical governance framework, is needed to support rural emergency services. The published evidence suggests that this situation currently does not exist in Victoria. Strategies are offered for creating and supporting a negotiated division of labour. Relevance to clinical practice., This paper offers some strategies for establishing a negotiated division of labour between doctors and nurses in rural emergency care. [source] The development of the serious mental illness physical Health Improvement ProfileJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2009J. WHITE rn bsc (hons) pgcert People with serious mental illness (SMI), such as schizophrenia and bipolar disorder, are more likely to suffer from a range of long-term physical conditions including diabetes and cardiovascular disease. Consequently they will die 10,15 years earlier than the general population. Health services have failed to address this major health inequality because of a lack of consensus about the type and frequency of monitoring people with SMI require and a lack of knowledge and skills in the mental health workforce. We developed the SMI physical Health Improvement Profile to help mental health nurses profile the physical health of the SMI patients they work with and direct them towards the evidence base interventions available to address identified health problems. [source] Comorbidity of mental health and substance misuse problems: a review of workers' reported attitudes and perceptionsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2008M. W. ADAMS rmn bsc (hons) cert. ed (fe) A comorbidity of mental health and substance misuse problems has been associated with deleterious outcomes. In the United Kingdom it has been acknowledged that people with comorbidity have often received poor care, with gaps in service provision suggesting ambivalence towards this issue. Previous reviewing authors have concluded that health professionals hold stereotypical views towards people that misuse substances, but these findings may not be directly comparable to those who work within mental health services. There is however a growing body of evidence concerning this context. The author has reviewed the literature from 1996 to 2006 to ascertain mental health professionals and allied workers attitudes and perceptions towards comorbidity, perceptions on the effectiveness of service systems, and perceptions of personal knowledge and skill in providing effective interventions. The evidence presented mainly pertains to mental health nurses, which reflects their status as the largest discipline within the mental health workforce. Overall attitudes towards comorbidity are mixed, possibly being related to contextual issues of practice and are not necessarily negative. However, there is an almost universal negative perception of deficiencies in service provision and the adequacy of training. Implications for research, development and practice are explored. [source] Evaluation of a postgraduate training programme for community mental health practitionersJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2005A. N. GAUNTLETT rmn bsc msc Government guidelines on mental health care in England have considerable implications for the level of competency required by the mental health workforce. Implementing these changes requires the widespread introduction of training initiatives whose effectiveness in improving staff performance need to be demonstrated through programme evaluation. This exploratory study evaluates the impact of a 2-year mental health training programme by measuring skill acquisition and skill application, by identifying the key ingredients for facilitating the transfer of learning into practice, and by examining differences in outcome between the academic and the non-academic students. High skill acquisition and application was reported in the majority of interventions, however, low skill application was reported for some key interventions (assertive outreach, dual diagnosis). Statistically significant differences were found between student cohorts in one intervention for skill acquisition (crisis intervention) and two interventions for skill application (client strengths model; medication management). The main ingredients for facilitating transfer were found to be the credibility of the trainers and training alongside colleagues from their own workplace. Some of the possible explanatory factors for these findings are discussed. [source] An Assessment of the Dental Public Health Infrastructure in the United StatesJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2006Scott L. Tomar DMD Abstract Objectives: The National Institute of Dental and Craniofacial Research commissioned an assessment of the dental public health infrastructure in the United States as a first step toward ensuring its adequacy. This study examined several elements of the US dental public health infrastructure in government, education, workforce, and regulatory issues, focused primarily at the state level. Methods: Data were drawn from a wide range of sources, including original surveys, analysis of existing databases, and compilation of publicly available information. Results: In 2002, 72.5% of states had a full-time dental director and 65% of state dental programs had total budgets of $1 million or less. Among U.S. dental schools, 68% had a dental public health academic unit. Twelve and a half percent of dental schools and 64.3% of dental hygiene programs had no faculty member with a public health degree. Among schools of public health, 15% offered a graduate degree in a dental public health concentration area, and 60% had no faculty member with a dental or dental hygiene degree. There were 141 active diplomates of the American Board of Dental Public Health as of February 2001; 15% worked for state, county, or local governments. In May 2003, there were 640 US members of the American Association of Public Health Dentistry with few members in most states. In 2002, 544 American Dental Association members reported their specialty as Dental Public Health, which ranged from 0 in five states to 41 in California. Just two states had a public health dentist on their dental licensing boards. Conclusions: Findings suggest the US dental public health workforce is small, most state programs have scant funding, the field has minimal presence in academia, and dental public health has little role in the regulation of dentistry and dental hygiene. Successful efforts to enhance the many aspects of the US dental public health infrastructure will require substantial collaboration among many diverse partners. [source] The Public Health Nursing Practice Manual: A Tool for Public Health NursesPUBLIC HEALTH NURSING, Issue 2 2004M.S.N./ M.P.H., Sharon D. Sakamoto R.N. Abstract Public health nursing is recognized as an important and critical component of the public health workforce, and today, it makes up the largest single category of public health professionals, according to the U.S. Department of Health and Human Services. Preparation of generalist public health nurses with the knowledge base, skills, and training to effectively respond to public health challenges is essential. The County of Los Angeles Department of Health Services, Public Health Nursing Section, in response to this need, implemented the Public Health Nursing Practice Manual to provide public health nurses with interventions and guidelines to articulate their role and practice as outlined by the framework of the Public Health Nursing Practice Model developed by Los Angeles County. Identification and development of new methods to support the practice of nursing is imperative in facilitating a more sophisticated and expanded level of practice, as well as providing a means of improving, protecting, and enhancing the quality of health for all people. The Public Health Nursing Practice Manual is an effective tool to monitor performance improvement and provide standardization of the generalist public health nurse practicing in Los Angeles County. [source] Attitudes of the Victorian oral health workforce to the employment and scope of practice of dental hygienistsAUSTRALIAN DENTAL JOURNAL, Issue 1 2008M Hopcraft Abstract Background: Increasing the number of dental hygienists and expanding their scope of practice are two policy directions that are currently being explored to increase the supply of dental services in the context of projected oral health workforce shortages in Australia. Understanding factors relating to the employment of hygienists and the attitudes of the oral health workforce to dental hygiene practice are important in this policy debate. Methods: A postal survey of a random sample of Victorian dentists, periodontists, orthodontists and hygienists was undertaken in 2006. Dentists and specialists were grouped into those whose practice employed or did not employ a hygienist. Data on the attitudes of dentists, specialists and hygienists towards various aspects of dental hygiene practice were explored. Results: A response rate of 65.3 per cent was achieved. Hygienists believed that their employment made dental care more affordable (53.7 per cent) and improved access to dental care (88.1 per cent), while few dentists believed hygienists made care more affordable. Most hygienists believed they were capable of diagnosing periodontal disease and dental caries and formulating a treatment plan, but there was less support from employers and non-employers. Dentists were strongly opposed to independent practice for dental hygienists, although there was qualified support from employers for increasing the scope of practice for hygienists. Conclusions: Dentists who worked with hygienists acknowledged their contribution to increasing practice profitability, efficiency and accessibility of dental services to patients. Hygienists and employers supported increasing the scope of dental hygiene practice, however the majority of non-employers opposed any expansion. [source] ROLES AND ACTIVITIES OF THE COMMONWEALTH GOVERNMENT UNIVERSITY DEPARTMENTS OF RURAL HEALTHAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2000John S. Humphreys ABSTRACT Since 1996, University Departments of Rural Health (UDRH) have been established at Broken Hill, Mount Isa, Shepparton, Launceston, Whyalla, Alice Springs and Geraldton. Each UDRH is underpinned by Commonwealth funding for an initial period of 5 years. The role of the UDRHs is to contribute to an increase in the rural and remote health workforce through education and training programs, as well as a reduction in the health differentials between rural and urban people and between indigenous and non-indigenous peoples. A strong population health focus involving partnerships between existing health providers in a targeted region and the university sector underpins their operation. While UDRHs have been established as a means of addressing a national workforce problem, their organisational arrangements with universities and local service providers vary widely, as does the program mix of activities in education, research service development, facilitation and advocacy. This article outlines some of the activities and progress of the UDRHs to date. [source] | ||||||||||||||||||||||