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PubMedDate not supplied

New graduate RN internship program: a collaborative approach for system-wide integration.

Population growth and aging increase the demand for skilled nurses. Hospitals face the challenge of supplying experienced and qualified caregivers. The cost of training new nurses remains significant. Nursing educators are pivotal in developing the nursing workforce, especially under tightening constraints. This article examines the development of a nursing internship program aimed at attracting and retaining newly graduated nurses and its effect on retention to the institution.

Cooperative Behavior↗
PubMed1998

Methodological issues in medical workforce analysis: implications for regional Australia.

Medical workforce data have a profound impact on health policy formulation, but derived doctor population ratios (DPR) are often more relevant to plotting national trends than providing a detailed regional or local workforce perspective. Regional workforce data may be more useful if national approaches are augmented by local information. In developing a detailed workforce analysis for one region of Australia, the authors encountered several challenging methodological issues, including the accuracy of medical workforce databases, clarity of definition of community boundaries, interpretation of workforce definitions and the difficulty accounting for local community needs. This paper discusses the implications for regional workforce research.

Health Services Research↗
PubMed2000

Too few dentists? Workforce planning 1996-2036.

The development and use of forecasting models can stimulate the debate on workforce planning for dentists by improving the quality of the data available, by providing a framework within which the debate can be conducted and by providing a means whereby the effects of different trends and policy options can be measured in a consistent way. The number of dentists on the Dentists Register aged under 60 years may well fall over the 40 years between 1996-2036, while the proportion of female dentists is likely to grow from under 30% to almost 50%. If the present gender differences in dentists' output persist, the effective 'whole-time equivalent' (WTE) size of the dentist workforce could fall by 15%. While future patterns of disease and the efficacy of future treatments are difficult to predict, the demand for dentistry is very likely to increase, given the forecast ageing of the UK population. The number of people aged 65-74 years could increase by 50% to eight million and those over 75 years by 70% towards seven million. Further, almost of all of this greatly increased older population will have retained some of their own teeth. The edentulous adult population was 37% in 1968 and might fall to less than 5% by 2036. These trends taken together could increase the number of courses of treatment per WTE dentist by as much as 40% over these 40 years. Such modelling can help to reduce the degree of uncertainty in future workforce planning.

Adult↗
PubMedDate not supplied

The politics of specialist/advanced practice: conflict or confusion?

This article explores the discrepancies between bench marks and the ad hoc development of specialisms. It suggests an agenda for remedying the invisibility of nursing in the shaping of health-care policy. Particular reference is made to the need for nurses to shape future policy on how the nursing workforce should be developed and utilised.

Career Mobility↗
PubMed1991

The effect of smoking on the development of allergic disease and specific immunological responses in a factory workforce exposed to humidifier contaminants.

The effects of smoking on the development of work related asthma and on the production of specific IgE and IgG antibodies to antigen from a contaminated humidifier are described for a sample of 258 workers from a printing factory. Current smoking was associated with low production of IgG antibody but with higher production of IgE antibody. No dose response for either antibody was found when numbers of cigarettes or pack-years smoked were considered. Work related asthma was detected in 12 workers by peak flow recordings. Six were current smokers and one was an ex-smoker. One subject with work related asthma had a high (and one a marginal) concentration of specific IgE to humidifier antigen.

Air Conditioning↗
PubMed1995

The changing workforce: the role of health psychology.

Because the federal government is the largest payer of all health costs, unbridled increases in the health workforce have profound fiscal implications. Recent efforts to control health spending through modifications of health delivery systems are related to the consequences of the unlimited production of health professionals. However, the federal government has established processes to review physician workforce changes, and these mechanisms have become important in accessing federal training monies. Psychologists have no concerted workforce policy and receive little federal training money. Moreover, other health professionals have attained statutory authority to perform and provide the same services as psychologists. This diffusion of professional functions impedes the ability to assess the status of the workforce and the development of psychology as a health profession.

Delivery of Health Care↗
PubMed2001

Sustainable rural practice for female general practitioners.

An expert panel of female rural and remote doctors have nominated updating professional skills as the most important strategy for sustainable rural general practice for women. The panel was comprised of members of the Australian College of Rural and Remote Medicine (ACRRM). The panel was asked to identify and prioritise strategies they had used to make rural practice work for them. They identified and ranked the following eight groups of strategies: (i) structure medical practice to work for you; (ii) implement personal strategies; (iii) obtain and update professional skills; (iv) establish professional and personal boundaries; (v) gain exposure to rural practice; (vi) engage with the community; (vii) implement professional strategies; and (viii) engage with women. Detailed strategies within these groups have been identified and will form the basis of grounded knowledge about how to structure rural and remote practice to work for women. This will complement the work of ACRRM, the Rural Doctors Association and workforce agencies in developing models of sustainable rural medical practice.

Attitude of Health Personnel↗
PubMed2002

Linking cultural competency and community service: a partnership between students, faculty, and the community.

OBJECTIVE: The purpose of the migrant health initiative is to give medical students the opportunity to provide clinical services, at appropriate levels of training, to a population that reflects a different ethnic and economic background than medical students typically see in the clinical setting. This initiative integrates concepts of cultural competency with experiential learning. DESCRIPTION: The migrant health initiative provides an infrastructure for a cultural competency educational program in the first two years of medical school within an essentials of clinical medicine course (ECM). The ECM course emphasizes the impacts of family, society, and community on the delivery of patient health care. Experience in the provision of clinical care to migrant workers provides an exceptional opportunity to expose students to a medically underserved, diverse group of people and to provide care to persons with a different language. The program was developed from grass-roots initiatives of students and the region's Area Health Education Center (AHEC). Historically, migrant workers provide the majority of the labor for harvesting onions in southeast Georgia. In April 2000, the regional AHEC organized a one-day clinic for migrant workers, staffed by one local physician and allied health students. Care was provided to over 400 laborers. As a result of the response by the migrant workforce, the AHEC developed a partnership with the local community to expand the health care services to this underserved group. Five medical students, working with the school's associate dean for curriculum and local AHEC, had observed a migrant health clinic organized by the AHEC and were seeking ongoing community service opportunities. Based on the interest and enthusiasm of the students, a faculty-supervised migrant health elective was developed for first- and second-year students. The number of students who wanted to take the elective exceeded the available opportunities. The ECM course will be enhanced with an integrated and longitudinal curriculum that focuses on migrant health care; the revised ECM course will provide students with the knowledge, skills, attitudes, and behaviors to care for individuals from different cultures. First-year students will be able to volunteer to work in the program. Second-year students will participate in at least one migrant health clinic, traveling only three hours but providing a different world with medical care. In addition, the opportunities for medical students to participate in a community health initiative and to work with nursing and allied health students will enhance their public health knowledge and their team and leadership skills. DISCUSSION: The partnership between students, faculty, and the community provides the mechanism to thoughtfully develop and integrate cultural issues and experiences into the curriculum. Students have recently received a Caring for Community five-year grant from the Association of American Medical Colleges. Program expansions will continue into the third-year medicine clerkship and include a senior elective. The program expansions will result in a migrant health initiative that will be coordinated; comprehensive; and expand student knowledge, skills, and experiences in cultural health care.

Community Health Services↗
PubMedDate not supplied

Pharmaceutical care for rural patients: ominous trends.

The findings of the Lake Superior Rural Cancer Care Project may be a harbinger of impeding shortages of pharmacists in most rural areas of the United States. Elderly patients, the population that is most reliant on medication, constitute a large portion of the citizens who are potentially underserved in terms of pharmaceutical care in rural areas. Education for rural practice is largely overlooked in current pharmacy curricula. The national pharmacy leadership must develop a sensible workforce policy that considers the needs of rural patients.

Community Pharmacy Services↗
PubMed1994

Generalist physicians in nonmetropolitan countries in Ohio.

OBJECTIVE: To identify by specialty (family practice, general internal medicine, and general pediatrics) the number and ratios of generalist physicians per 100,000 population in nonmetropolitan counties in Ohio and to describe the trends in these data from 1975 through 1990. DESIGN: The data were compiled on a country basis by physician census takers residing in each county in Ohio. The US Office of Management and Budget's definition of nonmetropolitan counties formed the basis of the calculations. RESULTS: In nonmetropolitan counties of Ohio, generalist physician numbers and ratios improved between 1975 and 1990 in general internal medicine (from 5.9 to 10.2 per 100,000 population) and general pediatrics (from 2.6 to 4.9 per 100,000 population) but not in family practice, which experienced a decrease from 31.0 to 28.7 per 100,000 population. Eight counties with no hospitals were unable to attract general internists or general pediatricians. CONCLUSIONS: The results of this study indicate the importance of characterizing generalist physician workforce data by specialty and practice location on a state-wide basis and suggest that increasing the supply of physicians does not greatly improve the geographic distribution of the medical workforce. These findings should affect the development of local, state, and federal physician workforce policies aimed at addressing the problem of physician geographic maldistribution.

Family Practice↗
PubMed2002

Health protection--a strategy and a national agency.

The Chief Medical Officer for England has published a strategy for health protection and announced the formation of a new body, the Health Protection Agency, to deal with the threats to health from infectious disease, chemicals, toxins and radiation hazards. This reflects international recognition of the need to combat threats to health from the likes of tuberculosis, HIV, influenza, anti-microbial resistance, chemical accidents and bio-terrorism, and the risks to health associated with increased movements of people, animals and goods, climate change and industrialisation. The strategy will strengthen surveillance and response linking contributions from clinical specialities with public health, microbiology, toxicology and radiation science within the health protection family. The Agency will be formed by combining a number of national and specialist public bodies and personnel delivering local protection services. The strategy represents a unique opportunity to strengthen local and national structures and develop a world-class health protection service. Detailed plans are being developed by the Department of Health with a variety of stakeholders for the launch of the Agency in 2003. A number of challenges will have to be met including developing and training the workforce in health protection, providing career structures for public health scientists and nurses, strengthening electronic communications and developing health protection networks within broader public health structures. Health protection should now be recognised as a sub-speciality of public health.

Bioterrorism↗
PubMed2002

Nurses and English primary care groups: their experiences and perceived influence on policy development.

AIMS OF THE STUDY: To investigate the experiences and perceived influence of nurses serving on English primary care group boards. BACKGROUND: The development of the nursing workforce and nursing services in primary care have been piecemeal and nurses have not always contributed to policy development. The recent establishment of primary care groups (PCGs) in the United Kingdom (UK) potentially offers nurses the opportunity to take a concerted and strategic role in developing professional roles and planning service developments. RESEARCH METHODS: As part of a longitudinal study of a 15% random sample of English primary care groups, nurse board members were surveyed in the winter of 1999. One hundred and forty-four nurses were invited to return self-completion questionnaires. RESULTS: Completed questionnaires were returned by 106 of those invited to participate (73%). Respondents reported that combining their usual work with their role in the PCG was frequently difficult. Only 26% perceived that they had been well prepared for their new role. Compared with other board members [for example, general practitioners (GPs)], nurses perceived that their own influence was limited, with only a quarter rating the influence of nurses on decision-making as great. Most of the sample were feeding back information to other primary care and community nurses working in the locality and 52% rated communication with this wider constituency as good or better. Nurse board members were enthusiastic about their role and optimistic about the positive future impact of PCGs on health. CONCLUSIONS: PCGs are still at a relatively early stage in their development. It is still too early to assess their impact on nurses working in primary care and community settings. Board membership offers nurses a voice in local health policy development.

Attitude of Health Personnel↗