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At least 217 records · Page 12Linked to original sources
PubMed2001

Changes, challenges and choices for the primary health care workforce: looking to the future.

AIMS: The main aim of this paper is to draw attention to problems facing the primary health care workforce in terms of demand for treatment of minor illness over the next two decades. These predictions have implications for the community nursing workforce in particular and the flexibility of primary health care teams in general. BACKGROUND: Care delivered in the primary care sector influences, and is influenced by, the characteristics of the health care workforce. These characteristics fall into two main groups: firstly, the shape of the present medical and nursing workforce and manpower trends; and secondly, the changes in doctors' and nurses' workloads. DESIGN: This paper draws on two studies, both commissioned by the Department of Health; the first study focusing on skill mix and delegation in primary health care teams and the second addressing the implications of skill mix for medical workforce scenarios in the changing policy environment. FINDINGS: From the first study, general practitioners across ten general practices were prepared to delegate at least one topic from over a third of 836 consultations and a further 17% of entire consultations. This potential delegation fell mainly to practice nurses and nurse practitioners. The second study used data extracted from the National Morbidity Surveys of 1981 and 1991 predicting that minor consultations are set to increase by 11 million from the 1990s to 2020--a minimal estimate. The authors argue that many of these extra predicted consultations will find their way onto practice nurses' and nurse practitioners' caseloads. CONCLUSIONS: Workforce issues and questions of professional roles and boundaries, in the context of the "greying" community nursing workforce, demand solutions if patient/client demand is to be met over the next two decades.

Community Health Nursing↗
PubMedDate not supplied

Effects of current and future information technologies on the health care workforce.

Information technologies have the potential to affect the types and distribution of jobs in the health care workforce. Against a background of an explosively growing body of knowledge in the health sciences, current models of clinical decision making by autonomous practitioners, relying upon their memory and personal experience, will be inadequate for effective twenty-first-century health care delivery. The growth of consumerism and the proliferation of Internet-accessible sources of health-related information will modify the traditional roles of provider and patient and will provide opportunities for new kinds of employment in health-related professions.

Computer Literacy↗
PubMed2003

Competency development needs of the Australian public health nutrition workforce.

OBJECTIVES: To assess factors affecting competency development of the Australian public health nutrition workforce and investigate competency development intentions, barriers and self-reported training needs. DESIGN: Cross-sectional study using self-administered mail- or email-delivered questionnaire. SETTING AND SUBJECTS: Two hundred and forty practitioners working in designated community and public health nutrition positions in the Australian health system. RESULTS: An 87% questionnaire response rate was achieved. The profile of the sample included female practitioners (95%) within the age range of 26-45 years (67%), from dietetic backgrounds (75%) and employed in state health departments as community dietitians/nutritionists (52%) or public health nutritionists (32%). Only 14% had completed higher degree qualifications but most (80%) reported an intention to do so in the future. Entry-level dietetic education was considered by most respondents (57%) to be inadequate preparation for public health nutrition practice but considered it had utility as a precursor for public health nutrition competency development because of its strong grounding in nutrition knowledge, basic research skills and problem-solving. On-the-job learning was the most prominent competency development influence reported by this workforce. Flexibility in teaching and learning approaches is needed to facilitate workforce participation in further competency development. The main competency development needs focused on analytical and policy process competencies; however, there was a general need expressed for competency development across many competency areas. CONCLUSIONS: These data provide intelligence to inform public health nutrition workforce development, particularly that relating to continued professional development amongst the existing workforce.

Adult↗
PubMedDate not supplied

[The World Health Organization and the development of human resources of the health system].

Health workforce is among the main components of the health care system. The performance of the latter depends on the knowledge, competence and motivations of the various categories of health workers. The task of the World Health Organization is to analyze the main problems related to health workforce and to help member-states overcome these problems. An other task is to facilitate intercountry comparisons. To attain these objectives, WHO has developed a conceptual framework, taking into account elements such as the labour market, the health care system, the policies and macro-factors (economic, socio-demographic). Among the main issues related today to health workforce, one can quote: the numbers and distribution of health workers, their migration, their involvement into the field of public health, the contents of their training, and, finally, the increased risk factors they are challenging.

Career Mobility↗
PubMed2005

Public health job vacancies--who wants what, where?

This paper presents a snapshot of job vacancies in the public health workforce labour market. The analysis is based on 404 advertised public health jobs appearing in the press, and on-line job alerts over a 2-month period in mid 2003. The analysis reveals who was seeking employees, what formal qualifications and competencies were required, what salary and other conditions of employment were offered and where the vacant jobs were located. The study demonstrates the heterogeneity of the public health workforce, which limits definition of clear practice boundaries and complicates workforce planning. The findings further demonstrate the benefit of reviewing both the demand and the supply side of the labour market, and point to the value of repeated surveys of advertised jobs as part of an ongoing public health workforce monitoring and planning process.

Australia↗
PubMed1991

Economic indicators and involvement of health professionals at worksite health services in a developing country.

Identification of accurate source lists for workplace health service research is problematic. Using the national list of health professionals registered to dispense medicines at 981 worksites in South Africa, a third of questionnaires were undelivered. A 33 per cent response rate was obtained to delivered questionnaires. Non-responders appeared to lack the information required. Although the number of employees at a worksite may influence sickness absenteeism, it does not appear to affect the absolute cost per employee nor the relative expenditure on different categories of costs incurred by worksite health services. Expenditure on staff and consumables accounts for nearly 80 per cent of worksite health service costs, regardless of workforce size. In 1988, the average cost of registered workforce health services at which medicines were dispensed and information was available, was R125 (35 pounds) per employee per year. Establishing standards and applying them to intra and inter industrial economic evaluation of workforce health services using sickness absenteeism and percentage breakdown of costs appears feasible in South African industries with both large and small workforces, provided that health professionals have access to adequate management information systems.

Absenteeism↗
PubMed2006

Commentary: Health systems and health policy: a curriculum for all medical students.

A companion article in this issue of Academic Medicine provides an example of a method for electively integrating health systems and health policy issues into medical education. However, a curriculum in health systems and health policy is crucial to the education of all future physicians and other health professionals. The Clinical Prevention and Population Health Curriculum Framework of the Healthy People Curriculum Task Force has recently recommended a health systems and health policy curriculum that includes the domains of organization of clinical and public health systems; health services financing; health workforce; and health policy process. The curriculum should commence prior to year three and continue in years three and four so that students have a framework for integrating and subsequently sharing their experiences. Current Liaison Committee on Medical Education data indicate that on average less than 70% of medical schools require any curriculum in these four domains and only 40% of medical schools include all four of these domains in their required curriculum. Incorporation all of these domains into well-defined, required curricula that are broad in scope has the potential to change the attitudes of future clinicians toward efforts to control costs, collaborate with other health professions, and influence health policies.

Curriculum↗
PubMed2002

Integrating health services research into nursing doctoral programs: the evolution of nursing research.

Traditionally, nursing research has focused on the effect of an intervention on selected patients without considering the influence of the system of care and its myriad characteristics. Health services research (HSR) focuses on organization and financing of health services; access to health care; quality of care; clinical evaluation and outcomes research; informatics and clinical decision making; practitioner, patient, and consumer behavior; health professions workforce; health policy formulation and analyses; and health care model and service use. Doctoral students can benefit from HSR's broad perspective if it is included in existing nursing curricula. Ultimately, HSR could help the nursing profession achieve the capacity to develop health policy and new systems of health care for the 21st century.

Education, Nursing, Graduate↗
PubMed1994

Change of government and health services policy in Victoria, 1992-93 [see comment].

Although constrained by Federal financial dominance, State governments can, nevertheless, significantly shape a number of aspects of health policy within their own jurisdiction. New governments often seek to implement both substantive and symbolic policy changes. This is often also accompanied by alterations to organisational structures and personnel with a view to making implementation more effective. This article chronicles the continuities and changes in health services policy in the first year of the Liberal-National Coalition State Government in Victoria. These include institutional changes, key ministerial and bureaucratic appointments, health workforce issues, health services funding decisions, public and community health, and relations with the Federal Government. The decision-making style of the new government is also discussed. The authors regard the economic imperatives of Victoria's severe deficit as the dominant influence in all areas of public policy, including health services policy, although certain ideological predilections have also been evident. They further argue that the new government has primarily sought legitimacy by appealing to what it regards as its mandate to rectify Victoria's 'economic crisis' by reducing public expenditure and reforming managerial practices in the public sector.

Community Health Planning↗
PubMed2005

Florida public health nurse workforce initiative: opportunity through crisis.

The National Public Health Leadership Institute (NPHLI), a partnership between the Centers for Disease Control and Prevention and the University of North Carolina at Chapel Hill invites public health professionals to participate in a 2 year leadership program. Three Florida nurses participated in the NPHLI along with a cadre of 40 to 50 participants from the United States and foreign countries. Part of the commitment involved implementing a leadership project. This team chose to address the nursing shortage by developing and piloting mentorship program. Baseline research included a basic review of the literature and involvement in several work groups addressing various aspects of employing and retaining qualified public health nurses in Florida. During their NPHLI scholar year, team members sought input from a variety of professional sources on the reasons for the shortage of public health nurses in Florida. Based on responses from nurses, professional association members, and employees in the Florida Department of Health, team members developed a nursing mentorship project designed to address public health nursing retention and education. The goal was to develop a two-pronged mentorship program, which supported the attainment of clinical competence and workplace confidence while also improving the public health theoretical knowledge base of more experienced nurses. Nursing leadership at both the state and local levels agreed and embraced the concept. The Florida Team developed a Mentorship Handbook, which contains recruitment criteria, baseline, midterm and end of project assessment tools, and numerous other documents. The Team gained endorsement for the project and a commitment to see it through from the Department of Health's Nursing Office. The Florida Nurses Association partnered with the team to initiate the kickoff and involve team members in important discussion groups. In effecting change it is vital to have engaged and included the targeted "community" in the process. Achieving buy-in and ownership takes some investing. Time is important, everything seems to take longer than expected-therefore maintaining momentum is critical for team members. Finding resources for an unfunded project can be a challenge. Creative thinking in how the project relates to available resources is important.

Florida↗