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PubMed2002

The health care workforce in Los Angeles County and New York City: a comparison and analysis.

New York City and Los Angeles County have the largest health systems in the United States, but they differ significantly in structure. This study compares and analyzes the structural and workforce differences between the two. The health system in New York City is centered around its large hospitals, and as a result New York employs many more health workers than Los Angeles County, where the health system is centered around physician groups. Health care is a significant contributor to the economy of both areas, but a larger contributor to the economy in New York City.

Adolescent↗
PubMed2006

Use of research by the Australian health promotion workforce.

This paper examines the attitudes and practices of Australian health promotion practitioners toward evidence-based practice (EBP). The study used a survey methodology and questionnaires were sent to 1114 members of the Australian Health Promotion Association. A response rate of 27% (n = 277) was achieved. The data showed that the vast majority of participant's attitudes toward EBP was very welcoming. However, in practice the impact of EBP was limited. Participants identified a range of significant barriers to implementing EBP including organizational culture, policy directives and lack of resources. A range of concerns was also identified regarding the applicability of the medically based EBP model within health promotion, which is based upon a social model of health. The findings highlight the importance of acknowledging the complexity of health promotion interventions and working toward developing an appropriate evidence base.

Adult↗
PubMed1994

Impediments to progress in health care workforce policy: license and practice laws.

Any meaningful reform of health care delivery will have to overcome current barriers to effective utilization of nonphysician providers. These barriers include cultural and professional realities, as well as a number of explicit legal impediments. Medical practice acts remain overly broad and indeterminate, with concomitant and unnecessary restrictions in the licensure and practice acts of nonphysician providers. If we are to achieve our goal of offering high-quality care, at an affordable cost, to everyone who needs it, we must ensure that all health care providers are able to practice within the full scope of their professional competencies.

Allied Health Personnel↗
PubMedDate not supplied

Nursing drives interdisciplinary health care workforce planning in Wisconsin: one state's experience.

The Consortium for Primary Care in Wisconsin convened a forum to develop an interdisciplinary primary care workforce plan to address issues related to the supply of and demand for primary health care providers in Wisconsin. Nursing leaders played a pivotal role in making this effort successful and in ensuring that the focus would be on all primary health care professionals, not just physicians. This process used a primary care workforce planning tool (IRM) developed by the Bureau of Health Professions, U.S. Public Health Service which allowed Wisconsin to (1) examine its own workforce needs with data produced in Wisconsin, (2) compare the state's situation with national trends, and (3) include these data and projections in a cooperative process for state-level planning for interdisciplinary workforce development. The Bureau has encouraged other states and organizations to adopt a similar strategy through a series of IRM workshops in which the Wisconsin process serves as a model for training materials developed for these workshops. The Wisconsin planning process is an innovative model for other states to follow in facilitating workforce development and serves to encourage other states to share their experiences in the academic literature.

Health Planning↗
PubMedDate not supplied

Report of recommendations: the Annapolis Coalition Conference on Behavioral Health Work Force Competencies.

In May 2004, the Annapolis Coalition on Behavioral Health Workforce Education convened a national meeting on the identification and assessment of competencies. The Conference on Behavioral Health Workforce Competencies brought leading consumer and family advocates together with other experts on competencies from diverse disciplines and specialties in the fields of both mental health care and substance use disorders treatment. Aided by experts on competency development in business and medicine, conference participants have generated 10 consensus recommendations to guide the future development of workforce competencies in behavioral health. This article outlines those recommendations. A collaborative effort to identify a set of core or common competencies is envisioned as a key strategy for advancing behavioral health education, training, and other workforce development initiatives.

Behavioral Medicine↗
PubMed2005

Complementary competencies: public health and health sciences librarianship.

OBJECTIVES: The authors sought to identify opportunities for partnership between the communities of public health workers and health sciences librarians. METHODS: The authors review competencies in public health and health sciences librarianship. They highlight previously identified public health informatics competencies and the Medical Library Association's essential areas of knowledge. Based on points of correspondence between the two domains, the authors identify specific opportunities for partnership. RESULTS: The points of correspondence between public health and health sciences librarianship are reflected in several past projects involving both communities. These previous collaborations and the services provided by health sciences librarians at many public health organizations suggest that some health sciences librarians may be considered full members of the public health workforce. Opportunities remain for productive collaboration between public health workers and health sciences librarians. CONCLUSIONS: Drawing on historical and contemporary experience, this paper presents an initial framework for forming collaborations between health sciences librarians and members of the public health workforce. This framework may stimulate thinking about how to form additional partnerships between members of these two communities.

Community-Institutional Relations↗
PubMedDate not supplied

Use of public health nurse competencies to develop a childcare health consultant workforce.

UNLABELLED: The purpose of this article is to describe the efforts in the state of Georgia to train public health nurse-childcare health consultants (PHN-CCHCs) using the framework of the "Core competencies for public health practice." OBJECTIVES: The goal of the training was twofold: (1) to prepare a statewide cadre of PHNs as the primary workforce for Georgia's emerging childcare health consultation (CCHC) system and (2) to prepare their district nurse directors to lead and support CCHCs. DESIGN: Administrators attended a 2-day workshop followed by access to executive coaching for their management teams. PHNs participated in a three-phase training program, with phases 1 and 3 offered as 3-day workshops with field experiences, and phase 2 offered online and as a practicum. SAMPLE: Forty-four administrators and over 85 PHN-CCHCs completed the training. RESULTS: Graduates of the program reported satisfaction with training and reported the use of PHN core competencies in CCHC. Graduates also found enhanced skills in using core competencies to be applicable to a variety of population-based practices. Beyond CCHC being instituted in selected health districts, interest in CCHC has occurred statewide. CONCLUSIONS: The PHN-CCHC program enhanced the knowledge and use of core competencies and heightened interest in CCHC statewide.

Attitude of Health Personnel↗
PubMed2005

An assessment of critical issues facing the clinical laboratory workforce.

The National Center for Health Workforce Analysis of the Health Resources and Services Administration (HRSA), Bureau of Health Professions contracted with the University of California at San Francisco Center for the Health Professions to conduct a study of the clinical laboratory workforce. The study utilized existing and new survey data, in collaboration with the American Society for Clinical Pathology (ASCP), as well as interviews with experts in the field. This paper will describe the demographic characteristics, roles, and scope of practice of this workforce, as well as identify factors that influence the current and future demand for and supply of workers. There is ample evidence of a shortage of workers over the past few years, indicated by double-digit vacancy rates, increasing salaries, and the use of other incentives to fill positions. Recent data show a reduction in vacancy rates, although an increase in per diem and contract workers may mask a continuing shortage. There is recent growing interest in the profession, as evidenced by an increase of applicants to educational programs. Several factors make it difficult to predict the future need for and role of clinical laboratory workers, including an aging population and the demand for increased services, the possible retirement of many current workers, automation, new technology and tests, and public health challenges.

Adult↗
PubMedDate not supplied

The occupational transformation of the mental health system.

The mental health workforce has changed dramatically since the mid-1970s. Nonphysician providers, particularly psychologists and clinical social workers, have become a much larger share of the workforce. While the supply of psychiatrists has been relatively stable, there has been a dramatic increase in the supply of psychologists and social workers. Changes in clinical practice, combined with the continued expansion of managed care into mental health, will largely determine the future composition and supply of the mental health workforce.

Forecasting↗
PubMed2002

We're all right Jack?

"Planning for Canada's Health Workforce: Looking Back, Looking Forward" is a readable overview that presents a pastiche of data collected by a number of organizations. The paper deals with a policy area of immense importance to the future sustainability of Canada's health system and therefore warrants attention. In the remarks that follow, we would like to amplify the following points: There is a major disconnect between the tenor of the invited essay and the profound sense of urgency in addressing the emerging shortages of health human resources (HHR) that are evident both nationally and internationally. There has been, in fact, very little progress in the comprehensive measurement of the health workforce since the 1964 Hall report. Perhaps most important, there is an absolute need to involve the practising community more in the collection and analysis of health information.

Canada↗
PubMed2002

Skill mix in the health care workforce: reviewing the evidence.

This paper discusses the reasons for skill mix among health workers being important for health systems. It examines the evidence base (identifying its limitations), summarizes the main findings from a literature review, and highlights the evidence on skill mix that is available to inform health system managers, health professionals, health policy-makers and other stakeholders. Many published studies are merely descriptive accounts or have methodological weaknesses. With few exceptions, the published analytical studies were undertaken in the USA, and the findings may not be relevant to other health systems. The results from even the most rigorous of studies cannot necessarily be applied to a different setting. This reflects the basis on which skill mix should be examined--identifying the care needs of a specific patient population and using these to determine the required skills of staff. It is therefore not possible to prescribe in detail a "universal" ideal mix of health personnel. With these limitations in mind, the paper examines two main areas in which investigating current evidence can make a significant contribution to a better understanding of skill mix. For the mix of nursing staff, the evidence suggests that increased use of less qualified staff will not be effective in all situations, although in some cases increased use of care assistants has led to greater organizational effectiveness. Evidence on the doctor-nurse overlap indicates that there is unrealized scope in many systems for extending the use of nursing staff. The effectiveness of different skill mixes across other groups of health workers and professions, and the associated issue of developing new roles remain relatively unexplored.

Allied Health Personnel↗
PubMed1999

The effect of information technology on the physician workforce and health care in isolated communities: the Canadian picture.

The ratio of physicians to population in Canada peaked in the mid-1990s and is now falling. The decrease in the number of family physicians has had a disproportionate effect on rural and remote communities, and surveys have indicated that the availability of physicians and services is likely to deteriorate in rural and remote communities. Telemedicine is increasingly evident in every Canadian province and territory, and it could assist in more effective use of workforce resources by linking appropriate experts at central sites to patients and practitioners at remote sites. Positive effects on recruitment and retention of health providers and morale of the local workforce can be expected. In spite of national interest, evidence for the effect of telemedicine on staff distribution, roles and recruitment, use of health resources, health management and system integration is very limited. Telephone interviews were therefore conducted to collect information from 12 telehealth projects in Canada, one from each province or territory. The responses confirmed observations in the literature that telemedicine has positive outcomes for the workforce.

Canada↗