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PubMed2006

A flying start to health promotion in remote north Queensland, Australia: the development of Royal Flying Doctor Service field days.

CONTEXT: The Royal Flying Doctor Service (Queensland Section), Australia, provides health services for remote populations across an area of approximately 600,000 km2. The challenge presented to the service was to provide effective health promotion as well as acute clinical services. ISSUE: This article describes the development of field days, an initiative based on a capacity building approach to health promotion. Field days have been conducted at station properties, national parks, remote tourist facilities, a roadhouse and country racecourse. They usually consist of a morning interactive workshop based on locally identified health topics followed by an afternoon clinic. A developmental approach has been adopted, with participant feedback from each field day and reflections by health staff informing future field day activities and adjustments in methods of delivery. Between November 2001 and August 2005, 726 adults and 248 children attended 53 field days conducted at 18 remote locations in north Queensland. EVALUATION: Participants were asked to rate the overall usefulness, content and quality of the presentations/workshops on a scale from 1 (not useful/poor) to 10 (very useful/very good). Overall, feedback from participants was positive. The average scores were 9.1 for overall usefulness of the day and content of the sessions, and 9.2 for quality of the presentations. Field days demonstrate a flexible health promotion initiative based on a capacity building approach which is rated as useful and appropriate by participants. LESSONS LEARNED: The implementation of field days has highlighted the importance of building on community and organisational strengths as a means of overcoming skepticism about new services and approaches to health. Methods of delivery that are fun, non-threatening, practical, locally relevant, culturally appropriate and interactive work best. The development of field day packages containing workshop plans and resources facilitates flexibility and enables the program to be tailored to meet the needs of participants. Workforce planning and development have played a key role in reorienting existing services towards health promotion. Field days can inform the development of locally relevant health promotion initiatives based on a capacity building approach in other remote areas of Australia and internationally.

Adult↗
PubMed2005

An international review of the long-term care workforce: policies and shortages.

The developed world's population is aging, due to trends of increased life expectancies and decreased fertility rates. These trends are predicted to increase demand on long-term care services. At the same time, the long-term care workforce is in shortage in most of the developed world. Moreover, such shortages are expected to increase due to parallel socio-demographic factors. The increase in demand for longterm care, coupled with shortage in supply of care workers, has promoted some attention from policymakers. The current paper provides an international review of institutional arrangements for long-term care in different developed countries and in particular explores different strategies used or proposed to resolve the shortage in the long-term care workforce.

Aged↗
PubMedDate not supplied

Developing a foundation apprenticeship in care.

This article explores the development of a foundation apprenticeship in care at Sheffield Teaching Hospitals NHS Foundation Trust. The benefits for recruitment and development of the workforce are discussed.

Career Choice↗
PubMed2005

The general practitioner pharmacotherapy prescribing workforce: examining sustainability from a systems perspective.

As prescribers of opioid pharmacotherapies, general practitioners (GPs) are pivotal to the sustainability of opioid pharmacotherapy treatment services. The goal of this study was to examine the nature and sustainability of the Australian GP prescriber workforce in order to inform future programmes and policy development in this area. Data were collected from four Australian states: South Australia, Queensland, Victoria and New South Wales. Key features of the available data were: a heavy client load carried by a small number of prescribers, a high proportion of trained but inactive prescribers, and a high proportion (one-third to two-thirds) of medical practitioners who undertake training but do not take up prescribing, i.e. a high attrition rate. Available data indicate significant shortfalls in the number of prescribers available in each state to service this patient population. Across all states a relatively small number of prescribers were providing services for the majority of methadone clients. In order to achieve sustainable, high quality prescriber service provision, workforce development strategies are needed which focus on recruitment of new prescribers, and the support and retention of existing and inactive prescribers. Establishment of systematic and detailed data collection systems should also be considered a priority.

Adult↗
PubMedDate not supplied

Credentialing the public health workforce: an idea whose time has come.

The importance of a well-prepared public health workforce is widely recognized and appreciated. Strategies for enhancing workforce capacity and competency have been discussed by agencies, associations, committees, and expert panels since the landmark 1988 Institute of Medicine report. The need to foster the development of incentives for lifelong learning and career growth is of current interest to national public health associations and federal agencies. The fact that the public health workforce is not a single profession, but rather a fabric of many professions dedicated to a common endeavor, creates challenges to any singular approach. This article explores the relationships among competency, certification, and accreditation and summarizes the expert panel dialogue on workforce development incentives, specifically regarding certification and credentialing. The authors challenge public health leaders to become actively involved in framing the issues so the best possible strategies can be developed.

Accreditation↗
PubMedDate not supplied

Refresher course for inactive RNs facilitates workforce reentry.

A refresher course developed in conjunction with a local community college has been successful in facilitating workforce reentry by inactive and retired RNs. Support of the program by the hospital and exposure to the hospital during the clinical practicum, has reaped benefits as the majority of participants have sought employment upon completion of the course.

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↗
PubMed2005

Development and implementation of a public health workforce training needs assessment survey in North Carolina.

Assessing the training needs of local public health workers is an important step toward providing appropriate training programs in emergency preparedness and core public health competencies. The North Carolina Public Health Workforce Training Needs Assessment survey was implemented through the collaboration of several organizations, including the North Carolina Center for Public Health Preparedness at the North Carolina Institute for Public Health, the outreach and service unit of the University of North Carolina School of Public Health, the Office of Public Health Preparedness and Response in the North Carolina Division of Public Health Epidemiology Section, and local health departments across the state.

Data Collection↗
PubMed2003

Combating the nursing shortage. Vermont's call to action.

This article describes the centrality of the nursing leadership role in Vermont's statewide efforts to combat the nursing shortage, particularly the establishment of a Blue-Ribbon Commission and an Office of Nursing Workforce Research, Planning, and Development. Recommendations by the Blue-Ribbon Commission along with its progress to date are presented. The role of the Office of Nursing Workforce Research, Planning, and Development is described in accomplishing the recommendations of the Blue-Ribbon Commission. These efforts have been cumulative, characterized by innovation and unprecedented collaboration between stakeholders representing nursing, public health, health care administration, education, and the political and private sectors. Lessons for replication are underscored.

Fellowships and Scholarships↗
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↗
PubMed2003

Nursing workforce management: using benchmarking for planning and outcomes monitoring.

The goal of maintaining the balance between demand for nursing care and the supply of nurses is the basis for state and regional planning to meet future nursing workforce needs. Projecting nursing supply needs solely on the basis of historical registered nurse to population ratios does not specifically consider the healthcare needs of the population. The authors present a model in which state population data and nursing resource data are compared with national data to assist state planning groups in developing an effective workforce management plan. Integrating population demographic data, healthcare needs of citizens, and nurse resource factors at the state level can improve the accuracy of projection statistics.

Adult↗
PubMed2007

An agency capacity model to facilitate implementation of evidence-based behavioral interventions by community-based organizations.

The Centers for Disease Control and Prevention (CDC) implemented the Diffusion of Effective Behavioral Interventions Project to disseminate evidence-based behavioral interventions to community-based HIV prevention providers. Through development of intervention-specific technical assistance guides and provision of face-to-face, telephone, and e-mail technical assistance, a range of capacity-building issues were identified. These issues were linked to a proposed agency capacity model for implementing an evidence-based intervention. The model has six domains: organizational environment, governance, and programmatic infrastructure; workforce and professional development; resources and support; motivational forces and readiness; learning from experience; and adjusting to the external environment. We think this model could be used to implement evidence-based interventions by facilitating the selection of best-prepared agencies and by identifying critical areas of capacity building. The model will help us establish a framework for informing future program announcements and predecisional site visit assessments, and in developing an instrument for assessing agency capacity to implement evidence-based interventions.

Centers for Disease Control and Prevention, U.S.↗
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↗