Organizational redesign. Changing educational needs of midlevel nurse administrators.
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Education, Nursing, Continuing↗
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Results for “workforce development”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Improving performance at the local level: implementing a public health learning workforce intervention.
In an effort to continually improve performance of the essential public health services with community partners, the diverse public health workforce in a major metropolitan area engaged in an organizational learning process. Core public health organizational competencies, identified in a multi-year collaborative applied research initiative, provided the curricula content for the public health learning experience. All members (about 600) of the Columbus and Franklin County (Ohio) Health Departments participated in four one-half day small group, highly interactive modules conducted during a 2-year period. The purpose of this article is to describe the design and implementation of this workforce intervention, the lessons learned, and implications for developing organizational capacity and improved performance.
Competency-Based Education↗
Mental health, educational and social needs of young offenders in custody and in the community.
PURPOSE OF REVIEW: The purpose of this review is to highlight recent findings from research on mental health, educational and social needs of young offenders and the implications for key agencies that commission or provide services. RECENT FINDINGS: Young offenders have high levels of morbidity in a number of areas, including mental health. A substantial number of young offenders have learning disabilities, which has implications for educational provision and delivering interventions. Other learning problems, such as low reading and comprehension ages, also have consequences for society in a number of areas, including occupational functioning and the associated development of a skilled workforce. There is some evidence that female offenders and persistent offenders are particularly at risk of psychosocial problems. Need is often unmet due to the lack of adequate assessment. Other reasons include inaccessibility of services and difficulties experienced in engaging young people in treatment. Young offenders in the community and those from ethnic minorities are particularly at risk of having poor access to services. SUMMARY: Providing services for young offenders requires investment from all the agencies in prioritising their needs. Research can continue to contribute by informing policy and practice, although further understanding of the developmental trajectories of high-risk groups is still needed.
Adolescent↗
An evaluation of critical care lecturer practitioners.
The aim of this study was to evaluate the educational value and impact upon staff of critical care lecturer practitioners. Data were collected through three staff focus groups (n=21) and a questionnaire completed by 70 members of trust or university staff. A majority of respondents felt that the lecturer practitioner roles had considerable effect upon adult critical care services. Six main categories of findings were derived from analysis and integration of both focus group and questionnaire data--development of knowledge; staff support; being a teacher; developing and maintaining the workforce; role improvement plus removal of the lecturer practitioner role. Many of these findings concur with the limited quantity of evaluative literature on the lecturer practitioner role. The authors produced a report recommending continued funding for existing lecturer practitioner posts; introduction of more lecturer practitioner posts should be considered, and further role evaluation should be conducted at both a local and national level.
Attitude of Health Personnel↗
Rural palliative care volunteer education and support program.
The present paper looks at the challenges of palliative care delivery in rural and remote areas and proposes the establishment, education and coordination of a network of palliative care volunteers to assist in the delivery of non-clinical services. The development of a rural palliative care volunteer education and support training package is documented, together with details of the trailing of the package and its evaluation. Possible benefits of the program and some key issues to be considered when establishing a volunteer network are raised.
Attitude of Health Personnel↗
The provision of general surgical services in rural South Australia: a new model for rural surgery.
BACKGROUND: Rural South Australia (SA), like other rural areas in Australia, faces a crisis in the medical workforce. It is also generally assumed that the same applies to rural surgical services but finding evidence to support this is scarce. METHODS: All hospitals situated outside the outer metropolitan area of SA were surveyed about surgical services (n = 57). Questions were asked about the frequency of emergency and elective theatre usage and which surgeons provided surgical services. RESULTS: Operating theatre facilities were in active use in 39 of the 57 hospitals studied. At the time of the study there were seven specialist general surgeons resident in rural SA. General practitioners continued to have a major input in the provision of surgical services, either by providing the general anaesthetic (34/39) or by performing the surgical procedures (26/39). CONCLUSIONS: The Department of Surgery at the University of Adelaide is instituting various measures to counter the rural surgical workforce problem and is developing a model that serves either the individual or the two-person surgical practice. Metropolitan teaching hospitals can play an important role in supporting current rural surgeons and can foster an increased commitment to the future of rural general surgery.
Humans↗
Positions and training of the indigenous health workforce.
A survey of community-controlled and state health services was conducted in 1995 as part of a needs assessment for a tertiary training initiative in applied epidemiology. Information for 792 Indigenous people in health-related occupations was obtained. Mean time in the current position was 4.8 years, 75% were in designated Aboriginal positions and 44% were health workers. Of the total, 49% had a diploma or certificate, but only 3% had a bachelors degree. The latter compares with 75% of the public health workforce generally which has a bachelors degree or higher. The high proportions of health worker and designated Aboriginal positions, short tenure and low level of degree training suggest that there are a range of employment and training issues which need to be addressed if an appropriate level of Indigenous workforce participation is to be achieved and Indigenous health professionals are to have access to the same vertical and lateral employment mobility as non-Indigenous workers. In particular, there is a huge need to enhance Indigenous participation in health workforce training, and to develop strategies for certification and recognition of the wide range of non-course-based training being undertaken.
Adolescent↗
The direct care worker: the third rail of home care policy.
Home health aides, home care workers, and personal care attendants form the core of the paid home care system, providing assistance with activities of daily living and the personal interaction that is essential to quality of life and quality of care for their clients. High turnover and long vacancy periods are costly for providers, consumers, their families, and workers themselves. In 2002, 37 states identified worker recruitment and retention as major priority issues. Demographic and economic trends do not augur well for the future availability of quality home care workers. Policymakers in the areas of health, long-term care, labor, welfare, and immigration must partner with providers, worker organizations, and researchers to identify and implement the most successful interventions for developing and sustaining this workforce at both policy and practice levels. The future of home care will depend, in large part, on this "third rail" of long-term care policy.
Health Policy↗
Implications of the Health Security Act for mental health services for children and adolescents.
Lack of adequate insurance coverage is one reason that the percentage of children who currently utilize mental health services is significantly lower than the estimated percentage of children with serious mental disorders. Principles of a reformed health care system with particular relevance for children's mental health services include coverage of a broad array of home- and community-based services, provision of organized systems of care for children with serious and persistent mental illness, mechanisms to ensure appropriate utilization of services, and provision of mental health services on the same terms and conditions as other health services. The Clinton Administration's proposed Health Security Act embodied many of these principles. In addition, its call for universal coverage and for elimination of insurance exclusions for preexisting conditions would extend mental health coverage to children who are currently uninsured or underinsured; the plan would also expand the range of services covered to include state-of-the-art approaches such as intensive nonresidential services and other alternatives to hospitalization. Implementation of the proposed plan would require developing the service and workforce capacity to provide a full continuum of services, ensuring availability of existing services, integrating existing and new systems of care, guarding against underserving children with serious mental illness, and planning for the role of Medicaid funding in the reformed health care system.
Adolescent↗
Initiation of a school employee wellness program: applying the Comprehensive Health Education Model.
Employee wellness is an important component of a coordinated school health program and one that often lacks formalization. With many things competing for the school nurse's attention, health promotion for staff most often consists of helping to arrange flu vaccination and blood pressure screenings. The Comprehensive Health Model assists school personnel desiring to formalize an employee wellness program. An earlier nursing practice management article (Galemore, 2000) explored the history and components of work-site wellness programs. The purpose of this article is to review the process as outlined by the Comprehensive Health Education Model used by one school district to initiate an employee wellness program.
Health Promotion↗
A systematic review of evidence about extended roles for allied health professionals.
OBJECTIVE: Extending the role of allied health professionals has been promoted as a key component of developing a flexible health workforce. This review aimed to synthesize the evidence about the impact of these roles. METHODS: A systematic review of extended scope of practice in five groups: paramedics, physiotherapists, occupational therapists, radiographers, and speech and language therapists. The nature and effect of these roles on patients, health professionals and health services were examined. An inclusive approach to searching was used to maximize potential sources of interest including multiple databases, 'grey' literature and subject area experts. An expanded Cochrane Collaboration method was used in view of the anticipated lack of randomized controlled trials and heterogeneity of designs. Papers were only excluded after the search stage for lack of relevance. RESULTS: A total of 355 papers was identified as meeting relevance criteria and 21 studies progressed to full review and data extraction. The primary reason for exclusion from data extraction was that the study included neither qualitative nor quantitative data or because methodological flaws compromised data quality. It was not possible to evaluate any pooled effects as patient health outcomes were rarely considered. CONCLUSIONS: A range of extended practice roles for allied health professionals have been promoted and are being undertaken, but their health outcomes have rarely been evaluated. There is also little evidence as to how best to introduce such roles, or how best to educate, support and mentor these practitioners.
Allied Health Personnel↗
Teaching and continuing professional development: an Italian experience.
Continuing Professional Development (CPD) is a key factor for effective implementation of Clinical Governance. The development of a quality system is, in fact, strictly related to the development of competencies of healthcare professionals. Lifelong learning has emerged as a new paradigm that underlines the need to maintain and continuously improve knowledge, competencies and attitudes in the changing scenario of healthcare systems. CPD accreditation is another fundamental issue and a variety of voluntary and compulsory approaches can be recognised at an international level. The experience of the University Hospital of Padova may be useful to demonstrate that CPD can be addressed to implement a Clinical Governance project.
Education, Medical, Continuing↗
Lower percentage of CD56+ cells associated with long working hours.
In a study of 142 Japanese men from a cross-section of the workforce of a technology development company, we found that the percentage of CD56+ cells was inversely correlated with the number of hours worked per week. A low CD56+ cell percentage was associated with longer weekly working hours and shorter daily sleeping hours.
Adult↗
LPN certification programs offer one solution to nurse crunch.
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Certification↗
Empowering employees to take charge of their performances.
To retain staff and operate effectively, an agency must reward and develop its personnel. One Wisconsin agency worked with its staff to develop a review tool that enabled the staff to take part in their own evaluation and thus perform to their best abilities.
Employee Incentive Plans↗
Staff empowerment: a medical record department's preliminary experiences with continuous quality improvement.
After observing the results of continuous quality improvement, no one would argue against its value in the workplace. However, learning to apply the concepts requires change on everyone's part, and the challenge lies in effecting this change. Not everyone will want to work in this type of environment and, if the organization is truly committed to continuous quality improvement, those individuals may have to make hard decisions as to whether the organization is the right place for them to work. Certain skills are required for staff empowerment to be successful, and training in these skills is essential. The medical record department staff learned early in this process that, although the group possessed job skills, interaction and team skills were lacking. The Development Dimensions International program helped the managers and staff identify the weaknesses of the group and provided educational tools for improvement. The changes often are so subtle, the group does not realize anything has changed. It was not until recently, when the medical record department staff was requested by administration to identify department quality improvement projects, that the group looked back at where the process started and realized how different things are today from three years ago--now staff members lead team meetings, work-groups are redesigning their job processes, and teams update the rest of the department staff on its progress at department meetings. Everyone expressed a sense of pride and accomplishment that the group had indeed responded to the challenge. The experiences of the medical record department thus far clearly support empowerment of employees.(ABSTRACT TRUNCATED AT 250 WORDS)
Attitude of Health Personnel↗
A home care nurse residency program.
Hiring new graduate nurses into the home care setting is no longer a taboo. With a carefully scheduled learning program and ongoing supervision and support, this program has shown that recently graduated nurses can be good home care clinicians.
Community Health Nursing↗
'Career ladder' improves support staff's success.
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Career Mobility↗