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PubMed2006

The 5-10-25 challenge: an observational study of a web-based wellness intervention for a global workforce.

We conducted and evaluated a 4-year, web-based wellness program involving 2498 global employees. The program was designed to encourage improvement in diet, exercise level, and weight control. Each month, after enrollment, participants were prompted to log on and enter personal data. Four years' worth of nonparametric data were analyzed. Seventy-seven percent of participants were men, 53% were overweight or obese, and mean beginning body mass index (BMI) was 25.9. Only 35% of starting participants ate five or more servings of fruit and vegetables daily, and fewer than 38% engaged in 30 min of activity or 10,000 steps. At the end of the intervention, there was a statistically significant (p < 0.05) improvement in the diet, exercise habits, and weight of participants. Results suggests that our web-based wellness intervention was successful in improving key health indicators for a mobile, global workforce.

Adult↗

PubMed1996

Opportunity wages and workforce adjustments: understanding the cost of in-home elder care.

Time spent providing informal care represents a real cost to caregivers and potentially affects their decisions about alternative activities, including paid work. This study offers estimates of opportunity wages incurred by informal caregivers and explores the impact of these costs on their decisions to reduce or abandon workforce participation. We consider caregivers at two points in time: 1982 and 1989. Our estimates of caregivers' imputed wages vary more widely and range higher than those reported elsewhere, varying from $0.78 to $27.18 per hour, compared to values in the literature ranging from $4.64 to $10.30. In both years, caregivers with higher imputed wages were significantly more likely to work, with this effect stronger in 1989 as all noneconomic factors became less important. However, accommodation (working fewer hours or foregoing job opportunities) decreased with higher imputed wages in 1982 only. In 1989, elders' frailty became a significant determinant of accommodation.

Aged↗

PubMed1987

Respiratory questionnaires in occupational studies: their use in multilingual workforces on the Witwatersrand.

The mother tongue of the majority of black workers in the industrial workforces of the Witwatersrand is either Zulu or S Sotho/Tswana, and these are also the main languages spoken in the area. However a substantial minority cite one of several other languages as their mother tongue. In consequence, in occupational surveys using a respiratory questionnaire, the accepted practice has been to use multilingual interviewers who administer the questionnaire in whichever of the two main languages the interviewee requests, but work from an English language version. To test the reproducibility of the information so gathered, a standardized questionnaire was administered to 56 subjects on two occasions approximately three weeks apart by each of two interviewers, one of whose mother tongue was Zulu and the other S Sotho. Reproducibility was little affected by whether the interviewer used her mother tongue or not, pointing to the multilingual competence of both interviewers. Reproducibility was, however, less in subjects not interviewed in their mother tongue compared to those who were. In general, reproducibility was also less for symptom than for history questions, though the phlegm question performed comparably to that reported for more homogeneous language/ethnic groups. Thus, even if internally valid, respiratory symptom information obtained by this method may have limited generalizability. However respiratory history information appears more reliable and may prove of value in the investigation of the natural history of chronic lung disease in this and similar communities.

Adult↗

PubMed1999

Two cases of thyroid cancer in a small workforce.

In 1994, in a large parcel depot in the north of England employing 600 staff and 24 electrical and mechanical engineers, two engineers developed papillary cell carcinoma of the thyroid in the same year. A comprehensive review of the literature revealed that ionizing radiation is the only known direct cause of this disease. There was speculation that air filter changing undertaken by the two men affected, shortly after the Chernobyl accident in 1986, may have exposed them to concentrated radioactive fallout. A radiation survey of the parcel depot was undertaken and revealed no evidence of abnormal radioactivity. A total of 27 past and present engineering staff were screened for thyroid cancer. No cases of thyroid cancer were found. Investigation of clusters of rare disease in the occupational setting is indicated mainly in order to address the concerns of the workforce. Nevertheless, investigation is warranted, especially when the aetiology of a disease is poorly understood. It would be prudent for doctors, in whatever speciality, to take an occupational history from individuals who develop thyroid cancer.

Carcinoma, Papillary↗

PubMed2002

The estimated workforce served by occupational physicians in the UK.

During the past decade, an occupational disease surveillance scheme has been created in the UK, based on systematic reporting of newly diagnosed cases by six groups of clinical consultants and by specialist occupational physicians. Labour Force Survey statistics have proved a reasonably satisfactory denominator for the former, but not for the occupational physicians, who provide services for only a selected subsection of the employed population. To remedy this deficiency, approximately 700 occupational physicians who were recorded as having been a reporter at some time were invited to provide their best estimate of the number of employees for whom they were responsible. After various exclusions--mainly physicians who were not, or were no longer, responsible for any defined workforce, and others who had not reported for at least 3 years--the number of active participants for whom data, by industry, occupation and sex, were obtained or estimated was 503. The resulting total number of employees served was estimated at 3.2 million, comprising 12% of the general working population. The proportion with access to an occupational physician varied enormously, from 43% in the health and social services to 1% in agriculture, forestry and fishing, and 6% in the rest of industry. Numbers estimated for each industrial sector were fairly reliable, but by occupation less so, especially in the health and social services.

Female↗

PubMed2000

The cost effectiveness of anesthesia workforce models: a simulation approach using decision-analysis modeling.

UNLABELLED: The objective of this study was to evaluate the incremental cost effectiveness of anesthesia workforce staffing scenarios, as a function of skill mix, by using the technique of decision analysis. A decision tree model was constructed to compare the incremental cost effectiveness of alternative delivery systems for anesthesia care from the perspective of the payer. Five different staffing scenarios, ranging from physician-intensive to nurse-intensive, were modeled. In the nurse-intensive model, low- and intermediate-risk patients were cared for by solo certified registered nurse anesthetists (CRNAs) and high-risk patients were cared for by physicians. In the physician-intensive model, physicians anesthetized all patients. In the first-, second-, and third-team models, all high-risk patients were cared for by physicians working alone, and all intermediate-risk patients were cared for using an anesthesia care team approach with a ratio of one physician to two CRNAs. The low-risk patients were managed by using an anesthesia care team approach with physician to CRNA ratios of 1:2, 1:4, and 1:8 in the first-, second-, and third-team models, respectively. The findings of this decision-analysis model suggest that physician-only anesthesia is not cost effective. However, the third-team model is cost effective when compared with the nurse-intensive model. IMPLICATIONS: An anesthesia care-team approach with a physician to certified registered nurse anesthetist (CRNA) ratio of 1:2 is the preferred staffing scenario for intermediate-risk patients. Although medical direction of CRNAs caring for low-risk patients is cost-effective, the small improvement in outcome resulting from increasing the physician to CRNA ratio from 1:8 to 1:4 may not be justified by the added cost.

Adult↗

PubMed2003

Developmental and behavioral pediatric practice patterns and implications for the workforce: results of the Future of Pediatric Education II Survey of Sections Project.

A survey of developmental-behavioral pediatricians was conducted to obtain data and insights on their current practice. As part of the Future of Pediatric Education (FOPE) II Survey of Sections Project, questionnaires were sent to individuals who were most likely to represent those pediatricians engaged in the subspecialty of developmental-behavioral pediatrics. Four groups of physicians were compared within the survey: developmental-behavioral fellowship group (n = 272), developmental disabilities fellowship group (n = 139), general academic pediatrics or other fellowship group (n = 57), and a nonfellowship group (n = 224). A majority of respondents indicated a need for an increased number of subspecialists in developmental-behavioral pediatrics in their community during the next 3 to 5 years. There were significant differences in the survey results of a variety of practice issues between those who had and had not received formal fellowship training. The survey data illustrate a developmental-behavioral pediatrician workforce that is becoming increasingly fellowship trained, receiving more referrals, and encountering constraints to seeing more patients in an era of declining reimbursement for services. To overcome these obstacles, stakeholders in child health, including health care payers, will need to be educated about the unique skills and clinical expertise of physicians in developmental-behavioral pediatrics and neurodevelopmental disabilities.

Child↗

PubMedDate not supplied

Hospital initiatives to support a better-educated workforce.

A 2003 article in the Journal of the American Medical Association documented that mortality rates from common surgical procedures were significantly lower in hospitals employing more staff nurses prepared at the baccalaureate level. In this report, that study's authors review case studies of 6 hospitals that demonstrate the kinds of initiatives employers are sponsoring to support a better-educated nurse workforce.

Academic Medical Centers↗

PubMed2002

Otolaryngology residents' objectives in entering the workforce.

OBJECTIVES: To determine the priorities of current otolaryngologists-in-training in considering their first employment opportunities. STUDY DESIGN: Twenty-one-item survey measuring the importance of various first job issues, with all items scored on a five-point Likert-type ordinal scale. METHODS: The resident membership of the American Academy of Otolaryngology-Head and Neck Surgery was anonymously surveyed by means of mail-in questionnaires. Results were stratified by years of training. RESULTS: Responses from 242 of 1174 mail-in surveys (21% response rate) exhibited a wide distribution of responses for all 21 questions. The availability of free time to spend with one's family was regarded by more than half of the respondents to have the highest overall importance. As years of training increased, priorities shifted toward geographic location, away from issues such as the on-call schedules. The availability of research time and resources received the overall lowest priority, with more than half of the respondents ranking it as only somewhat important or lower. CONCLUSIONS: Otolaryngologists-in-training feel strongest about the availability of free time to spend with their families as they finish formal training and consider employment opportunities. By acknowledging the concerns of graduating residents, including the ability to pursue their primary interests when they start working, we can better adapt conditions to create a more comfortable and stable entry into the workforce.

Attitude of Health Personnel↗

PubMed2002

Emergence of the free agent nurse workforce.

The health care world is changing rapidly and so is its workforce. As nurses are welcomed as copartners in care delivery and design, a new relationship between employer and employee is forged. Nurses who see themselves as free agents, working in partnership with their employers, function within a very different employment relationship than in past years. The concept of free agency is more familiar to nurses in the Generation X age cohort but is of great interest to all nurses and nurse administrators. Free agency is more of a mindset than an employment status and is explored in this article.

Career Choice↗

PubMedDate not supplied

Preparing a new workforce.

Human caring, while instinctive, can also be taught, learned, and measured through the nursing education system. For decades information has been obtained that suggests people enter nursing because they value interpersonal relationships, altruism, and a desire to help others. Building on this "caring ethic," nursing students can be professionally trained so that the very best in nursing comes through in their practice. By using nursing theory, students realize their potential while gaining all requisite skills and competencies of today's practicing nurse. They enter the workforce with excitement and enthusiasm, confident that reflective, patient-centered care is always the goal.

Attitude of Health Personnel↗

PubMedDate not supplied

Culture diversity/a mobile workforce command creative leadership, new partnerships, and innovative approaches to integration.

Today's healthcare environment requires that nursing leaders meet the needs of a growing multicultural workforce and patient population. Cultural factors may be overlooked as healthcare delivery becomes increasingly dominated by technological, economic, and social changes. Through creative leadership, the chief nurse executive (CNE) can encourage staff to pay closer attention to cultural factors that will impact on patient, staff, and hospital outcomes. The CNE can begin by enhancing his/her own multicultural competency, building these competencies in his/her staff, and then empowering staff to respect and accommodate cultural differences. An understanding to transcultural nursing theory can enhance the development and maintenance of a multicultural perspective. The use of Madeline Leininger's Culture Care modalities can assist staff in making culturally competent decisions and in implementing actions. This article will provide an overview of one community hospital's experiences in integrating a multicultural perspective to better meet the needs of specific patient populations.

Attitude of Health Personnel↗

PubMed2005

How do you measure workforce integrity?

Behavioral hallmarks such as honesty, high ethical standards, and maintained moral principles define workforce integrity. Here, learn methods for integrating them into management practices.

American Nurses' Association↗

PubMed2005

Nursing workforce issues and trends affecting emergency departments.

Explore current nursing workforce issues--staffing issues, nurse-to-patient ratios, current emergency department benchmarking data, and operational factors--that affect the quality of care and safety in emergency departments. Learn several recommended strategies to improve care for patients and increase the recruitment and retention of qualified nurses and personnel in emergency care settings.

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

Strengthening the public health workforce: three CDC programs that prepare managers and leaders for the challenges of the 21st century.

To address the need for management development in public health, the Centers for Disease Control and Prevention (CDC) established three independent workforce development initiatives aimed primarily at strengthening management and leadership capacity: the Sustainable Management Development Program, the Management Academy for Public Health, and the CDC Leadership and Management Institute. Though independently designed and implemented, the programs share similar guiding principles in their approach to management development: interactive (adult) learning, management tools that reinforce evidence-based decision making, individual feedback, continuous improvement of the learning process, posttraining support for networking and life-long learning, and teamwork. This article will discuss important lessons learned regarding best practices in management and leadership development.

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

PubMedDate not supplied

Identifying training needs in the public health workforce: the public health prevention service as a case study.

The Public Health Prevention Service is a three-year training program committed to developing a workforce that is skilled in planning, managing, and evaluating prevention programs. In 2000, a questionnaire was administered to participants to assess their training needs. According to the resultant data, training is preferred in traditional formats (e.g., case studies and group discussion) and in short installments (one to three hours). Topics identified for future training included software application, prevention effectiveness (i.e., economic analysis), program evaluation, budgeting, and consensus building.

Competency-Based Education↗

PubMedDate not supplied

Are the public health workforce competencies predictive of essential service performance? A test at a large metropolitan local health department.

Since many training initiatives employ the core public health workforce competencies as objectives, it is important to demonstrate an association between competency and essential service job performance. A cross-sectional survey of 420 employees of a local health department was conducted in 1999, with a response rate of 76 percent. Each of ten essential service performance measures was regressed on four core competency measures, controlling for employee experience and education. The competencies explained 2 percent to 20 percent of the variance in essential service performance. While offering support for the core competencies as a foundation for training program content, the results also make clear the large role that other individual, organizational, and community influences may have. Explaining additional variance in performance will require incorporating these variables into future studies.

Efficiency, Organizational↗