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At least 811 records · Page 45Linked to original sources
PubMed2003

Hospital downsizing and workforce reduction strategies: some inner workings.

Downsizing, manpower reductions, re-engineering, and resizing are used extensively in the United States to reduce cost and to evaluate the effectiveness and efficiency of various functions and processes. Published studies report that these managerial strategies result in a minimal impact on access to services, quality of care, and the ability to reduce costs. But, these approaches certainly alienate employees. These findings are usually explained by the significant difficulties experienced in eliminating nursing and other similar direct patient care-oriented positions and in terminating white-collar employees. Possibly an equally plausible reason why hospitals and physician practices react so poorly to these management strategies is their cost structure-high fixed (85%) and low variable (15%)-and that simply generating greater volume does not necessarily achieve economies of scale. More workable alternatives for health executives to effectuate cost reductions consist of simplifying prepayment, decreasing the overall availability and centralizing tertiary services at academic health centres, and closing superfluous hospitals and other health facilities. America's pluralistic values and these proposals having serious political repercussions for health executives and elected officials often present serious barriers in their implementation.

Attitude of Health Personnel↗
PubMed2001

Workforce productivity and incentive structures in the UK National Health Service.

The UK National Health Service (NHS) is a labour-intensive service, yet the productivity of one of the largest labour forces in the world has been relatively ignored over the last 50 years. The data available to measure productivity over time are limited and focus on inputs and activity, not outcome. However, what data there are indicate that, despite major increases in NHS funding and staffing, changes in technology and continuous reorganisation of structures, productivity tends to show little or no change over successive decades. The challenges to policy-makers are how to improve the measurement of productivity and how to alter the behaviour of hospital clinicians and general practitioners by reform of incentive structures in the UK NHS.

Efficiency, Organizational↗
PubMed2002

Planning for Canada's health workforce; past, present and present.

In a service enterprise, the front line is the product. Health human resources issues, however, continue to be treated as simple input problems. More data, in and of itself, will not solve health human resources planning challenges. The definition of how many and what types of healthcare providers are needed first requires a model of delivery of professional services built around professional healthcare workers. If we do not get this right, soon the shortage of healthcare workers will get even worse as young people choose careers in fields other than health services.

Canada↗
PubMed2002

The capacity to change? Workforce growth in the health sector; a U.K. perspective.

Canada is not alone in having to face up to significant human resource (HR) challenges as it debates how healthcare should be managed and delivered in the 21st century. The United Kingdom is having to deal with many similar issues related to demographic change, skills shortages and the drive to "modernize" public services. This commentary highlights some of the main dimensions of HR-related change in the U.K. National Health Service (NHS) to counterpoint the main messages in the lead paper. The primary focus is on examining the key HR aspects of achieving sustained improvement in staffing levels, mix and motivation.

Health Care Reform↗
PubMed2002

Planning for Canada's health workforce: looking back, looking forward.

"Are there enough health professionals in Canada, and will they be there when I need them? " Answers to these two seemingly simple questions cover a variety of complex and interrelated factors that are not fully understood, as the report about Canada's Healthcare Providers (CIHI 2001) makes clear. The report appears at a time when Canadian political leaders, healthcare organizations, caregivers and others involved with the healthcare system are looking for creative solutions to the human resources challenges facing the health system. Many of the issues are not new; over the last 50 years they have been raised by various groups and government commissions. But there is a sense of urgency today as options for renewing and sustaining Canada's health system are actively being explored. This essay offers highlights from the report, providing a portrait of what is known (and not known) about the people who work in healthcare across the country. It makes clear that whether there are (or are not) enough healthcare providers is not simply a question of numbers of health professionals. From changes in health and healthcare to shifts in the worklife and practice patterns of professionals, a better understanding of the wide range of factors affecting healthcare providers is essential to further the important debates taking place.

Canada↗