Workforce Challenges Research Articles

Rural Eye Care Access, Workforce Challenges and Opportunities: Perspectives of the Eye Health Workforce in Western Australia.

Rural residents face numerous barriers to accessing eye care services that contribute to disparities in eye health outcomes. This study aimed to explore the perspectives of the rural workforce on opportunities to improve patient access to eye care services, as well as understand the ways the workforce can be supported. Regional, rural and remote Western Australia. A qualitative descriptive approach was taken. Maximum variation and snowball sampling were used, and semi-structured interviews were conducted until data saturation. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis. Seventeen semi-structured interviews were conducted with six ophthalmologists, 10 optometrists and one non-clinician involved in delivering eye care services in rural Western Australia. Four major themes were identified. 'Access to care' pertained to barriers and facilitators of timely and appropriate eye care for rural residents. 'Need for collaborative care framework' between ophthalmology and optometry emerged as a key opportunity to decrease wait times and maximise efficiency of visiting services. 'Motivation to work in rural settings' and 'challenges of working in rural settings' suggested opportunities to support the workforce. This study finds that continued support through financial, personal, and professional means is important for workforce retention and satisfaction among eye care service providers in rural Western Australia. Although collaborative care models currently exist, the extent of collaboration between practitioners varies considerably. Further research is required on developing innovative, scalable and sustainable models of care to meet the eye care needs in rural Australia.

Brain drain in Emergency Medicine in Lebanon, building locally and exporting globally

ObjectiveDespite the growth of Emergency Medicine (EM) globally, shortages of EM-trained physicians persist in many countries, disproportionately affecting lower middle/low-income countries (LMIC/LIC). This study examines the career paths of graduates of an Emergency Medicine residency-training program established in Lebanon with the aim of building local capacity in EM.Design and patientsThis descriptive study utilizes secondary data sourced from an alumni database that includes nine cohorts of graduates from an Emergency Medicine residency program at the American University of Beirut Medical Center in Lebanon.Measurements and main resultsWithin 12 years since the EM residency program establishment a total of 9 cohorts, including 44 physicians had completed their residency training in EM, with 40.9% being female and 95.5% Lebanese citizens. After graduation, almost half of our graduates (47.7%) enrolled in fellowship training programs and 40.9% joined the workforce. Fellowships in Trauma (19%) and Oncologic Emergencies (19%) were the most commonly pursued. Initial employment destinations predominantly included Lebanon, the United Arab Emirates and the Kingdom of Saudi Arabia, (61.1, 33.3 and 5.6% respectively). However, retention within the local market declined with time, with a median time spent in Lebanon of 1 year and a mean of 3.3 years of practice in Lebanon prior to emigration. Presently, graduates are mostly dispersed across the Gulf Cooperation Council region (38.6%), the USA (25%), and Lebanon (20.5%).ConclusionBuilding Emergency Medicine expertise to match the growing population needs for specialized acute care remains a challenge globally, especially in low-middle income and low-income countries. Our study highlights the challenge of retaining specialized medical graduates in LMIC. Understanding and addressing the root-causes of out-migration of highly specialized medical workforce is an essential component of addressing local workforce challenges that needs to be coupled with capacity building initiatives for meaningful impact.

Enhancing access to primary care is critical to the future of an equitable health service: using process visualisation to understand the impact of national policy in the UK

Access to UK general practice is complicated by the need to provide equitable and universal care within a system adapting to workforce challenges, digital innovation, and unprecedented demand. Despite the importance of accessing primary care in meeting the overall aim of delivering equitable care, this is the first time the direct and indirect influence of policies intended to facilitate access have been systematically explored. Further consideration by policymakers is needed to accommodate the difference between what patients need and what patients want when accessing primary care, and the differences in their ability to utilise digital options. The designation of care was hindered by long-standing issues of reliable data and variations in the interpretation of local and national protocols and guidelines.

Pengembangan Instrumen Penilaian Berbasis Proficiency Test Untuk Pendidikan Kesetaraan Paket C

The Community Learning Center (PKBM), through its Paket C program, plays a vital role in providing equality education for individuals unable to access formal schooling. This study aims to develop a proficiency test -based assessment instrument designed to holistically evaluate the competencies of Paket C learners. The instrument assesses mastery of academic material, functional skills, and entrepreneurial abilities, which are distinctive features of the Paket C program. The research adopts a qualitative approach, utilizing observation to create test specifications, blueprints, and items tailored to appropriate difficulty levels, discrimination indices, and distractor functions. The findings indicate that proficiency test s address the limitations of the current assessment system, which primarily focuses on standardized examinations, by offering a more comprehensive, valid, and relevant evaluation aligned with workforce demands. Moreover, the flexible scheduling and needs-based approach of Paket C education provide broader access for working individuals or those who have not completed formal education. Proficiency test s also ensure the fulfillment of Graduate Competency Standards (Standar Kompetensi Lulusan or SKL) through assessments that integrate Competency Credit Unit (SKK)-based curricula and the evaluation of applied skills. The study recommends the adoption of proficiency test s as an integral part of Paket C's educational evaluation system to create a more inclusive, adaptive, and relevant assessment model that aligns with the learners' needs and the challenges of the modern workforce.

Poor quality care in healthcare settings: an overlooked epidemic

Adverse events in healthcare settings, including medical errors, healthcare-associated infections (HAIs), and surgical complications, have been a persistent challenge globally, contributing significantly to patient morbidity and mortality. Over the past decade, these events have remained prevalent despite increasing efforts to improve patient safety. This narrative literature review explores the burden of poor-quality care. It examines the trends in adverse events and associated mortalities from 2015 to 2024, highlighting the impact of these events on global health outcomes and identifying potential strategies for reducing their occurrence. Data were collected from various sources such as PubMed, Google Scholar, Scopus, and Ebscohost. The analysis revealed that ~10%−12% of hospitalized patients in high-income countries experienced adverse events annually from 2015 to 2024. Globally, the WHO estimated that 134 million adverse events occurred each year, with ~2.6 million deaths attributed to these events. Adverse events in healthcare settings remain a significant public health challenge, contributing to millions of preventable deaths annually. The persistence of these events highlights systemic issues within healthcare delivery, including inadequate safety protocols, underreporting, and workforce challenges.

Gender and ethnic diversity and wage gaps in the Canadian chiropractic workforce

BackgroundAs health systems worldwide continue to face health workforce challenges exacerbated by the Covid-19 pandemic, chiropractors can play an important role in meeting increasing needs for rehabilitation services. However, limited evidence from some countries suggests the chiropractic workforce does not reflect the diversity of the population it serves. This observational study quantifies the chiropractor workforce in Canada in gender and ethnocultural composition and earnings, as tracers of equity and inclusion within this healthcare profession.MethodsWe used 2021 population census data with integrated administrative income tax records to identify and characterize chiropractic practitioners aged 25–54. Following a descriptive analysis, multivariate regression and Blinder-Oaxaca decomposition methods were applied to assess gender and ethnic earnings differences, adjusting for a range of professional and personal factors.ResultsThe chiropractic workforce was underrepresented regarding women (44.5% versus 50.6% of the total population) and visible minorities (20.0% versus 26.5%). Despite similar levels of education, women’s (unadjusted) earnings averaged 77.1 cents for every dollar earned by men in pandemic-affected 2020, narrowing slightly from 76.7 cents in 2019. Regression results showed significant earnings differences by gender and by ethnocultural identity, adjusting for other factors. An unexplainable gender wage gap persisted in the decomposition analysis, with women earning 6% less than men due to factors that could not be explained by differences in age structure or part-time work, pointing to additional contributing but unmeasured structural dynamics.ConclusionSignificant earnings disparities by gender and ethnicity among chiropractors emphasize the need for equity-oriented initiatives in leadership opportunities and compensation structures, to help influence the attractiveness of the profession to new talent.

Gains and pains: a qualitative study on the implications of value-based health care for professionals

BackgroundWhile aiming to optimize patient value, the shift towards Value-Based Health Care (VBHC) in hospitals worldwide has been argued to benefit healthcare professionals as well. However, robust evidence regarding VBHC’s workforce implications is lacking. This gap is problematic, as the motivation and health of healthcare professionals are central to the quality of care and crucial amidst contemporary workforce challenges. This study aims to qualitatively examine the implications of VBHC for healthcare professionals’ motivation, job strain, and ongoing participation in VBHC. In addition, it explores how these outcomes are regulated at both the individual and organizational levels.MethodsSemi-structured interviews were conducted with 26 healthcare professionals across six Dutch hospitals. Interviewees engaged in three VBHC activities: (1) value-based outpatient consultations and/or; (2) value-based quality improvement activities; as well as in; (3) VBHC implementation. Interview questions and data analysis were guided by the Job Demands–Resources model.ResultsVBHC interacts with four themes perceived to affect professional’s motivation (perception of making a positive impact, enjoyability of job activities, personal development, and sense of community and support) and three themes perceived to affect job strain (workload, cognitive demands, and confidence). VBHC creates both gains (primarily increasing motivation; occasionally reducing strain) and pains (primarily increasing strain; sometimes reducing motivation). The perceived impact of VBHC depends on the fit between the individual, one’s activities in VBHC, the working conditions, and the pace of VBHC implementation. An observation that warrants attention is that healthcare professionals with a 'do-er' mentality and high ambitions to optimize patient value can become demotivated to continue advancing VBHC with the same intensity, particularly due to perceived slow progress.ConclusionsWhile VBHC is centered around patients, this study emphasizes that the needs, experiences and changing role identities of healthcare professionals cannot be overlooked in this transition. VBHC currently presents as a double-edged sword for healthcare professionals: resulting in both gains and pains. In the move to VBHC, it is crucial to maintain alignment between the individual, their job activities, the work environment, and the pace at which VBHC unfolds. This is essential for fostering and retaining motivated individuals, who are not only vital to the workforce but also pivotal in advancing VBHC.

Ethical considerations in the UK-Nepal nurse recruitment: Nepali nurses' perspectives.

The global migration of nurses from resource-constrained to affluent nations raises complex ethical concerns, often rooted in historical power imbalances and neocolonial legacies. The Nepal-UK Memorandum of Understanding (MoU) on nurse recruitment, while presented as a solution to workforce shortages, exemplifies this complex dynamic, prompting critical questions about its implications for individual nurses and the healthcare systems involved. This qualitative study explored the ethical complexities and dilemmas associated with the Nepal-UK nurse recruitment Memorandum of Understanding (MoU). This bilateral agreement has sparked debate about its potential impact on both individual nurses and the healthcare systems of Nepal and the UK. A qualitative exploratory design utilizing semi-structured interviews was employed. Data were analyzed using reflexive thematic analysis. Twelve Nepali nurses from two private hospitals in Kathmandu, Nepal, participated in the study. The study was approved by the Nepal Health Research Council. All participants provided informed consent and were assured of confidentiality and anonymity. Four themes emerged from the data: (1) The lingering legacy of colonialism casts a shadow on the Nepal-UK relationship, raising concerns about potential exploitation and unequal power dynamics. (2) Nepali nurses grapple with the ethical dilemmas of pursuing personal dreams while acknowledging their responsibilities towards their communities and Nepal's healthcare system. (3) The MoU's claims of ethical recruitment are scrutinized, with nurses questioning its fairness and sustainability. (4) The agreement is challenged as a potential band-aid solution that may perpetuate global health inequities rather than fostering a genuine partnership. The Nepal-UK MoU, while offering opportunities for individual nurses, also raises alarms about brain drain, exploitation, and the perpetuation of global health disparities. The study underscores the urgent need for a paradigm shift in international nurse recruitment practices, prioritizing genuine partnership, equitable distribution of benefits, and sustainable solutions that address the root causes of healthcare workforce challenges in both source and destination countries.

Health workforce issues and challenges in the post-pandemic era.

The health workforce is an essential component of our health care delivery system. A well-trained, sufficiently sized, and diverse workforce is critical to meet the health care needs of the population. However, in this postpandemic era, many challenges persist. The following introduction describes a special collection of papers that address several key issues confronting the health workforce. It provides an overview of each article in the collection, highlighting their relevance to current workforce challenges. Each article in this series was developed by 1 of the 9 federally funded Health Workforce Research Centers.

Editorial Comment: U.S. Radiologist Workforce Challenges and Opportunities.

Editorial Comment: U.S. Radiologist Workforce Challenges and Opportunities.

Examining South Tyrol's Experience: Digital Health Adoption and Workforce Issues in Implementing Italy's Primary Care Reform Under Ministerial Decree No. 77/2022.

Background: Ministerial Decree (D.M.) 77/2022 aims to reform Italy's primary care system by establishing community health centres and integrating digital tools to address healthcare access disparities and workforce shortages. This review focuses on frailty assessment tools, digital health innovations, and workforce challenges in the Autonomous Province of Bolzano, South Tyrol, emphasising interprofessional trust and collaboration issues. Methods: Using a narrative custom review approach guided by the SANRA checklist, this study synthesised findings from PubMed, official health websites, and regional surveys on frailty, workforce dynamics, interprofessional collaboration, and digital infrastructure in South Tyrol. Results: General practitioners (GPs) exhibited high professional motivation but expressed concerns about autonomy and administrative burdens in collaborative care models. Trust issues between GPs and specialists hinder workforce cohesion and care coordination, highlighting the need for structured inter-professional communication. Frailty assessments, such as the PRISMA-7 tool, identify over 33% of community-dwelling individuals aged 75 years and older as frail, necessitating targeted interventions. Digital health adoption, particularly electronic health records and telemedicine, is slow because of workforce shortages and infrastructure limitations. Conclusions: The successful implementation of D.M. 77/2022 in South Tyrol requires addressing workforce challenges, improving interprofessional trust, expanding digital infrastructure, and integrating frailty assessment findings into care strategies. These measures are critical for achieving a more resilient, equitable, and effective primary healthcare system.

The Future of Trucking: Trends Shaping the Industry Over the Next Five Years

The trucking industry in the United States is at a pivotal moment, driven by advancements in technology, regulatory pressures, and evolving market demands. This paper examines key trends poised to shape the industry over the next five years, including the rise of autonomous vehicles, electrification of fleets, and digital innovations in logistics and dispatching. The discussion also delves into the impact of stricter environmental regulations, workforce challenges, and shifting customer expectations in a rapidly growing e-commerce landscape. By analyzing recent data and insights, this research provides a forward-looking perspective on how stakeholders can prepare for an increasingly complex and dynamic trucking ecosystem. Recommendations are offered for businesses, policymakers, and industry professionals to capitalize on emerging opportunities while addressing challenges. Keywords: Trucking industry, Autonomous vehicles, Fleet electrification, Digital freight platforms, E-commerce logistics, U.S. trucking trends

Bridging the Gaps in Pediatric Orthopaedics: A Holistic Approach to Strengthening the Workforce

The pediatric orthopaedic workforce in the United States faces critical challenges as the demand for specialized services grows. Despite recent advancements, significant gaps remain in the availability and geographic distribution of pediatric orthopaedic surgeons, particularly in rural underserved areas. These disparities affect the quality of care pediatric and adolescent patients deserve. While efforts to improve disproportionality have shown some progress, overall gender and racial diversity remains low. Furthermore, the osteopathic approach, which emphasizes whole-person care and preventive strategies, offers valuable insights and interventions for addressing these workforce challenges. By integrating osteopathic principles, such as the interrelationship of structure and function and osteopathic manipulative treatment (OMT), into preoperative and postoperative care, pediatric orthopaedists can enhance patient outcomes and long-term recovery, benefitting both subspecialists and generalists. This article reviews the current state of the pediatric orthopaedic workforce, proposes recommendations to address existing gaps, and highlights the role of osteopathic distinctiveness in strengthening healthcare for pediatric patients.

Caring for the Health Care Workforce

This special theme issue of NEJM Catalyst Innovations in Care Delivery, guest edited by Frederick P. Cerise, MD, MPH, includes articles, case studies, and research reports on workforce challenges, a worksite health scorecard, well-being committees, physician peer support, a coaching program, positive psychology for team building, and reflective writing workshops.

Focus Group Discussions on Enhancing Laboratory-based Surveillance Capabilities for Emerging Infectious Disease Response

The COVID-19 pandemic highlighted critical gaps in the Philippine health laboratory system, including limited testing capacities, insufficient trained personnel, and inadequate resource distribution. To address these issues, the Philippine government established the Office for Health Laboratories (OHL) and sought technical assistance from the Japan International Cooperation Agency (JICA) through the Project for Strengthening the Philippine National Health Laboratory Network for Infectious Diseases (PHeLNIDs). This project aims to enhance the National Health Laboratory Network's (NHLN) capacity for infectious disease surveillance and response. Phase 1 of the PHeLNIDs project included focus group discussions (FGDs) conducted across 17 regions to assess challenges and develop recommendations for a tier-based laboratory network. Key findings revealed logistical, workforce, transportation, and data management challenges that hinder the effectiveness of specimen referral workflows. Recommendations emphasized decentralizing diagnostic capabilities through subnational reference laboratories, strengthening logistics, and implementing an Integrated Laboratory Information Management System (ILIMS). This article underscores the importance of laboratory decentralization, capacity building, and improved resource management to enhance laboratory-based surveillance and response to emerging infectious diseases. The proposed interventions aim to bolster the Philippine laboratory network, reduce turnaround times, and improve public health outcomes.

Impact of Technology-Driven Start-ups in Empowerment of Youth in India: An Empirical Investigation

Technology-driven start-ups have appeared as transformative agents, significantly contributing to the empowerment of youth. There is an important part of these start-ups in the innovative sectors like artificial intelligence, fintech, and renewable energy where they are enhancing employment opportunities by generating diverse jobs for youths. Skill-based hiring is prioritised in these start-ups which fosters the economy, offers flexibility and global exposure. “Hands-on learning, access to cutting-edge technologies, and cross-disciplinary collaboration, equipping youth with future-ready capabilities” are skill development drives promoted in these ventures. Technology-driven start-ups empower youth by nurturing culture of innovation, self-reliance, and adaptability which leads to economic and societal transformation, shapes a future-ready workforce and address critical global challenges. Start-ups nurtures entrepreneurship among young population where they provide digital platforms, funding opportunities, and access to mentorship and global networks. They inspire innovation and encourage the entrepreneurial attitude needed to deal with current challenges. A sample of 219 young entrepreneurs from different entrepreneurial sectors were surveyed to explore the factors that shows the Impact of Technology-Driven Start-ups in Empowerment of Youth and found that job creation, skill enhancement, entrepreneurship, and digital inclusion are the factors that shows the Impact of Technology-Driven Start-ups in Empowerment of Youth.

Career choices and career mobility of chinese pharmacy graduates: a cross-sectional study

BackgroundThis study investigates the career mobility and employment status of Chinese pharmacy graduates, aiming to address workforce challenges and career planning within the pharmacy profession. Given the rapid expansion of the healthcare sector in China, understanding factors influencing job changes and career decisions is crucial for ensuring workforce stability and professional development. The study covers pharmacy graduates enrolled at Kunming Medical University from 1996 to 2012.MethodsA cross-sectional online survey collected data from 231 respondents in April 2022, focusing on demographic characteristics, career choices, job changes, and the factors influencing these decisions. Multivariate logistic regression and Chi-square (χ²) tests were used to analyze the data, with a particular focus on the pharmacy practice, pharmaceutical sciences, and clinical pharmacy.ResultsOf the 231 respondents, 52.4% (n = 121) had never changed jobs, and 32.5% (n = 75) had changed jobs once or twice. The majority preferred working in governmental institutions (n = 146, 63.2%), with fewer graduates choosing domestic (n = 48, 20.8%) or overseas pharmacy enterprises (n = 20, 8.7%). Income and personal growth were significant factors influencing job changes (p < 0.05). Respondents who had changed jobs three or more times placed a greater emphasis on personal growth (Relative Risk Ratio [RRR]: 2.96; 95% Confidence Interval [CI]: [1.6, 5.49]).ConclusionsThis study reveals significant variations in job mobility and career choices among Chinese pharmacy graduates. Graduates in governmental institutions showed lower mobility, while those in pharmacy enterprises and non-pharmaceutical sectors experienced higher job changes. Income, personal growth, and work environment were key factors.

Older Care Leavers Entering the Aged Care System: A Narrative Review.

This review examines Australian and international literature on older care leavers' experiences with aged care services, highlighting their preferences for home-based care that respects autonomy and personal history. It identifies systemic issues within aged care, including workforce challenges and a lack of tailored, trauma-informed support, that hinder effective care. The review underscores the need to incorporate care leavers' voices in research to inform policy and practice. Recommendations include adopting trauma-informed, care-leaver-centered services to address care leavers' unique needs and improve well-being and dignity within aged care settings.

Comprehensive Review of Healthcare Workforce Challenges, Technological Solutions, And Training Programs

The healthcare workforce is under pressure from, among other things, workforce deficit, staff fatigue, and changes in demand for skills due to the changing technological environment. This review, therefore, reviews these workforce challenges and examines how AI, telemedicine technology, EHRs, and wearable technology can suggest some of the mentioned workforce pressures. Moreover, it evaluates the changing trends in healthcare training programs and explores the need to adopt new technologies for innovation. Healthcare organizations can take advantage of the right technological solutions and increase the medical staff's and patients' effectiveness through increased efficiency, education, and training. Based on the arguments made throughout this paper, the following suggestions are made for healthcare organizations, policymakers, and educators to prepare the workforce for future needs.

Exploring Pathways to Recovery: A Comprehensive Literature Review on Mental Health Rehabilitation for Patients

Mental health rehabilitation is a critical component of the recovery process for individuals experiencing mental health challenges. This comprehensive literature review explores the diverse approaches to mental health rehabilitation, including psychosocial interventions, medical treatments, vocational programs, and the integration of digital tools. Emphasizing patient-centered care, the review highlights the importance of addressing individual needs, reducing stigma, and fostering social reintegration. Key barriers, such as limited resources and workforce challenges, are identified, alongside metrics for evaluating patient outcomes, including quality of life and clinical improvement. The review underscores the significance of tailored rehabilitation programs and calls for further research to bridge existing gaps and enhance the effectiveness of interventions.