Health Workforce Education Research Articles

Contextualizing algorithmic literacy framework for global health workforce education

With the rapid and accelerating advancement of generative artificial intelligence (AI), research is lagging on how to ensure that the health workforce becomes and stays AI-literate. This paper describes a way forward specifically toward establishing an AI-augmented curriculum within global health workforce education. By global health workforce education, we refer to the academic staff or faculty and students in medicine, nursing, global public health, and other health science fields. AI, unlike other technological advancements, is constantly changing. Therefore, the adoption of specific tools for health workforce education has to be analyzed in the context of the educational setting for shaping a sustainable and equitable AI-augmented global health workforce curriculum. This necessitates an integration of AI algorithmic literacy within academic curricula. In this paper, we propose the algorithmic literacy framework (ALF) for global health workforce education to address individual and organizational readiness. At the individual level, ALF examines one’s knowledge of and skills needed to implement AI within the context of their respective health education expertise. At the organizational level, ALF examines readiness across five areas: infrastructure and support systems, institutional support, Information and Communications Technology technical expertise, student engagement, faculty engagement, and analytics technical expertise. ALF offers universities and health workforce training institutions a way of organizing their approach to algorithmic/AI literacy readiness that embraces their organization’s values and, at the same time, urging them to act.

Behavioral Health Workforce Education and Training Program for Professionals (HRSA)

Behavioral Health Workforce Education and Training Program for Professionals (HRSA)

Indicators of primary health care workforce equity for attaining health equity

Abstract Background Healthcare workforce crises are often the result of inequities faced by healthcare workers. This study aims to discuss the primary policy questions related to health equity regarding the primary healthcare (PHC) workforce indicators. Methods Following the purposive review of published literature on HWF equity in PHC services, we applied an intersectional analysis of the compendiums of HWF indicators (e.g., supply, flows, skill mix, working conditions, promotion, training, funding, governance, etc.) to strategically link them to PHC policy issues for health equity and categorized qualitatively under each policy pillar against HWF crises. Results The proposed indicators address the measurement of multiple dimensions of health workforce equity. These include financial and non-financial incentives to monitor worker attrition reduction, gender pay gap, fairness in employment arrangements, remuneration, and working conditions. By monitoring the minimum wage for financially vulnerable health workforce groups, we can identify the need for potential increases to support well-being, reduce turnover, and increase productivity. Equally important is monitoring equity in health workforce education, planning, and management, which is crucial for achieving population health equity. By implementing indicators of health workforce diversity to address rural and underrepresented communities, primary healthcare managers can effectively plan the reduction of their unmet needs and minimize avoidable referrals. Conclusions To ensure equitable access to primary healthcare, we must measure workforce equity and its impact on population health. Monitoring the indicators of equitable health workforce policies and evaluating the improvement in retention and recruitment processes can more effectively address workforce crises. Key messages • Health workforce crises often stem from healthcare workforce inequities. • Health workforce equitable policies require a clear set of indicators.

Identifying implementation barriers and facilitators in an integrated behavioral health training program to improve workforce development.

Integrated behavioral health (IBH) in pediatric primary care settings can improve access to needed care and outcomes. Behavioral Health Workforce Education and Training (BHWET) programs can better prepare the workforce and support improved care access. This case study identified factors that impede and facilitate the implementation of practice-based training in a BHWET program using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Surveys were administered to BHWET trainees and primary care partners to assess stakeholder perspectives on field-based training processes. Qualitative data were extracted from surveys and trainee clinical logs. Providers reported high levels of satisfaction with IBH care training experiences. Data analysis identified several implementation facilitators and barriers. Implementation facilitators were associated with two EPIS outer context factors (leadership and collaboration) and one inner context factor (partner staffing). Identified barriers were associated with two inner context factors (organizational characteristics and data collection). Although the facilitators and barriers identified in this study were program specific, they have relevance for similar programs. Barriers identified at the organizational level reflect those identified in the research literature and provide insights for university programs regarding factors that must be considered when integrating IBH training components in primary care settings.

Mapping competency profiles of schools of public health: implications for public health workforce education and training in Israel.

Competency frameworks are essential for analyzing capabilities of Schools of Public Health to adequately prepare public health (PH) professionals to address contemporary challenges. This study maps the competency profiles of PH training programs in Israel using a novel curriculum mapping tool. This study assessed all five Israeli Health Education Institutions (HEIs) offering MPH or Bachelors in Public Health (BPH) degrees across 57 competencies in six domains to determine the extent to which competencies were addressed in the curriculum. The competencies list was based on the Association of Schools of Public Health in the European Region (ASPHER) List of Core Competences for the Public Health Professional, adapted for Israeli HEIs. The core curricula in the four MPH programs addressed 45-84% of all competencies. The BPH program addressed 79% of competencies. In MPH programs, the core curricula addressed most or all competencies in the Methods and the Socioeconomic Determinants of Health domains. Competencies in the domains of Environmental Determinants of Health, Health Policy, Economics & Organization, and Health Promotion and Prevention were less comprehensively addressed in most core curricula. Students' opportunities to broaden their exposure to competencies outside the core curricula were context dependent. The curriculum competencies mapping tool that was developed served to assess both strengths and shortcomings in PH education in Israel. The findings demonstrate a highly variable array of PH curriculum models in Israeli HEIs, as well as overall shortcomings in the Environmental, Health Policy Economics and Organization, and Health Promotion and Prevention domains. This analysis has already led to reassessment of the curriculum, and will continue to guide the next steps to increase the harmonization of PH training curricula and to better meet PH challenges in Israel.

War and peace in public health education and training: a scoping review

BackgroundArmed conflict and war are public health disasters. Public health action has a crucial role in conflict-related emergencies and rehabilitation but also in war prevention and peace promotion. Translating this into public health training and competencies has just started to emerge, especially in Europe.MethodsWe conducted a Scoping Review to map and identify the role of public health education and training of public health workforce relating to the prevention of war and promoting peace, as reflected in the scientific literature. We searched in PubMed, CINAHL, PsycINFO, Embase, Web of Science Core Collections as well as the reference list of included material in English, German and Polish. Focusing initially on the European region, we later expanded the search outside of Europe.ResultsWe included 7 publications from opinion pieces to an empirical assessment of curricula and training. The educational programs were predominantly short-term and extra-curricular in postgraduate courses addressing both public health professionals in conflict-affected countries as well as countries not directly affected by war. Publications focused on public health action in times of war, without specifying the context and type of war or armed conflict. Competencies taught focused on emergency response and multi-disciplinary collaboration during emergencies, frequently drawing on experience and examples from natural disaster and disease outbreak management.ConclusionsThe scientific discourse on competences in public health education for times of war and for the promotion of peace, predominately focuses on immediate emergency response actions. The prevention of war and the promotion of peace are missing foci, that need to feature more prominently in public health training. Public Health Education and training should ensure that war prevention and peace promotion, as well as public health action in times of war, are included in their competencies for public health professionals.

Improved student outcomes: a unique, culturally relevant, and intensive behavioral health training program

ABSTRACT The behavioral health workforce shortage is pervasive across the United States. To address this need, it is important to establish effective and culturally relevant trainings for behavioral health practitioners. This study examines the results of a Health Resource Service Administration (HRSA) Behavioral Health Workforce Education and Training (BHWET) funded program intended to increase the qualified workforce meeting high need and demand. Over the four-year funding of the program, 119 Masters of Social Work students graduated from the social work program with specialized training. The program was successful providing innovative training focused on interdisciplinary collaboration, evidence-based practices, and culturally responsive services.

Evaluation of the Rural Interprofessional Behavioral Health Scholars Program to Expand Public Health Workforce Capacity During COVID-19

ABSTRACT Mental health and substance use are growing nationwide public health concerns being exacerbated by the COVID-19 pandemic. At the same time, there is a dire shortage in the public health workforce. This paper shares the design and mixed-method outcome evaluation of a Behavioral Health Workforce Education and Training (BHWET)-funded rural, interprofessional, behavioral health training program (RIBHS) delivered during COVID-19 at one southeastern US public university. Twenty-six advanced year MSW students completed the RIBHS program. Data were collected from trainees via pre/post surveys and two focus groups. Trainees’ self-reported statistically significant increases in teamwork, behavioral health, and rural practice competencies. Trainees also described how COVID-19 shaped their experience in the RIBHS program. The RIBHS program prepared trainees with the competencies needed to address the growing behavioral health crisis in the US and can serve as a training model for other social work and related public health workforce initiatives.

History of development of undergraduate public health education in Bulgaria.

The study aims to present a historical review and analysis of the establishment and development of undergraduate public health (PH) education in Bulgaria from 1878 until 2019. А search and selection of historical documents was performed, including laws, rules, regulations, government plans, programmes, scientific publications from periodical medical press, journals, specialized monographs, and books. A retrospective analysis of the normative documents related to the organization of the sanitation and public health activities, and to the provision of professional undergraduate education of the public health workforce in Bulgaria has been carried out. The required competences and tasks of the specialists exercising public health control services were extracted. The development in the public health educational activities were followed in three consecutive periods: the newly independent state (1878-1944); the socialist state (1945-1990); the democratizing state (1990-2019). The development of organized PH activities began after the liberation of Bulgaria in 1878. The historical analysis reveals a direct link between the major socioeconomic changes in the country and the organization of PH undergraduate education which passed through dynamic transformations. The professional education in the sphere of PH started with the training of feldshers, followed by sanitary feldsher and sanitary health inspectors performed in secondary vocational medical schools during the socialist period, reaching the stage of undergraduate university PH education provided by medical colleges associated with universities in the third period. Despite the continuous development in the organization of undergraduate PH education in Bulgaria, its content is still not fully compatible with the basic European PH services and actions. There is a growing need for wider standardization and integration of undergraduate PH education in the EU so that the specialty can reach the status of a regulated health profession similar to medicine, nursing, and others.

The Coalition of National Health Education Organizations: Recent Advances to Strengthen the Health Education Profession.

The Coalition of National Health Education Organizations (CNHEO) has existed since 1972, with a mission of bringing together national and international health education organizations who serve within the United States to seek joint actions in support of the health education profession. Much success and collaboration have occurred over the last 50 years, including developing and implementing the 2018-2025 strategic plan. The nine member organizations of the Coalition paused to review individual and collaborative work in addressing shared goals and objectives around policy and mandates, preparation and professional development, credentialing, identity and value of health education, health education workforce and diversity, and research and practice. Findings of this mid-progress strategic plan review suggest that great value is provided to the profession via the collaborative work of organizations (sharing of advocacy alerts and work, supporting training and certification efforts, etc.), but areas for improvement exist (more joint policy statements, better study and support for the profession, etc.). This article outlines important Coalition history for the profession, describes goal and objective accomplishments related to the CNHEO 2018-2025 strategic plan, and makes suggestions for future improvement designed to affect the health of the public and the health education profession.

Primary Care Supervision: A Community of Practice.

The goal of this project was to determine the feasibility of a Community of Practice (CoP) model to support behavioural health (BH) clinical supervisor professional development. Fourteen supervisors participated in 13 CoP-focused workshops focused on supervision within the Primary Care Behavioural Health (PCBH) model over a 4-year period. These workshops occurred twice a semester (in person and virtually) for supervisors hosting students participating in a Health Resources and Services Administration (HRSA) Behavioural Health Workforce Education Training (BHWET) grant. The program focused on preparing masters-level clinical mental health counselling students to function as Behavioural Health Consultants (BHCs) in primary care settings in rural and urban areas. Supervisors completed post-workshop surveys on their satisfaction with the content and the impact of the workshop content on building their PCBH supervision skills. Supervisors were satisfied with the content presented during the CoP workshops as well as indicated improvements in their confidence with providing supervision within the PCBH model. Areas of improved confidence and competence included supervision in integrated health care settings, topics discussed in primary care, and telehealth visits. Overall, this demonstrates an approach to building supervisor confidence in working with pre-licensure trainees within the PCBH model. CoP workshops show promise as an approach that institutions of higher education and health care organisation can adopt to improve clinical teaching and supervision in primary care as well as support supervisors in the community who work with trainees in primary care.

1.N. Workshop: Improving the wellbeing of the health workforce in Europe: Issues and lessons from Ireland

Abstract Health systems have been subject to a series of crises over the last fifteen years from economic austerity to the COVID-19 pandemic and now the cost of living crisis. At the same time many high-income countries have bolstered their own deficient supply of health workers by importing skilled health professionals from other countries. The health workforce has borne the brunt of each of these shocks and it is no surprise that there is demotivation, burnout and high attrition across staff cadres across Europe. Not enough is known about the root causes of these phenomena and therefore what can be done to effectively enhance workforce wellbeing and engagement and also assist health systems to deal effectively with the legacy of pent up demand from the pandemic which is threatening to overwhelm services. This session seeks to identify and evaluate the different factors that have led to disengagement of staff and assess strategies to improve staff wellbeing, retention and health system recovery, based on quantitative and qualitative research. Three case studies from Ireland distinguish different elements of the problem: 1) an investigation of the dimensions of disengagement and their underlying causes after austerity across staff cadres with particular focus on bullying and discrimination 2) an evaluation of turnover amongst nurses post COVID and the factors which are linked to this, and 3) an examination of racial attitudes and discrimination towards non-Irish health professionals in Irish hospitals. Each study highlights particular factors which have caused disengagement and evaluates their consequences and causes. Together they paint a powerful picture of a health system and its workforce struggling to cope with crisis after crisis, mismanagement and ambitious change programmes. A fourth presentation will compare and contrast this picture with analysis from other high-income countries and examine optimal investment strategies to solve the heath workforce problems. This high-level analysis places the Irish case studies in perspective and allows a more thorough evaluation of key factors and strategies to turn round the situation across Europe. Each presenter will be given a strict deadline of 10 minutes each by the chair and then the audience will be invited to debate the problems identified and strategies proposed to discuss: (i) the appropriate course of action for health systems in Europe at this time, (ii) the conditions under which strategies will achieve the desired results for the health workforce and (iii) how and whether a coordinated approach across Europe would be more effective. Key messages • This session will improve understanding of the causes of burnout, disengagement and high turnover amongst the health workforce in order to address these problems. • Strategies for investing in the education, protection and wellbeing of the European health workforce will be evaluated to assist with our readiness for future shocks.

Years of life lost due to deaths of despair and COVID-19 in the United States in 2020: patterns of excess mortality by gender, race and ethnicity

BackgroundIn 2020 COVID-19 was the third leading cause of death in the United States. Increases in suicides, overdoses, and alcohol related deaths were seen—which make up deaths of despair. How deaths of despair compare to COVID-19 across racial, ethnic, and gender subpopulations is relatively unknown. Preliminary studies showed inequalities in COVID-19 mortality for Black and Hispanic Americans in the pandemic's onset. This study analyzes the racial, ethnic and gender disparities in years of life lost due to COVID-19 and deaths of despair (suicide, overdose, and alcohol deaths) in 2020.MethodsThis cross-sectional study calculated and compared years of life lost (YLL) due to Deaths of Despair and COVID-19 by gender, race, and ethnicity. YLL was calculated using the CDC WONDER database to pull death records based on ICD-10 codes and the Social Security Administration Period Life Table was used to get estimated life expectancy for each subpopulation.ResultsIn 2020, COVID-19 caused 350,831 deaths and 4,405,699 YLL. By contrast, deaths of despair contributed to 178,598 deaths and 6,045,819 YLL. Men had more deaths and YLL than women due to COVID-19 and deaths of despair. Among White Americans and more than one race identification both had greater burden of deaths of despair YLL than COVID-19 YLL. However, for all other racial categories (Native American/Alaskan Native, Asian, Black/African American, Native Hawaiian/Pacific Islander) COVID-19 caused more YLL than deaths of despair. Also, Hispanic or Latino persons had disproportionately higher mortality across all causes: COVID-19 and all deaths of despair causes.ConclusionsThis study found greater deaths of despair mortality burden and differences in burden across gender, race, and ethnicity in 2020. The results indicate the need to bolster behavioral health research, support mental health workforce development and education, increase access to evidence-based substance use treatment, and address systemic inequities and social determinants of deaths of despair and COVID-19.

Implementation strategies to scale up self-administered depot medroxyprogesterone acetate subcutaneous injectable contraception: a scoping review

BackgroundSelf-administered depot medroxyprogesterone acetate subcutaneous injectable contraception (DMPA-SC) is registered in many countries. It shows great potential for improving contraceptive access, continuation, and autonomy. However, there are challenges in rolling out this new efficacious intervention, and major implementation problems have been encountered during scale-up.ObjectiveTo describe the implementation strategies to scale up self-administered DMPA-SC and the barriers, facilitators, and outcomes of these programs.MethodRecent guidelines, including the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews, were used to design and report this review. An article or report was eligible for inclusion if it reported interventions that could scale up self-administered DMPA-SC implementation or its facilitators, barriers, or outcomes. We searched six electronic databases and the grey literature for eligible articles and reports. Two reviewers independently screened the document titles, abstracts, and full texts to identify eligible documents. Data were extracted using structured forms. Using the Effective Practice and Organization of Care (EPOC) taxonomy of health systems framework for thematic analysis, data were presented in a narrative approach.ResultsOf the 755 retrieved documents, 34 were included in this review. Most of the documents included were multi-country reports (n = 14), and all documents were published within the last 5 years (2018–2021). This review identified documents that reported interventions in all EPOC domains. The most-reported interventions were: task-sharing amongst health workforce cadres, engaged leadership, encouraging policies, training and education, DMPA-SC demand generation, integration into existing programs, improved funding mechanisms, collaboration with development partners, and supply chain strengthening. The main barriers were suboptimal funding, inadequate human resources, and poor logistics supply of DMPA-SC. There was minimal evidence of scale-up outcomes.ConclusionThis scoping review reported a wide range of interventions employed by countries and programs to scale up DMPA-SC self-administration but minimal evidence of the scale-up outcomes. Evidence from this review can help design better programs that improves access to quality family planning services to achieve the Sustainable Development Goals (SDG) targets 3.7. However, efforts should focus on rigorous implementation research that assess scaled up self-administered DMPA-SC interventions and report their outcomes.RegistrationThe protocol for this review was registered in the protocols.io repository (https://www.protocols.io/view/a-protocol-for-a-scoping-review-of-implementation-x54v9yemmg3e/v1).

Lessening the Impact of Opioid Misuse at a Federally Qualified Health Center in New York: Outcomes of an Integrated Workforce Training Program.

The COVID-19 pandemic has placed an unprecedented burden on patients, health care providers, and communities and has been particularly challenging for medically underserved populations impacted by the social determinants of health, as well as people with co-occurring mental health and substance use risks. This case study examines outcomes and lessons learned from a multisite low-threshold medication-assisted treatment (MAT) program at a federally qualified health center in partnership with a large suburban public university in New York to integrate and train Health Resources & Services Administration Behavioral Health Workforce Education and Training-funded graduate student trainees in social work and nursing in screening, brief intervention, and referral to treatment and patient care coordination, including social determinants of health and medical and behavioral comorbidities. The MAT program for the treatment of opioid use disorder has a low threshold for entry that is accessible and affordable, reduces barriers to care, and uses a harm reduction approach. Outcome data showed an average 70% retention rate in the MAT program and reductions in substance use. And, while more than 73% of patients reported being somewhat or definitely impacted by the pandemic, most patients endorsed the effectiveness of telemedicine and telebehavioral health, such that 86% indicated the pandemic did not affect the quality of their health care. The main implementation lessons learned were the importance of increasing the capacity of primary care and health care centers to deliver integrated care, using cross-disciplinary practicum experiences to enhance trainee competencies, and addressing the social determinants of health among populations with social vulnerabilities and chronic medical conditions.

Enhancing the nation's public health information infrastructure: a report from the ACMI symposium.

The COVID-19 pandemic exposed multiple weaknesses in the nation's public health system. Therefore, the American College of Medical Informatics selected "Rebuilding the Nation's Public Health Informatics Infrastructure" as the theme for its annual symposium. Experts in biomedical informatics and public health discussed strategies to strengthen the US public health information infrastructure through policy, education, research, and development. This article summarizes policy recommendations for the biomedical informatics community postpandemic. First, the nation must perceive the health data infrastructure to be a matter of national security. The nation must further invest significantly more in its health data infrastructure. Investments should include the education and training of the public health workforce as informaticians in this domain are currently limited. Finally, investments should strengthen and expand health data utilities that increasingly play a critical role in exchanging information across public health and healthcare organizations.

Education of the public health workforce and the Sustainable Development Goals: An analysis of existing competency sets

ObjectivesThis paper describes a project designed to quantify the extent to which existing competency frameworks used for educating the public health workforce contribute to achieving the Sustainable Development Goals (SDGs) directly relevant to public health. Study designThis was a qualitative study involving a content and thematic analysis and mapping of nine available public health competency sets against the World Federation of Public Health Association's Global Charter for the Public's Health and the SDGs. MethodsFirst, the SDG targets directly relevant to public health were selected, then mapped against the elements of the Global Charter to illustrate their alignment with aspects of public health practice. Next, competencies from each respective framework were mapped against the SDG targets, and the results quantified as to the coverage of the SDG targets by each of the frameworks. ResultsOverall, very few competencies directly or fully covered the SDG targets in question, however, there were more competencies partially covering the targets. Except for one framework, many issues found in the SDG targets were not explicitly addressed by the competencies in most of the frameworks, namely, migration, human rights, violence, and food and water scarcity. ConclusionsOverall, urgent action is required to ensure public health competency frameworks are more in line with the SDGs and include public health issues that disproportionally affect low- and middle-income countries.

Let's Not Reinvent the Wheel: Using Communities of Learning and Practice to Address SDOH and Advance Health Equity.

Despite advances in knowledge and science, evidence indicates that health care disparities and inequities continue to exist across diverse populations. Educating and training the next generation of health professionals to focus on addressing social determinants of health (SDOH) and advancing health equity is a key priority. This aim requires educational institutions, communities, and educators to strive for change in health professions education, to attain the goal of creating transformative educational systems that better meet the public health needs of the 21st Century. Communities of practice (CoPs) are groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. The National Collaborative for Education to Address Social Determinants of Health (NCEAS) CoP is focused on integrating SDOH into the formal education of health professionals. The NCEAS CoP is one model to replicate how health professions educators can work together for transformative health workforce education and development. The NCEAS CoP will continue to advance health equity by sharing evidence-based models of education and practice that address SDOH and help build and sustain a culture of health and well-being through sharing models for transformative health professions education. Our work is an example that shows we can build partnerships across communities and professions, thereby freely sharing ideas and curricular innovations that address the systemic inequities that continue to fuel persistent health disparities and inequities, and contribute to moral distress and burnout of our health professionals.

TOWARDS INTEGRATING REHABILITATION INTO HEALTH SYSTEMS THROUGH PROFESSIONAL REGULATION

Strengthening rehabilitation in health systems and integrating rehabilitation across all levels of care depends on a mix of strategies, however all depend on an appropriately trained, resourced and organized workforce. Indeed, among the ten areas for action described in the World Health Organization 2030 initiative is developing a strong multidisciplinary rehabilitation workforce that is suitable for country context, and promoting rehabilitation concepts across all health workforce education. The rehabilitation workforce is constantly evolving as it strives to provide safe practices and treatment choices based on the best available evidence to improve function, promote independence and help people reach their maximum potential. However, barriers to this evolution include a lack of well-resourced training programs, variations in the competencies expected within the standard entry-level curriculum, limited opportunities for continuing professional development, geopolitical instability, competing demands for limited health budgets and persistent de-prioritization of rehabilitation.

Government-supported clinical knowledge and information resource portals are key to ensuring quality, safe health care and evidence-based practice - the Australian context.

ObjectiveThe aim of this study was to describe Australia's government-supported clinical knowledge and information resource portals and their alignment with government policies for digital health within an Australian context, and to clarify the role of hospital libraries in the public health system as an adjunct to state and territory portals.MethodsGovernment-supported clinical resource portals in Australian states and territories were examined and benchmarked. A comprehensive search of Australian state, territory, and federal government websites was conducted for strategies, policies, and projects relating to medical research, digital health, and health workforce education. These documents were screened for reference to clinical knowledge and information resource portals, clinical decision support tools, hospital libraries, or educational resources for the health workforce. Additionally, information was derived from relevant published Australian studies to provide context and additional information about access to evidence in public hospitals.ResultsClinical resource portals are a vital part of evidence-based health care in Australia; however, there are inconsistencies in these portals due to differences in policy, funding, and strategy between Australia's states and territories. Libraries in the healthcare sector play a key role in ensuring centralised clinical knowledge and information resource portals are easily available to clinicians, and in building on the initial portal collection, curate bespoke library collections for their individual organisations.ConclusionThis investigation highlights the importance of government-supported clinical knowledge and information resource portals and the role they play in the provision of safe, quality, evidence-based health care. These portals, in conjunction with hospital library activities, are an integral part of the clinical governance framework.