Health Care Human Resources Research Articles

Surgical site infection and antimicrobial use following caesarean section at QECH in Blantyre, Malawi: a prospective cohort study

BackgroundSurgical site infections (SSIs) are one of the most common healthcare-associated infections and preventable complication of surgical procedure; continue to threaten public health with significant effects on the patients and health care human and financial resources. Therefore, this study aimed to determine the incidence of SSIs, risk factors and common microorganisms associated with SSI and assess the practice of antimicrobial use in women following Caesarean Section (CS) at Queen Elizabeth Central Hospital (QECH).MethodsThis was a hospital-based quantitative prospective study design involving pregnant women who underwent a CS between February, 2023 and July, 2023 at QECH with 30 day-follow-ups. Wound specimens (wound swabs) were collected from all infected CS wounds and processed at QECH main laboratory, and susceptibility testing was conducted using the Kirby-Bauer disk diffusion method with results reported only as susceptible, intermediate, or resistant and the collected data was analyzed using Stata.ResultsThe overall cumulative incidence of SSI recorded at QECH during the study period was 9.61% (20 cases out of 208). Of these, 19 (95%) of them reported superficial SSI following CS. The mean age was 26.1 years with a standard deviation of 6.2. All pregnant women who underwent for CS received antibiotic prophylaxis. This study revealed that 138 (66.35%) patients received both preoperative antibiotics (ceftriaxone) and post-CS antibiotics without knowing the specific bacterial organism isolated. This study revealed that ruptured membrane had twice the incidence of SSIs compared to intact membrane (χ2 = 2.0922), though not statistically significant. The majority of patients with SSIs (n = 12, 60%) were readmitted and 5 (25%) out of 20 with SSIs had antimicrobial resistance following susceptibility testing. Staphylococcus aureus was the most common organism (3, 60%) and other bacterial isolates included were Enterobacteriaceae and Acinetobacter baumanni.ConclusionThe incidence of SSIs and inappropriate antimicrobial use following CS remains a challenge at QECH. Therefore, due to increased number of SSIs following CS with relative emergence of AMR ensure intensive infection prevention and control practices, establishing AMS program and routine surveillance of SSIs at QECH.

The impact of the COVID-19 pandemic on healthcare workers

Purpose This paper aims to examine the impact of the COVID-19 pandemic on healthcare workers’ perception of job pressure as well as their anxiety and depression levels. Design/methodology/approach Survey data were collected from 109 healthcare workers enrolled in two MBA courses in Healthcare Human Resources Management at a university in the Southern USA, respectively, Fall 2020 and Fall 2021. A path analysis was conducted to test a model of the impact of the COVID-19 pandemic on healthcare workers’ perception of job pressure as well as their anxiety and depression levels. Findings The study results showed treatment of COVID-19 patients led to increased work hours for healthcare workers; changes in work hours and work methods were related to healthcare workers’ perception of job pressure; healthcare workers perceptions of job pressure were positively related to their anxiety levels; organizational support was negatively related to healthcare workers’ anxiety levels; and healthcare workers’ anxiety levels were positively related to their depression levels. Originality/value Findings from the tested model provide support for the Job Demands-Resources model in the context of the COVID-19 pandemic.

Evaluating Medical Students' Knowledge, Attitudes, and Practices in Pharmacovigilance: A Cross-Sectional Study

Background: It is an indispensable tool for ensuring patient safety, while its practice raises numerous questions in developing countries, including Bangladesh. This paper aims at determining medical students’ Knowledge, attitude and practice (KAP) of pharmacovigilance to inform ADR reporting. Objective: To evaluate the KAP of pharmacovigilance with second-year students, final-year students, and interns enrolled in a community-oriented medical college in Bangladesh. Methods: A quantitative study design using the cross-sectional survey approach was used together with a self-administered, well-validated structured questionnaire. Second-year, final-year, and intern groups were selected with one hundred participants from each group. Descriptive statistical analysis and chi-square analysis were used in data analysis. Results: A total of 49 percent of the participants were able to correctly define pharmacovigilance; final-year students had the highest knowledge score of 72 percent. A total of 80–85% of the participants endorsed the need to report ADRs, and 75–84% believed that reporting ADRs is a professional responsibility. However, ADR reporting practice varied significantly: In the final-year students, 90% reported having filled out an ADR form, while the corresponding numbers for second-year students and interns were 12% and 34%, respectively. While 70-90% of the participants claimed to have ever been trained on how to report an ADR, only 20-28% of the participants reported to have ever experienced an ADR. Conclusion: Thus, though attitudes toward pharmacovigilance were mostly positive, major knowledge and practical implementation deficits were found, mainly concerning interns. The study underscores the need for enhanced systematic, comprehensive, and clinically focused instruction in pharmacovigilance learning in medical schools. This paper recommends that foresulfide should strengthen the existing knowledge prerequisite, integrate compulsory continuous education programs, advance practical practice, and smoothen the procedure of reporting ADRs to amplify the practices in pharmacovigilance among future healthcare human resources of Bangladesh.

Pioneering approaches: Navigating mind wandering and self-silencing in dissociated adolescent female sexual trauma survivors - An interpretative phenomenological analysis

BackgroundMinimal exploration exists on mind wandering and self-silencing in adolescent girls with sexual trauma and dissociation. ObjectiveTo investigate the lived experiences of female adolescent sexual trauma survivors with dissociation, focusing on overcoming mind-wandering and self-silencing through Pranayama, mindfulness meditation, music, and art therapy. Participants and settingsThis study, conducted in Sikkim, India, addresses a research gap in a culturally distinct context. Three adolescent girls diagnosed with PTSD and dissociation by a psychiatrist were selected through purposive sampling. MethodThis study uses Interpretative Phenomenological Analysis (IPA) to explore participants' individual stories and perspectives. It provides a comprehensive understanding of the lived experiences and narratives of three participants. ResultsThe IPA analysis revealed three super-ordinate themes: coping mechanisms, support and relationships, and, therapeutic approaches and the healing journey. In coping mechanisms participants reported (1) mind-wandering, self-blame, and daydreaming, (2) self-silencing, and (3) sublimation through academic achievement. The support and relationships theme included (1) lack of support from family, (2) attachment issues with mothers, (3) gender-based double standards, (4) Lack of infrastructure and health care human resources, with some participants turning to (5) faith-healing for mental health issues. The therapeutic approaches and healing journey theme demonstrated the effectiveness of Pranayama, mindfulness meditation, music, and art therapy in alleviating mind-wandering and self-silencing. ConclusionsThis study underscores the resilience of survivors of post-sexual trauma, advocating for culturally sensitive healing and evidence-based practices. Addressing mind-wandering and self-silencing through Pranayama, mindfulness meditation, music, and art therapy strengthens support systems, pioneering ways to mitigate the impact of sexual abuse.

Factors associated with the non-retention of health sector employees recruited in Iran: a survival analysis

BackgroundHealth staff are an essential component of the health system and a significant factor in improving health outcomes. As a result, without a suitable number of trained and supported workforces, health-related goals will not be achieved. As a result, one of the most significant tasks of the government and healthcare human resource management in healthcare organizations is focusing on development and maintenance of personnel.MethodThis study was a longitudinal and historical cohort study. Data was collected on the 40 medical universities and healthcare organizations under the jurisdiction of Iran Ministry of Health and Medical Education from 2008 to 2018 from the human resources database. In this study the COX regression and survival analysis was used to assess the factors of staff maintenance, retention rate, and the risk of turnover.Result46,939 health workforces were included in the study, of which 13,328 (28.4%) were men and 33,611 (71.6%) were women. Based on the finding of cox regression model, the retention of staff were statistically different between male and female. Employees whose current work place and birthplace were similar had a significantly higher probability of retention. Accordingly, the cox regression result showed, the risk of employee turnover for single personnel was higher than the married ones.Conclusionan applicable policy for increasing maintenance among workforce recruitment, could be considering the native born professionals instead of non-natives born which reduce the costs of employee turnover, including re-hiring, initial and on-the-job training, housing, and other extra living expenses away from home and family.

Lifelong Learning: Factor of Productive Change in Human Resource Management at a Local Hospital of Greece

Objective: The objective of this study is to investigate the need of human resources in Greek hospitals to acquire new knowledge, with the aim of continuously improving their skills for effective management and productivity. Theoretical Framework: Lifelong education not only increases productivity but also equips healthcare professionals to address societal shifts, profession-specific challenges, and stress-related errors. It underscores the connection between superior healthcare services and continuous learning, highlighting the benefits for teamwork, personal growth, and knowledge enhancement. Method: The methodology adopted for this research includes literature review and research methodology. Data collection was carried out through questionnaires to 170 participants employed in the health care sector. Results and Discussion: The obtained results revealed the need for continuous improvement of health professionals' skills for better management and productivity enhancement. Lifelong learning of health professionals will improve the quality of health services, responding to changing needs. Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how the results can be applied or influence practices in the field of helath care. These implications could encompass the development of a competent, adaptable and responsive healthcare workforce in Greece and optimizing healthcare delivery to patients through the acquisition of expertise. Originality/Value: This study contributes to the literature by relating lifelong learning to the field of health promotion. The relevance and value of this research is demonstrated by the fact that continuous learning will improve health care provision and human resource management, with the aim of better responding to patient needs.

Impacts of the COVID-19 pandemic on HIV care and treatment services among adolescents attending a tertiary hospital in Dar es Salaam, Tanzania: a qualitative study

BackgroundThe COVID-19 pandemic has caused substantial disruption on HIV care and treatment programmes, especially for adolescents living with HIV (ALHIV) who are known to have poorer health outcomes compared with...

Public health infrastructure and human resources in tribal areas of India: a decadal assessment (2012–2022) with Rural Health Statistics data

PurposeThe recommended public healthcare infrastructure and human resources are essential to deliver healthcare services, particularly in tribal areas, as the country’s tribal population depends mainly on the public healthcare system for their medical needs. India has a substantial share of the tribal population, accounting for approximately 9% of the total population. The paper reviews the state of public healthcare infrastructure and human resources in tribal areas for a period that spreads over a decade.Design/methodology/approachThe paper relied on data from the Government of India’s Rural Health Statistics (RHS) reports (2011–2012 and 2021–2022). From these reports, data on the physical infrastructure and human resources in the tribal areas were extracted. The extracted data were compiled and analyzed using Microsoft Excel.FindingsThe analysis showed that the improvement in public healthcare infrastructure and human resource situation in tribal areas of the country was not commensurate with the tribal population growth seen in the last decade. As a result, the average population covered by a health facility was greater than the prescribed norms in the tribal-dominated geographies. The health worker-population ratio at the primary healthcare level was also higher than the national norms. However, there was a substantial improvement in the doctor-population ratio at the primary health center level. In comparison to tribal-lean states, tribal-dominated states faced the concurrent challenge of a growing population and strained healthcare facilities and human resources. As a result, the healthcare infrastructure and human resource gap continued in the tribal-dominated states of the country. The gaps in health infrastructure and human resources in tribal-dominated states must be addressed as a priority under the health infrastructure strengthening efforts to ensure that the tribal population receives and has access to quality health care from publicly funded health facilities, leading to improved health outcomes in the tribal population and the achievement of the sustainable development goals (SDGs).Originality/valueWe have not come across any paper that has carried out pancountry analysis of healthcare infrastructure and human resources in tribal areas.

The favourable alliance between CardioMEMS and levosimendan in patients with advanced heart failure.

We report the results of a real-world study based on heart failure (HF) patients' continuous remote monitoring strategy using the CardioMEMS system to assess the impact of this device on healthcare outcomes, costs, and patients' management and quality of life. We enrolled seven patients (69.00±4.88years; 71.43% men) with HF, implanted with CardioMEMS, and daily remote monitored to optimize both tailored adjustments of home therapy and/or hospital infusions of levosimendan. We recorded clinical, pharmacological, biochemical, and echocardiographic parameters and data on hospitalizations, emergency room access, visits, and costs. Following the implantation of CardioMEMS, we observed a 50% reduction in the total number of hospitalizations and a 68.7% reduction in the number of days in the hospital. Accordingly, improved patient quality of life was recorded with EQ-5D (pre 58.57±10.29 vs. 1year post 84.29±19.02, P=0.008). Echocardiographic data show a statistically significant improvement in both systolic pulmonary artery pressure (47.86±8.67 vs. 35.14±9.34, P=0.022) and E/e' (19.33±5.04 vs. 12.58±3.53, P=0.023). The Quantikine® HS High-Sensitivity Kit determined elevated interleukin-6 values at enrolment in all patients, with a statistically significant reduction after 6months (P=0.0211). From an economic point of view, the net savings, including the cost of CardioMEMS, were on average €1580 per patient during the entire period of observation, while the analysis performed 12months after the implant vs. 12months before showed a net saving of €860 per patient. The ad hoc analysis performed on the levosimendan infusions resulted in 315days of hospital avoidance and a saving of €205158 for the seven patients enrolled during the observation period. This innovative strategy prevents unplanned access to the hospital and contributes to the efficient use of healthcare facilities, human resources, and costs.

Physician Workforce in Lithuania: Changes during Thirty Years of Independence.

Healthcare human resource planning is one of the biggest challenges facing the healthcare systems in many countries. Inadequate decisions in human resource planning can lead to an insufficient number of healthcare professionals then healthcare inequalities. One of the components of resource planning in the healthcare system is long-term data monitoring and the identification of potential trends. Since 1990, the number of physicians in Lithuania has decreased by 15.3% (-2266), but the decrease in the population has led to a 13.61% increase in the number of physicians per 10,000 inhabitants (5.32). During the analyzed period, the largest decrease in the number of physicians workforce by specialty was the number of medical physicians (-73.08%), epidemiology and hygiene (-69.30%), children's diseases (-49.08%), the most increased number was of family/general practitioners (GPs), geneticists, physical medicine, and rehabilitation specialists. Since 1992, the number of visits to physicians in Lithuania, which has been decreasing for a long time, began increasing, and in 2022 (9.3 visits) it has almost reached the number of visits (9.5) per capita as in 1991. The aim of this research was to collect long-term data from various databases, summarize them, and identify possible trends and the reasons for data changes. The study analyzed data from the Lithuanian healthcare system from the Declaration of Independence of Lithuania to the last 30 years. The data includes or affects the indicators of the healthcare system, changes in population and doctors, the number of visits to doctors, the number of medical students and residents, and data determining inequalities in the healthcare system. Long-term data analysis is useful for developing a model of healthcare human resource planning and for planning healthcare resources.

Toward Equity in Access to Midwifery in Saskatchewan: Key Informants’ Perspectives

In this article, we report on the second phase of our exploratory research into issues related to equity in access to midwifery in Saskatchewan. This phase of the research project aimed to explore equity in access to midwifery as understood and experienced by key stakeholders involved in the early stages of midwifery implementation in Saskatchewan. A total of 19 interviews were conducted with participants from Saskatchewan Health, the Midwifery Transitional Council, and Saskatoon’s Regional Midwifery Operations Committee, as well as practitioners, primary health care managers, directors from select regional health authorities, and Saskatchewan midwives. Additionally, all available midwifery policy documents and relevant Primary Health Care and Health Human Resource documents complemented the qualitative analysis. Initial thematic analysis led to five policy recommendations: (1) develop a provincial definition of “priority population” for midwifery clients, (2) establish a midwifery health human resource plan, (3) identify provincial midwifery research priorities, (4) facilitate growth in interprofessional relationships, and (5) develop a provincial “road map” for implementation. A secondary analysis of participants’ responses revealed concern over the poor public education about midwifery services and lack of provincial government prioritization, as well as varied perceptions of the concept of “equity.” We conclude that although general commitments to equity in midwifery service and access are enshrined in Saskatchewan’s health care policies and midwifery regulations, insider perspectives suggest that significant yet modifiable barriers to equity in access to care currently exist. This article has been peer reviewed

Trends in the mobility of primary healthcare human resources in underdeveloped regions of western China from 2000 to 2021: Evidence from Nanning

ObjectiveThis research aimed to identify the fundamental and geographic characteristics of the primary healthcare personnel mobility in Nanning from 2000 to 2021 and clarify the determinants that affect their transition to non-primary healthcare institutions.MethodsThrough utilizing the Primary Healthcare Personnel Database (PHPD) for 2000–2021, the study conducts descriptive statistical analysis on demographic, economic, and professional aspects of healthcare personnel mobility across healthcare reform phases. Geographic Information Systems (QGIS) were used to map mobility patterns, and R software was employed to calculate spatial autocorrelation (Moran’s I). Logistic regression identified factors that influenced the transition to non-primary institutions.ResultsPrimary healthcare personnel mobility is divided into four phases: initial (2000–2008), turning point (2009–2011), rapid development (2012–2020), and decline (2021). The rapid development stage saw increased mobility with no spatial clustering in inflow and outflow. From 2016 to 2020, primary healthcare worker mobility reached its peak, in which the most significant movement occurred between township health centers and other institutions. Aside from their transition to primary medical institutions, the primary movement of grassroots health personnel predominantly directs towards secondary general hospitals, tertiary general hospitals, and secondary specialized hospitals. Since 2012, the number and mobility distance of primary healthcare workers have become noticeably larger and remained at a higher level from 2016 to 2020. The main migration of primary healthcare personnel occurred in their districts (counties). Key transition factors include gender, education, ethnicity, professional category, general practice registration, and administrative division.ConclusionsThis study provides evidence of the features of primary healthcare personnel mobility in the less developed western regions of China, in which Nanning was taken as a case study. It uncovers the factors that impact the flow of primary healthcare personnel to non-primary healthcare institutions. These findings are helpful to policy refinement and support the retention of primary healthcare workers.

Spatial distribution of pediatric cancer patients using Geographic Information System (GIS) across the Philippines

Background: Every year, many children around the world get cancer, and this is a severe health problem. The Philippines is one such country where childhood cancer is a leading cause of death. This study uses unique maps (Geographic Information Systems or GIS) to examine these young cancer patients' locations. By doing this, we hope to find areas with more cases and see if children in those areas have easy access to the medical care they need. Methods: Methods involved primary and secondary data collection, including surveys and hospital records, with geospatial data analyzed using QGIS 3.4 Madeira. The study focuses on four Department of Health (DOH) tertiary hospitals: Philippine Children Medical Center (PCMC), Bicol Regional Training and Training Hospital (BRTTH), Southern Philippines Medical Center (SPMC), and Vicente Sotto Memorial Medical Center (VMMC) Participants from significant regions contributed to the study. Results: Results indicate that cancer centers, notably the primary children’s hospital, cater to patients from far-reaching areas, causing them to consult distant hospitals despite accessible alternatives. Nearly all (around 92.5%) patients seek care at specialized hospitals, even though only a small proportion (roughly 12.3%) live close to such facilities. Instead, 37.3% reported the closest health facility (within 10 kilometers) is a secondary government hospital, increasing the burden on patients with additional travel and non-medical costs. Conclusions: The study concludes that pediatric cancer patients face challenges accessing healthcare facilities, necessitating alternative methods like telemedicine and mobile clinics. The findings underscore the need for improved healthcare infrastructure and human resources to address the burdens faced by these patients.

Challenges and Strategies in Implementing Hospital Accreditation Standards Among Healthcare Professionals in Healthcare Systems in Yemen: A Phenomenological Study.

The implementation of hospital accreditation standards in healthcare systems in Yemen that ensure safe and high-quality healthcare services is hampered by specific challenges. Therefore, this study was purposed to explore the challenges and strategies for applying hospital accreditation standards among healthcare professionals in Yemen. A qualitative, phenomenological design was adopted to conduct this study. Semi-structured interviews were used to collect data during the period from January 1, 2022, to February 28, 2022. Based on the content analysis, the study outcomes and lack of (i) funding, (ii) competent human resources, (iii) optimal infrastructure, and (iv) equipment and supplies deter the implementation of hospital accreditation standards. Also, this study highlighted the cultural and social barriers limiting the effectiveness of hospital accreditation standards, the need for increased investment in healthcare infrastructure and human resources, and cultural sensitivity training for healthcare professionals to enhance the implementation of and compliance with hospital accreditation standards. Policymakers should engage global corporations and development partners for technical assistance and capacity building that support the local application of hospital accreditation standards.

A Model Proposal for Developing a Solution and Determining the Administrative Problems of Hospitals in Turkey: The BUY Model.

Background and Purpose: This study was conducted in line with the request of the senior management of a hospital. The objective of the current research is to identify managerial problems through the relationship between health employees' perceptions of organizational justice, trust in the manager and the organization, and job satisfaction; develop a solution proposal over the relationships between these variables and motivation variables; and present a model proposal (BUY Model) as a result. Methods: The study sample is comprised of 673 employees. The study data were collected online using a questionnaire consisting of five scales. The data were analyzed by descriptive statistical methods, correlation analysis, and regression analysis. Results: The findings obtained from the study showed that the participants' perceptions of organizational justice, trust in the manager and the organization, job satisfaction and motivation were generally at a moderate level. The study also determined that trust in the manager and the organization had a partial mediation effect on the effect of organizational justice on job satisfaction and the variables of trust in the organization, organizational justice, and trust in the manager, respectively, and especially, the job satisfaction variable also affected motivation. Conclusion: The BUY model was developed to identify problems related to the management of healthcare human resources and solve these problems. Considering the importance of the concepts of job satisfaction and motivation in terms of employee performance, health service quality, and patient satisfaction, it is thought that the developed model will benefit managers of health institutions in increasing the job satisfaction and motivation levels of health employees.

Human Resources in Health Care – Governance, Operation, Handling, and Oversight

Abstract In this article, the topic of human resource management (HRM) is examined as a technique to raise employee output, which, in turn, increases patient pleasure and contentment with the services that are delivered. Care that is not only risk-free but also timely, patient-centered, cost-effective, and delivered in an equitable manner should be the major priority of any health-care system. Training, motivation, and retention of employees should be prioritized as part of HRM, along with the introduction of novel strategies and the rigorous, data-driven planning of how those resources will be utilized. In the modern health-care system, many employees have not received adequate training or have not yet achieved the needed level of mastery in the competencies they are expected to possess. It has become increasingly clear that to deliver high-quality medical services, it is necessary to provide patients with care that is individualized to meet their specific requirements. To stay up with the rapid changes taking place in the health-care industry, the field of human resources development needs to modernize its procedures. In addition, the management of human resources requires keeping an eye on how the rules and regulations governing the health-care system impact staff members. To provide high-quality medical care, it is essential to perform a gap analysis, incorporate appropriate available skills to close the gap, diversify the work among the available team, and use quality improvement methodologies to create an interdisciplinary group for better patient-centered health care.

Towards green governance and real economy development: how digital technology affects health human resource allocation?

ABSTRACT The adoption and integration of digital technology have profoundly reshaped societal and environmental governance within the healthcare sector. This study aims to explore the influence of digital technology development on the allocation of healthcare human resources, intending to contribute to the net-zero carbon process. Utilizing panel data from 30 provinces and cities across mainland China during the period 2011 to 2020, we computed three unique indices for health resource density. Employing the spatial Durbin model, our analysis unveiled a gradual augmentation in the overall level of healthcare human resource allocation in China due to the spatial impact of digital technology development. Robustness tests substantiated a noteworthy positive spatial spillover effect of digital technology, contributing to the augmentation of healthcare human resource allocation at the regional level. Heterogeneity results revealed a notably more pronounced promotional effect in the eastern region, contrasting with the central and western regions. From the perspective of sustainable development, the development of digital technology can contribute to the advancement of environmentally friendly healthcare by optimizing the allocation of healthcare human resources. In conclusion, this study offers valuable insights for China to formulate effective policies for healthcare human resource allocation, contributing to the attainment of sustainable development goals.

2024 Watch List: Top 10 Technologies and Issues Related to Caring for Children and Youth With Medical Complexity

What Is the 2024 Watch List?
 
 The Watch List annual Horizon Scan report presents emerging technologies and issues that have the potential to shape the future of health care in Canada.
 CADTH’s 2024 Watch List focuses on care for children and youth with medical complexity. This top 10 has been divided in 2 parts — the top 5 technologies and top 5 issues related to children and youth with medical complexity that have the potential to make a significant and meaningful impact in transforming health systems in Canada over the next 5 years. These technologies and issues could shape the future of health care for not only children and youth with medical complexity, but also for others with chronic health conditions.
 
 Why Is This an Issue?
 
 Children and youth (people aged 24 years and younger) with medical complexity are a diverse group with a range of needs (e.g., single or multiple conditions, rare diseases). Although there is no single definition, common characteristics include significant functional limitations often causing the child or youth to be reliant on technology; high health care utilization, often requiring specialized care and services from different providers in multiple settings; and high health care service needs, such as care provision in the home and care coordination, which can have significant social and financial impacts on caregivers and the family.
 Children and youth with medical complexity account for less than 1% of all children and youth in Canada, but they account for 37% of hospital stays and 17% of emergency department visits. Due in part to the high number of health care interactions, this group experiences the effects of challenges within the health care system more acutely than their less medically complex peers.
 
 What Is the Potential Impact?
 
 The Watch List highlights areas for innovation, systems change, and investment.
 Advances in medical care have resulted in more children living with conditions that previously would not have been survivable in infancy and childhood. Now there are more children and youth with medical complexity, and they are living longer. Our current health systems were not designed to meet the complex needs of this group of people and their caregivers, including that many of them face challenges in accessing needed care. This year’s Watch List spotlights new and emerging technologies and key issues that could have a major impact on how patient care is provided to children and youth with medical complexity.
 
 What Else Do We Need to Know?
 
 In the 2024 Watch List, we identify and describe the top 5 new and emerging technologies that could shape the future of health care for children and youth with medical complexity in Canada, including new models of care and technologies and systems to improve communication. We also explore some considerations for health care decision-makers about the potential impact of these technologies on care pathways, health care human resources, health care infrastructure, and health equity.
 The 2024 Watch List also identifies the top 5 issues that limit health systems from providing optimal quality of care for children and youth with medical complexity. Key issues such as the need for increased interoperability between health systems and the need for strategies to improve sustainability warrant more attention and will influence the wider adoption, diffusion, and implementation of new and emerging technologies for children and youth with medical complexity.
 Monitoring ongoing developments and evidence related to the top technologies and issues highlighted in the 2024 Watch List can help guide health system planning in Canada and improve access to high-quality care.

The impact of psychological capital on nurses’ job performance: a chain mediation analysis of problem-focused coping and job engagement

BackgroundPrevious studies have explored the relationships of psychological capital with employees’ job performance in the health sector. However, the possible indirect pathways, including a serial mediation of problem-focus coping and job engagement, have not been extensively examined. This article explores how psychological capital influences nurses’ coping strategies focused on problem-solving, their level of engagement with their jobs, and how this, in turn, affects their job performance.MethodsThe study involved 575 nurses from Cameroon’s public health sector. It investigated how psychological capital, an intrinsic resource, triggers nurses’ problem-focus coping liaison with job engagement to impact job performance. Analysis was conducted to assess the relationships among psychological capital, problem-focus coping, job engagement, and job performance with the use of SmartPLS 4.0 and PROCESS 4.2.ResultsFindings revealed a significant effect of psychological capital on problem-focus coping, job engagement and job performance. Moreover, notable relationships were identified between psychological capital, problem-focus coping, job engagement, and performance, highlighting a chain mediation effect.ConclusionThe research advocates for hospital managers to employ strategies fostering employees’ psychological capital to better cope with organizational stressors to promote job engagement and enhance job performance. The study contributes fresh insights into healthcare organizational dynamics and human resource management, providing a foundation for future advancements in this field.

Unsupervised mobility and motion assessment in neuromuscular and musculoskeletal disorders using mobile health technology.

Mobility deficits are not uncommon in persons with neuromuscular and musculoskeletal disorders. This can have a negative impact in terms of morbidity, mortality, quality of life and activities of daily living (1). Conventionally, mobility and physical activity have been measured in a clinical and laboratory setting by a qualified health professional and is thus called supervised assessment (1). It is either a qualitative or quantitative one- time snapshot evaluation of physical activity, mobility or motion and is highly influenced by factors such as the Hawthorne effect, the time of day when the measurement was taken, white coat and reverse white coat effect (1). Moreover, supervised mobility assessment may have many limitations such as limited ecological validity, lack of patient-centered focus, inability to record real-world challenges, absence of real-time feedback, lack of ability to consider patient's environment, and an omission in observing the range of performance across the day or week (1). To tackle the above mentioned limitations, recently unsupervised mobility assessment of mobility and physical activity using mobile health technology has emerged as an alternative to conventional supervised assessment (1-3). Significant differences may be observed when comparing identical mobility outcomes measured under supervised and unsupervised conditions (1, 3). A systematic review revealed significant variations of 40-180% in identical mobility measures acquired from the same participants across different settings (1). The disparities between supervised and unsupervised measurements are notably greater than the effects observed in treatment interventions. Minor to moderate treatment effects may be overshadowed by these substantial differences in measurement modes (1). Unsupervised assessment holds the potential to address the limitations of supervised assessment as it is patient-centered, ecologically valid, capable of recording fluctuating and rare events, unaffected by the white coat and Hawthorne effects, provides real-time treatment feedback, records real-world challenges, is influenced by a person's mood and fatigue, considers the environment, and reports performance across the day or week (1). Moreover, unsupervised assessment does not require the presence of a trained professional, or the patient to report to a clinic or hospital, and thus can be of great value in rural environments and in tele-medicine/rehabilitation. Not only would this be cost effective, it will also decrease the load on the health care system and the need for health care human resource. ---Continue