Healthcare Professional Workforce Research Articles

Activities of the oral health teams in primary health care: a time-motion study

BackgroundEfficient planning of the oral health workforce in Primary Health Care (PHC) is paramount to ensure equitable community access to services. This requires a meticulous examination of the population’s needs, strategic distribution of oral health professionals, and effective human resource management. In this context, the average time spent on care to meet the needs of users/families/communities is the central variable in healthcare professional workforce planning methods. However, many time measures are solely based on professional judgment or experience.ObjectiveCalculate the average time parameters for the activities carried out by the oral health team in primary health care.MethodThis is a descriptive observational study using the time-motion method carried out in five Primary Health Care Units in the city of São Paulo, SP, Brazil. Direct and continuous observation of oral health team members occurred for 40 h spread over five days of a typical work week.ResultsA total of 696.05 h of observation were conducted with 12 Dentists, three Oral Health Assistants, and five Oral Health Technicians. The Dentists’ main activity was consultation with an average duration of 24.39 min, which took up 42.36% of their working time, followed by documentation with 12.15%. Oral Health Assistants spent 31.57% of their time on infection control, while Oral Health Technicians spent 22.37% on documentation.ConclusionThe study establishes time standards for the activities performed by the dental care team and provides support for the application of workforce planning methods that allow for review and optimization of the work process and public policies.

Perception and Recognition of Clinical Medical Physicist Roles and Responsibilities by Specialist Physician Staff: The First Mexican Survey.

Although medical physics as a profession is recognized as part of the health-care professional workforce by the International Labor Organization, in the Mexican context, the figure of the medical physicist (MP) is often inappropriately associated solely with technical work, leading to perception, recognition, and salary implications. The aim of this study was to explore the perception of medical specialists regarding the role and responsibilities of MPs in clinical practice in Mexico. A national survey was answered by medical personnel, ranging from residents to qualified specialists in November 2019. The questionnaire consisted of ten questions related to perception of MPs. The survey was open to all medical specialists regardless of their involvement in the use of ionizing radiations or otherwise. It was shown that approximately two-thirds of specialists know and recognize the medical physics profession in hospitals and the roles and responsibilities of MPs. However, 19% of medical specialists considered the standard of service as inadequate. MPs must exert greater efforts to promote their status and enhance the recognition of their contribution to health care. The low level of recognition in diagnostic and interventional radiology and in nuclear medicine in Mexico might be related to nonexistent or unclear documentation and inadequate regulations, policies, or directives promoted by the health-care authorities.

Pharmacovigilance in Multiple Myeloma Care in Sub-Saharan Africa: A Review of Immunomodulatory Anti-myeloma Guidelines Using Kenyan AMPATH Framework

Background: Pharmacovigilance is a science that deals on the impact of therapeutic interventions (i.e., benefits and adverse effects) on the target body. In multiple myeloma treatment, it deals with the impact of anti-myeloma drugs on target patients through their risk assessment and risk management. This framework ensures safety and surveillance of anti-myeloma drugs administered to prospective multiple myeloma patients. Pharmacovigilance of anti-myeloma therapy is rarely instituted in the health institutions in sub-Saharan Africa due to late diagnosis and poor palliative care system in the region. The hallmarks are increased disability adjusted life-years, reduced quality adjusted life-years and average survival interval of people living with multiple myeloma in the region.
 Aim: This study highlighted the safety measures undertaken by the healthcare professionals and multiple myeloma patients who are on immunomodulatory (Thalidomide and Lenalidomide) anti myeloma drugs to prevent or minimize adverse drug reactions.
 Methodology: This study was a review of the guidelines for Pharmacovigilance using Kenyan AMPATH anti-myeloma pharmacovigilance brochures and other research database as literature sources. The paper was analysed and grouped according to the following categories namely the adverse drug reactions encountered with the use of anti-myeloma drugs and pharmacovigilance risk management programme (RMP) for immunomodulatory drugs (thalidomide and lenalidomide).
 Results: The three major identified safety tools for effective pharmacovigilance of the anti-myeloma patient population were the healthcare professional workforce, safety guidelines brochures and safety forms for registration and documentation of impact of therapeutic interventions. The healthcare professionals are key players in the formulation of pharmacovigilance risk management protocols. The risk management starts with education of the healthcare providers and myeloma patients using guidelines brochures designated for the respective groups. The prescriber registration-, pharmacy registration-, treatment initiation-, prescription authentication-, and adverse drug reaction forms are the essential safety working documents that are needed to be completed by the patient and healthcare professionals for effective monitoring and evaluation. Both the healthcare provider and the myeloma patient are expected to adhere strictly to the safety measures enshrined in the pharmacovigilance guideline brochures. The patient’s anti-myeloma safety measures are stratified into female of child bearing age, women above the child-bearing age and the male sub-population.
 Conclusion: In setting up a comprehensive multiple myeloma care centre, an effective pharmacovigilance program is paramount. This requires healthcare professional workforce, safety guidelines brochures and safety forms for registration and documentation of impact of therapeutic interventions. Policy formulation, sustainable drug availability and collaboration with support groups are vital tools to drive this operative framework in underserved settings of sub-Saharan Africa.

Need for a competency-based approach for the Public Health Workforce training: the ISS proposal

Abstract Issue The COVID-19 pandemic acted as a catalyst for a reconsidering health care professional workforce (HCPW) competency needed to face future public health challenges, in line with the recent WHO “Global Competency and Outcomes Framework for UHC” document. In this context, in the Italian G20 Presidency framework, the Italian National Institute of Health (ISS), launched a program named “Laboratorium” - recognised in the G20 Declarations of Ministers of Health and Leaders - aimed to the development of training tools suitable for distance learning in whatever context they are placed. Description of the problem Common competencies and needs of the HCPW have to be fulfilled through cross-sectional and multilevel training, to overcome the current emergency and be able to face future challenges. The aim is to provide a modular educational approach that is finalized to actively involve the participant: health professionals step in their training pathway according to their knowledge gaps, identify their specific learning objectives and, through a problem-based learning approach, acquire the proper skills for their function and tasks. Results We propose a two-tiered approach to training: the development of competence based courses oriented to active learning. A pilot course on Epidemic Intelligence design according to this model is ready to be released. At the same time, a repository of everything available on the web systematically selected from authorised sources by a scientific committee was created to support the training objective. It is characterised by a detailed multilevel tagging that allows an effective modularisation to reach only the content useful for its user. Lessons Accessibility to health-related training materials is a required necessity at every level of HCPW. Profiles within healthcare are increasingly heterogeneous and there is a need to focus on disseminating tools that can provide knowledge to address different healthcare scenarios and common purposes. Key messages • Future public health challenges underline a need for a competencies-based learning approach in Healthcare Workforce training. • Italian National Institute of Health propose two methods within the ‘Laboratorium’ project to enable this type of learning: specifically designed courses and a structured document repository.

Advantages and Challenges in Using Telehealth for Home-Based Palliative Care: Protocol for a Systematic Mixed Studies Review.

BackgroundGiven the increasing number of people in need of palliative care services and the current health care professional workforce strain, providing equitable, quality palliative care has become a challenge. Telehealth could be an innovative approach to palliative care delivery, enabling patients to spend more time or even remain at home, if they wish, throughout the illness trajectory. However, no previous systematic mixed studies reviews have synthesized evidence on patients’ experiences of the advantages and challenges of telehealth for home-based palliative care.ObjectiveThe aim of this systematic mixed studies review is to critically appraise and synthesize findings from studies that investigated patients’ use of telehealth in home-based palliative care with a focus on the advantages and challenges experienced by the patients.MethodsThis article describes the protocol for a systematic mixed studies review with a convergent design. The reporting will be guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A systematic search was performed in eight databases for studies published from January 2010 to June 2020. The search will be updated in 2021. Pairs of authors will independently assess eligibility, extract data, and assess methodological quality. The data will then be analyzed using thematic synthesis.ResultsWe describe the rationale and design of a systematic mixed studies review. The database searches were performed on June 25, 2020. Assessment of eligibility and further steps have not yet been performed. Results are anticipated by August 2021.ConclusionsFollowing the ethos of patient-centered palliative care, this systematic mixed studies review could lead to recommendations for practice and policy, enabling the development and implementation of telehealth applications and services that align with patients’ preferences and needs at home.International Registered Report Identifier (IRRID)PRR1-10.2196/22626

Can webinars support the implementation of video consultations at pace and scale within the allied health professions?

Background/aims In an attempt to reduce the impact of COVID-19 and support remote working, many allied healthcare professionals were equipped with video consultation technology. To support this new way of working, profession-specific webinars were delivered and attended by over 50% of the total allied healthcare professional workforce in Scotland. This study aimed to evaluate the impact of these webinars on the knowledge and confidence of allied health professionals in delivering services via video conferencing. Methods Attendees knowledge and current video conferencing use were ascertained immediately before and after webinars. Surveys were also completed at 4 and 8 weeks after the webinar to establish any impact on clinical practice. Results Levels of understanding, knowledge and confidence increased considerably (P<0.001). Follow up at 8 weeks post webinar identified that 75.5% of attendees were using video conferencing, with allied healthcare professional video conferencing activity representing 17% of all national activity by June 2020. Conclusions Upskilling a diverse and dispersed workforce at pace and scale to enable safe remote working has been critical throughout the pandemic. Webinars have proven to be popular with staff to increase their knowledge of and ability to confidently use video conferencing to provide allied healthcare professional services across Scotland.

APA Calls for Opioid Settlements to Fund Workforce Training, Treatment

Back to table of contents Previous article Next article ProfessionalFull AccessAPA Calls for Opioid Settlements to Fund Workforce Training, TreatmentMark MoranMark MoranSearch for more papers by this authorPublished Online:24 Jun 2020https://doi.org/10.1176/appi.pn.2020.7a30AbstractA 29-page white paper describes existing evidence-based practices that can be expanded to improve treatment of pain and addiction and emphasizes the need for more rigorous enforcement of parity laws.Some funds from the class action suits filed against opioid manufacturers should be used to expand the number of health professionals who are trained to treat patients with substance use disorders (SUDs), disseminate evidence-based treatments, and enforce parity laws, according to APA and six other mental health and addiction specialty groups.APA and its partners made their request in a letter to the attorneys representing the classes of patients represented in lawsuits filed against pharmaceutical companies for the manufacture and promotion of opioids that resulted in widespread addiction and overdose. The letter was also copied to Judge Dan Aaron Polster of the Northern District of Ohio, who is presiding over the class action suits.The letter was accompanied by a 29-page white paper outlining the scope of the opioid epidemic and an analysis of what is necessary to meet the demand for treatment.“While opioid addiction is complex, it is treatable and preventable,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., and leaders of the other groups wrote, “but not with current limitations on the workforce trained in the treatment of substance use disorders, limited access to quality care, and discriminatory insurance coverage for mental health and substance use disorders. Should there be a settlement of the legal cases, we respectfully request that funds be used to expand the workforce qualified to prevent and treat substance use and mental health disorders; disseminate trainings and education regarding evidence-based treatments to increase adoption of clinical best practices; and enforce mental health and addiction parity and consumer protection statutes in states.”Also signing the letter were Kevin A. Sevarino, M.D., Ph.D., president of the American Academy of Addiction Psychiatry; Gabrielle A. Carlson, M.D., president of the American Academy of Child and Adolescent Psychiatry; Martha J. Wunsch, M.D., president of the American College of Academic Addiction Medicine; Paul Earley, M.D., president of the American Society of Addiction Medicine; Paula J. Lum, M.D., M.P.H., president of the Association for Multidisciplinary Education and Research in Substance Use and Addiction; and Kathleen T. Brady, M.D., Ph.D., president of the International Society of Addiction Medicine.In addition to boosting the workforce and disseminating best practices, the 29-page white paper emphasized the need for more rigorous enforcement of parity laws. “State insurance commissions and attorneys general have significant workloads of which parity and consumer health fraud are but a small part. These agencies need additional resources to aggressively and proactively ensure compliance with existing federal and state laws in order to guarantee that discrimination against those with mental health and SUDs and misrepresentations about insurance coverage do not preclude access to evidence-based care.”The paper concluded: “There is no silver bullet that will cure those with addiction and co-occurring mental illness or that will cure or prevent another crisis. However, the funding generated from this litigation could be used to make substantial progress toward controlling the OUD epidemic and ensuring that it or similar substance use consequences do not recur in the future. … What the litigants can do immediately is use some of the funds that will come out of this litigation to ensure that there is an adequately trained health care professional workforce to continue the research into prevention and treatment of addiction, to treat patients using clinical best practices, and to guarantee that persons with addiction and/or mental illness have access to nondiscriminatory health insurance to afford their treatment.” ■A copy of “Addressing Access to Care in the Opioid Epidemic and Preventing a Future Recurrence” may be obtained by contacting Ashley Witmer at [email protected]. ISSUES NewArchived

Diversity and Cultural Competency in Oral and Maxillofacial Surgery.

Health disparities in the United States have been well documented over the past several decades and continue to affect the American population. As the world becomes more diverse, it is imperative that the health care professional workforce is trained to care for the diversifying patient population, striving to improve health disparities in the United States and worldwide. Improving the diversity within the health care professional workforce likely will aid in emphasizing the importance of cultural competency of health care professionals, with the development of programs aimed at cultural competency training and assessment.

Mobility for Healthcare Professional Workforce Continues to Soar

Mobility for Healthcare Professional Workforce Continues to Soar

A Conceptual Analytics Model for an Outcome-Driven Quality Management Framework as Part of Professional Healthcare Education.

BackgroundPreparing the future health care professional workforce in a changing world is a significant undertaking. Educators and other decision makers look to evidence-based knowledge to improve quality of education. Analytics, the use of data to generate insights and support decisions, have been applied successfully across numerous application domains. Health care professional education is one area where great potential is yet to be realized. Previous research of Academic and Learning analytics has mainly focused on technical issues. The focus of this study relates to its practical implementation in the setting of health care education.ObjectiveThe aim of this study is to create a conceptual model for a deeper understanding of the synthesizing process, and transforming data into information to support educators’ decision making.MethodsA deductive case study approach was applied to develop the conceptual model.ResultsThe analytics loop works both in theory and in practice. The conceptual model encompasses the underlying data, the quality indicators, and decision support for educators.ConclusionsThe model illustrates how a theory can be applied to a traditional data-driven analytics approach, and alongside the context- or need-driven analytics approach.

Will the NP Workforce Grow in the Future?

The nurse practitioner (NP) workforce has been a focus of considerable policy interest recently, particularly as the Patient Protection and Affordable Care Act may place additional demands on the healthcare professional workforce. The NP workforce has been growing rapidly in recent years, but fluctuation in enrollments in the past decades has resulted in a wide range of forecasts. To forecast the future NP workforce using a novel method that has been applied to the registered nurse and physician workforces and is robust to fluctuating enrollment trends. An age-cohort regression-based model was applied to the current and historical workforce, which was then forecasted to future years assuming stable age effects and a continuation of recent cohort trends. A total of 6798 NPs who were identified as having completed NP training in the National Sample Survey of Registered Nurses between 1992 and 2008. The future workforce is projected to grow to 244,000 in 2025, an increase of 94% from 128,000 in 2008. If NPs are defined more restrictively as those who self-identify their position title as "NP," supply is projected to grow from 86,000 to 198,000 (130%) over this period. The large projected increase in NP supply is higher and more grounded than other forecasts and has several implications: NPs will likely fulfill a substantial amount of future demand for care. Furthermore, as the ratio of NPs to Nurse Practitioners to physicians will surely grow, there could be implications for quality of care and for the configuration of future care delivery systems.

Racial Diversity in American Oral and Maxillofacial Surgery

Health care disparity in the United States is a significant problem. Part of the solution is to improve the diversity of health care providers. The purpose of this study is to review the racial demographic of American oral and maxillofacial surgery as it compares with the racial demographic of the United States. Additionally, the racial demographic of the American dental and medical professions are reviewed. Databases from the American Association of Oral and Maxillofacial Surgeons, American Dental Association, and Association of American Medical Colleges were analyzed, specifically reviewing racial demographic data of academic oral and maxillofacial surgery, dentistry, and medicine. Of the 349 full-time faculty, 248 were white (71.1%), 24 black (6.9%), 18 Hispanic (5.1%), 30 Asian (8.6%), and 29 other/unknown (8.3%); there were no full-time faculty of American Indian or Alaska Native descent. Of the 991 oral and maxillofacial surgery residents, whites comprised 701 (70.7%), blacks 43 (4.3%), Hispanics 42 (4.2%), Asians 197 (19.9%), and unknown 8 (0.8%). There are currently no residents of American Indian/Alaska Native origin. A 2006 American Dental Association survey of the distribution of race among the 179,594 professionally active dentists in the United States revealed 86.2% white, 3.4% black, 3.4% Hispanic, 6.9% Asian, and 0.12% American Indian. In 2004, whites comprised 36.7% (344,821) of US physicians, blacks 3.3% (30,598), Hispanics 2.8% (26,094), and Asians 5.7% (53,799); 27.6% (258,950) of US physicians were listed as unknown, and 23.6% (221,633) were listed as international medical graduates without demographic information. American oral and maxillofacial surgery's racial demographic (just as dentistry and medicine) does not remotely resemble the racial demographic of the United States. To improve health care disparity in this nation, diversifying the health care professional workforce is essential. Oral and maxillofacial surgery, a unique surgical specialty connecting medicine to dentistry, is positioned to make an impact on the oral health care disparity in this nation and as such should make a concerted effort to improve the racial diversity of the specialty.