Staffing Decisions Research Articles

Working at home: Individual level drivers of MEPs’ focus on constituency work

Abstract This article investigates how Members of the European Parliament (MEPs) allocate resources between their parliamentary and constituency work, focusing on their staffing decisions. Specifically, it examines the distribution of MEPs’ staff between accredited assistants, based in the European Parliament (EP), and local staff working in their constituency. The study seeks to explain why some MEPs allocate a larger share of their staff to constituency work compared to others by testing several hypotheses related to the individual characteristics of MEPs while controlling for variations across Member States. Using a newly developed database with data on MEP assistants at three points during the 9th EP, the analysis reveals that Member State differences do not solely explain the variation in staff distribution. While there is no evidence that staff allocation is driven by strategic considerations to secure re-election, it depends significantly on their ideology and past political experience.

Employing School Librarians: What Decision-Makers Tell Us

Although research has shown that having a school librarian benefits students, librarian positions are being cut in schools across the U.S. SLIDE — The School Librarian Investigation: Decline or Evolution? — examined federal data on school library staffing and interviewed 49 district leaders about their decisions to eliminate or add librarian positions. Keith Curry Lance, Debra E. Kachel, and Caitlin Gerrity report that of 54 total decisions leaders made related to changes in librarian staffing, 28 resulted in librarian increases and 26 resulted in librarian decreases. Decisions to add or eliminate positions were generally related to changes in district priorities. Although leaders expressed that they value librarians’ role in providing information literacy instruction and support and had positive experiences with librarians, some had to allocate resources to other positions. Others had trouble finding librarians with the necessary qualifications. When making staffing decisions, leaders need to consider what benefits librarians offer and how to meet student and staff needs for information and media literacy.

Diversity challenges in German nursing teams: a participatory organizational development approach

Abstract Background Migration of health care professionals, demographic change and the transformation of the health care system result in highly diverse nursing teams in German hospitals and nursing homes. Different orientations (regarding qualification, generation or migration background) collide in a working environment characterized by staff shortage, time pressure and decisions about life and death. But team cooperation not only has a strong impact on patient safety, but on job satisfaction and therefore retention management. Little is known on how teams cope with diversity challenges and how this is linked with organizational structures. Methods Based on qualitative content analysis of 197,5 hours of participatory observation, 8 group discussions and 25 interviews in 6 nursing teams in 2 hospitals and 2 nursing homes situated in a major German city, we developed workshops on the topic of team diversity and cooperation. 10 workshops (4-16 participants each) were in held in 2023/24 both on team- and management-level. Results All teams are struggling with diversity-related problems, but in their specific ways, depending on the particular neighbourhood of the facility and team composition among other things. Due to the strong team spirit and identity, the teams have a fundamental tendency to integrate diverse perspectives and orientations. But they need time capacities and supportive organizational structures. The workshops created a space to discuss the team specific problems. Starting points for structural changes could be identified and further discussed in the workshops at the next higher hierarchical level. Conclusions Organisational structures provide the framework conditions that enable teams to integrate different perspectives resulting from diversity in a productive way. One-fits all solutions are not suitable to address those problems and improve teamwork. A participatory bottom-up process seems to be the most appropriate approach. Key messages • Institutions need to provide structures in which diversity is not perceived as an additional burden. • The best way to initiate improvements is through a participatory bottom-up approach.

The Moderating Role of the Five-Factor Model of Personality in the Relationship between Job Demands/Resources and Work Engagement: An Online Cross-Sectional Study.

When organizations or managers utilize personality assessments for their workers, it is crucial to consider not only personality profiles but also the interaction between these profiles and the psychosocial environmental factors in the workplace. The present study aimed to examine the moderating effects of the five-factor model (FFM) of personality traits on the relationship between job demands/resources and work engagement (WE). A cross-sectional online survey was conducted between November and December 2022, targeting full-time workers in Japan. Data were collected from 1500 participants (757 men and 743 women). The survey included demographic variables, job demands and resources (job control, supervisor, and coworker support), WE, and the FFM. The primary statistical analysis was hierarchical regression analysis, which tested the interactions between job demands/resources and each personality trait. Four significant interactions were found: job demands and neuroticism, control and neuroticism, control and conscientiousness, and supervisor support and extraversion. High conscientiousness was associated with higher WE when job control was abundant. Moreover, low levels of both neuroticism and extraversion were linked to higher WE. The results suggest that managers can enhance WE by aligning workplace factors with employee personality traits. These insights can be applied to organizational staffing decisions.

Factors affecting problem-solving court team decisions about medications for opioid use disorder

BackgroundProblem-solving courts (PSCs) provide alternatives to prosecution and incarceration for drug-related crimes and offer integrated support for people who have lost custody of children due to drug use. Methadone and buprenorphine are lifesaving medications for opioid use disorder (MOUD) but are underused by PSC clients. Even when PSCs lack a court-level prohibition against MOUD, court staff still make individualized decisions about whether a court client can use MOUD. Therefore, we sought to identify factors involved in such individualized PSC court decisions about clients' use of MOUD. MethodsWe conducted semi-structured interviews and focus groups between Summer and Fall 2022 with a convenience sample of 54 PSC staff members from 33 courts across four states. Data were analyzed using iterative categorization. ResultsInterviewees indicated that their courts had eliminated blanket prohibitions against MOUD due to federal and state policy funding requirements, widespread dissemination of voluntary best practice standards, fear of lawsuits, and MOUD education targeting courts. Courts allowed MOUD if the court client accessed it through a treatment provider with whom the court collaborates. Some courts only allowed court clients to access MOUD from non-partnering treatment providers after a court-led “vetting” process of the proposed MOUD provider. MOUD provider characteristics considered during the vetting process included the provider's willingness to communicate with the court, frequent drug testing, adjustments of medication or dosage in response to aberrant results, offering of counseling, and acceptance of Medicaid or sliding scale payments. PSC staff were least comfortable with court clients using methadone treatment. ConclusionsThe presence (or lack of) a PSC-MOUD partnership is a key factor involved in court staff decisions when a court client desires MOUD. Therefore, increasing the number of partnerships between PSCs and MOUD providers could lead to higher rates of MOUD utilization. It is unclear whether court-led vetting processes for non-partnering MOUD treatment providers are necessary or appropriate, and such vetting processes could reduce treatment choice or access in communities with few MOUD providers.

Career management practices and job performance among university library personnel in southwest Nigeria

This study investigated the level of career management practices and job performance among library personnel in university libraries in south-west Nigeria. The study adopted a correlational survey research design. Data was collected from 433 respondents using a questionnaire. The results showed a moderate level of career management practices, with personnel moderately agreeing that human resource development programs contribute to achieving library objectives and impact productivity and performance. The level of job performance was rated as high, with very high scores for administrative duties and working with co-workers. Career management practices like receiving performance feedback, allowing staff decision-making, and using weaknesses for training were moderately implemented. Common career management strategies employed included library linkages, staff engagement, and deployments/retraining, while workforce planning and promotion exercises were least used. A positive correlation was found between career management practices and job performance (r = 0.086, p < .05). The study concludes there is a correlation between career management practices and job performance of library personnel in these university libraries. The study recommends that university libraries strengthen their human resource development programs, ensuring HRD is given adequate attention and resources, including regular training and development opportunities and comprehensive HRD policies and strategies.

Factors Promoting a Sense of Home Among Older Adults in Residential Care Facilities in Italy.

Understanding the housing needs of older adults is crucial for policy makers, service providers, and professional carers. Evidence about the factors that contribute to older adults' "sense of home" and their practical and policies implications are lacking. Semi-structured interviews were conducted with 78 community-dwelling older adults to investigate which structural and organizational requirements and relational-affective environments could contribute to their experiencing a sense of home. Through inductive content analysis 119 subcategories were derived and grouped into eight main categories: being considered as a person; a safe, quiet, welcoming, and personalizable environment; meaningful relationships; optional and stimulating activities; active involvement in the organization within the facility; competent care personnel; preserving life memories; facility open and integrated with the community. Findings suggest that multiple factors might influence "feeling at home," and many strategies can be adopted to facilitate older adults' successful adaptation. It is important that healthcare organizations consider these factors from a person-centered care perspective, and that care staff are trained in this type of care to enhance staff decision-making and older adults' wellbeing.

A case-crossover analysis to quantify the impact of wildfire smoke on hospital respiratory admissions in the Rogue Valley, Oregon

BackgroundWith the increasing prevalence of wildfire smoke in the Pacific Northwest, it is important to quantify health impacts to plan for adequate health services. The Rogue Valley region has historically faced some of the greatest wildfire threats in the state. Health impacts from smoke have been estimated in several recent studies that include Oregon's Rogue Valley, but the results between studies are conflicting. ObjectiveThe objective is to critically examine impacts of wildfire smoke on health in the Rogue Valley area and translate the results to support hospital staffing decisions. Study designThe study adopts a case-crossover approach. MethodsApply a conditional Poisson regression to analyze time stratified counts while controlling for mean temperature. ResultsEvery 10 μ/m3 increase in PM2.5 is associated with a 2% increase in same-day hospital or emergency room admission rates for respiratory conditions during fire season after adjusting for temperature and time (OR = 1.020; 95% CI: 1.004–1.034); a 10 μ/m3 increase in PM2.5 lasting nine days is associated with a 4% increase in admission rates (OR = 1.041; 95% CI: 1.018–1.065). In other words, for each 10 μ/m3 single day increase in pollution from smoke, an additional 0.26 respiratory patients would be expected in the area hospitals. With a single day increase from 10 μ/m3 to 150 μ/m3, hospitals could expect an additional four patients. ConclusionsThere are small but significant health impacts in the Rogue Valley. These impacts are smaller than some statewide estimates. We need further research to understand these differences.

Circadian variation in coaches’ decision-making in the National Football League’s evening games

ABSTRACT The aim of this study was to explore whether National Football League (NFL) coaches show variation in their decision-making on fourth down when traveling through time zones. Data from visiting teams in games from 20 seasons (2000–2020) of the NFL were retrieved from online sources (n = 5360 games). Decision-making was measured with the percentage of offensive plays on fourth down. A factorial ANCOVA was done to verify whether travel direction had an impact on fourth downs in evening games, while controlling for the seasons. A moderation analysis was computed to verify whether the time of game moderates the relationship between longitudinal distance traveled and decisions on fourth downs. Results showed that in evening games, coaches in teams traveling westward called more offensive plays on fourth down, compared to when they traveled in any other direction. Results from the moderation analysis showed that only in evening games, further westward longitudinal degrees traveled predict more fourth downs. For the first time, this study offers insight that circadian misalignment may not only affect player performance but also influence coaching decisions in professional sports. These results beg the question whether other aspects of coaching or staff decisions show circadian variations in professional sports.

Estimating the Relationship Between Nurse Staffing and Medication Pass Workload Using National Barcode Data.

Measuring and assessing the relationship between inpatient nurse staffing and workload across a national health system is difficult due to challenges in systematically observing inpatient workload at the unit level. The objective of this study was to apply a novel measure of inpatient nurse workload to estimate the relationship between inpatient nurse staffing and nurse workload at the unit level during a key nursing activity: the peak-time medication pass. A retrospective observational study was conducted in the Veterans Health Administration, the largest employer of nurses in the U.S. The sample included all patients (n= 1,578,399 patient days) admitted to 311 non-intensive care unit inpatient acute care units in 112 hospitals in 2019 (104,588 unit days). Staffing was measured as the unit-level, nurse-to-patient ratio, and workload was measured using average time (duration) for RNs to complete the peak-time medication pass. We found a negative relationship between the RN-to-patient ratio and average peak time medication pass duration after adjusting for unit-level patient volume and average patient severity of illness and other unit-level factors. This relationship was non-linear: the marginal effect of staffing on workload decreased as staffing increased. As unit-level nurse staffing increased, average RN workload decreased. This result suggests that interventions to improve nurse staffing may have larger non-linear effects for units with lower staffing levels. Understanding the effect of differing staffing decisions on variations in nursing workload is critical for adopting models of care that effectively use scarce staffing resources and contribute to retaining nurses in the inpatient workforce. This work provides evidence that peak time medication pass duration is a valid process-based measure of workload and highlights the potential diminishing returns to increasing staffing.

Analysis of Teacher Inclusion in Decision-Making Processes in Public Basic Schools in the Ho West District

This study sought to analyze teacher inclusion in decision-making processes in public basic schools in the Ho West District of the Volta Region. Drawing on Charles et al.'s (1997) shared decision-making theory, the research employed a quantitative approach and utilized the descriptive survey design. The sample included 450 public school teachers selected through stratified random sampling. Data were collected using questionnaires with a Cronbach's Alpha coefficient of 0.85 and analyzed using mean, standard deviation, and independent samples t-test. Results indicated that teachers were actively involved in providing input on resources and participating in professional development, but their engagement was less prominent in areas such as staff hiring and decision- making related to school improvement initiatives. Factors influencing teacher inclusion included the school administration's recognition of teacher input, clarity in communication, time constraints, and leadership support. Based on these findings, recommendations were suggested to enhance communication channels, ensure transparency, and establish structured mechanisms for teacher involvement in decision-making.

A longitudinal study combining the Double Diamond framework and Behavior Change Wheel to co-create a sedentary behavior intervention in police control rooms.

Police work can be sedentary and stressful, negatively impacting health and wellbeing. In a novel co-creation approach, we used the Behavior Change Wheel (BCW) and Double Diamond (DD) design framework to guide the collaborative design and development of a sedentary behavior intervention in the control rooms of two British police forces. Multiple stakeholders participated in four phases of research. In Phase 1, a literature review, focus groups (n=20) and interviews (n=10) were conducted to 'discover' the relationship between physical activity and wellbeing in the police. In Phase 2, a steering group consolidated Phase 1 findings to 'define' a specific behavior for intervention. Phases 3 and 4 'developed' the intervention across six workshops with control room workers and six steering group workshops. The co-creation process identified contextual sedentary behavior as the target behavior, driven by behavioral regulation, social influence and social norms. The sedentary behavior intervention targeted these drivers and aimed to engage control room workers in short bursts of physical activity throughout their shifts. Key intervention features targeted involvement of staff in decision-making and embedding physical activity into work practices. The BCW and DD can be combined to co-create evidence-based and participant-informed interventions and translate science into action.

Enhancing Efficiency, Improving Care: Exploring Patient Opinions on Hospital Social Work

Purpose: This study investigates patient perceptions of factors influencing the efficiency of hospital social work services. Specifically, it explores the perceived role of social workers in addressing patients' psychosocial needs and identifies potential strategies for enhancing service efficiency. By understanding the patient perspective, this research aims to illuminate the impact of various factors on social work effectiveness and ultimately contribute to improved patient care delivery. Methods: A convenience sampling technique was employed to recruit 130 patients from Trung Vuong Hospital who participated in a self-administered survey assessing their perspectives on hospital social work services. The survey comprised two scales: one evaluating factors affecting social work efficiency and another proposing measures for improvement. Descriptive statistics were utilized for data analysis. Results: Patient perceptions identified "patient needs" and "knowledge and skills of medical staff, doctors, and social workers" as the most critical factors impacting hospital social work efficiency. This underscores the importance of ongoing professional development for social workers and ensuring adequate staffing levels. Proposed strategies for improvement included: enhanced professional training for social workers, fostering effective communication regarding social work services available to patients, and the expansion of external resource networks to provide comprehensive support for patients facing complex challenges. Conclusion: This study sheds light on critical areas for optimizing hospital social work efficiency, highlighting the importance of strategic staffing decisions, fostering interdisciplinary collaboration, and prioritizing continuous professional development for social workers. By integrating patient feedback into service delivery models, social work departments can enhance patient support and contribute to improved healthcare outcomes. Future research efforts should strive for broader generalizability by incorporating diverse healthcare settings and soliciting the perspectives of a wider range of stakeholders. This will provide a more comprehensive understanding of social work effectiveness in the evolving landscape of healthcare delivery.

The Cost of a Locum: A Simulation to Determine When You Are Paying Too Much for Your Anesthesia Locum Tenens Coverage.

Current research on locum tenens physicians has primarily focused on their safety, reliability, and patient outcomes, leaving a significant gap in understanding the financial implications of their employment in health systems. Amidst a persistent shortage of physicians across specialties, healthcare organizations have increasingly relied on locum tenens to meet the rising demand for clinical services. This study aims to bridge the knowledge gap by evaluating the financial feasibility of employing locum tenens physicians compared to full-time anesthesiologists, given the context of growing physician shortages and increasing healthcare demands. We developed a Python simulation model to compare the costs of hiring locum tenens versus full-time anesthesiologists. The model inputs included hourly rates for both locum tenens and full-time anesthesiologists and the upfront hiring costs for full-time physicians. By plotting these costs against each other, the model identifies the breakeven point: the number of working hours at which the cost of employing a locum tenens physician equals that of hiring a full-time physician. Utilizing Monte Carlo simulations with data from the Northeastern United States, we assessed the variability and determined an average breakeven point across different scenarios. The Monte Carlo simulation, based on 10,000 iterations, revealed an average breakeven point of 665 hours, corresponding to just over 11 weeks of 60-hour workweeks. This suggests that for any locum tenens engagement exceeding this duration, hiring a full-time anesthesiologist becomes more cost-effective for the healthcare institution. The simulation also showed that 28% of scenarios had a breakeven point below 60 days, highlighting the financial dynamics and decision-making complexities in employing locum tenens versus full-time physicians. The findings indicate that employing locum tenens physicians for durations shorter than 665 hours remains financially viable compared to the option of hiring full-time anesthesiologists. However, the significant variability observed in the simulations underscores the importance of context in making staffing decisions. Healthcare organizations must consider the specific needs and circumstances of their operations when deciding between hiring locum tenens and full-time physicians, especially for longer-term coverage requirements.

“No Abnormality Detected”: A Mixed-Methods Examination of Emergency Department Coding Practices for People in Suicidal Crisis

Background Accurate identification of suicidal crisis presentations to emergency departments (EDs) can lead to timely mental health support, improve patient experience, and support evaluations of suicide prevention initiatives. Poor coding practices within EDs are preventing appropriate patient care. Aims of the study are (1) examine the current suicide-related coding practices, (2) identify the factors that contribute to staff decision-making and patients receiving the incorrect code or no code. Method A mixed-methods study was conducted. Quantitative data were collated from six EDs across Merseyside and Cheshire, United Kingdom from 2019 to 2021. Attendances were analyzed if they had a presenting complaint, chief complaint, or primary diagnosis code related to suicidal crisis, suicidal ideation, self-harm or suicide attempt. Semi-structured interviews were conducted with staff holding various ED positions (n = 23). Results A total of 15,411 suicidal crisis and self-harm presentations were analyzed. Of these, 21.8% were coded as ‘depressive disorder’ and 3.8% as ‘anxiety disorder’. Absence of an appropriate suicidal crisis code resulted in staff coding presentations as ‘no abnormality detected’ (23.6%) or leaving the code blank (18.4%). The use of other physical injury codes such as ‘wound forearm’, ‘head injury’ were common. Qualitative analyses elucidated potential causes of inappropriate coding, such as resource constraints and problems with the recording process. Conclusion People attending EDs in suicidal crisis were not given a code that represented the chief presentation. Improved ED coding practices related to suicidal crisis could result in considerable benefits for patients and more effective targeting of resources and interventions.

ADDRESSING INTERDISCIPLINARY OF MUSIC

Didactic strategies combine all the elements of the educational process, being a way of combining and chronologically organizing the set of methods and means chosen to achieve certain didactic objectives. This way,, the didactic strategy is expressed in organic units of methods, procedures, educational means and ways of organizing/achieving the learning process, i.e. head-on, in groups and individually [Potolea, D. The teacher and the strategies of learning management. Bucharest: Academy Publishing House, 1989, p. 146]. From the given perspective, we would like to mention that the didactic strategy unifies, integrates and brings together learning tasks with learning situations, creating a complex and logical system structured by means, methods, materials and other educational resources aimed at achieving certain objectives, which constitute a extremely necessary aspect in any pedagogical action, which finds its central place in the educational process. This is due to the fact that the design and organization of a lesson takes place in close connection with the strategic decision of the teaching staff and, therefore, it is designed as a complex didactic scenario, in which the actors of the educational act - of teaching-learning are involved, the conditions in which it is carried out, the objectives and the proposed methods. This way, the strategy determines the most appropriate, logical and efficient methodical itinerary for approaching a concrete teaching-learning situation, avoiding some errors, risks and unwanted events that may appear in the activity of the teaching staff.

Implementation and impact of rapid SARS-CoV-2 point of care test on patient flow in the frailty pathway; A quality improvement approach.

To maintain patient flow during the COVID-19 pandemic, rapid and accurate decisions for the safe triage of geriatrics patients was essential as turnaround times for laboratory testing was ineffective at supporting rapid clinical decision-making for transfer of care. Thus, to mitigate and inform these clinical decisions, a quality improvement collaborative project with the geriatrics and virology department was conducted at the Frailty Assessment Unit (FAU) at Aberdeen Royal Infirmary. The goal was to facilitate patient triage during transfer of care with the introduction of Point of Care testing (POCT). The interventions which resulted in significant improvements were based on the fishbone problem solving approach and the driver diagram with change ideas informing the five Plan, Do, Study and Act (PDSA) cycles. The QI intervention was crucial in supporting clinical staff decision making during transfers for 95% of patients who had been clinically judged as asymptomatic for COVID-19 infection. High staff engagement was observed with 83% of staff suggesting the process map was easy to follow and 92% of clinical staff agreed it contained sufficient information to support the testing process. With POCT introduction, the proportion of patients who were transferred with an early POCT result increased by 20% in the Rosewell House group and by 65% in the community Hospitals group, once governance arrangements were in place. Finally, the considerable uptake of POCT by the ward consequently led to a decrease of up to 86% in the number of samples sent to the laboratory for rapid SARS-CoV-2 testing. The quality improvement project provided a rapid and reliable SARS-CoV-2 triage tool and was effectively integrated into the geriatrics triage algorithm to facilitate patient placement and flow.

Universally optimal staffing of Erlang-A queues facing uncertain arrival rates

In many service systems, the staffing decisions must be made before the arrival rate is known with certainty. Thus, it is more appropriate to consider the arrival rate as a random variable at the time of the staffing decision. Motivated by this observation, we study the staffing problem in a service system modeled as an Erlang-A queue facing a random arrival rate. For linear staffing costs, linear waiting costs, and a cost per customer abandonment, we propose a policy that is based on modifying the well-known square-root safety staffing policy to explicitly account for the randomness in the arrival rate. Our primary contribution is to show that our proposed policy is “universally optimal”, i.e., irrespective of the magnitude of randomness in the arrival rate, the optimality gap between our proposed policy and the exact optimal policy remains bounded as the system size grows large. This is important because earlier performance guarantees for Erlang-A queues either (1) are not universal and offer performance guarantees that depend on the magnitude of uncertainty in the arrival rate or (2) are universal but assume a deterministic arrival rate. The practical relevance of this provable robustness is that our proposed policy is a “one-size-fits-all” as it is guaranteed to perform well for all levels of arrival rate uncertainty.

"Technology is the enabler Enhancing “one team, one record, one number, one fund” and connecting Home Care utilization to outcomes for patients and providers”.

Since 2012, St. Joseph’s Health System has been testing and evaluating Integrated Models of Care while maintaining a focused commitment to spreading and scaling sustainable integrated service delivery and integrated funding models.
 Our collective learnings and expanding partnerships are being celebrated through the creation of the SJHS Centre for Integrated Care. The Centre for Integrated Care, or “CIC”, is an innovation incubator and accelerator powered by the St. Joseph’s Health System (SJHS), the Research Institute of St. Joe's Hamilton, and the partners we work with.
 We believe getting timely and adequate care should be less complicated: fewer steps, less confusion, less wasted effort, more sharing, and more time to spend with people. Integrated care means integrating people who provide care and the systems they use. We prefer practical and simple innovations that fit within existing resources. Our mission is to integrate systems and remove barriers to advance people-centred care.
 Our hub includes patients, families/caregivers, care providers, health care leaders, researchers, educators, and technology experts who are united in one goal: to improve the delivery of health and social services for better outcomes.
 During the presentation we will describe our Integrated Comprehensive Care (ICC) Program for COPD and CHF patients and highlight how the work and in particular the technology, has enabled integration at the micro, meso, and macro levels with a specific focus on equity, access, and provider experience.
 We will touch on learnings from the pandemic and provide a visual representation linking actual volume and type of home care utilization to outcomes both the year prior to the pandemic and two years during the pandemic; Understanding service delivery trends is important to understanding how resources are contributing to an outcome, such as community staffing decisions impacting hospital lengths of stay. Discussion begins with best practice care standards and pathways. Funding constraints are secondary. The ongoing dialogue between and within acute and home and community care serves to educate and adjust practice as the evidence directs. This approach comes from establishing a shared vision, transparency, trust, and hard work upfront when developing programs. As opposed to command and control, it’s a collective goal to provide the best care within the existing resources and be open to shuffling resources, and looking at other ways of delivering care, including the use of technology, to provide services.
 Time permitting, we will engage participants in discussions around how we can collectively advance integrated care and suggest opportunities for moving forward.
 At the end of the day, technology is not the driver in health care. Rather, care is enabled by technology – to support remote access, consistent practice, easily accessible synchronous documentation, ongoing refinement of best practice, and much more. It is essential to the future of health care, meeting client expectations and supporting practitioners to give their best.

An Assessment of Human Resource Management Practices on Newly Appointed Teachers in Secondary Schools in Gwembe District, Zambia

The study assessed the human resource management practices on newly appointed teachers in secondary schools in Gwembe District. The objectives of the study examined teachers` biographics, the effects of human resource planning and human resource training and development on organizational effectiveness, assessed and determined the influence of employee recognition and the extent to which work place climate influenced teacher effectiveness in secondary schools. Descriptive research method was employed. The target population comprised 16 secondary schools and 212 teachers. A sample contained 14 schools and 112 teachers (8 per school). All the 7 senior schools with grades 8-12 were purposively selected and out of the 9 junior schools with grades 8-9, only 7 schools were simple randomly selected and used. A questionnaire and an interview guide were used. A pilot study was conducted in two schools to determine the reliability of instruments. An Alpha reliability coefficient of 0.890 was obtained which deemed the instrument reliable. The data collected was coded and analyzed using descriptive statistics, regression and content analysis. Findings from the study on demographics revealed that the teaching profession was dominated by males, majority teachers held Bachelor’s Degree, were married and have worked for about 10 years to 14 years. Other findings revealed that HR planning, training and development, employee recognition programs and work place climate had a positive and significant influence on organizational and teacher effectiveness. The study concluded that teachers were not given job descriptions; orientations were not done. The majority teachers were not confirmed within 3/6 months of their appointment. Schools lacked effective communication and management did not involve staff in decision making. Also, teachers refused of having a health scheme supported by the government. The study recommended that job descriptions should be given to newly appointed teachers at the initial stage. Adequate orientation should be conducted. Teachers should be confirmed within 3/6 months. Management should enhance effective communication and involve staff in decision making at all times. The government should support teachers practically with health scheme not just on paper.