Staffing Decisions Research Articles

Mobility of Teaching and Research Staff: Determinants and Post Factum Effects

This paper reports the findings of a study investigating higher education institutions (HEIs) in Romania and the motivations lying behind the decision of undertaking professional mobilities in academia. Although professional mobilities are known to be a frequent practice in various fields of activity, the teaching and research mobilities of academics distinguish themselves among the mobilities of all sectors, deserving a special attention. In this context, our study investigated the incentives and deterrents of undertaking academic mobilities in Romanian HEIs. It divided the determinants of undertaking mobilities into those leading to mobilities and the others slowing them down. Results have shown that the desire of expanding professional experience has the highest influence on teaching and research staff's decision to undertake a mobility, while insufficient funding explains mobilities drop-off, as it is the factor of highest influence on people’s decision of not undertaking mobilities. The study also analysed the mobility post factum implications for the academic community. The development of research networks and career enrichment were the main benefits of academic mobilities indicated by study results. In this sense, most study participants reported that they developed their network to do research during the mobilities and they have also managed to enrich their professional careers thanks to these mobilities.

Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019.

Advanced practice providers (APPs) comprise an increasing proportion of the emergency medicine (EM) workforce, particularly in rural geographies. With little known regarding potential expanding practice patterns, we sought to evaluate trends in independent emergency care services billed by APPs from 2013 to 2019. We performed a repeated cross-sectional analysis of emergency clinicians independently reimbursed for at least 50 evaluation and management (E/M) services (99281-99285, 99291) from Medicare Part B, with high-acuity services including Codes 99285 and 99291. We describe the outcome proportion of E/M services by acuity level and report at (1) the encounter level and (2) at the clinician level. We stratified analyses by clinician type and geography. A total of 47,323 EM physicians, 10,555 non-EM physicians, and 26,599 APPs were included in analyses. APPs billed emergency care services independently for 5.1% (rural 7.3%, urban 4.8%) of all high-acuity encounters in 2013, increasing to 9.7% (rural 16.4%, urban 8.8%) by 2019. At the clinician level, in 2013, the average rural-practicing APP independently billed 22.8% of services as high acuity, 72.6% as moderate acuity, and 4.5% as low acuity. By 2019, the average rural-practicing APP independently billed 36.2% of services as high acuity, representing a +58.8% relative increase from 2013. Relative increases in high-acuity visits independently billed by APPs were substantially greater when compared to EM physicians across both rural and urban geographies. In 2019, APPs billed independent services for approximately one in six high-acuity ED encounters in rural geographies and one in 11 high-acuity ED encounters in urban geographies, and well over one-third of the average APPs' encounters were for high-acuity E/M services. Given differences in training and reimbursement between clinician types, these estimates suggest further work is needed evaluating emergency care staffing decision making.

Selected aspect of Pierre Bourdieu's "Praxis" in the area of decision-making about therapy and medical care.

In the era of increasingly developing medical services, decision-making about therapy and care is conditionednot only by medical and psychological factors, but also by increasingly institutional and social factors. Whichof the factors of the social environment and medical institutions play the greatest role in the process of decidingon therapy and medical care? In seeking answers to the questions posed, reference was made to the theory of"praxis" by P. Bourdieu. These theoretical concepts: habitus, capital field, have been presented in such a waythat it is possible to see their impact on the decisions of patients and medical staff and to take into accountthe dependencies and mutual influences between them. The article refers to Polish and English-languageliterature. Research results and theoretical conclusions on the impact of social factors and the direct institutionalenvironment on the decision formation of various entities involved in the decision-making process have beenpresented.

Factors That "Nudge People towards the Healthier" Snacks-A Qualitative Study with Student, Faculty, and Staff Leaders and Decision Makers.

(1) College campuses pose numerous public health challenges for students, faculty and staff. The healthfulness of the snacks available on campuses is lacking, and there is a desire for change among the students and staff. The objective of this study is to understand the perspectives of the students, staff, and decision makers regarding the college campus food environment and the perceived facilitators and barriers to improving it. (2) In-depth interviews were conducted (n = 15) with decision makers in food, policy development, wellness, and nutrition at a large Hispanic-Serving University in South Florida. (3) The key stakeholders shared that educational campaigns, student buy-in, raising awareness around obesity and chronic disease, and the university's position within the community would all help to facilitate improvements to the snack food environment. However, the participants noted that the complex nature of what is considered to be healthy and what divergent consumers want are significant barriers to improving the snack food environment along with concerns over lost revenue and the corporate structure. (4) These results inform potential focal points for multi-level interventions and inform policy discussions focused on improving the snack food environment at minority-serving universities. Taking strategic actions to improve the snack food environment may aid the students and staff of the university to enhance their diet quality.

What influences decisions to transfer older care-home residents to the emergency department? A synthesis of qualitative reviews.

care home residents aged over 65 have disproportionate rates of emergency department (ED) attendance and hospitalisation. Around 40% attendances may be avoidable, and hospitalisation is associated with harms. We synthesised the evidence available in qualitative systematic reviews of different stakeholders' experiences of decisions to transfer residents to the ED. six electronic databases, references and citations of included reviews and relevant policy documents were searched. Reviews of qualitative studies exploring factors that influenced care home staff, medical practitioners, residents' family or residents' experiences and factors influencing decisions to transfer residents to the ED were included. Thematic analysis was used to synthesise findings. six previous reviews were included, which synthesised the findings of 34 primary studies encompassing 152 care home residents, 283 resident family members or carers and 447 care home staff. Of the primary studies, 19 were conducted in the North America, seven in Australia, five were conducted in Scandinavia, two in the United Kingdom and one in Holland. Three themes were identified: (i) power dynamics between residents, family members, care home staff and health care professionals (external to the care home) influence decisions; (ii) admission can be necessary; however, (iii) some decisions may be driven by factors other than clinical need. transfer decisions are complex and are determined not just by changes in health status interventions aimed at reducing avoidable transfers need to address the key role family members have in transfer decisions, the medical legal fears of care home staff and barriers to accessing community services.

THE APPLICATION OF DEMOCRATIC LEADERSHIP STYLE OF THE HEAD OF BANGUN VILLAGE, MUNJUNGAN DISTRICT, TRENGGALEK REGENCY

This study examines the application of the leadership style of the Head of Bangun Village, Munjungan District. This research aims to evaluate how effectively the Head of Bangun Village uses a democratic leadership style. A qualitative descriptive approach and literature review were used in this study. The research results on indicators of the democratic leadership style of Pasolong in Hardianti (2016): 1) Decisions are taken jointly. The village head always discusses joint decision-making with his staff and offers opportunities or involves staff in decision-making. 2) Appreciate the potential of subordinates; in this case, the village head often thanks his staff because it can provide a positive effect or motivation to employees in improving performance towards village progress; 3) Hearing criticism, suggestions and opinions of employees that leaders cannot be separated from criticism, input and opinions when leading a government agency. This can be seen when the village head wakes up always accommodates, and listens to criticism, suggestions, or opinions levelled at him from any party, including his employees; 4) Working closely with subordinates, the village head of Bangun has worked well with his subordinates and the village head of Bangun always goes directly to the field with his employees. The application of the democratic leadership style of the Bangun Village Head is considered to be so dominant in showing cooperation with subordinates.

Hospital transfers from care homes: conceptualising staff decision-making as a form of risk work

When making decisions about whether to transfer residents to hospital, care home staff consider the possible benefits and risks of different courses of action. However, to date, an in-depth and theoretically informed engagement with these decision-making processes and their associated behaviours has been lacking. We conducted an ethnographic study of care home staff’s decision-making about resident hospital transfers in England between May 2018 and November 2019. We combined staff interviews at six care home sites, with 30 members of staff, with 113 hours of ethnographic observation at three care homes sites. ‘Risk’ and risk management emerged as important overarching themes. In this article we conceptualise staff decision-making about potential hospital transfers for residents as a form of risk work. In doing so, we identify the different forms of risk knowledge that staff used to conceptualise risk and explore the ways staff navigated tensions between different forms of risk knowledge. We highlight the ways individual understandings of risk were influenced by social interactions with others, both at an interpersonal and organisational level, before identifying strategies that staff use to manage risk. By understanding transfer decisions explicitly in terms of the different forms of risk that care home staff manage, our analysis provides new insights into hospital transfers from care homes and contributes to the wider literature around risk work, demonstrating the utility of this concept in researching organisations that fall under the umbrella of social care, which have been previously neglected in academic research.

Intimate relationships in residential aged care: what factors influence staff decisions to intervene?

Intimacy contributes to our well-being and extends into older age, despite cognitive or physical impairment. However, the ability to enjoy intimacy and express sexuality is often compromised—or even controlled—when one...

Original Research: 'It Would Be Nice to Think We Could Have a Voice': Exploring RN Involvement in Hospital Staffing Policymaking.

Hospitalized patient and nursing outcomes improve when nurses are involved in decision-making practices through shared governance structures. Yet there has been little research investigating how staff nurses are involved in hospital staffing policymaking and how they perceive this process. The study's primary aims were to increase understanding of staff nurses' perceptions of factors that hinder or support nurse involvement in hospital nurse staffing policymaking and to learn more about how nurses are, or would like to be, so involved. We also collected nurses' work environment and demographic information to further inform our understanding. This study used a qualitative descriptive approach. Using QuestionPro software, we solicited open-ended responses to semistructured questions to explore the topics of interest. The online form was distributed via social media. Results were analyzed using conventional content analysis. Multiple-choice questions related to demographics and nurse work environments were also included, and these results were analyzed using descriptive statistics. Thirty-two staff nurses completed the online form between April 5 and May 24, 2021. Identified themes include "We aren't asked": structural barriers to staff nurse involvement; "No one cares": workplace culture barriers to staff nurse involvement; and "'They' versus 'we'": lack of power sharing for staffing decision-making. Participants described feeling powerless with regard to, and having little to no involvement in, hospital staffing policymaking. Yet they also expressed their desire to be engaged in this process and offered suggestions for how nurse involvement in such policymaking could be improved. Our findings provide crucial insight into how organizations can address existing structural barriers to nurse involvement, offer more equitable opportunities for nurse involvement, foster more inclusive workplace cultures, and recognize the value of nurse input and autonomy regarding staffing decisions.

“Status quo bias and resistance to positive behaviour support: implications for leaders”

Purpose This paper aims to focus on why some practitioners in learning disability services resist implementing evidence-based approaches, such as positive behaviour support, despite its benefits. Design/methodology/approach Status quo bias theory was used to explain why practitioners choose existing practices over evidence-based approaches despite the negative consequences to their well-being. Findings Staff members’ decision to maintain the status quo should not be based solely on a cost–benefit analysis, as is commonly believed, as several factors influence it. Originality/value This lies on the development of leadership action based on the factors that influence staff's decision making in favour of the status quo.

Prediction of hospital mortality in intensive care unit patients from clinical and laboratory data: A machine learning approach.

BACKGROUNDIntensive care unit (ICU) patients demand continuous monitoring of several clinical and laboratory parameters that directly influence their medical progress and the staff’s decision-making. Those data are vital in the assistance of these patients, being already used by several scoring systems. In this context, machine learning approaches have been used for medical predictions based on clinical data, which includes patient outcomes.AIMTo develop a binary classifier for the outcome of death in ICU patients based on clinical and laboratory parameters, a set formed by 1087 instances and 50 variables from ICU patients admitted to the emergency department was obtained in the “WiDS (Women in Data Science) Datathon 2020: ICU Mortality Prediction” dataset. METHODSFor categorical variables, frequencies and risk ratios were calculated. Numerical variables were computed as means and standard deviations and Mann-Whitney U tests were performed. We then divided the data into a training (80%) and test (20%) set. The training set was used to train a predictive model based on the Random Forest algorithm and the test set was used to evaluate the predictive effectiveness of the model.RESULTSA statistically significant association was identified between need for intubation, as well predominant systemic cardiovascular involvement, and hospital death. A number of the numerical variables analyzed (for instance Glasgow Coma Score punctuations, mean arterial pressure, temperature, pH, and lactate, creatinine, albumin and bilirubin values) were also significantly associated with death outcome. The proposed binary Random Forest classifier obtained on the test set (n = 218) had an accuracy of 80.28%, sensitivity of 81.82%, specificity of 79.43%, positive predictive value of 73.26%, negative predictive value of 84.85%, F1 score of 0.74, and area under the curve score of 0.85. The predictive variables of the greatest importance were the maximum and minimum lactate values, adding up to a predictive importance of 15.54%.CONCLUSIONWe demonstrated the efficacy of a Random Forest machine learning algorithm for handling clinical and laboratory data from patients under intensive monitoring. Therefore, we endorse the emerging notion that machine learning has great potential to provide us support to critically question existing methodologies, allowing improvements that reduce mortality.

Data-Driven Nurse Staffing in the Neonatal Intensive Care Unit.

The challenge of nurse staffing is amplified in the acute care neonatal intensive care unit (NICU) setting, where a wide range of highly variable factors affect staffing. A comprehensive overview of infant factors (severity, intensity), nurse factors (education, experience, preferences, team dynamics), and unit factors (structure, layout, shift length, care model) influencing pre-shift NICU staffing is presented, along with how intra-shift variability of these and other factors must be accounted for to maintain effective and efficient assignments. There is opportunity to improve workload estimations and acuity measures for pre-shift staffing using technology and predictive analytics. Nurse staffing decisions affected by intra-shift factor variability can be enhanced using novel care models that decentralize decision-making. Improving NICU staffing requires a deliberate, systematic, data-driven approach, with commitment from nurses, resources from the management team, and an institutional culture prioritizing patient safety.

A STUDY ON FINANCIAL PLANNING INFLUENCE THE INVESTMENT DECISION OF NON-TEACHING WOMEN STAFFS IN COLLEGES WITH SPECIAL REFERENCE OF COIMBATORE CITY

The main objective of the research is to determine the financial planning and investment decision of non-teaching staff in colleges done in Coimbatore city. Sample size of study is 90 and use cluster sampling technique is used for data collection. The major finding is most of the respondents are willing to take moderate risk investment, they expect 8-10% of returns from their investment, 25.56% of respondents are invest in physical gold. From the study all the respondents have known the ETF gold stock Mutual fund but them don’t have willing to invest in long term investments. Keywords: Financial planning, Investment decision, Investment pattern

Cardiac arrest centers-certification fosters inflow of patients by emergency medical services

Since 2015, the international resuscitation guidelines recommend the implementation of specialized hospitals (so-called cardiac arrest centers, CAC) for patients with out-of-hospital cardiac arrest (OHCA). The aim was to investigate the potential influence of hospital certification as aCAC on the decision of emergency medical service staff (EMS, including out-of-hospital emergency physicians and paramedics) when transporting OHCA patients to ahospital. Aweb-based, anonymous questionnaire with 20items was performed from 15May2018 to 15June2018 in Germany. Target groups were out-of-hospital emergency physicians and paramedics. Of 437 respondents, 378 responses (n = 292 emergency physicians, n = 86paramedics) were included in the statistical analysis. In all, 75.1% (n = 284) indicated that CAC certification of hospitals would matter in their own transportation decisions for OHCA patients in future transportations, 78.3% (n = 296) expected that CAC certification will result in an improvement in patient care, and 78.8% (n = 298) were in favor of implementing the CAC certification. Respondents would accept an additional 16.3 min (95% confidence interval 15.2-17.3) of transportation time to reach aCAC. Certification of hospitals as CAC has the potential to influence emergency medical personnel decisions about which hospital to transport OHCA patients to. Due to the limited additional acceptable transport time to reach aCAC, aclose network of certified hospitals is needed nationwide.

'Weighing up risks': a model of care home staff decision-making about potential resident hospital transfers.

Backgroundcare home staff play a crucial role in managing residents’ health and responding to deteriorations. When deciding whether to transfer a resident to hospital, a careful consideration of the potential benefits and risks is required. Previous studies have identified factors that influence staff decision-making, yet few have moved beyond description to produce a conceptual model of the decision-making process.Objectivesto develop a conceptual model to describe care home staff’s decision-making when faced with a resident who potentially requires a transfer to the hospital.Methodsdata collection occurred in England between May 2018 and November 2019, consisting of 28 semi-structured interviews with 30 members of care home staff across six care home sites and 113 hours of ethnographic observations, documentary analysis and informal conversations (with staff, residents, visiting families, friends and healthcare professionals) at three of these sites.Resultsa conceptual model of care home staff’s decision-making is presented. Except in situations that staff perceived to be urgent enough to require an immediate transfer, resident transfers tended to occur following a series of escalations. Care home staff made complex decisions in which they sought to balance a number of potential benefits and risks to: residents; staff (as decision-makers); social relationships; care home organisations and wider health and social care services.Conclusionsduring transfer decisions, care home staff make complex decisions in which they weigh up several forms of risk. The model presented offers a theoretical basis for interventions to support deteriorating care home residents and the staff responsible for their care.

Cultivating a Leadership Pipeline: Using a Real Options Lens to Understand Executives’ Strategic Staffing Decisions

This paper adapts real options theory to explain how executives create and maintain real options portfolios within leadership pipelines. Hypotheses flowing from our theorizing predict that executives often make seemingly risky staffing decisions for leaders who occupy stepping-stone positions. Focusing on their option (future potential) rather than project (current productivity) value, executives laterally transfer leaders in stepping-stone positions frequently, despite it resulting in lower short-term job performance, but often promote these leaders at lower levels of performance and sooner. Once leaders are promoted to destination positions where they may stay indefinitely, executives tend to transfer high-performing leaders more often but not when they are still improving the effectiveness of their current unit. We present evidence suggesting that executives make these decisions to improve other units and maintain a flexible system, possibly recapturing previous investments in developing those leaders. We provide empirical support for our hypotheses using eight years of data in a large retail organization (n = 25,004) where executives overseeing thousands of units made internal mobility decisions. These findings refine real options theory, show that it explains these phenomena better than existing theories, and provide important and immediately usable practical implications for executives. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2022.1608 .

Nursing Staff's Role in Detecting Urinary Tract Infections in Nursing Homes: An Integrative Review.

Despite evidence-based protocols, inappropriate antibiotic use still presents a systemic global threat to health care in nursing homes (NHs). Nursing staff are responsible for recognizing signs and symptoms that may indicate urinary tract infections (UTIs). The current integrative review was designed to examine the state of the literature related to the role of nursing staff in UTI identification and care in NHs. This review, which includes 19 articles published between 2011 and 2020, identified that, although prescribers are the experts in UTI management, nursing staff in NHs were the individuals who recognized changes and communicated residents' needs to prescribers. Further research is required to understand nursing staff's decision making and unique perspectives and determine if evidence-based protocols align with current practice in the NH setting. [Journal of Gerontological Nursing, 48(5), 43-50.].

Guidance to (Re)integrate Caregivers as Essential Care Partners Into the LTC Setting: A Rapid Review.

This rapid review aimed to identify the strategies used to (re)integrate essential caregivers (ECs) into the LTC setting, particularly pertaining to principles of equity, diversity, and inclusion. In addition, this rapid review aimed to identify the strategies used during prior infectious disease threats, when similar blanket visitor restrictions were implemented in LTC homes. The review was part of a larger effort to support LTC homes in Ontario. A rapid review was conducted in accordance with principles from the Canadian National Collaborating Centre for Methods and Tools. ECs, residents, staff, and policy decision makers in long-term care home settings. Five electronic databases were searched for academic and gray literature using predefined search terms. Selected documents met inclusion criteria if they included policy guidance or an intervention to (re)integrate ECs into LTC homes at the local, national, and/or international level. In total, 15 documents met the inclusion and exclusion criteria. All documents retrieved focused on the context of COVID-19. Documents were either policy guidance (n= 13) or primary research studies (n= 2). Documents differed in these notable ways: Definition of EC; the degree to which an EC is recognized for her or his role in the care of the resident; the degree to which ECs are (re)integrated into the LTC setting is prioritized; response to community spread of COVID-19; visitation during an outbreak or if a resident is symptomatic; the reliance on equity, diversity, and inclusion principles; and lastly, monitoring and improving the process. Using an equity, diversity, and inclusion lens, we posit promising practices for (re)integration. It is clear from the rapid review that more research is needed to understand the efficacy of policies and guidelines to (re)integrate ECs into the LTC setting. Until such evidence is available, expert opinion will drive best care practices.

Nonveterinarian staff increase revenue and improve veterinarian productivity in mixed and companion animal veterinary practices in the United States.

To determine the contributions of veterinarians and support staff to revenue and veterinarian productivity (ie, number of patients seen/full-time-equivalent veterinarian/wk) in private mixed and companion animal practices in the US and identify staff-to-veterinarian labor ratios (SVLRs) that maximized these 2 practice outputs. 409 owners of mixed and companion animal practices who participated in the 2020 AVMA Practice Owner Survey. Data regarding owner demographics, practice characteristics, labor (defined as mean total hours worked/wk), and gross revenue in 2019 were obtained from participating practices. Multivariable ordinary least-squares regression was used to identify factors associated with revenue and productivity as well as the SVLRs at which revenue and productivity were maximized. For each 10% increase in total veterinarian hours worked per week, revenue increased by a mean of approximately 9%. A 1-unit increase in total number of technician hours used to support 1 hour of veterinarian work was associated with a 20.5% increase in revenue but with no change in productivity. The same increase in total number of nonmedical staff hours was associated with a 17.0% increase in revenue and 14.4% increase in productivity. In terms of revenue, the optimal SVLRs for veterinary technicians and nonmedical staff were 9:1 and 8:1, respectively. In terms of productivity, the optimal SVLR for nonmedical staff was 10:1. Findings confirmed the important role of nonveterinarian staff in revenue and veterinarian productivity in mixed animal and companion animal practices and may be useful for making evidence-based staffing decisions.

Zero tolerance to sexual harm in schools – from broken rules to broken systems

ABSTRACT In 2020, student disclosure of sexual harm through the website “Everyone’s Invited” reignited discussions of sexual harm in schools with many calling for “zero tolerance” approaches to sexual harm. This article considers the impact of zero tolerance policies drawing upon school policies and practices, coupled with students experiences. The article draws upon findings from a mixed-methods study conducted from 2018–2020 within four local authority areas in England: focus groups with staff and students, surveys with students and parents, case review, observations, and school self-assessments. Analysis evidenced that where schools drew on punitive and sanctions-based approaches these impacted student disclosure, limited staff decision making, and were not seen to be effective by students. Rather than zero tolerance policies, the findings evidence the need to: tackle environments where sexual harm is tolerated; consider systemic barriers to disclosure, and expand what justice means for responses to sexual harm in schools.