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Health Sector Human Resource Crisis in Africa: An Issues Paper United States Agency for International Development; Academy for Educational Development 2003 Huddart J and Picazo OF [Excerpt from authors] The human resource (HR) problem in the health sector in sub-Saharan Africa (SSA) has reached crisis proportions in many countries. Although the gravity of the problem varies across the region, the situation in some countries is so grave that urgent action is needed. A complex set of factors has contributed to this problem, some exogenous, such as the austere fiscal measures introduced by structural adjustment, which often result in cutbacks in the number of health workers. But endogenous factors are also to blame, including misdirected human resource and training policies, weak institutions, and inappropriate structures. Section I of this paper lays out the key features of the HR crisis as gathered from available data and reports. Section II of the paper gathers together a few good practices and mechanisms that have been tried to ease the HR problems in the region. It highlights some opportunities for reform and cites the continuing challenges and risks. Details
Reduced In-Hospital Mortality After Improved Management of Children Under 5 Years Admitted to Hospital with Malaria: Randomised Trial British Medical Journal 2007 Biai S, Rodrigues A, Gomes M, Ribeiro I, Sodemann M, Alves F and Aaby P [Excerpt from authors]Objective: To test whether strict implementation of a standardised protocol for the management of malaria and provision of a financial incentive for health workers reduced mortality. Conclusions: Supervising healthcare workers to adhere to a standardised treatment protocol was associated with greatly reduced in-hospital mortality. Financial incentives may be important for the dedication and compliance of staff members. Details
Impact of Hospital Nursing Care on 30-day Mortality for Acute Medical Patients Blackwell Publishing 2007 Tourangeau AE, Doran DM, McGillis Hall L, O'Brien Pallas L, Pringle D, Tu JV and Cranley LA [Excerpt from auhtors]Aim: This paper reports on structures and processes of hospital care influencing 30-day mortality for acute medical patients.Conclusion: Just as hospitals and clinicians caring for patients focus carefully on completing accurate diagnosis and appropriate and effective interventions, so too should hospitals carefully plan and manage structures and processes of care such as the proportion of Registered Nurses in the staff mix, percentage of baccalaureate-prepared nurses, and routine use of care maps to minimize unnecessary patient death. Details
Fact Sheet: Applying Utilization Levels to Evaluate Nurse Staffing Nursing Health Services Research Unit 2007 Meyer R, O'Brien-Pallas L and Thomson D [Excerpt from authors] This fact sheet builds on selected content from the Evidence-based Standards for Measuring Nurse Staffing & Performance Study & is based on the completed research of O'Brien-Pallas, L., Thomson, D., McGillis Hall, L., Pink, G., Kerr, M., Wang, S., Li, X. & Meyer, R. (2004). The full report is available on line at www.chsrf.ca or www.nhsru.com. Details
Human Resources Planning and the Production of Health: A Needs Based Analytical Framework Canadian Public Policy 2007 Birch S, Kephart G, Tomblin Murphy G, O'Brien-Pallas L, Alder R and MacKenzie A Excerpt from authors] Traditional approaches to health human resources planning emphasize the effects of demographic change on the needs for health human resources. Planning requirements are largely based on the size and demographic mix of the population applied to simple population-provider or population-utilization ratios. We develop an extended analytical framework based on the production of health-care services and the multiple determinants of health human resource requirements. the requirements for human resources are shown to depend on four separate elements: demography, epidemiology, standards of care, and provider productivity. The application of the framework is illustrated using hypothetical scenarios for the population of the combined provinces of Atlantic Canada. Details
Lost in Translation: Exploring the Link Between HRM and Performance in Healthcare Blackwell Publishing, Inc.; Human Resource Management Journal 2007 Bartram T, Stanton P, Leggat S, Casimir G and Fraser B [Excerpt from authors]In this article we report on evidence from public healthcare organisations in Victoria, Australia. Using survey data collected in 2004 from 132 Victorian public health facilities, we investigated the adoption of strategic HRM from the reported experiences of chief executive officers (CEOs), HR directors (HRDs) and other senior managers (SMs). In this article, first, we investigate links between HRM and performance in healthcare settings and the extent to which healthcare organisations are monitoring HRM. Second, we explore differences and similarities in perspectives of strategic HRM from the respondent groups. Finally, we provide insights into some of the factors associated with these similarities and differences. Details
The Forces of Magnetism: Core Characteristics to Achieve Magnet Recognition American Nurses Credentialing Center 2007 Morgan SH This article explores the 14 Forces of Magnetism. Details
Discussion Paper 49: The Costs and Benefits of Health Worker Migration from East and Southern Africa (ESA): A Literature Review EQUINET / HST 2007 Robinson R [Excerpt from publisher]This report commissioned by EQUINET / HST in co-operation with the ECSA-HC presents a review of literature on the methods for analysis costs and benefits of the migration of health workers from East and Southern African (ESA) countries. Details
Initial Community Perspectives on the Health Service Extension Programme in Welkait, Ethiopia Human Resources For Health 2007 Negusse H ,McAuliffe E and MacLachlan M [Excerpt from authors]BACKGROUND The Health Service Extension Programme (HSEP) is an innovative approach to addressing the shortfall in health human resources in Ethiopia. It has developed a new cadre of Health Extension Workers (HEWs), who are charged with providing the health and hygiene promotion and some treatment services, which together constitute the bedrock of Ethiopia's community health system. RESULTS Although Health Extension Workers (HEWs) had visited them less frequently than planned, participants generally found the programme to be helpful. Despite this, their basic health knowledge was still quite poor regarding the major communicable diseases and their vectors. Participants felt the new HESP represented an improvement on previous health provision. HEWs were preferred over Traditional Birth Attendants for assistance with labour CONCLUSION While the introduction of HEWs has been a positive experience for women living at the study site, the frequency of visits, extent of effectively imparted health knowledge and affects of HEWs on other health providers needs to be further explored. Details
HRH Fact Sheets Africa Health Workforce Observatory; World Health Organization 2007 [Excerpt from publisher]The HRH country fact sheets presented here are intended to give a brief summary of the HRH situation in each country. Details
Addressing Health Worker Shortages: Recruiting Retired Nurses to Reduce Mother-to-Child Transmission in Guyana Family Health International 2005 Morgan R [Excerpt from author]When GHARP set out to recruit these new service providers, it faced a dilemma. Due to the limited supply of health workers in Guyana, the project needed to avoid recruiting health care providers already working for the MOH. Hiring existing health workers away from their jobs would simple reshuffle the distribution of health workers, rather than add new ones.To address the problem, GHARP staff decided to recruit retired nurses to fill the positions. Details
Developing and Sustaining Effective Teams Royal College of Nursing, UK 2007 [Excerpt from publisher]These guides are designed to be used by anyone who works in a team and who wishes to improve the ways in which the team operates. They contain practical, useful and thought provoking ideas to increase team effectiveness and initiate change. Details
Long Term Conditions Workforce Development Resource Pack NHS National Workforce Projects 2007 [Excerpt from publisher] This resource pack has been designed to be used by all staff involved in planning and developing the long term conditions workforce - be they workforce, service or HR planners or clinical leads in primary, secondary or social care. The pack contains workforce planning checklists, together with examples of best practice and frequently asked questions (FAQ's) that other organisations have developed to solve common issues. A section on useful contacts and resources together with contact details for each best practice example has also been included. Details
Planning Now for Your Future Workforce Needs NHS National Workforce Projects 2005 [Excerpt from publisher]This guide discusses the importance of long term planning, and steers you through the challenges you may face when creating a long term plan for your workforce. Details
Nurse Workforce Planning in the UK: A Report for the Royal College of Nursing Royal College of Nursing 2007 Buchan J [Excerpt from author]This report has been prepared for the Royal College of Nursing. Its main objective is to provide a commentary on the current status of nursing workforce planning systems and data in the NHS. It also identifies current limitations and critical gaps in nurse workforce data availability in the NHS. Comparisons are also made with non UK sources and approaches where these serve to illustrate possible options to improve current UK systems and data gathering approaches. Details
New Ways of Working for Everyone - A Best Practice Implementation Guide National Institute for Mental Health in England National Workforce Programme 2007 [Excerpt from publisher] The purpose of this best practice implementation guide, produced by the National Institute for Mental Health in England (NIMHE) National Workforce Programme (NWP), is to set out how health and social care organisations could take a strategic approach to the implementation of New Ways of Working (NWW). New Ways of Working (NWW) is about a new way of thinking which includes the development of new, enhanced and changed roles for mental health staff, and the redesigning of systems and processes to support staff to deliver effective, personcentred care in a way that is personally, financially and organisationally sustainable. Details
Workplace Violence Among Iraqi Hospital Nurses Balckwell Synergy; Journal of Nursing Scholarship 2007 AbuAlRub RF, Khalifa MF and Habbib MB [Excerpt from auhtors]Purpose: To investigate (a) the occurrence and frequency of physical workplace violence among Iraqi hospital nurses as well as the complaints and responses of nurses to such violence; (b) measures and policies in the workplace to deal with violence; and (c) factors that contribute to the workplace violence and the strategies to prevent them from Iraqi nurses' perspective. Note: An online subscription or single article purchase is required to access this article. Details
Public-private Options for Expanding Access to Human Resources for HIV/AIDS in Botswana Human Resources for Health 2007 Dreesch N, Nyoni J, Mokopakgosi O, Seipone K, Kalilani J, Kaluwa O and Musowe V [Excerpt from auhtors]In responding to the goal of rapidly increasing access to antiretroviral treatment (ART), the government of Botswana undertook a major review of its health systems options to increase access to human resources, one of the major bottlenecks preventing people from receiving treatment. In mid-2004, a team of government and World Health Organization (WHO) staff reviewed the situation and identified a number of public sector scale up options. The team also reviewed the capacity of private practitioners to participate in the provision of ART. Subsequently, the government created a mechanism to include private practitioners in rolling out ART. At the end of 2006, more than 4500 patients had been transferred to the private sector for routine follow up. It is estimated that the cooperation reduced the immediate need for recruiting up to 40 medically qualified staff into the public sector over the coming years, depending on the development of the national standard for the number and duration of patient visits to a doctor per year. Thus welcome relief was brought, while at the same time not exercising a pull factor on human resources for health in the sub-Saharan region. Details
The Value of RNs: How Can We Communicate our Economic Worth? and other articles that may be of interest American Nurses Association; Online Journal of Issues in Nursing 2007 Various [Excerpt from publisher] The 5 new articles in the September 30, 2007 OJIN topic, The Value of RNs: How Can We Communicate our Economic Worth? encourage readers to think about nursing's value contribution, present and future, to the health care system. The articles discuss mandatory hospital nurse staffing ratios, the relevance and use of the National Database of Nursing Quality IndicatorsTM (NDNQI ), the business case for nurse retention, and reconceptualization of nursing's value using cost-utility analysis. While economic concepts may be daunting, the content of these five articles gives a needed voice to demystifying these concepts. ANA members have the first opportunity to access the most recent OJIN topic. When each new OJIN topic is posted, the previous topic then becomes available to non-members. All previously published OJIN content remains accessible to all readers. Details
Addressing Africa's Health Workforce Crisis The McKinsey Quarterly 2007 Conway M, Gupta S and Khajavi K [Excerpt from publisher]Millions of people across sub-Saharan Africa suffer needlessly because they cannot obtain medical care from trained workers. Fully 820,000 additional doctors and nurses are needed to provide the region with even the most basic health services. The money to hire, train, and sustain such an increase won't be available in the foreseeable future. Even if funding materialized, 600 additional medical and nursing schools would be needed to fill the gap, and it would take more than two decades to train the requisite number of professionals. To ameliorate the problem in the coming decade, countries in Africa should build systems based on thoughtful ratios between professional and paraprofessional workers. Governments can't do so alone; the development community and the private sector also have roles to play. Details
Engaging with Care- A Vision for the Health and Care Workforce of England The Nuffield Trust, UK 2007 Dawson S, Morris Z, Erickson W, Lister G, Altringer B, Garside P and Craig M [Excerpt from Preface]This Nuffield Trust report focuses on the third phase of the Health Policy Futures series and is based on work by a team led by Professor Dame Sandra Dawson at the Judge Business School at Cambridge University. This third and final phase of work examines the current health and care needs of people in England and the human resources and facilities that will be required to meet these needs in the future. It develops three scenarios for how patients, citizens and carers (both professional and informal) might engage with the health and social care system in 2022 and looks at the implications of each. Details
Human Becoming and 80/20: An Innovative Professional Development Model for Nurses SAGE Publications; Nursing Science Quarterly 2007 Bournes DA and Ferguson-Par? M [Excerpt from publisher]The authors describe a study that evaluated implementation of a professional development model in which nurses spend 80% of their salaried time in direct patient care and 20% of their salaried time on professional development. The professional development time includes focused learning about patient-centered practice guided by the human becoming nursing theory. A qualitative descriptive preproject-process-postproject method and a longitudinal, repeated measures, descriptive-comparative method were used to answer the research questions. Participants were 33 nurses, 11 other nurse leaders and health professionals, and 55 patients and family members. The findings show that on the study unit overtime hours decreased significantly, the education hours were sustained throughout the study period, workload hours per patient day increased significantly, sick time stayed low, patient satisfaction scores increased, staff satisfaction scores were significantly higher than for comparator groups, and turnover was non-existent among study participants in year 2. Average variable direct labor cost increased over time, but the increase was not significantly higher than on the control units. Themes from the interviews with participants are presented. Ongoing evaluation of the model and implications for future research are discussed. Details
Health Workforce Innovations:A Synthesis of Four Promising Practices The Capacity Project 2007 Buchan J and McCaffery J [Adapted from introduction]This synthesis paper summarizes promising practices in four African countries: Task shifting: Ghana and Uganda; Improving retention: Malawi; and Increasing recruitment and rapid deployment: Namibia. Details
Lateral Violence: Nurse Against Nurse - Continuing Education Module American Nurses Association 2007 Rowell PA [Excerpt from author] Violence between and among workers is not unusual today. In health care, violence is a growing problem among nurses, as well as other disciplines. This independent study module focuses on lateral violence between and among nurses. The purpose of this independent study module is to increase nurses' awareness and understanding of the problem of violence between nurse co-workers in the health care setting. Although there are several theories regarding why lateral violence is a problem among nurses, the core issue continues to be that violent behavior towards another oftentimes injures the other's self-esteem. Such an adversarial dyad serves no one but establishes an atmosphere for increasing anger and possibly violent behavior. To stop lateral violence, the chief executive nursing officer must set a "zero tolerance" policy towards violent or abusive behavior among staff. This policy must be strictly and justly administered so that all employees accept that the policy is "for real" and applies to staff nurse and/or nurse administrators. No one ever deserves to be abused by anyone or by any type of behavior. Details
Workplace Violence : The Nurse Victim - Continuing Education Module Amercian Nurses Association 2007 Rowell PA [Excerpt from author] Of two major types of trauma - interpersonal and non-interpersonal - the most common, for most people, is interpersonal trauma. This trauma can come from being the recipient of actual violence from one person upon another, e.g., rape or beating, observing violent acts of one person upon another, e.g., fights or stabbings, or being demeaned and berated by someone of influence in one's life. All of these actions can be a threat or perceived threat to one's safety and well being. The target person's physiology, behaviors, and thoughts can change so that the person may suffer from a variety of symptoms - some short- term, some chronic, or none at all. Why some persons suffer sequelae and others do not remains an unanswered question even though some hints are being identified. Details
Bullying in the Workplace: Reversing a Culture - Continuing Edcuation Module American Nurses Association 2007 Rowell PA [Excerpt from author] The purpose of this CE module is to provide an opportunity for RNs to learn about "bullying" and horizontal violence. This educational program will offer an in-depth examination of the phenomena of bullying, including the consequence and methods to address bullying in the workplace. Details
Establishing Human Resource Systems for Health During Post Conflict Reconstruction Management Sciences for Health 2006 Smith JH and Kolehmainen-Aitken RL [Excerpt from authors] This paper seeks to elucidate HRH issues in the critical start up period of reconstruction in countries that have experienced relatively prolonged and major conflict. The examples are drawn mostly from Afghanistan and Cambodia, two countries that experienced more than twenty years of conflict. Details
When the Tide Goes Out: Health Workforce in Rural, Remote and Indigenous Communities The Medical Journal of Australia 2006 Murray RB and Wronski I [Excerpt from authors]There is compelling evidence for the success of the "rural pipeline" (rural student recruitment and rurally based education and professional training) in increasing the rural workforce.The nexus between clinical education and training, sustaining the health care workforce, clinical research, and quality and safety needs greater emphasis in regional areas.A "teaching health system" for non-metropolitan Australia requires greater commitment to teaching as core business, as well as provision of infrastructure, including accommodation, and access to the private sector.Workforce flexibility is mostly well accepted in rural and remote areas. There is room for expanding the scope of clinical practice by non-medical clinicians in both an independent codified manner (eg, nurse practitioners) and through flexible local medical delegation (eg, practice nurses, Aboriginal health workers, and therapists).The imbalance between subspecialist and generalist medical training needs to be addressed.Improved training and recognition of Aboriginal health workers, as well as continued investment in Indigenous entry to other health professional programs, remain policy priorities. Details
Global Report- Equality at Work: Tackling the Challenge International Labour Office 2007 [Excerpt from publisher]The second Global Report on discrimination under the follow-up to the ILO Declaration on Fundamental Principles and Rights at Work examines emerging issues in patterns of workplace discrimination and inequalities and recent policy responses, and outlines the ILO's experience and achievements to date and the challenges it faces. It points to the need for better enforcement of legislation against discrimination, as well as non-regulatory initiatives by governments and enterprises, and equipping the social partners to be more effective in making equality a reality at the workplace. The Report puts forward other proposals for future action, including making equality a mainstream objective of the ILO's Decent Work Country Programmes. Available in: English, ??????? , Deutsch, Fran?ais, Espa?ol and??????? Details
Initial Community Perspectives on the Health Service Extension Programme in Welkait, Ethiopia Human Resources for Health 2007 Negusse H , Mc Auliffe E and MacLachlan M [Excerpt from authors]Background: The Health Service Extension Programme (HSEP) is an innovative approach to addressing the shortfall in health human resources in Ethiopia. It has developed a new cadre of Health Extension Workers (HEWs), who are charged with providing the health and hygiene promotion and some treatment services, which together constitute the bedrock of Ethiopia's community health system. Methods:This study seeks to explore the experience of the HSEP from the perspective of the community who received the service. A random sample of 60 female heads-of-household in a remote area of Tigray participated in a structured interview survey. Results:Although Health Extension Workers (HEWs) had visited them less frequently than planned, participants generally found the programme to be helpful. Despite this, their basic health knowledge was still quite poor regarding the major communicable diseases and their vectors. Participants felt the new HESP represented an improvement on previous health provision. HEWs were preferred over Traditional Birth Attendants for assistance with labour.Conclusions: While the introduction of HEWs has been a positive experience for women living at the study site, the frequency of visits, extent of effectively imparted health knowledge and affects of HEWs on other health providers needs to be further explored. Details
Managing Attrition Rates for Student Nurses and Midwives - A Guide to Good Practice for Strategic Health Authorities and Higher Education Institutions Department of Health 2007 [Excerpt from publisher] Despite the fact that there has been a common definition of 'Attrition' since 2002, the available data still suggests that there are very significant differences in attrition rates for student nurses and midwives around the country depending on which University and local health economy these students relate to. Whilst this is obviously a matter of public interest from a value for money perspective, it does also need to be recognised that some of the media coverage has been based on misleading or inaccurate data. One of the two main purposes of this document is to explore some of the sometimes complex data issues associated with 'attrition' so as to assist both Universities and NHS organisations in their efforts to produce information that is based on not just common data definitions; but also on a common interpretation of common data definitions. Details
Work Attitudes of Older RNs SAGE Publications;Policy, Politics, & Nursing Practice 2007 Kovner CT, Brewer CS, Cheng Y and Djukic M [Excerpt from publisher] Using data collected from 1,906 RNs from Metropolitan Statistical Areas in 29 states, the purpose of this study was to examine the characteristics and work attitudes of older RNs compared to RNs less than age 50 at two time periods, and compare among the older RNs those who are working in nursing, working outside nursing, and not working. Older RNs reported more distributive justice (fairness of rewards), work group cohesion, and supervisory support and less organizational constraint, and quantitative workload than younger RNs. Overall, older RNs were more satisfied, had greater organizational commitment, and had less desire to quit than younger RNs. There were no significant differences between older and younger RNs for autonomy, mentor support, or variety. Strategic efforts by employers and government could be used to retain older workers, attract RNs working in nonnursing settings back into nursing, and recruit retired RNs into the nursing workforce. Details
Strategies Employed to Rebuild Nursing Following Restructuring: Canadian Perspectives SAGE Publications; Journal of Research in Nursing 2005 McGillis Hall L [Excerpt from publisher]This study explores the strategies employed by nurse executives to rebuild the nursing workforce in a sample of 140 Canadian hospitals following a period of restructuring, as well as identifying the mechanisms being used to monitor ongoing nursing expenditures in an era of fiscal accountability. The most common restructuring strategy employed was to change the nursing staff mix. Nurses' responses to these efforts was concerning. Focused initiatives developed by nurse executives to rebuild nurse staffing levels included increasing the employment of full-time nurses, as well as enhancing support roles utilised in the hospital healthcare system (e.g. professional practice leaders, case managers, clinical nurse specialists, nurse practitioners, nurse educators). Future efforts to monitor nursing expenditures should be balanced examining potentially positive as well as negative nursing cost utilisation. Details
Nurses' Perceptions of Hospital Work Environments Blackwell Synergy; Journal of Nursing Management 2007 McGillis Hall L and Doran D [Excerpt from publisher] Aim: To examine factors within the nursing work environment that may affect nurse outcomes. Background: Primary data were acquired from unit managers and staff nurses on the study units. Secondary data were collected from health records administrative databases. The sample included adult medical and surgical units within all 19 teaching hospitals in Ontario, Canada. Methods: A cross-sectional study design was employed in this study. A random sampling process was used to recruit the number of nurses (n = 1,116) required to provide a statistically adequate sample for the survey. Results: Perceptions of the quality of care at the unit level were found to have a statistically significant positive influence on nurses' job satisfaction, and a statistically significant negative influence on nurses' job pressure and job threat. Conclusions: The results of this study underscore the importance of examining the environment in which nurses' work as a potential factor that influences outcomes experienced by patients and nurses. Details
Nurse Staffing Models as Predictors of Patient Outcomes Lippincott Williams & Wilkins, Inc.; Medical Care 2003 McGillis Hall L, Doran D, Baker GR, Pink GH, Sidani S, O'Brien-Pallas L and Donner GJ. [Excerpt fron publisher]Background. Little research has been conducted that examined the intended effects of nursing care on clinical outcomes. Objective. The objective of this study was to evaluate the impact of different nurse staffing models on the patient outcomes of functional status, pain control, and patient satisfaction with nursing care. Research Design. A repeated-measures study was conducted in all 19 teaching hospitals in Ontario, Canada. Subjects. The sample comprised hospitals and adult medical-surgical and obstetric inpatients within those hospitals. Measures. The patient's functional health outcomes were assessed with the Functional Independence Measure (FIM) and the Medical Outcome Study SF-36. Pain was assessed with the Brief Pain Inventory and patient perceptions of nursing care were measured with the nursing care quality subscale of the Patient Judgment of Hospital Quality Questionnaire. Results. The proportion of regulated nursing staff on the unit was associated with better FIM scores and better social function scores at hospital discharge. In addition, a mix of staff that included RNs and unregulated workers was associated with better pain outcomes at discharge than a mix that involved RNs/RPNs and unregulated workers. Finally, patients were more satisfied with their obstetric nursing care on units where there was a higher proportion of regulated staff. Conclusions. The results of this study suggest that a higher proportion of RNs/RPNs on inpatient units in Ontario teaching hospitals is associated with better clinical outcomes at the time of hospital discharge. Details
Pay for Performance, Quality of Care, and Outcomes in Acute Myocardial Infarction Journal of the American Medical Association 2007 Glickman SW, Ou FS, DeLong ER, Roe MT,Lytle BL, Mulgund J, Rumsfeld JS, Gibler WB, Ohman M, Schulman KA and Peterson ED, [Excerpt from authors]Context: Pay for performance has been promoted as a tool for improving quality of care. In 2003, the Centers for Medicare & Medicaid Services (CMS) launched the largest pay-for-performance pilot project to date in the United States, including indicators for acute myocardial infarction. Objective: To determine if pay for performance was associated with either improved processes of care and outcomes or unintended consequences for acute myocardial infarction at hospitals participating in the CMS pilot project. Conclusions: Among hospitals participating in a voluntary quality-improvement initiative, the pay-for-performance program was not associated with a significant incremental improvement in quality of care or outcomes for acute myocardial infarction. Conversely, we did not find evidence that pay for performance had an adverse association with improvement in processes of care that were not subject to financial incentives. Additional studies of pay for performance are needed to determine its optimal role in quality-improvement initiatives. Details
The Ethical Recruitment of Internationally Educated Health Professionals: Lessons from Abroad and Options for Canada Canadian Policy Research Networks 2007 Klassen N, McIntosh T and Torgerson R [Excerpt from Publisher] A new report by CPRN calls for provincial governments to take a closer look at the way they hire doctors, nurses and other health professionals from developing countries. Canada has always relied on newcomers to help deal with shortages in this field, but increasingly these professionals are coming from developing countries, especially from Africa and Asia, which have staffing shortages and critical health problems of their own. The report, The Ethical Recruitment of Internationally Educated Health Professionals: Lessons from Abroad and Options for Canada, looks at how other countries are handling the issue, examines the views of key players and outlines some first steps for Canada's provinces to begin the process of developing a code of practice or series of guidelines. Details
Positive Practice Environments: Quality Workplaces = Quality Patient Care International Council of Nurses 2007 Baumann A [Excerpt from author]It is a pressing reality. Health systems worldwide are increasingly challenged - faced with a growing range of health needs and financial constraints that limit services' potential to strengthen health sector infrastructures and workforces. We are immersed in a global nursing workforce crisis - one marked by a critical shortage of nurses. The reasons for the shortage are varied and complex, but key among them are unhealthy work environments that weaken performance or alienate nurses and, too often, drive them away ? from specific work settings or from the nursing profession itself. Yet there are environments that do just the opposite, that support excellence and have the power to attract and keep nurses. These have come to be called positive practice environments. Their beneficial effect on everything from nurse satisfaction to patient outcomes to innovation is documented by a substantial body of evidence. Still, much work needs to be done to make positive practice environments the norm. Toward this end, ICN has chosen Positive Practice Environments: Quality Workplaces = Quality Patient Care as the theme of International Nurses Day 2007 and the focus of this tool kit. Designed to help nurses raise awareness and take action, the kit can be used by managers, front-line nurses, chief executive officers, professional associations and/or regulatory bodies. The kit is designed to provide data on positive practice environments to all health stakeholders who are interested in improving the delivery of quality services. Details
Trends in Nursing Staff Allocation: The Nurse-to-Patient Ratio and Skill Mix Issues in Israel International Nursing Reveiw; Blackwell Publishing 2007 Rassin M and Silner D [Excerpt from authors]This article describes a case study relating to trends in nurse-to-patient ratios and nursing staff mix in Israel. Details
Holding On: Nurses' Employment and Morale in 2007 Royal College of Nursing UK 2007 Ball J and Pike G This is the 21st employment survey commissioned by the Royal College of Nursing UK. The survey reports on nurses views about pay and rewards; working hours; workload and staffing; job change, etc. It concludes that nurses' morale is at a 10-year low. Details
The Benefits of Teamwork in Healthcare - eVD Canadian Health Services Research Foundation 2007 [Excerpt from publisher]The Foundation presents a short electronic video documentary (eVD) about the benefits of teamwork in healthcare, with an engaging cast of researchers, policy makers, staff, and patients. Windows Media Player required. Details
Providing the Providers - Remedying Africa's Shortage of Health Care Workers NEJM 2007 Pooja K [Excerpt from author] The pressures on Mfeka and Nkabinde reflect a global problem that is finally receiving attention from donors and international agencies: a critical shortage of health care workers in many parts of the world. Although this shortage is not new, recent international efforts to vaccinate children and to fight human immunodeficiency virus (HIV) infection and AIDS, malaria, tuberculosis, and other diseases have brought it into sharper focus. Donors are increasingly realizing that without enough trained workers to deliver drugs, vaccines, and care, pumping money into projects will not have the desired effects. "Even if you have the medicine, the vaccines, and the bed nets, you need the health workers to deliver the service," says Manuel Dayrit, director of the Department of Human Resources for Health at the World Health Organization (WHO). "With the experience of the last few years, where you have had huge global funds move into an activity to provide resources . . . we've found that the bottleneck is really the delivery." Details
Working for an Accessible, Motivated and Supported Health Workforce Global Health Workforce Alliance 2007 Omaswa F [Excerpt from author]One of the most important health goals was articulated by Lee Jong-wook: "Access to a motivated and supported health worker for every person in every village everywhere."Whether one is ill, in need of urgent care but denied access to essential services due to the absence of a health worker - or looking from the perspective of an over-stretched health worker who is inadequately equipped and supported, and brings barely poverty-level wages back to the family - the crisis in human resources for health (HRH) is an old problem which has developed right in front of us, and has now been exposed and accentuated by fresh forces.Yet two to three decades ago, as a health worker in Africa, I enjoyed decent wages and good working conditions; and this was the case in many other sub-Saharan African countries. Details
At Breaking Point:? A Survey of the Wellbeing and Working Lives of Nurses in 2005 Royal College of Nursing, UK 2006 Ball J, Pike G and Bradley M [Excerpt from authors] The RCN commissioned a survey of 6,000 members in 2000 to explore nurses' wellbeing and working lives. The results1 subsequently helped shape RCN policy and materials for members on topics such as bullying and harassment, violence, needlestick injury and employee-friendly working practices. Five years on, the RCN has commissioned a second survey looking at a similar range of issues. This report documents the findings of that survey, and describes differences between the 2000 and 2005 survey findings. Details
Addressing the HRH Crisis: the Importance of Infection Prevention and Control Commonwealth Regional Health Community for East, Central and Southern Africa 2003 Munjanja O and Lynam P [Excerpt from authors]This presentation examines the importance of infection prevention and control. Details
The Least Developed Countries Report, 2007 UNCTAD 2007 [Excerpt from publisher]This Report explores how national and international policies can promote more effective technological learning and innovation in the least developed countries (LDCs). It extends and deepens the analysis in The Least Developed Countries Report 2006. Chapter 4 looks at the loss of skilled human resources through emigration and at policy options for dealing with that issue. Also available in: Arabic Chinese French Russian Spanish Details
Predictors of Job Satisfaction Among Doctors, Nurses and Auxiliaries in Norwegian Hospitals: Relevance for Micro Unit Culture Human Resources for Health 2006 Krogstad U, Hofoss D, Veenstra M and Hjortdahl P [Excerpt from authors] Objective: To explore what domains of work are important for job satisfaction among doctors, nurses and auxiliaries and to discuss differences between professional groups in the perspective of micro team culture. Conclusion: The professional values of medicine, the organizational and holistic skills of nurses and the practical experience of auxiliaries should all be valued in the building of interdependent micro teams. Details
Royal College of Nursing Lone Working Survey Royal College of Nursing 2007 Smith M [Excerpt from publisher]The Royal College of Nursing (RCN) has been concerned about the level of risks to nurses. It has been working in a number of ways to raise awareness of the problem and to contribute towards the development of solutions to reduce the incidence of violence, as well as ensure those who are subjected to violence receive the support they need. The RCN believes that those who assault nurses should face criminal sanctions where appropriate, but highlights the fact that there are relatively few prosecutions in relation to the number of incidents. In 2006, the RCN published a survey looking at all aspects of nurses' working environment, including assaults from patients and the public. Four in 10 respondents reported that they had been harassed or assaulted by patients or relatives in the previous 12 months - an increase on an earlier report in 2000. Of these, 25 per cent were reported by nurses working in the community. Interventions to reduce levels of violence and aggression are frequently focussed on the acute sector and emergency departments in particular. However, working in the community means that nurses face all the risks of lone working, resulting in exposure to violence and aggression. Details
Major Surgery Delegation to Mid-level Health Practitioners in Mozambique: Health Professionals' Perceptions Human Resources for Health 2007 Cumbi A, Pereira C , Malalane R, Vaz F, McCord C, Bacci A and Bergstrom A [Excerpt from authors]This study examines the opinions of health professionals about the capacity and performance of the 'tecnico de cirurgia', a surgically trained assistant medical officer in the Mozambican health system. Particular attention is paid to the views of medical doctors and maternal and child health nurses. Details
National Workforce Plan 2006 - NHS Scotland Scottish Executive 2006 [Excerpt from Publisher] The purpose of this document is primarily to articulate and describe workforce supply. The aim of this is two-fold. First, it will help NHS Boards and other employers to understand where their future workforce is likely to come from and second, it provides a vehicle for setting medical, dental and nursing training numbers and helps inform education providers about future workforce needs and likely supply pathways. Details
New Ways of Working - Improving Workflow on Patient Care Units Pilot Program American Hospital Association; Maryland Hospital Association 2007 [Excerpt from Publisher] The continuing and growing health care workforce shortage is one of the most serious ongoing issues faced by hospitals. As part of its efforts to help hospitals build a thriving workforce, the American Hospital Association (AHA) has been working with colleagues from the Changing Workforce Programme of the English National Health Service (NHS) for several years. This NHS initiative used workforce changes, particularly role/job redesign, to lead improvement in services to patients. Through a number of pilots in England, the NHS demonstrated that better allocation of staff skills to the tasks of treatment and care results in more effective use of time and higher staff motivation. Senior, highly trained staff can focus their skills on areas of greatest clinical need, while enhanced support staff roles offer career development and greater job satisfaction. Details
Nurses' Experiences of Recruitment and Migration from Developing Countries: A Phenomenological Approach Human Resources For Health 2007 Troy PH, Wyness LA and McAuliffe E [Excerpt from authors]There is growing concern globally at the current flows of nurse migration, particularly from low-income to middle and high-income countries. Recruitment practices of many countries such as Ireland are thought to be fuelling this rate of migration. This paper aims to establish the perceptions and opinions of those involved in the recruitment process on their role in recruitment and the effects recruitment has on both source and destination countries. Details
Help Wanted: Confronting the Health Worker Crisis to Expand Access to HIV/AIDS Treatment - MSF Experience in Southern Africa M?decins Sans Fronti?res 2007 [Excerpt from publisher] This report focuses on the impact of human resource shortages witnessed by MSF teams in four southern African countries - Lesotho, Malawi, Mozambique, and South Africa. While the focus is largely on nurses in rural areas, it should be acknowledged that health staff is lacking across the spectrum - from doctors to laboratory technicians to pharmacists - at all levels of care. The report also describes how MSF teams and local partners are trying to overcome staff shortages to reduce waiting times and increase access to care. Details
Guidelines for Evaluation Nursing and Midwifery Education and Training Programmes - DRAFT World Health Organization Regional Office for Africa 2005 [Excerpt from authors] In the context of the critical role that human resources play in delivering health services to populations and as human resources represent a critical constraint in achieving the targets of the Millennium Development Goals, it becomes imperative that effective systems for regulation, education, research and performance management be strengthened in order to achieve the required improvement in health health outcomes. The guidelines will provide a framework to health policy and decision-makers, planners and implementers of health sciences education and training programmes to improve health programmes and the services for delivering them, and to guide in allocation of human and financial resources in current and future programmes and services. Details
Policies and Plans for Human Resources for Health - Guidelines for Countries in the WHO African Region World Health Organization Regional Office for Africa 2006 Nyoni J, Gbary A, Awases M, Ndecki P and Chatora R [Excerpt from Foreward]These guidelines are intended for use by Ministry of Health officials responsible for human resources development as well as others in relevant ministries and agencies. It is hoped that these guidelines will be used for the review and development of human resource situation analysis, policies and plans and will be adapted as necessary by each Member country in the WHO African Region. Also available in Fran?ais and Portugu?s. Visit http://www.afro.who.int/hrh-observatory/documentcentre/index.html Details
Workers' Health: Draft Global Plan of Action World Health Organization 2007 [Excerpt from publisher] The proposed plan of action deals with all aspects of workers' health, including primary prevention of occupational hazards, protection and promotion of health at work, employment conditions, and a better response from health systems to workers' health. Available in Arabic, Chinese, English, French, Spanish and Russian. Details
Africa Health Strategy: 2007-2015 AU 2007 The Strategy contains a section on human resources Details
Health Human Resources Policy in the 21st Century Canadian Public Policy 2007 Guest Editors: Stephen Birch and Ivy Lynn Bourgeault [Excerpt from publisher]A central piece of Canada's health-care system is human resources. Current concerns with shortages of various types of health-care providers, whether real or perceived, and the impact that these shortages have on other policy initiatives (e.g., primary care reforms, wait-time reduction, etc.), have drawn the attention of policymakers to the need for improvement in the planning for and use of healthc are human resources. Health human resource planning is not only a critical task, it is also increasingly complex. Healthcare production is labour-intensive and the human resource inputs used are well trained. Moreover, the context within which these health workers are deployed is highly regulated, constrained by pre-existing policy and institutional imperatives, and subject to a range of political influences. The collection of papers in this Special Issue of Canadian Public Policy/Analyse de politiques presents a wide range of contributions to some of the key problems associated with health human resources in the Canadian context. Details
Deteriorated External Work Environment, Heavy Workload and Nurses' Job Satisfaction and Turnover Intention Canadian Public Policy 2007 Zeytinoglu IU, Denton M, Davies S, Baumann A, Blythe J and Boos L [Excerpt from authors]Health system reform experienced in Canada since the 1990s profoundly affected health-care workplaces and workers' attitudes. In this paper we examine associations between deteriorated external work environment, heavy workload and nurses' job satisfaction and turnover intention. Data are from our 2002 survey responses of 1,396 nurses employed in three teaching hospitals in southern Ontario. Data are analyzed first for all nurses and then separately for full-time, part-time, and casual nurses. External work environment refers to nurses' perceptions of important decisions being made outside the hospital, limited resources, and budget cuts. Results show that when nurses perceive a deteriorated external work environment and consider their workload to be heavy, they also report low job satisfaction. Low job satisfaction and heavy workload, in turn, are associated with nurses' turnover intention. However, when nurses perceive a deteriorated external work environment they are more inclined to stay. When data are examined separately for each employment status group, the effect of external work environment and workload are different on turnover intentions for fulltime, part-time, and casual nurses. We suggest managers and policymakers pay attention to the impact of deteriorated external work environment and heavy workload in developing strategies for nurses' job satisfaction and retention. More importantly, the different impact of these factors according to employment contracts should be considered in developing human resources policies for nurses' job satisfaction and retention. Details
Human Resources Planning and the Production of Health: A Needs-Based Analytical Framework, Canadian Public Policy 2007 Birch S, Kephart G, Tomblin-Murphy G, O'Brien-Pallas L, Alder R and MacKenzie A [Excerpt from authors]Traditional approaches to health human resources planning emphasize the effects of demographic change on the needs for health human resources. Planning requirements are largely based on the size and demographic mix of the population applied to simple population-provider or population-utilization ratios. We develop an extended analytical framework based on the production of health-care services and the multiple determinants of health human resource requirements. The requirements for human resources are shown to depend on four separate elements: demography, epidemiology, standards of care, and provider productivity. The application of the framework is illustrated using hypothetical scenarios for the population of the combined provinces of Atlantic Canada. Details
A Review of Non-financial Incentives for Health Worker Retention in East and Southern Africa Regional Network for Equity in Health in East and Southern Africa; East Central and Southern African Health Community 2007 YM Dambisya [Excerpt from author]This paper was commissioned by the Regional Network for Equity in Health in east and southern Africa (EQUINET) in co-operation with the and the East, Central and Southern African Health Community (ECSA-HC) to inform a programme of work on 'valuing health workers' so that they are retained within the health systems. The paper reviewed evidence from published and grey (English language) literature on the use of non-financial incentives for health worker retention in sixteen countries in east and southern Africa (ESA): Angola, Botswana, DRC, Kenya, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. There is a growing body of evidence on health worker issues in ESA countries, but few studies on the use of incentives for retention, especially in under-served areas. Details
Career Intentions of Nursing Students and New Nurse Graduates: A Review of the Literature International Journal of Nursing Education Scholarship 2006 Hayes L, Orchard C, McGillis Hall L, Nincic V, O'Brien-Pallas L and Andrews G [Excerpt from authors]This paper highlights findings from a literature search to examine the role of nursing education in preparing nurses to meet healthcare demands. The review focused on nursing students' perceptions of nursing and whether these views change during their nursing studies and impact workplace preferences. Nursing students often enter their program with preconceived ideas of where they want to work following graduation. Large urban hospitals were favored over community care because of the perceived opportunities for support. Of particular importance were the negative views relating to care of elderly patients. Unless attitudes are changed during their nursing studies, they may affect initial job selection. Implications for nursing education include provision of educational experiences that foster an optimistic career outlook in areas where there is a growing need for nursing services. More research is needed to determine how to enable appropriate learning experiences when there are limited resources and practice placements. Details
Task Shifting to Tackle Health Worker Shortages World Health Organization 2007 [Excerpt from publisher]At the June 2006 General Assembly High-Level Meeting on HIV/AIDS, United Nations Member States agreed to work towards the goal of "universal access to comprehensive prevention programmes, treatment, care and support" by 2010.Countries all around the world have made significant progress in scaling up HIV services. Nevertheless, major barriers must be overcome if universal access is to be achieved. One of the main constraints is a serious shortage of health workers-the people on the front line of the efforts to prevent and treat HIV infection. Details
Maternity Services Workforce Development Resource Pack NHS 2007 [Excerpt from publisher]This workforce planning resource pack is part of a range of resources developed by NWP to support maternity services. This range includes a maternity e-learning CD and a series of maternity workforce development workshops. All these resources are aimed at a mixed audience involved in the delivery of these changes which includes clinicians, heads of midwifery and service management staff as well as human resources, service redesign and workforce planning leads. This pack provides policy background and contains workforce planning checklists, together with case studies and frequently asked questions (FAQs) that other organisations have developed to solve common issues. Details
Mid-level and Nurse Practitioners in the Pacific: Models and Issues World Health Organization Western Pacific Region 2001 [Excerpt from publisher] The purpose of this report is to summarize the roles and functions of midlevel and nurse practitioners in Pacific island countries and to present the findings and the conclusions of a ten-country assessment of mid-level and nurse practitioners to Health Ministers by:presenting the current models of mid-level provider education and practice in Pacific island countries;discussing the issues facing governments when they make decisions about mid-level providers in their health workforce;discussing strategies for strengthening the education and practice of midlevel providers; andpresenting recommendations for the use of mid-level practitioners in Pacific island countries. Details
Workplace Violence in the Health Sector - Country Case Study South Africa International Labour Office; International Council of Nurses; World Health Organisation; Public Services International 2003 Steinman S [Excerpt from author]The purpose of the study is to obtain information on the level of workplace violence in the health sector in South Africa. In particular this study examines the extent of workplace violence, factors that may contribute to violence and explore the most suitable strategies and appropriate policies to prevent and address violence in the workplace. Details
Training Competent and Effective Primary Health Care Workers to Fill a Void in the Outer Islands Health Service Delivery of the Marshall Islands of Micronesia Human Resources for Health 2006 Keni BH [Excerpt from author] Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities. In an effort to remedy the effectiveness of health care delivery to these islands, a program to train mid-level health care workers (Hospital Assistants) was developed and implemented by the Ministry of Health in conjunction with the hospital in Majuro, the capital city of the Marshall Islands. This paper discusses the details of the training, the modalities used to groom the candidates, and an assessment of the ultimate effectiveness of the program. Details
Workplace Violence in the Health Sector - Lebanon Country Case Study International Labour Office; International Council of Nurses; World Health Organisation; Public Services International 2003 Deeb M This case study examines workplace violence in the health sector of Lebanon using qualitative and quantitative analysis. Details
Workplace Violence in the Health Sector - Portuguese Case Studies International Labour Office; International Council of Nurses; World Health Organisation; Public Services International 2003 Ferrinho P; Antunes AR; Biscaia A; Concei??o C; Fronteira I; Craveiro I; Flores I; Santos O [Excerpt from authors] These studies measure and characterize the problem of violence against health professionals in the workplace in selected settings in Portugal. They answer questions such as: Who are the most affected health professionals? What types of violence are most frequent? In what circumstances do episodes of violence happen? What are the institutional procedures? What are the consequences for the victims, the Institutions and the perpetrators? What is the positioning of the NHS managers, the professional councils the unions and the professional associations about this problem? Details
Workplace Violence in the Health Sector - A Case Study in Thailand International Labour Office; International Council of Nurses; World Health Organisation; Public Services International 2003 Sripichyakan K, Thungpunkum P and Supavititpatana B [Excerpt from Preface] This research report has been published to illustrate the situation of workplace violence in the health sector in Thailand as well as contributing factors to, the consequences, and management of that violence. Details
Workplace Violence in the Health Sector - Case Study Bulgaria International Council of Nurses; International Labour Organization; World Health Organization; Public Service International 2003 Tomev L, Daskalova N and Ivanova V This case study examines the issue of workplace violence in Bulgaria's health sector. Details
Workplace Violence in the Health Sector Country Case Study - Brazil International Labour Office; International Council of Nurses; World Health Organisation; Public Services International 2003 Pal?cios M, Loureiro dos Santos M, Barros do Val M, Medina MI, de Abreu M, Soares Cardoso L and Bragan?a Pereira B [Excerpt from authors] The objective of the country case studies consists in showing country-specific evidence and practical solutions concerning workplace violence in the health sector. By summarising existing information and analysing newly obtained information the study aims to identify risk factors as well as best practices of anti-violence interventions in the given socio-cultural context. This work will serve as a basis for the formulation of guidelines for prevention and coping strategies targeting issues of workplace violence in the health sector. Details
Workplace Violence in the Health Sector: State of the Art Paper 2002 Cooper CL and Swanson N [Excerpt from authors] This State of the Art paper explores the literature and issues associated with violence in the health sector. It draws on the expertise of leading international experts in the field of "violence at work", getting them to focus on the health sector. We assess in this paper the scope, definition and global context of workplace violence, information and reporting of violence, existing evidence of the prevalence of violence, the origins of violence, the impact of violence, and prevention and interventions to minimize workplace violence in the health sector. The final section highlights some of the gaps in research and practice. Details
Safe Staffing Saves Lives - Information and Action Tool Kit International Council of Nurses 2006 [Excerpt from publisher] This tool kit is designed for use by professional nursing associations and nurses. It outlines the essential background information to support the argument for appropriate staffing levels. The annexes contain support material that include a nurse staffing assessment tool, a list of activities for nurses to improve safe staffing a fact sheet, a sample press release, a sample power point presentation and examples of nursepatient ratios. The main document includes a backgrounder on safe staffing with relevant information that is essential to consider when discussing safe staffing issues. Evidence is provided that staffing levels have an impact on morbidity and mortality outcomes. The importance of skill mix and the clarification of roles are emphasized. The section entitled "How Is It Done?" describes legislation and frameworks and emphasizes the role of professional judgement in promoting strategies for safe staffing. In addition, important position statements are outlined to provide further background. Recommendations will guide nursing associations as they lobby for adjustments in work environments and adequate levels of nursing staff to provide safe care. Fran?ais: http://www.icn.ch/indkit2006f.pdf Espa?ol:http://www.icn.ch/indkit2006sp.pdf Details
Working Together For Health: World Health Report 2006 World Health Organization 2006 [Excerpt from publisher] The World Health Report 2006 - Working together for health contains an expert assessment of the current crisis in the global health workforce and ambitious proposals to tackle it over the next ten years, starting immediately. The report reveals an estimated shortage of almost 4.3 million doctors, midwives, nurses and support workers worldwide. The shortage is most severe in the poorest countries, especially in sub-Saharan Africa, where health workers are most needed. Focusing on all stages of the health workers' career lifespan from entry to health training, to job recruitment through to retirement, the report lays out a ten-year action plan in which countries can build their health workforces, with the support of global partners. Fran?ais: http://www.who.int/whr/2006/fr/index.html Espa?ol: http://www.who.int/whr/2006/es/index.html Details
Paying for People: Financing the Skilled Workers Needed to Deliver Health and Education Services for All Oxfam International 2007 [Excerpt from publisher] Millions of people are dying, sick, or out of school because there are not enough teachers, nurses, and doctors in poor countries. Some poor-country governments have doubled expenditure on health and education since 2000 but still cannot afford to pay for these workers, so aid must plug the gap. But current aid is failing poor people - only 8 cents in the aid dollar are channelled into government plans that include the training and salaries of teachers and health workers. Two million teachers and 4.25 million health workers must be recruited to make health and education for all a reality. Aid donors must change the way they provide money, making long-term commitments and supporting national plans. This is the first in a series of three papers that examines the financing of services in developing countries. This paper focuses on external assistance in the form of aid and debt cancellation. The other papers in the series will focus on internal revenues; first, receipts from taxation and then receipts from extractive industries. Details
The Role of the Physical and Social Environment in Promoting Health, Safety, and Effectiveness in the Healthcare Workplace The Center for Health Design, US 2006 Joseph A [Excerpt from auhtor] Objective: To examine how the physical environment, along with other factors such as culture and social support, impact (a) the health and safety of the care team, (b) effectiveness of the healthcare team in providing care and preventing medical errors, and (c) patient and practitioner satisfaction with the experience of giving and receiving care. Conclusions: The physical environment along with social support, organizational culture, and technology can play an important role in improving health, safety, effectiveness and satisfaction of the healthcare team. Details
Improving Retention: Nurse Tutors in Malawi The Capacity Project 2007 [Excerpt from publisher] This summary brief is a component of a larger effort to document and disseminate four promising human resources for health practices from Africa. The brief is excerpted from Health Workforce Innovations: A Synthesis of Four Promising Practices (Buchan and McCaffery). The synthesis paper and a full report on this particular promising practice, Attracting and Retaining Nurse Tutors in Malawi (Caffrey and Frelick), are available in the Publications and Resources section at www.capacityproject.org Details
The United States Health Workforce Profile The New York Center for Health Workforce Studies 2006 Dionne M, Moore J, Armstrong D, and Martiniano R This report compiles, organises and presents a wide range of data on the health workforce. It aims to assist policy makers and planners to better understand and address workforce issues. Details
Developing a Nursing Database System in Kenya Health Services Research; Blackwell Synergy 2007 Riley PL, Vindigni SM, Arudo J, Waudo AN, Kamenju A, Ngoya J, Oywer EO, Rakuom CP, Salmon ME, Kelley M, Rogers M, St. Louis ME and Marum LH [Excerpt from authors]Objective. To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Details
Nurse Migration from a Source Country Perspective: Philippine Country Case Study Health Services Research; Blackwell Synergy 2007 Lorenzo FME, Galvez-Tan J, Icamina K and Javier L [Excertp from authors] Objectives. To describe nurse migration patterns in the Philippines and their benefits and costs. Details
Potential of China in Global Nurse Migration Health Services Research; Blackwell Synergy 2007 Fang ZZ [Excerpt from authors] Objective. The purpose of this paper is to examine what is known about the nurse workforce and nursing education in China in order to assess the likely potential for nurse migration from China in the future. Details
Nurses on the Move: A Global Overview Health Services Research; Blackwell Synergy 2007 Kingma M [Excerpt from author]Objective. To look at nurse migration flows in the light of national nursing workforce imbalances, examine factors that encourage or inhibit nurse mobility, and explore the potential benefits of circular migration. Details