Category Archives: Health Care Workers

Developing Guidelines for Evaluating the Results of Criminal Background Checks

Source: Nikki Hopkins, Katherine Thomas, Journal of Nursing Regulation, Volume 4, Number 3, October 2013
(subscription required)

From the abstract:
Criminal history is becoming a significant challenge in determining appropriate sanctions for licensed nurses and applicants. Through the development of objective disciplinary guidelines for criminal conduct, the Texas Board of Nursing has been able to ensure consistency and fair consideration of criminal history information in licensing and disciplinary decisions. This article describes the development of the guidelines, the underlying policy considerations, and the efforts to maintain and improve them.

Policies and Practices in the Delivery of HIV Services in Correctional Agencies and Facilities – Results From a Multisite Survey

Source: Steven Belenko, Matthew Hiller, Christy Visher, Michael Copenhaver, Daniel O’Connell, William Burdon, Jennifer Pankow, Jennifer Clarke, Carrie Oser, Journal of Correctional Health Care, Vol. 19 no. 4, October 2013
(subscription required)

From the abstract:
HIV risk is disproportionately high among incarcerated individuals. Corrections agencies have been slow to implement evidence-based guidelines and interventions for HIV prevention, testing, and treatment. The emerging field of implementation science focuses on organizational interventions to facilitate adoption and implementation of evidence-based practices. A survey of correctional agency partners from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) revealed that HIV policies and practices in prevention, detection, and medical care varied widely, with some corrections agencies and facilities closely matching national guidelines and/or implementing evidence-based interventions. Others, principally attributed to limited resources, had numerous gaps in delivery of best HIV service practices. A brief overview is provided of a new CJ-DATS cooperative research protocol, informed by the survey findings, to test an organization-level intervention to reduce HIV service delivery gaps in corrections.

Health Care Workers Unprotected: Insufficient Inspections and Standards Leave Safety Risks Unaddressed

Source: Keith Wrightson, Taylor Lincoln, Public Citizen, July 17, 2013

From the press release:
Health care workers suffer more injuries and illnesses on the job each year than those in any other industry, but the Occupational Safety and Health Administration (OSHA) conducts relatively few inspections of health care facilities and is hamstrung in its ability to take action to resolve unsafe conditions by an absence of needed safety standards, a new report by Public Citizen shows…. Nurses, nursing aides, orderlies and attendants suffer more musculoskeletal injuries than workers in any other field. Costs associated with back injuries in the health care industry are estimated to be more than $7 billion annually….

New Study Challenges Conventional Wisdom on Pay-for-Performance Incentive Programs

Source: Robert Wood Johnson Foundation (RWJF), Press Release, September 19, 2013

One of the many approaches the Affordable Care Act takes to making health care more efficient is pay-for-performance incentives for clinicians. The underlying idea is that if doctors, nurses, physician assistants, and others are judged and rewarded based on the quality of the care they provide and actual patient outcomes, more of the necessary interventions will occur while fewer unnecessary tests and procedures will be performed, saving money and improving the quality of care.

Various studies have tested the concept, reaching mixed results. But two new studies by Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research recipient R. Adams Dudley, MD, MBA, and colleagues suggest that for incentives to be effective, they must be carefully targeted and designed.

Dudley’s two studies were published this month in the Journal of the American Medical Association. The first tests the effectiveness of incentives for small medical practices that have implemented electronic health records (EHRs). The second focuses on how incentives should be distributed to achieve maximum effect—to individual clinicians, to their practices, or to both….
Related:
Effect of Pay-for-Performance Incentives on Quality of Care in Small Practices with Electronic Health Records – A Randomized Trial
Source: Naomi S. Bardach, Jason J. Wang, Samantha F. De Leon, Sarah C. Shih, W. John Boscardin, L. Elizabeth Goldman, R. Adams Dudley, Journal of the American Medical Association, Vol. 310 No. 10, September 11, 2013

Effects of Individual Physician-Level and Practice-Level Financial Incentives on Hypertension Care – A Randomized Trial
Source: Laura A. Petersen, Kate Simpson, Kenneth Pietz, Tracy H. Urech, Sylvia J. Hysong, Jochen Profit, Douglas A. Conrad, R. Adams Dudley, LeChauncy D. Woodard, Journal of the American Medical Association, Vol. 310 No. 10, September 11, 2013

2013 Healthcare Workforce Report

Source: South Dakota Department of Health, Health Care Workforce Center, 2013

Recognizing the importance of a highly trained and available health care workforce, the South Dakota Department of Health established the Health Care Workforce Center to help address the health care workforce needs of the State. The purpose of the Center is to function as a clearinghouse for health care workforce-related data and information. The Center is also designed to develop and implement programs and projects that assist individuals, agencies and facilities in their efforts to ensure a competent and qualified health care workforce to meet the health needs of all South Dakota residents. Based on population and employment statistics, projections indicate that thousands of health care workers will be needed in the health care industry in the next decade. This profile of health care professions serves as an aid in planning for the health care workforce needs in the future. The report draws upon labor statistics, educational preparation data, and current health professions’ licensing registries. The report profiles the health care workforce projected needs in the future and workforce distribution by geography, age, and profession. The report is designed to be used by policy-makers in the development and coordination of health care education and recruitment programs to meet the health care workforce needs of the future.

Trends in the Earnings of Male and Female Health Care Professionals in the United States, 1987 to 2010

Source: Seth A. Seabury, Amitabh Chandra, Anupam B. Jena, JAMA Internal Medicine, Research Letter, Online First, Published online September 2, 2013
(subscription required)

From the abstract:
Nearly 40 years after the adoption of the Title IX Amendments of the US Civil Rights Act, women account for almost 50% of US medical students and more than one-third of all physicians. Historically, female physicians have earned considerably less than male physicians, though in the 1990s much of this was attributable to gender differences in specialty choice and hours worked. However, more recent data suggest that female physicians currently earn less than male physicians even after adjustment for specialty, practice type, and hours worked. Salary differences between men and women currently exist among physician researchers as well. This raises questions about whether the gender gap in earnings among US physicians has closed over time, particularly compared with the earnings gap for other health care professionals and workers overall. Comparing earnings of male and female physicians over time is important in assessing the impact of policies to promote gender equality among physicians.

Immunizing health care workers against influenza: A glimpse into the challenges with voluntary programs and considerations for mandatory polices

Source: Susan Quach, Jennifer A. Pereira, Jeffrey C. Kwong, Sherman Quan, Lois Crowe, Maryse Guay, Julie A. Bettinger, American Journal of Infection Control, Article in Press, August 23, 2013
(subscription required)

From the abstract:
Vaccination of health care workers (HCWs) is an important patient safety initiative. It prevents influenza infection among patients and reduces staff illness and absenteeism. Despite these benefits, HCW influenza immunization uptake is low. Therefore, strategies to achieve high immunization coverage in HCWs, barriers to uptake, and perceptions of mandatory influenza immunization policies were discussed in key informant interviews with influenza immunization program planners…. Participants used a variety of promotional and educational activities, and many vaccine delivery approaches, to support HCW immunization programs. Barriers to achieving high coverage in HCWs included misconceptions about the safety and effectiveness of the influenza vaccine, negative personal experiences associated with the vaccine, and antivaccine sentiments. Participants mentioned mandatory influenza immunizations as a solution to low coverage. However, they identified challenges with this approach such as obtaining support from stakeholders, enforcement, and limiting personal autonomy….
Participants believed immunization coverage in health care organizations will continue to be suboptimal using existing program strategies. Although participants discussed mandatory immunization as a way to improve uptake, potential obstacles will need to be addressed for this to be implemented successfully.

Health Care Workers: Unprotected Insufficient Inspections and Standards Leave Safety Risks Unaddressed

Source: Public Citizen, July 17, 2013

On March 8, 2012, John Shick walked into Western Psychiatric Institute and Clinic at the University of Pittsburgh with one motive on his mind, to cause harm to others. Upon his arrival, Shick opened fire in the lobby. His shooting rampage left one person dead and six others wounded. Although we cannot know for certain, the incident might have been prevented if the Western Psychiatric Institute were required to have a plan to prevent violence, as recommended nearly two decades ago by the Occupational Safety and Health Administration (OSHA). But OSHA never issued a rule to require employers to create such a plan. The Western Psychiatric Institute, in turn, had no “policy or procedure that specifically addresses the risk of patient on staff violence,” according to a draft report on the shooting. The insufficiency of OSHA’s actions to prevent workplace violence is emblematic of overall shortcomings in the agency’s efforts to protect health care workers. The government’s responsibility, as written in law, is “to assure so far as possible every working man and woman in the Nation safe and healthful working conditions.” But OSHA is not fulfilling that obligation for health care workers, who suffer more injuries than workers in any other sector in the United States. In 2010, for instance, health care employers reported 653,900 workplace injuries and illnesses, more than 152,000 more than the next most afflicted industry sector, manufacturing.