Category Archives: Health Care Workers

The Real Effects of Today’s Economy on the Healthcare Industry

Source: Amy N. Kaminski, Compdata Surveys, 2009

Less than a year ago, many were concerned with hiring shortages in the healthcare industry. At the onset of the recession, some thought healthcare would remain impervious to the increasing economic pressures. The 2009 Compensation Data Healthcare results have found the industry is not as immune as many had once suspected. Pay increase budgets have fallen and healthcare costs are up placing mounting pressure on the industry. Organizations are looking for ways to enhance their compensation packages without affecting their bottom line. This whitepaper will give you a clearer picture of what’s really happening in healthcare by covering topics, such as:

• Workforce demands
• Pay increase budgets
• Healthcare premium increases
• Cost containment and reduction measures
• Trends in wellness programs
• Time off packages
See also:
Press release

Investing in California’s Direct Care Workforce by Increasing Geriatric Training Opportunities

Source: SCAN Foundation, August 2009

On any given day, 126,000 Californians in nursing homes receive care from Certifed Nursing
Assistants (CNAs). An additional number of the State’s residents receive care in their own homes from the 54,260 registered Home Health Aides (HHAs). Each of these persons is dependent on Direct Care Workers (DCWs) to address at least some of their most fundamental human needs. The DCW is also a liaison to the nursing staff, reporting the care-receiver’s medical and emotional status and she or he may also be the person’s key connection to the outside world.

This paper was developed as a “think piece” to stimulate dialogue among stakeholders who are
discussing the needed components of training for DCWs. For 35 years, NCCNHR has maintained this kind of dialogue with long-term care consumers including nursing home and board and care residents, their families, and their advocates, and more recently those receiving services in their own homes. As our experience has shown in this paper, DCWs are essential to the quality of life for and quality of care of older adults. Furthermore, there is a critical need to better support DCWs through cultural sensitivity, involvement in care planning, by addressing systemic issues and through comprehensive training opportunities.

Nurse Labor Data: The Collection and Interpretation of Nurse-to-Patient Ratios

Source: Ann F. Minnick, Lorraine C. Mion, JONA: The Journal of Nursing Administration, Volume 39 – Issue 9, September 2009
(subscription required)

From the abstract:
Nurse labor has been shown to be related to some patient outcomes, but varying definitions and measurement approaches have resulted in conflicting findings about the nature of the relationship. Nurse administrators and researchers need to know rates of missing data and error in labor data to better inform decision making. The authors compare the degree of completeness and the agreement between these approaches (nurse survey and nurse-to-patient ratio staffing plans) to obtain patient-to-nurse ratios at the unit level.

Violence Against Nurses Working in US Emergency Departments

Source: Jessica Gacki-Smith, Altair M. Juarez, Lara Boyett, Cathy Homeyer, Linda Robinson, Susan L. MacLean, JONA: The Journal of Nursing Administration, Volume 39 – Issue 7/8, July/August 2009
(subscription required)

From the abstract:
The objective of this study was to investigate emergency nurses’ experiences and perceptions of violence from patients and visitors in US emergency departments (EDs).

Approximately 25% of respondents reported experiencing physical violence more than 20 times in the past 3 years, and almost 20% reported experiencing verbal abuse more than 200 times during the same period. Respondents who experienced frequent physical violence and/or frequent verbal abuse indicated fear of retaliation and lack of support from hospital administration and ED management as barriers to reporting workplace violence.

Violence against ED nurses is highly prevalent. Precipitating factors to violent incidents identified by respondents is consistent with the research literature; however, there is considerable potential to mitigate these factors. Commitment from hospital administrators, ED managers, and hospital security is necessary to facilitate improvement and ensure a safer workplace for ED nurses.

Part 1–Factors Associated with School Nurse Ratios: An Analysis of State Data

Source: Erin Maughan, The Journal of School Nursing, Vol. 25, No. 3, June 2009
(subscription required)

From the abstract:
Despite the recognized importance of school nurses, the ratios of nurse to pupil are insufficient in many states across the country. The purpose of this study was to describe school nurse-to-pupil ratios by state and to statistically identify factors that may influence these ratios. Funding per pupil unit in general and support services and laws mandating school nurse ratios were some of the factors found to be associated with school ratios. Although the study has significant limitations, this is the first study of its kind to examine factors associated with ratios using secondary databases that are state-specific. Data such as this provide a context for studying those factors potentially influencing ratios. Further studies are needed to explore the numerous potential determinants described in the literature. Once key factors are identified, school nurses can effectively focus their efforts to lower school nurse-pupil ratios.
See also:
Part II–Factors Associated with School Nurse Ratios: Key State Informants’ Perceptions
Erin Maughan, The Journal of School Nursing, Vol. 25, No. 4, August 2009
(subscription required)

Job Satisfaction Behind Walls and Fences – A Study of Prison Health Care Staff

Source: Brett E. Garland, William P. McCarty, Criminal Justice Policy Review, Vol. 20, No. 2, June 2009
(subscription required)

From the abstract:
Health care staff serve important humanitarian, legal, and security functions inside prisons. Although medical and health staff have become critical to daily life in prisons, little is known about their work attitudes and outcomes. This article examines the job satisfaction of 430 health care practitioners in the federal prison system. Ordinary least squares regression is used to analyze responses to a global measurement of job satisfaction. This analytic procedure was chosen after tests determined that prison-level characteristics would have very little influence on the job satisfaction of this sample. Work-related variables were stronger predictors of job satisfaction than personal characteristics. Feeling effective in dealing with inmates had the strongest impact on job satisfaction. Health care staff also had higher job satisfaction when they perceived greater flexibility and effectiveness in organizational operations and when they had more positive feelings about supervision. Significant personal characteristics that influenced job satisfaction included race and education level.

How Public Health and Prisons Can Partner for Pandemic Influenza Preparedness: A Report From Georgia

Source: Anne C. Spaulding, Victoria A. McCallum, Dawn Walker, Ariane Reeves, Cherie Drenzek, Sharon Lewis, Ed Bailey, James W. Buehler, Ellen A. Spotts Whitney, and Ruth L. Berkelman, Journal of Correctional Health Care, Vol. 15, No. 2, April 2009
(subscription required)

From the abstract:
As pandemic influenza becomes an increasing threat, partnerships between public health and correctional facilities are necessary to prepare criminal justice systems adequately. In September 2007, the Planning for Pandemic Influenza in Prison Settings Conference took place in Georgia. This article describes the collaboration and ongoing goals established between administrative leaders and medical staff in Georgia prison facilities and public health officials. Sessions covered topics such as nonpharmaceutical interventions, health care surge capacity, and prison-community interfaces. Interactive activities and tabletop scenarios were used to promote dynamic learning, and pretests and posttests were administered to evaluate the short-term impact of conference participation. The conference has been followed by subsequent meetings and an ongoing process to guide prisons’ preparation for pandemic influenza.

The Budgetary Effects of Expanding Governmental Support for Preventive Care and Wellness Services

Source: Congressional Budget Office, August 7, 2009

From CBO Director’s Blog:
On Friday CBO released a letter that discusses how the agency’s budget estimates reflect potential reductions in federal costs from improvements in health that might result from expanded governmental support for preventive medical care and wellness services.

Preventive medical care includes services such as cancer screening, cholesterol management, and vaccines. In making its estimates of the budgetary effects of expanded governmental support for such care, CBO takes into account any estimated savings to the government that would result from greater use of preventive care as well as the estimated costs of that additional care. Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.

That result may seem counterintuitive. For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed. But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. Judging the overall effect on medical spending requires analysts to calculate not just the savings from the relatively few individuals who would avoid more expensive treatment later, but also the costs of the many who would make greater use of preventive care.

Staff Stability Toolkit Version 1.2

Source: Quality Partners of Rhode Island, 2009

From a Commonwealth Fund summary:
Based on the experiences of more than 400 nursing homes, the Staff Stability Toolkit is designed to serve as an evidence-based resource for nursing homes that are working to reduce staff turnover. The toolkit, developed by Quality Partners’ of Rhode Island with Commonwealth Fund support, identifies some of the perverse incentives, such as giving hiring bonuses rather than retention bonuses, and poor management practices, such as ineffective hiring and scheduling, that contribute to high staff turnover in nursing homes. It also offers guidance on ways to sustain employee stability.
See also:
* Sample Worksheets – Worksheets 1 through 9
* Worksheet 1 – Employment Status
* Worksheet 2 – Current Staff by Length of Service
* Worksheet 3 – Vacancies
* Worksheet 4 – Turnover Rates
* Worksheet 5 – Turnover Replacement Costs
* Worksheet 6 – Terminations by Length of Service
* Worksheet 7 – Absenteeism
* Worksheet 8 – Call-In Log
* Worksheet 9 – Incentives
* Training Analysis