AFSCME Information Highway

Source: Center for Studying Health System Change

After the 9/11 terrorist attacks, interest in the state of America's public health system spiked, especially related to emergency preparedness. Significant new federal funding flowed to state and local agencies to bolster public health activities. But the spotlight on shoring up the nation's public health system has faded, and the public appears unaware of escalating threats to such basic services as disease surveillance. Local health departments face a mounting workforce crisis as they struggle to recruit, train and retain qualified workers to meet their communities' needs, according to a new study by the Center for Studying Health System Change (HSC).

Factors influencing the workforce shortage include inadequate funding, uncompetitive salaries and benefits, an exodus of retiring workers, insufficient supply of trained workers, and lack of enthusiasm for public health as a career choice. Local public health agencies have pursued strategies to improve workforce monitoring and planning, recruitment, retention, development and training, and academic linkages. However, little progress has been made to alleviate the shortages. Without additional support to address workforce issues, including the recruitment of the next generation of public health leaders, it is unlikely that local public health agencies will succeed in meeting growing community need, a situation potentially imperiling the public's health.

Full report (.pdf)

Posted by William at 8:17 AM in Health Care Workers | Permalink

Source: Governmental Accountability Office, March 31, 2008

According to the Centers for Disease Control and Prevention (CDC), health-care-associated infections (HAI) are estimated to be 1 of the top 10 causes of death in the United States. HAIs are infections that patients acquire while receiving treatment for other conditions. GAO was asked to examine (1) CDC's guidelines for hospitals to reduce or prevent HAIs and what the Department of Health and Human Services (HHS) does to promote their implementation, (2) Centers for Medicare & Medicaid Services' (CMS) and hospital accrediting organizations' required standards for hospitals to reduce or prevent HAIs and how compliance is assessed, and (3) HHS programs that collect data related to HAIs and integration of the data across HHS. GAO reviewed documents and interviewed officials from CDC, CMS, the Agency for Healthcare Research and Quality (AHRQ), and accrediting organizations.

Full report
Testimony

Posted by William at 10:17 AM in Health & Safety | Health Care Workers | Permalink

Source: Institute of Medicine (National Academies)

From news release:
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care work force that is too small and woefully unprepared to meet their specific health needs, says a new report from the Institute of Medicine. The report, Retooling for an Aging America: Building the Health Care Workforce, calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. Medicare, Medicaid, and other health plans should pay higher rates to boost recruitment and retention of geriatric specialists and care aides, said the committee that wrote the report.

The committee set a target date of 2030 -- the year by which all baby boomers will have turned 65 or older -- for the necessary reforms to take place.

Full Report (Read for free online.)
Project website

Posted by William at 10:32 AM in Health Care | Health Care Workers | Permalink

Source: Center for Studying Health System Change

From press release (Robert Wood Johnson Foundation):

As the nation's hospitals face increasing demands to participate in a wide range of quality improvement activities, the role and influence of nurses in these efforts is also increasing, according to a new study by the Center for Studying Health System Change (HSC). Hospital organizational cultures set the stage for quality improvement and nurses' roles in those activities. Hospitals with supportive leadership, a philosophy of quality as everyone's responsibility, individual accountability, physician and nurse champions, and effective feedback reportedly offer greater promise for successful staff engagement in improvement activities.

Yet hospitals confront challenges with regard to nursing involvement, including: scarcity of nursing resources; difficulty engaging nurses at all levels--from bedside to management; growing demands to participate in more, often duplicative, quality improvement activities; the burdensome nature of data collection and reporting; and shortcomings of traditional nursing education in preparing nurses for their evolving role in today's contemporary hospital setting. Because nurses are the key caregivers in hospitals, they can significantly influence the quality of care provided and, ultimately, treatment and patient outcomes. Consequently, hospitals' pursuit of high-quality patient care is dependent, at least in part, on their ability to engage and use nursing resources effectively, which will likely become more challenging as these resources become increasingly limited.

Full text

Posted by Info Center at 8:49 AM in Health Care | Health Care Workers | Permalink

Source: Albert Banerjee, Tamara Daly, Hugh Armstrong, Pat Armstrong, Stirling Lafrance, and Marta Szebehely, Institute for Social Research at York University, February 23, 2008

Working in Canadian long-term care is dangerous. But it need not be. This study shows that, while Canadians working in long-term facility care experience violence virtually every day, this is not the case in Nordic countries. Clearly, the high level of violence in Canadian facilities is not a necessary feature of work in long-term care and can be reduced.

This report on the violence experienced by personal support workers draws on an international study comparing long-term, facility-based care across three Canadian provinces (Manitoba, Nova Scotia, and Ontario) and four Nordic European countries (Demark, Finland, Norway and Sweden). It is supported by focused discussions and offers insight into long-term care from the perspective of workers.

Posted by Info Center at 3:05 PM in Health Care Workers | Workplace Violence | Permalink

Source: Center for State and Local Government Excellence, March 2008

From the summary:
A new Center for Excellence poll finds that most Americans are unaware that state and local public health departments are facing a serious shortage of skilled professionals that could put the health and lives of citizens at risk.

See also:
Fact Sheet: The Impending Shortage in the State and Local Public Health Workforce

Posted by Info Center at 5:59 PM in Health Care Workers | Public Sector | Workforce | Permalink

Source: At the Frontline, Columbia University Mailman School of Public Health, Vol. 3 no. 1, February 2008

In one of the largest studies of its kind, researchers from the Mailman School assessed the risk of exposure to bloodborne pathogens among non-hospital based registered nurses (RNs), and found that nearly one out of ten of the more than 1,100 nurse participants reported at least one needlestick injury in the previous 12 months. Findings of the study are published in the December issue of Industrial Health.

According to Robyn Gershon, DrPH, professor of Sociomedical Sciences and the study's principal investigator, "These rates of exposure are surprising since they are similar to rates reported for hospital-based nurses, even though hospitalized patients generally have high levels of acuity of patient care (i.e., more procedures, including more invasive procedures), than are typically performed in community healthcare settings." But, as Dr. Gershon and colleagues point out, these findings are not completely unexpected since patient care, including more complex types of care, is increasingly delivered at non-hospital based healthcare facilities, including out-patient clinics, nursing homes, doctor's offices, patients' homes, and public health clinics.

Posted by Info Center at 12:21 PM in Health & Safety | Health Care Workers | Permalink

Source: Mischa Gaus, Labor Notes Magazine, No. 347, February 2008

After a patient quietly died in registered nurse Danielle Magaña's hospital hallway, she decided she'd had enough. Although an autopsy later said the woman had died of natural causes, Magaña said the incident was waiting to happen at her chronically short-staffed San Antonio hospital.

Intensive-care nurses like her were assigned up to five patients per shift, including two in the hallways who weren't hooked into monitoring equipment that warns when a patient's vital signs slip away. Magaña still questions whether the woman could have been rescued if the nurses on her floor weren't carrying such heavy patient loads.

Hospital management, she said, "do not give us the right to say, you need to call in another nurse."

So Magaña became one of the 40,000 Texas registered nurses the National Nurses Organizing Committee (NNOC) estimates have left the hospital bedside, largely they argue because hospitals cut staff in the 1990s and quickened the pace of nursing work to intolerable levels. In a national study released in September, 42 percent of newly licensed RNs said they would like to leave bedside nursing.

Posted by Info Center at 11:40 AM in Health Care Workers | Permalink

Source: Genevieve Gencianos, PSI

The world lacks more than four million health care workers and this has been clearly stated by the World Health Organisation. This means that every country in the world has a shortage of health care workers. But where will these millions come from? A quick fix for rich countries is to recruit them in poorer ones. PSI is now campaigning for a code of practice in the international recruitment of health care workers.

Posted by Info Center at 5:13 PM in Health Care Workers | Workforce | Permalink

Source: United States Government Accountability Office, GAO-08-472T, February 12, 2008

Most of the funding for programs under title VII of the Public Health Service Act goes toward primary care medicine and dentistry training and increasing medical student diversity. Despite a longstanding objective of title VII to increase the total supply of primary care professionals, health care marketplace signals suggest an undervaluing of primary care medicine, creating a concern about the future supply of primary care professionals--physicians, physician assistants, nurse practitioners, and dentists. This concern comes at a time when there is growing recognition that greater use of primary care services and less reliance on specialty services can lead to better health outcomes at lower cost.

GAO was asked to focus on (1) recent supply trends for primary care professionals, including information on training and demographic characteristics; (2) projections of future supply for primary care professionals, including the factors underlying these projections; and (3) the influence of the health care system's financing mechanisms on the valuation of primary care services.

GAO obtained data from the Health Resources and Services Administration (HRSA) and organizations representing primary care professionals. GAO also reviewed relevant literature and position statements of these organizations.

Posted by Info Center at 5:01 PM in Health Care Workers | Permalink

Source: Felice J. Freyer, Providence Journal, January 26, 2008

So far, the number of foreign nurses in Rhode Island is small. Of the 20,553 nursing licenses, only 79 belong to foreign-trained nurses, some of whom probably have not yet arrived. Rhode Island Hospital's 20 foreign nurses work among 1,800 bedside nurses at the hospital.

But, here as elsewhere, the trend is clearly growing -- held in check, at least for now, by limits on the number of visas the State Department will give out. Rhode Island Hospital has offered jobs to 133 additional foreign nurses who are waiting for visas. Kent Hospital has 26 foreign nurses "on the way."

Nationwide, 12 percent of those who took the qualifying exam for a nursing license last year were educated overseas.

Posted by Info Center at 5:09 PM in Health Care Workers | Immigration | Workforce | Permalink

Source: Richard C. Baron, UPenn Collaborative on Community Integration Department of Psychiatry - University of Pennsylvania, October 2007

The Southeast Behavioral Health Industry Partnership has recently published a new study of the direct care professional workforce. The Report - A Review of Current Information about the Careers of the Direct Support Professional Workforce in the Mental Health, Developmental Disabilities, and Substance Abuse Service Delivery Systems - begins with a comprehensive review of the characteristics, job roles and responsibilities, demographic characteristics, compensation, tenure and reported job satisfaction of behavioral health frontline workers in institutional and community settings. The report also looks at required competencies, competency-based training opportunities for the workforce, work-based learning models and career development challenges for direct care professionals, leading to a dozen recommendations for change to better recognize and reward these critical workers. The report provides both a state and national analysis of the need for the development of more effective career paths for entry-level workers.

Posted by Info Center at 5:10 PM in Health Care Workers | Permalink

Source: RAND Corporation

Health care facilities usually have general disaster plans for dealing with the medical consequences of public health emergencies. However, most of their disaster plans do not address the psychological consequences of such events. These training manuals are designed to fill the gap by providing curricula that can be used to train hospital and clinic staff and department of mental health staff who would be deployed to hospitals and clinics about how to prepare for and respond to the psychological consequences of large-scale disasters. Meredith et al. include three separate training modules to address the needs of three audiences: (1) administrators and disaster planning and response staff in hospitals and clinics; (2) clinical, mental health, and non-clinical staff in hospitals and clinics; (3) disaster mental health staff in Los Angeles County. Terrorist attacks, natural disasters, and other large-scale public health emergencies such as severe acute respiratory syndrome (SARS) or pandemic flu can result in a large number of psychological casualties. Large-scale disasters can stress the capacity of hospitals and clinics to deal with the psychological consequences -- the emotional, behavioral, and cognitive reactions -- that could result from a terrorist or other public health event for victims, families, and staff members. The materials in these manuals are intended to be flexible so that hospital and clinic disaster coordinators can tailor a training session to the needs of local staff.

Posted by Info Center at 11:59 AM in Health Care Workers | Pandemic Influenza | Permalink

Source: Emerging Infectious Diseases (via Robert Wood Johnson Foundation)

From press release:
Hospitalizations related to methicillin-resistant Staphylococcus aureus (MRSA) infections more than doubled, from 127,000 to nearly 280,000, between 1999 and 2005, according to a new study in the December issue of the journal Emerging Infectious Diseases. During that same period, hospitalizations of patients with general staph infections increased 62 percent across the country.

Staph, or Staphylococcus aureus, are a kind of bacteria that attack wounds and cause life-threatening infections, such as blood poisoning and pneumonia. Methicillin-resistant S. aureus (MRSA) are "superbugs" that have evolved resistance to most commonly used antibiotics, so they are more difficult and expensive to treat.

The study, which is the first to examine the recent magnitude and trends related to staph and MRSA infections, found that such infections are now "endemic, and in some cases epidemic," in many U.S. hospitals, long-term care facilities and communities. Study researchers say that control of the infection should be made a "national priority."

Full Document (PDF; 192 KB)

Posted by Info Center at 10:28 AM in Health & Safety | Health Care Workers | Permalink

Source: United American Nurses, Press Release, November 13th 2007

Beckley, WV - The nearly 700 striking nurses at Appalachian Regional Health Care (ARH), represented by the Kentucky and West Virginia Nurses Associations/United American Nurses, AFL-CIO, are speaking out to call public attention to the underhanded and violent tactics exhibited against them by the hospital during their strike, which began Oct. 1. ARH has escalated its intimidation of striking nurses from hired security guards on the picket lines who routinely harass nurses to video surveillance of striking nurses to, it now appears, orchestrating the burning of the car of one of the union staff on hand to assist the nurses.

Related article:
Nurses' Strike Drags on in Appalachia
Associated Press, November 16, 2007

Posted by Info Center at 12:15 PM in Health Care Workers | Strikes | Permalink

Source: Rutgers University, Press Release, November 12, 2007

New Jersey registered nurses are teetering on the brink of exhaustion due to heavier work loads, feeling that they are not able to provide proper patient care and receiving little support from management, according to a survey conducted by Rutgers College of Nursing faculty member Linda Flynn.

The 11-page survey, funded by the Robert Wood Johnson Foundation, was mailed to the homes of 44,343 New Jersey registered nurses and more than 21,000 nurses responded to the survey. It was the largest and most comprehensive surveys of New Jersey nurses ever conducted.

Findings from the survey, The State of the Nursing Workforce in New Jersey: Findings from a Statewide Survey of Registered Nurses, also indicated that nurses face frequent and chronic exposure to verbal abuse, complaints and work-related injuries and one in three nurses reported that their work loads are so heavy that they actually miss important changes in their patients' conditions. More than 50 percent said that there was not enough staff to get the work done.

Posted by Info Center at 12:05 PM in Health Care Workers | Permalink

Source: S. McGinnis, Center for Health Workforce Studies, School of Public Health, SUNY Albany, January 2007
(download)

The services provided by parish nurse/faith community nurses (FCNs) include health education, personal health counseling, referrals and advocacy - services that are increasingly important because of their limited availability in the commercial health care system.

The current study represents a pilot effort at nationwide systematic data collection on parish nurse/FCNs. Data collected included information on background characteristics of parish nurse/FCNs (e.g., demographics and education), parish nursing/FCN practice (e.g., congregation characteristics), services provided to congregations, and workplace issues (e.g., satisfaction and future plans).

Posted by Info Center at 4:35 PM in Health Care Workers | Statistics | Permalink

Source: D. Robertson, S. McGinnis, and J. Moore, Center for Health Workforce Studies, School of Public Health, SUNY Albany, January 2007
(download)

The goal of the pilot study was to test the effectiveness if the survey instrument in producing a detailed description of local public health workers and understand how health workers' composition, roles, educational backgrounds, and training needs affect the organizational capacity of local health departments in New York to perform essential public health services.

The functional enumeration is still underway, but a sufficient number of online and scannable surveys were returned and processed under the pilot study to serve as a basis for this analysis. This report presents findings and recommendations of the pilot study based on survey responses from 1,480 public health workers at 26 local health departments across the state that were received by July 15, 2006.

Posted by Info Center at 4:33 PM in Health Care Workers | Statistics | Permalink

Source: John Gessner, Thisweek Newspapers, 10/26/07

...State law reflects growing concern about workplace safety of nurses, especially as hospitals deal with a national nursing shortage.

By next July 1, all Minnesota hospitals must have policies to minimize nurses' manual lifting of patients by 2011. The law calls for hospitals to use handling equipment and building modifications to achieve the goals....
Related:
American Nurses Association "Handle With Care" Campaign Fact Sheet

Posted by Info Center at 4:33 PM in Health & Safety | Health Care Workers | Permalink

Source: Eileen Prendiville and Mischa Gaus, Labor Notes, #344, November 2007

Leading a strike that one hospital administrator said cost her $1 million a day, 5,000 registered nurses at 10 Northern California hospitals in the Sutter Health chain walked off their jobs for two days in mid-October. Five facilities locked out striking nurses for an additional one to three days when the strike, the largest among nurses in a decade, was over.

Posted by Info Center at 4:24 PM in Health Care Workers | Strikes | Permalink

Source: Reagan Baughman and Kristin Smith, Monthly Labor Review, Vol. 130, Number 9, September 2007

Direct-care workers make up a low-wage, high-turnover workforce, but the demand is growing for long-term care by an aging U.S. population

Posted by Info Center at 5:24 PM in Health Care Workers | Home Health Workers | Permalink

Source: U.S. Department of Labor, Women's Bureau, Fact Sheet, October 2007

• Quick Facts on Registered Nurses (RNs)
• Registered nurses (RNs), regardless of specialty or work setting, perform basic duties that include treating patients, educating patients and the public about various medical conditions, and providing advice and emotional support to patients' family members.
• Registered Nurses (RNs) continue to be the healthcare occupation with the largest employment-2.5 million jobs. This is nearly three times the number of physicians and surgeons at 863,000.

Posted by Info Center at 5:17 PM in Health Care Workers | Statistics | Permalink

Source: Melanie Evans, Modern Healthcare, Vol. 37 no. 41, October 15, 2007
(subscription required)

One of healthcare's biggest nurses unions squared off against more than a dozen California hospitals last week, the latest example of labor's push to exercise its clout across the healthcare industry.

Posted by Info Center at 11:18 AM in Health Care Workers | Strikes | Permalink

Source: National Association of County and City Health Officials (NACCHO), August 2007

From http://www.naccho.org/press/releases/pr2007_09_10.cfm:
Federal funding received by local health departments for all-hazards emergency preparedness fell 20 percent last year, according to a new report by the National Association of County and City Health Officials (NACCHO). The report says that continued cuts in funding provided through the Centers for Disease Control and Prevention (CDC) threaten important, hard-won advances made in recent years in response planning to natural disasters, bio-terrorism events, emerging infectious diseases, and other public health emergencies.
See also:
National Preparedness Month

Posted by Info Center at 1:03 PM in Emergency Management | Health Care Workers | Public Sector | State & Local Finance | Permalink

Source: Ayse P. Gurses, Pascale Carayon, Nursing Research, Volume 56, Issue 3, May/June 2007
(subscription required)

From a summary:
A hospital intensive care unit (ICU) is typically an emotionally intense, loud, cramped, and stressful environment. ICU nurses face numerous obstacles to providing care to their critically ill patients, according to a new study of 217 nurses from 17 ICUs at 7 Wisconsin hospitals.

Posted by Info Center at 4:52 PM in Health Care Workers | Permalink

Source: Geri Scott and Randall Wilson, Jobs for the Future, April 2006

Community health workers are essential to the U.S. public health system. They work in diverse settings and under myriad titles to improve access to health care for underserved populations using culturally appropriate methods. Despite their importance, community health workers are often not well rewarded, and their job tenure is unstable. Well-defined career paths are lacking, as are systematic skills sets and credentials recognized across work settings and usable for higher education. With funding from the Robert Wood Johnson Foundation, SkillWorks asked JFF to recommend adaptations of the initiative's Workforce Partnership model in order to apply that approach to career advancement for community health workers. As the basis for these recommendations, JFF conducted research on the challenges to and national best practices for the advancement of community health workers.

Posted by Info Center at 2:22 PM in Health Care Workers | Permalink

Source: Cynthia A. Bascetta, testimony before the Subcommittee on Government Management, Organization, and Procurement, Committee on Oversight and Government Reform, House of Representatives, United States Government Accountability Office, GAO-07-1229T, September 10, 2007

Six years after the attack on the World Trade Center (WTC), concerns persist about health effects experienced by WTC responders and the availability of health care services for those affected. Several federally funded programs provide screening, monitoring, or treatment services to responders. GAO has previously reported on the progress made and implementation problems faced by these WTC health programs.

Posted by Info Center at 12:27 PM in Health & Safety | Health Care Workers | Permalink

Source: Diane L. Elliot, Kerry S. Kuehl, International Association of Fire Chiefs (IAFC) and the United States, Fire Administration (USFA), Oregon Health & Science University, June 2007

From the summary:
This new report, The Effects of Sleep Deprivation on Fire Fighters and EMS Responders, along with its accompanying computer-based educational program, presents background information on normal sleep physiology and the health and performance effects of sleep deprivation. Countermeasures for sleep deprivation are reviewed, which relate to identifying those particularly susceptible to risks of sleep deprivation, individual mitigating strategies and work-related issues. The project was supported by a cooperative agreement between the IAFC and the United States Fire Administration (USFA), with assistance from the faculty of Oregon Health & Science University.

Posted by Info Center at 2:41 PM in Health & Safety | Health Care Workers | Permalink

Source: Christine T. Kovner,Carol S. Brewer, Susan Fairchild, Shakthi Poornima, Hongsoo Kim, Maja Djukic, American Journal of Nursing, Vol. 107 no. 9, September 1, 2007
(subscription required)

From a summary:
In this article, researchers presented findings from the first wave of a three-year panel study on the work experience of newly licensed nurses. A randomly selected sample of 3,266 newly licensed RNs from 60 sites across the country participated in the study. RNs completed a multipage survey that addressed several aspects of their current employment.

Posted by Info Center at 4:31 PM in Health Care Workers | Permalink

Source: PricewaterhouseCoopers' Health Research Institute, 2007

Many nurses and physicians are among the baby boomers who will start to retire in the next three to five years. The federal government is predicting that by 2020, nurse and physician retirements will contribute to a shortage of approximately 24,000 doctors and nearly 1 million nurses. While hospital leaders voice much of the concern over possible shortages, the implications extend throughout the labor-intensive, trillion-dollar United States health system. It's expensive to educate new nurses and doctors. Taxpayer-funded Medicare spends $8 billion a year for residence training of physicians alone.

While the U.S. has more physicians and nurses today than ever before, they are not distributed or deployed efficiently. Shortage projections tend to be built around today's often dysfunctional system, which makes them problematic. However, while future shortages are certainly worrisome, the bigger issue for health industry leaders today lies in orchestrating care in an increasingly complex and converging healthcare labor market.

Posted by Info Center at 2:17 PM in Health Care Workers | Workforce | Permalink

Source: Rutgers College of Nursing, Press Release, August 15, 2007

From press release:
(NEWARK, N.J., Aug. 14, 2007) - Rutgers College of Nursing faculty member Linda Flynn is conducting a study to explore the effects of nurse staffing, work environment and safety technology on the frequency of non-intercepted medication errors in 17 New Jersey hospitals.

Funded by a two-year $308,254 grant from the Robert Wood Johnson Foundation, the study's focus is to determine the best practices for reducing non-intercepted medication errors.

Posted by Info Center at 2:15 PM in Health Care Workers | Permalink

Source: PricewaterhouseCoopers' Health Research Institute, 2007

It is impossible to improve what cannot be measured or to measure what hasn't been defined. Take, for example, the topic of healthcare quality. Everyone wants quality, but everyone's keeping score differently. This conundrum was described in some detail in The Quality Conundrum, a book developed and distributed in 2007 by PricewaterhouseCoopers' Health Research Institute (HRI). It explores practical approaches to improving the quality of patient care from the perspective of patients, physicians, payers, and employers.

One of these approaches is pay-for-performance (P4P), which attempts to define, measure, and reward quality. This represents a radical departure from traditional payment methods, which pay providers the same regardless of differences in quality. P4P has gained traction, largely because the Centers for Medicare and Medicaid Services (CMS) has told hospitals and physicians that future increases in payment will be linked to improvements in clinical performance. Commercial health plans are also responding to employers' demands for quality improvement by developing "scorecards" that use quality metrics to grade care provided by hospitals and physicians. By tying providers' scores to financial payments, non-financial rewards, and public reporting, both private and public payers intend to incent improvements in quality of care and outcomes.

The most mature P4P programs are more than 10 years old. However, among payers interviewed for this report, P4P programs are still evolving. As they've blossomed, providers have faced a host of new and varied reporting requirements-what some call a "virtual soup of different metrics." This has caused some to question the value of P4P and whether the results are worth the administrative burden.
See also:
Pay-for-Performance: Will the Latest Payment Trend Improve Care?
Source: Meredith B. Rosenthal, R. Adams Dudley, JAMA: Journal of the American Medical Association, Vol. 297 No. 7, February 21, 2007 (subscription required)

Posted by Info Center at 2:12 PM in Compensation | Health Care Workers | Permalink

Source: Council 31, American Federation of State, County and Municipal Employees (AFSCME), July 2007

From press release:
Council 31 of the American Federation of State, County and Municipal Employees (AFSCME) have issued a new report documenting low wage levels that keep patient-support staff art Resurrection Health Care hospitals mired in poverty and unable to support their families. Resurrection Health Care (RHC) is the second largest non-profit hospital system in the Chicago metropolitan area. It encompasses eight hospitals, as well as nursing homes, home health services, and outpatient clinics.

Entitled Coming Up Short: Resurrection Health Care’s Distorted Pay Priorities, the report depicts a starkly skewed pay structure in which the compensation of RHC hospital executives significantly exceeds national norms while the meager wages of patient-support staff (housekeepers, laundry and food service workers) fall far short of self-sufficiency standards in the Chicago area.

Posted by Info Center at 6:01 PM in Compensation | Health Care Workers | Income Inequality/Gap | Permalink

Source: Farr A. Curlin, MD, Lydia S. Dugdale, MD, John D. Lantos, MD, and Marshall H. Chin, MD, MPH, Annals of Family Medicine, Vol. 5 no. 4, July/August 2007

Religious traditions call their members to care for the poor and marginalized, yet no study has examined whether physicians’ religious characteristics are associated with practice among the underserved. This study examines whether physicians’ self-reported religious characteristics and sense of calling in their work are associated with practice among the underserved. This study entailed a cross-sectional survey by mail of a stratified random sample of 2,000 practicing US physicians from all specialties.

Posted by Info Center at 3:05 PM in Health Care Workers | Permalink

Source: Elisabeth D. Root, Jacqueline B. Amoozegar, Shulamit Bernard, Agency for Healthcare Research and Quality, AHRQ Publication No. 07-0029-1, May 2007

From the overview:
To date, most health care preparedness planning efforts have been focused on hospital and first responder preparedness. Nevertheless, the elderly are particularly vulnerable to bioterrorism and other public health emergencies due to their complex physical, medical, and psychological needs. The potential role and question of preparedness on the part of nursing homes has emerged in local and national preparedness discussions. However, little is known about the extent to which nursing homes have planned for and/or been incorporated into regional planning efforts
To address this issue, a series of focus groups was conducted to collect information about disaster- and bioterrorism-related planning activities among nursing homes in five States—North Carolina, Oregon, Pennsylvania, Washington, and Utah—and southern California. The aims of the focus groups were to:
• Determine if nursing home administrators have prepared and trained staff on disaster plans, including bioterrorism response.
• Assess the special needs of the elderly population in nursing home settings during a public health emergency.
• Determine if nursing homes are able to accommodate patient flows from acute care hospitals or provide other resources.
• Assess the impact of State regulations on the ability of nursing homes to offer support and/or surge capacity.
Findings from this report can provide important insight into current nursing home preparedness activities as well as the potential role of nursing homes in larger local or regional preparedness efforts and the special needs of the nursing home population.

See also: Emergency Preparedness Atlas — U.S. Nursing Home and Hospital Facilities
The Agency for Healthcare Research and Quality (AHRQ) sponsored preparation of this atlas to support local/regional planning and response efforts in the event of a bioterrorism or other public health emergency. In the atlas, case studies in six areas illustrate the location of nursing homes relative to population and various emergency preparedness regions. There are also maps of the location of hospitals and nursing homes in all 50 States and the District of Columbia.
Download in sections (PDFs)

Posted by Info Center at 2:00 PM in Emergency Management | Health Care Workers | Permalink

Source: John E Lyncheski, Nursing Homes: Long Term Care Management, Vol. 56 no. 7, July 2007

Misunderstood or misapplied provisions of the Department of Labor’s regulations can have explosive consequences. The Department of Labor has long-term care in its sights for nonexempt employee overtime infractions.

Posted by Info Center at 10:56 AM in Health Care Workers | Labor Laws/Legislation | Permalink

Source: Congressional Budget Office Background Paper, Pub. No. 2761, July 2007

Rising costs in Medicare, Medicaid, and other federal health-related programs represent the central long-term fiscal challenge facing the nation. The Congressional Budget Office (CBO) is therefore increasingly focusing on analyzing the causes of those rising costs and potential policy responses.

Medicare’s spending under the fee-for-service portion of the program depends on the rates that Medicare pays to medical providers and the volume of services that medical providers supply to beneficiaries. The Congress has periodically limited growth in Medicare’s payments to providers to reduce spending. The effect on Medicare’s spending of changes in Medicare’s payment rates depends on whether and to what extent the volume of services adjusts in response.

In this background paper, CBO examines changes in the volume of services provided by skilled nursing facilities (SNFs) in response to changes in Medicare’s payment rates for SNFs. As with other CBO background papers, it is designed to make the agency’s analyses more transparent by explaining CBO’s methods and assumptions. In keeping with CBO’s mandate to provide objective, nonpartisan analysis, this paper makes no recommendations.

Posted by Info Center at 5:51 PM in Health Care Workers | Permalink

Source: American Nurses Association and Inviro Medical Devices, 2007

The 2007 Study of Injectable Medication Errors gathered opinions of 1,039 U.S. nurses about errors related to injectable medications and syringe labeling. The independent research, sponsored by the American Nurses Association (ANA) and Inviro Medical Devices, reveals 97% of nurses worry about medication errors, and two-thirds (68%) believe medication errors could be reduced with more consistent syringe labeling.

Posted by Info Center at 11:44 AM in Health Care | Health Care Workers | Permalink

Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, March 2007

During the past decade, private insurers, business enterprises and the Federal government have implemented or proposed changes in health care delivery and financing. These payers were reacting to unprecedented increases in health-related expenditures amid hypercompetitive global markets. Simply, the cost of providing adequate health care to employees and the population at large had become very high.

Some viewed the community health worker (CHW) workforce as a component of cost-effective strategies addressing the health care needs of underserved communities. However, there was little rigorous, comprehensive research about the CHW workforce.

This report describes a comprehensive national study of the community health worker workforce and of the factors that affected its utilization and development.

Annotated Bibliography

Posted by Info Center at 11:30 AM in Health Care Workers | Workforce | Permalink