Healthcare Workforce

The mix and distribution of health care providers. LDI Senior Fellows study how to transform health care delivery through the optimal training, mix, and placement of health care professionals and allied health workers to deliver cost-effective care.

Impact Of Around-the-Clock Mental Health Staffing On Emergency Department Management of Patients Who Deliberately Self-Harm

May. 22, 2020

Sara Wiesel Cullen, Amaya Diana, Mark Olfson, Ming Xie, Steven C Marcus

Abstract [from journal]

Objective: Emergency departments (EDs) offer opportunities to deliver critical frontline suicide prevention services via assessment, safety planning, and linkages with community-based mental health care after discharge. Because mental health crises can occur at any time, this study sought to evaluate whether around-the-clock mental health staffing in the ED influences the likelihood of providing these evidence-based mental health services.

Methods: ED nursing leadership from a national sample of 406...

Transforming Mental Health Care Through Implementation of Evidence-Based Practices

Issue Brief
May. 21, 2020

Changing clinical practice is hard, and changing practices within larger organizations is even harder. Increasingly, policymakers are looking to implementation science—the study of why some changes prove more durable than others—to understand the dynamics of successful transformation. In this brief, we summarize the results of an ongoing community-academic partnership to increase the uptake of evidence-based practices in Philadelphia’s public behavioral health care system. Over five years, researchers found that widescale initiatives did successfully change the way care was delivered, albeit modestly and slowly. The evidence suggests that organizational factors, such as a proficient work culture, are more important than individual therapist factors, like openness in change, in influencing successful practice change. While practice transformation is possible, it requires focusing on underlying problems within organizations as well as championing new policies. 

Gender Differences in Authorship of Critical Care Literature

Jan. 22, 2020

Kelly C. Vranas, David Ouyang, Amber L. Lin, Christopher G. Slatore, Donald R. Sullivan, Meeta Prasad Kerlin, Kathleen D. Liu, Rebecca M. Baron, Carolyn S. Calfee, Lorraine B. Ware, Scott Halpern, Michael A. Matthay, Margaret Herridge, Sangeeta Mehta,  Angela J...

Abstract [from journal]

Rationale: Gender gaps exist in academic leadership positions in critical care. Peer-reviewed publications are crucial to career advancement, yet little is known regarding gender differences in authorship of critical care research.

Objectives: To evaluate gender differences in authorship of critical care literature.

Methods: We used a validated database of author gender to analyze authorship of critical care articles indexed in PubMed between 2008-2018 in 40 frequently-cited journals.