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.

How Context Influences Hospital Readmissions From Skilled Nursing Facilities: A Rapid Ethnographic Study

Sep. 14, 2020

Roman AyeleKirstin A. Manges, Chelsea Leonard, Marcie Lee, Emily Galenbeck, Mithu Molla, Cari Levy, Robert E. Burke

Abstract [from journal]

Introduction: Improving hospital discharge processes and reducing adverse outcomes after hospital discharge to skilled nursing facilities (SNFs) are gaining national recognition. However, little is known about how the social-contextual factors of hospitals and their affiliated SNFs may influence the discharge process and drive variations in patient outcomes. We sought to categorize contextual drivers that vary between high- and low-performing hospitals in older adult transition from hospitals to SNFs.


Case For Hospital Nurse-To-Patient Ratio Legislation In Queensland, Australia, Hospitals: An Observational Study

Sep. 6, 2020

Matthew D. McHugh, Linda H. Aiken, Carol Windsor, Clint Douglas, Patsy Yates

Abstract [from journal]

Objectives: To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.

Design: Analysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.

Setting: Public hospitals in Queensland.


Long-Term Care, Residential Facilities, And COVID-19: An Overview Of Federal And State Policy Responses

Angela Chen, MA
Sep. 1, 2020

Angela T. ChenKira L. Ryskina, Hye-Young Jung

Abstract [from journal]

The COVID-19 pandemic has disproportionately affected residents and staff at long-term care (LTC) and other residential facilities in the United States. The high morbidity and mortality at these facilities has been attributed to a combination of a particularly vulnerable population and a lack of resources to mitigate the risk. During the first wave of the pandemic, the federal and state governments received urgent calls for help from LTC and residential care facilities; between March and early June of 2020, policymakers responded


Perspectives Of Urban Adolescent Black Males And Their Parents On Well Care

Aug. 27, 2020

George Dalembert, Ima Samba, Victoria A. Miller, Carol A. Ford, Alexander G. Fiks

Abstract [from journal]

Objective: Adolescents have fewer well-care visits than all other age groups. Males and ethnic minorities are seen least often. We elicited, from Black adolescent males and their parents, key drivers of teen well-care seeking.

Methods: We conducted separate semi-structured interviews with Black adolescent males and their parents. We recruited parent-teen dyads from West Philadelphia. Eligible teens were age 13-18, with no complex chronic health conditions. We purposively sampled teens who had


Patterns Of Postpartum Ambulatory Care Follow-Up Care Among Women With Hypertensive Disorders Of Pregnancy

Aug. 27, 2020

Jennifer Lewey, Lisa D. Levine, Lin Yang, Jourdan E. Triebwasser, Peter W. Groeneveld 

Abstract [from journal]

Background Preeclampsia and gestational hypertension are hypertensive disorders of pregnancy (HDP) that identify an increased risk of developing chronic hypertension and cardiovascular disease later in life. Postpartum follow-up may facilitate early screening and treatment of cardiovascular risk factors. Our objective is to describe patterns of postpartum visits with primary care and women's health providers (eg, family medicine and obstetrics) among women with and without HDP in a nationally representative sample of commercially


Chronic Hospital Nurse Understaffing Meets COVID-19

Research Brief
Aug. 18, 2020

A study of hospitals in New York and Illinois at the start of the COVID-19 pandemic found that most did not meet benchmark patient-to-nurse staffing ratios for medical-surgical or intensive care units. New York City hospitals had especially low staffing ratios. Understaffed hospitals were associated with less job satisfaction among nurses, unfavorable grades for patient safety and quality of care, and hesitance by nurses and patients to recommend their hospitals. 

Intersectionality and Health Inequities For Gender Minority Blacks In The U.S.

Aug. 10, 2020

Elle Lett, Nadia L. Dowshen, Kellan E. Baker

Abstract [from journal]

Introduction: Gender minority blacks represent the intersection of multiply marginalized populations that experience severe health inequities in the U.S. However, few studies focus on the unique health experiences of this multiply disadvantaged population. This study quantifies the health inequities experienced by gender minority blacks in the U.S. using an intersectional framework.

Methods: This cross-sectional study analyzed data in 2018/2019 from the Behavioral Risk Factor Surveillance System, including all...

Toward A Practice-Informed Agenda For Hospice Intervention Research: What Are Staff Members' Biggest Challenges?

George Demiris, Penn Nursing School
Aug. 6, 2020

Karla T. Washington, Leticia M. Alaniz Staner, Benjamin E. Collie, Kevin W. Craig, George Demiris, Debra Parker Oliver

Abstract [from journal]

The translation of evidence-based interventions into routine hospice care is impeded by numerous barriers, including a disconnect between research priorities and clinical care. To inform the development of a more practice-informed agenda for hospice intervention research, our team conducted a qualitative descriptive study, posing the following research questions: 1) How do hospice staff members describe their most significant work-related challenges? and 2) What regulatory changes do hospice staff members report would most improve


Mobility Action Group: Using Quality Improvement Methods To Create A Culture Of Hospital Mobility

Aug. 5, 2020

Songprod Jonathan Lorgunpai, Bruce Finke, Isaac Burrows, Cynthia J. Brown, Fred H. Rubin, Heidi R. Wierman, Susan J. Heisey, Sarah Gartaganis, Shari M. Ling, Matthew Press, Sharon K. Inouye

Abstract [from journal]

Background/objectives: To describe the Mobility Action Group (MACT), an innovative process to enhance implementation of hospital mobility programs and create a culture of mobility in acute care.

Design: Continuous quality improvement intervention with episodic data review.

Setting: Inpatient units including medical, surgical, and intensive care settings.

Participants: A total of 42 hospitals of varying sizes across the United States.


The Psychological Experience Of Obstetric Patients And Health Care Workers After Implementation Of Universal SARS-CoV-2 Testing

Aug. 5, 2020

Whitney R. Bender, Sindhu Srinivas, Paulina Coutifaris, Alexandra Acker, Adi Hirshberg

Abstract [from journal]

Objective: This study was aimed to describe the hospitalization and early postpartum psychological experience for asymptomatic obstetric patients tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) as part of a universal testing program and report the impact of this program on labor and delivery health care workers' job satisfaction and workplace anxiety.

Study design: This is a cohort study of asymptomatic pregnant women who underwent SARS-CoV-2 testing between April 13,


Clinical Research In Hepatology In The COVID-19 Pandemic And Post-Pandemic Era: Challenges And The Need For Innovation

Aug. 2, 2020

Elizabeth C. Verna,  Marina Serper,  Jaime Chu,  Kathleen Corey,  Oren K. Fix,  Karen Hoyt,  Kimberly A. Page,  Rohit Loomba,  Ming Li,  Gregory T. Everson,  Michael W. Fried,  Guadalupe Garcia‐Tsao,  Norah Terrault,  Anna S. Lok,  Raymond T. Chung,  K. Rajender Reddy

Abstract [from journal]

The SARS-CoV-2 pandemic has drastically altered all facets of clinical care and research. Clinical research in hepatology has had a rich tradition in several domains, including the discovery and therapeutic development for diseases such as hepatitis B and C, and studying the natural history of many forms of chronic liver disease. NIH, foundation and industry funding has provided important opportunities to advance the academic careers of young investigators while they strived to make contributions to the field. Instantaneously,


A Passive Monitoring Tool Using Hospital Administrative Data Enables Earlier Specific Detection Of Healthcare-Acquired Infections

Jul. 31, 2020

Jeffrey Rewley, Laura Koehly, Christopher Steven Marcum, Felix Reed-Tsochas

Abstract [from journal]

Background: Healthcare-associated infections impose a significant burden on the health care system. Current methods for detecting these infections are constrained by combinations of high cost, long processing times, and imperfect accuracy, reducing their effectiveness.

Methods: We examine whether the quantity of time a patient spends in a ward with other patients clinically-suspected of infection, which we call co-presence, can be used as a tool to predict subsequent healthcare-associated