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.

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. 

Variables Associated with Missed Nursing Care in Alabama: A Cross‐Sectional Analysis

Colleen Anusiewicz
Feb. 18, 2020

Caitlin Marley Campbell, Aoyjai Prapanjaroensin, Colleen V. Anusiewicz, Marianne Baernholdt, Terry Jones, Patricia A. Patrician

Abstract [from journal]

Aim: To discover the extent of and factors associated with missed nursing care in Alabama.

Background: Missed nursing care is a well‐documented phenomenon. However, it has not been studied in U.S. southern states that consistently rank poorly in health outcomes, such as Alabama.



Effect Of Patient Education On Palliative Care Knowledge And Acceptability Of Outpatient Palliative Care Services Among Gynecologic Oncology Patients: A Randomized Controlled Trial

Feb. 1, 2020

Ashley Graul, Ashley Haggerty, Carolyn Stickley, Knashawn Morales, Hillary Bogner, Robert Burger, Mark Morgan, Emily Ko

Abstract [from journal]

Objectives: A randomized control trial (RCT) to estimate the effect of an interventional video on improving palliative care knowledge, acceptability and attendance to outpatient services in gynecologic oncology patients.

Methods: Women receiving treatment for gynecologic malignancy recruited at an academic tertiary care center were randomized to: palliative care educational video or non-directive cancer center video. The primary outcome was referral to


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.


The Relationship Between Hospital and Community Psychiatry: Complements, Not Substitutes?

Jan. 3, 2020

Isabel M. Perera

Abstract [from journal]

Community-based psychiatric services are essential to mental health. For decades, researchers, advocates, and policy makers have presumed that expanding the supply of these services hinges on reducing the supply of hospital-based care. Cross-national data from the World Health Organization call this presumption into question. Community and hospital psychiatry appear to be complements, not substitutes.