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.

The Role Of Staffing And Classroom Characteristics On Preschool Teachers' Use Of One-To-One Intervention With Children With Autism

Jul. 6, 2020

Victor LushinSteven Marcus, Daphney Gaston, Rinad Beidas, Ashlee Lamson, Ilene Goy, Irina Godina, Joanne Rees, Rebecca Rivera, David Mandell

Abstract [from journal]

For preschool children with autism, individual (one-to-one) behavioral interventions are among the best-tested treatments. However, they are rarely used in special education preschools. We observed formally and informally delivered one-to-one behavioral interventions use by classroom staff (n = 51) in 12 classrooms across three special education preschools for children with autism, aged 3-6 years, in a major US city. We estimated the associations between one-to-one intervention use and classroom characteristics including staff-student


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. 

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.