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.

Exploring social-based discrimination among nursing home certified nursing assistants

Aug. 9, 2019

Jasmine L. Travers, Anne M. Teitelman, Kevin A. Jenkins, Nicholas G. Castle

Abstract [from journal]

Certified nursing assistants (CNAs) provide the majority of direct care to nursing home residents in the United States and, therefore, are keys to ensuring optimal health outcomes for this frail older adult population. These diverse direct care workers, however, are often not recognized for their important contributions to older adult care and are subjected to poor working conditions. It is probable that social-based discrimination lies at the core of poor treatment toward CNAs. This review uses perspectives from critical social theory to explore the


State Laws And Nonprofit Hospital Community Benefit Spending

Aug. 1, 2019

Emily K. Johnson, Rose Hardy, Tatiane Santos, Jonathon P. Leider, Richard C. Lindrooth, Gregory J. Tung

Abstract [from jorunal]

Objective: To determine the association of state laws on nonprofit hospital community benefit spending.

Design: We used multivariate models to estimate the association between different types of state-level community benefit laws and nonprofit hospital community benefit spending from tax filings.

Setting: All 50 US states.

Participants: A total of 2421 nonprofit short-term acute care hospital organizations that filled an internal revenue service


Gender Differences Among Academic Pediatric Radiology Faculty in the United States and Canada

Jul. 29, 2019

William B. Counter, Kiran Khurshid, Sabeena Jalal, Mauricio Castillo, Ammie M. White, Hansel J. Otero, Savvas Nicolaou, Faisal Khosa

Abstract [from journal]

Objective: It is currently unknown whether efforts in recent years to create equal opportunities for female faculty in academic medicine have succeeded. We looked at faculty members in academic pediatric radiology departments across the United States and Canada to assess for evidence of gender disparities and differences in academic performance between males and females.

Methods: The analysis included diagnostic radiology programs across the United States and Canada, as specified by the American Medical


Showers, Culture, and Conflict Resolution: A Qualitative Study of Employees' Perceptions of Workplace Wellness Opportunities

Jul. 29, 2019

Michael Seward, Roberta Goldman, Stephanie Linakis, Paul Werth, Christina Roberto, Jason Block

Abstract [from journal]

Objective: Research on employee opinions of workplace wellness programs is limited.

Methods: At a large academic medical center in Boston, we conducted 12 focus groups on employee perceptions of wellness programs. We analyzed data using the immersion-crystallization approach. Participant mean age (N = 109) was 41 years; 89% were female; 54% were White.

Results: Employees cited prominent barriers to program participation: limited availability; time and marketing; disparities in access; and


Interactions Between Clinician and Organizational Characteristics to Predict Cognitive-Behavioral and Psychodynamic Therapy Use

Rinad Beidas head shot
Jul. 26, 2019

Emily M. Becker-Haimes, Nathaniel J. Williams, Kelsie H. Okamura, Rinad S. Beidas

Abstract [from journal]

Conceptual models of implementation posit contextual factors and their associations with evidence-based practice (EBP) use at multiple levels and suggest these factors exhibit complex cross-level interactions. Little empirical work has examined these interactions, which is critical to advancing causal implementation theory and optimizing implementation strategy design. Mixed effects regression examined cross-level interactions between clinician (knowledge, attitudes) and organizational characteristics (culture, climate) to predict cognitive-behavioral


Dissatisfied Creators: Generating Creative Ideas Amid Negative Emotion in Health Care

Ingrid Nembhard, PhD
May. 9, 2019

Yuna S. H. Lee, Ingrid M. Nembhard, Paul D. Cleary

Abstract [from journal]

Improving performance often requires creative ideas in extreme work settings like health care. Frontline workers are promising sources of creative ideas. The authors assert that their job dissatisfaction is positively associated with creativity in health care settings because negative emotion spurs creativity when tied to engaging work and that characteristics such as shorter tenure, greater role centrality, and high boundary spanning can strengthen this relationship. The authors find supporting evidence in data on ideas generated over 18


Meeting the Oral Health Needs of an Aging Population

May. 7, 2019

An important, yet often overlooked aspect of comprehensive health care for a “graying” U.S. population is dental health. In a new commentary, Tim Wang, Mark Wolff, and Neeraj Panchal bring attention to the oral health needs of a growing geriatric population in the U.S., and suggest practical ways to prepare providers to meet the challenge of treating this unique group.

Tracking a Trend: Nursing Home Specialists

Apr. 12, 2019

The world of health care is divided into many areas of specialization. At one point or another, we may have seen a podiatrist for a foot problem or a dermatologist for skin issues. Not all of us realize that – in addition to specializing in, say, the lungs – clinicians can devote their practice to providing general care to patients in a specific setting. For example, some physicians, called ‘hospitalists,’ see all or most of their patients in a hospital environment.

Assessing First Visits By Physicians To Medicare Patients Discharged To Skilled Nursing Facilities

Research Brief
Kira Rysinka, MD
Apr. 1, 2019

In this study of postacute care, more than 10% of Medicare skilled nursing facility (SNF) stays included no visit from
a physician or advanced practitioner. Of stays with visits, about half of initial assessments occurred within a day of
admission, and nearly 80% occurred within four days. Patients who did not receive a visit from a physician or advanced
practitioner were nearly twice as likely to be readmitted to a hospital (28%) or to die (14%) within 30 days of SNF
admission than patients who had an initial visit.