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.

Patient satisfaction with hospital care and nurses in England: an observational study

Jan. 11, 2018

Linda H. Aiken, Douglas M. Sloane, Jane Ball, Luk Bruyneel, Anne Marie Rafferty, Peter Griffiths

In BMJ Open, Linda Aiken and colleagues examine how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels, and hospital work environments in National Health Service (NHS) hospitals in England. The authors use national survey data from over 66,000 hospital patients and nearly 3,000 inpatient nurses for their analysis.

The authors find that patients have a high level of trust and confidence in RNs, but only 60 percent of patients indicated that there were enough RNs to care for them. The importance of adequate RN...

New OECD Report Highlights Expanded Primary Care Role for Nurses

Jan. 9, 2018

To meet population health care needs in developed countries, health systems must shift their focus from treating acute episodes to managing chronic conditions. With the rise of chronic care comes a new set of tasks that are more time-consuming and team-oriented. Policymakers in many countries are seeking to align the size and composition of their primary care workforce to meet these new needs, by expanding the role of advanced nurses.

Physicians and Advanced Practitioners Specializing in Nursing Home Care, 2012-2015

Research Brief
Nov. 29, 2017

The number of clinicians specializing in nursing home care increased by 33.7% from 2012 to 2015, although nursing home specialists made up only 21% of nursing home clinicians in 2015. Most of these specialists were advanced practitioners (physician assistants and nurse practitioners) delivering post-acute care. The change in number of nursing home specialists varied significantly by geographic region.

What Every Graduating Resident Needs to Know About Quality Improvement and Patient Safety: A Content Analysis of 26 Sets of ACGME Milestones

Nov. 29, 2017

Meghan Lane-Fall, Joshua J. Davis, Justin Clapp, Jennifer S. Myers, Lee Ann Riesenberg

In the Journal of the Association of American Medical Colleges, Meghan Lane-Fall and colleagues analyze milestones – competency-based outcomes assessing graduate medical trainees – across 26 specialties to identify common expectations related to quality improvement (QI) and patient safety (PS). The purpose of this work is to move toward a consensus around what every medical trainee needs to know in QI and PS, irrespective of specialty.

The authors performed a content analysis of 612 published milestones from the Accreditation Council for Graduate Medical Education (ACGME)....

System Redesign and the Health Care Workforce

Oct. 19, 2017

An interdisciplinary panel of experts from health care management, economics, and nursing came together at LDI’s 50th Anniversary Symposium to discuss their perspectives on how “organizational innovation” can be used to redesign health care systems and care delivery.

Moderator:
Linda Aiken, PhD, RN, University of Pennsylvania

Nursing Care Disparities in Neonatal Intensive Care Units

Oct. 11, 2017

Eileen T. Lake, Douglas Straiger, Erika Miles Edwards, Jessica G. Smith, Jeannette A. Rogowski

In Health Services Research, Eileen Lake and colleagues, including Jessica Smith and Jeannette Rogowski, compared missed nursing care for infants in neonatal intensive care units (NICUs) across hospitals with a predominantly-black versus non-black patient population. The authors sought to understand the factors that cause nurses to miss care. At sites across four states, NICU nurses completed a survey on the floor’s average patient load, nursing environment, and nursing professional characteristics, as well as their individual patient load and the care that they missed on their...

Changing Antibiotic Prescribing in a Primary Care Network: The Role of Readiness to Change and Group Dynamics in Success

Oct. 11, 2017

Suratha Elango, Julia E. Szymczak, Ian M. Bennett, Rinad S. Beidas, Rachel M. Werner

In the American Journal of Medical Quality, Suratha Elango and colleagues, including Rinad Beidas and Rachel Werner, studied factors important to combating overuse of broad-spectrum antibiotics in outpatient pediatric practices. Primary care clinics in the Children’s Hospital of Philadelphia network completed surveys and then semi-structured interviews on barriers and facilitators to improving their antibiotic prescribing practices, perceptions and reactions to the initiative, and the climate surrounding its implementation.

Practices with a high willingness...

Distribution of Medical Education Debt by Specialty, 2010-2016

Sep. 22, 2017

Justin Grischkan, Benjamin P. George, Krisda Chaiyachati, Ari B. Freidman, E. Ray Dorsey, David A. Asch

In JAMA Internal Medicine, Justin Grischkan and colleagues, including Krisda Chaiyachati and David A. Asch, analyze trends in the distribution of medical education debt. The increasing amount of graduate medical education debt is well known, yet a quieter upward trend in the number of graduates without debt also persists in the data.

The authors analyzed figures of self-reported debt from the 2010-2016 Association of American Medical Colleges Graduation Questionnaire. They find that the mean amount of debt increased from $161,739 in 2010 to $179,068 in 2016, and that the...

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