Table 5 - uploaded by Akiko Maeda
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This study reviews the status of existing surveys that measure health professional skills, and identifies gaps where more attention and resources will be needed to generate policy-relevant evidence on skills requirements, skills use and skills mismatch in healthcare settings. Furthermore, the study explores the feasibility of developing a standardi...
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... answering the questions regarding the attitudes, respondents are asked to report on their self-perceived level of skills (self-perceived efficacy) in performing given tasks, using a scale with a detailed description of each skills level. Table 5, below, is extracted from the Self-Assessment of Shared Decision Making Knowledge and Skills Survey (The Health Foundation, 2013). For skills related to team work/shared leadership and interprofessional collaboration, self-reporting tools allow also for assessing the sum of skills within a team by asking the respondents to rate the team's overall performance on selected items. ...
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Emergency Departments (EDs) play a unique role in every healthcare system as patients, in the event of an unexpected or urgent need, seek medical care through the services of these departments. In recent years however, the utilisation of EDs have been growing rapidly around the world and in Australia. This trend appears to occur irrespective of the...
Citations
... Such arrangements are particularly challenging given the changing demands on healthcare, characterised, on the one hand, by patients with multi-morbidity, and on the other hand by growing evidence for the benefits of multidisciplinary working, skills mixes and team approaches. 37,38 While theoretically possible for these new models of care to be adopted, proposals from those on the front line must be taken up through the hierarchy until they reach a point at which the silos join. This is also one of the main stumbling blocks for innovation in the system; proposals need to overcome many hurdles within the system and are rarely encouraged. ...
This article examines the role of physicians within the managerial structure of Russian hospitals. A comparative qualitative methodology with a structured assessment framework is used to conduct case studies that allow for international comparison. The research is exploratory in nature and comprises 63 individual interviews and 49 focus groups with key informants in 15 hospitals, complemented by document analysis. The material was collected between February and April 2017 in five different regions of the Russian Federation. The results reveal three major problems of hospital management in the Russian Federation. First, hospitals exhibit a leaky system of coordination with a lack of structures for horizontal exchange of information within the hospitals (meso-level). Second, at the macro-level, the governance system includes implementation gaps, lacking mechanisms for coordination between hospitals that may reinforce existing inequalities in service provision. Third, there is little evidence of a learning culture, and consequently, a risk that the same mistakes could be made repeatedly. We argue for a new approach to governing hospitals that can guide implementation of structures and processes that allow systematic and coherent coordination within and among Russian hospitals, based on modern approaches to accountability and organisational learning.
... Furthermore, a review undertaken for the OECD concludes that 'findings suggest that team-based care models where all providers work to their level of competency and scope of practice may result in higher quality care' [38, p.45]. European comparative studies add further evidence that the development of new skills can strengthen primary and chronic care reforms [30], while a feasibility study undertaken by the OECD explored indicators for an integrated team-based workforce development across countries [39]. However, primary care is still often organised in professional 'silos' and medical dominance is widespread [26,40,41]. ...
https://www.healthpolicyjrnl.com/article/S0168-8510(18)30323-3/pdf
Better primary care has become a key strategy for reforming health systems to respond effectively to increases in non-communicable diseases and changing population needs, yet the primary care workforce has received very little attention. This article aligns primary care policy and workforce development in European countries. The aim is to provide a comparative overview of the governance of workforce innovation and the views of the main stakeholders. Cross-country comparisons and an explorative case study design are applied. We combine material from different European projects to analyse health system responses to changing primary care workforce needs, transformations in the general practitioner workforce and patient views on workforce changes. The results reveal a lack of alignment between primary care reform policies and workforce policies and high variation in the governance of primary care workforce innovation. Transformations in the general practitioner workforce only partly follow changing population needs; countries vary considerably in supporting and achieving the goals of integration and community orientation. Yet patients who have experienced task shifting in their care express overall positive views on new models. In conclusion, synthesising available evidence from different projects contributes new knowledge on policy levers and reveals an urgent need for health system leadership in developing an integrated people-centred primary care workforce.
... The importance of better healthcare policy and governance to achieve a competent and sustainable health workforce is increasingly recognised in Europe [3][4][5][6][7][8][9][10]. This is now also supported by improved data sources as well as by international recommendations and frameworks for action [1,2,[11][12][13][14][15][16]. However, many challenges remain. ...
... It is also increasingly recognised that workforce change goes far beyond mere numbers and shortages. The drivers are highly complex and include, among others, stronger primary care and integrated care policies which may lead to new connections between health and social care and involvement of informal carers, new technologies (eHealth, robots, etc.) and improved health literacy to respond to changing expectations of the public and strengthen user participation [11,26]. ...
... These approaches are relevant on all levels of healthcare governance and shape the content of policy reforms, service organisation and professional practice; they are strongly embedded in the education and organisation of the health workforce. Moreover, occupational categories based on silos inform health workforce governance and planning as well as research, despite some novel approaches and European comparative research, such as the recent OECD feasibility study on skills assessment, which seeks to focus on tasks and functions rather than occupational categories [11]. Knowledge is poorly developed with regards to the policy levers for successfully implementing innovative and transformative actions and interventions, as well as the tools and channels through which to foster dissemination of this knowledge and provide advice for policy-makers. ...
The importance of a sustainable health workforce is increasingly recognised. However, the building of a future health workforce that is responsive to diverse population needs and demographic and economic change remains insufficiently understood. There is a compelling argument to be made for a comprehensive research agenda to address the questions. With a focus on Europe and taking a health systems approach, we introduce an agenda linked to the ‘Health Workforce Research’ section of the European Public Health Association. Six major objectives for health workforce policy were identified: (1) to develop frameworks that align health systems/governance and health workforce policy/planning, (2) to explore the effects of changing skill mixes and competencies across sectors and occupational groups, (3) to map how education and health workforce governance can be better integrated, (4) to analyse the impact of health workforce mobility on health systems, (5) to optimise the use of international/EU, national and regional health workforce data and monitoring and (6) to build capacity for policy implementation. This article highlights critical knowledge gaps that currently hamper the opportunities of effectively responding to these challenges and advising policy-makers in different health systems. Closing these knowledge gaps is therefore an important step towards future health workforce governance and policy implementation. There is an urgent need for building health workforce research as an independent, interdisciplinary and multi-professional field. This requires dedicated research funding, new academic education programmes, comparative methodology and knowledge transfer and leadership that can help countries to build a people-centred health workforce.
Keywords: Health workforce research, Health workforce policy, Health workforce governance, Human resources for health, Health professions, Skill mixes, Integrated care, Health workforce mobility, Europe
