Human Resources Management

Outcomes of Variation in Hospital Nurse Staffing in English Hospitals: Cross-Sectional Analysis of Survey Data and Discharge Records

Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention. The objectives of this article are to examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurserated quality of care. [from abstract]

UK Wide Workforce Planning Competence Framework

This framework encompasses the healthcare workforce planning skills and competences required at both strategic and operational level, for all types of staff, including chief executives, directors, clinicians, service development managers, ward managers, workforce planners, and contributes to the building of capability in human resource management identified in the HR in the NHS Plan. [publisher’s description]

Nurse Staffing and Quality of Patient Care

This review was designed to assess how nurse to patient ratios and nurse work hours were associated with patient outcomes in acute care hospitals, factors that influence nurse staffing policies, and nurse staffing strategies that improved patient outcomes. [from abstract]

Health Care Managers as a Critical Component of the Health Care Workforce

The main purpose of this chapter of “Human Resources for Health in Europe” is to develop a dynamic and unified framework for describing and analysing the role of the health care manager in a changing Europe. The chapter also attempts to combine the construction of this theoretical model with its application, drawing on empirical work in different European countries to illustrate the challenges and opportunities arising from the various elements of health care reform. [from introduction]

Human Resource Management in the Georgian National Immunization Program: a Baseline Assessment

Georgia’s health care system underwent dramatic reform after gaining independence in 1991. The decentralization of the health care system was one of the core elements of health care reform but reports suggest that human resource management issues were overlooked. The Georgian national immunization program was affected by these reforms and is not functioning at optimum levels. This paper describes the state of human resource management practices within the Georgian national immunization program in late 2004. [from abstract]

Towards Better Leadership and Management in Health Working Paper: Report on an International Consultation on Strengthening Leadership and Management in Low-Income Countries

This report is based on deliberations from an international consultation on strengthening leadership and management as an essential component to scaling health services to reach the Millennium Development Goals. The focus was on low-income countries though the principles discussed concerned leadership and management in other settings as well. The report describes a technical framework adopted by the consultation for approaching management development and sets out key principles for sustained and effective capacity building. [author’s description]

How Should Doctors Be Paid? Lessons from Theory and Practice

For long now, doctors in Uganda have been complaining that their terms of service, particularly remuneration, are not commensurate with the years that they spend training and the amount of work that they do. This issue has persistently been raised at several fora over the years but with no definite resolution. But how should doctors be paid? This paper attempts to answer this question. In the developed world, policy makers attempt to answer the question of cost containment. In Uganda, due to limited financial resources, the overriding question is where will the extra resources to adequately pay doctors be found? [from introduction]

Evidence-Based Standards for Measuring Nurse Staffing and Performance

Policy makers and hospital administrators are seeking evidence to support nursing staffing decisions that includes both the volume and mix of nurses required to provide efficient and effective care. The principal objective of this study was to examine the interrelationships between variables thought to influence patient, nurse, and system outcomes. The results provide quality, evidence-based standards for adjusted ranges of nursing productivity/utilization and for staffing levels for patients receiving cardiac and cardiovascular nursing care. [from executive summary]

Managing the Health Millennium Development Goals: the Challenge of Management Strengthening Lessons from Three Countries

Achieving the health Millennium Development Goals will require a significant scaling up of health service delivery in many countries. The number of competent managers will also have to be scaled up at the same time – managers are an essential resource for ensuring that priority needs are met and resources are used effectively. This study describes various management strengthening activities in 3 countries – South Africa, Togo and Uganda. [from executive summary]

Medicines without Doctors: Why the Global Fund Must Fund Salaries of Health Workers to Expand AIDS Treatment

Recent comments from the Global Fund suggest an intention to focus more on the three diseases, and to leave the strengthening of health systems and support for the health workforce to others. This could create a “Medicines without Doctors” situation in which the medicines to fight AIDS, tuberculosis, and malaria are available, but not the doctors or the nurses to prescribe those medicines adequately. [author’s description]

Creating Healthy Health Care Workplaces in British Columbia: Evidence for Action

The intent of the report is to stimulate creative discussions among [British Colubia’s] health system stakeholders about opportunities for coordinated action on employee and workplace health. The best available evidence suggests that the scope and depth of workplace health challenges today require solutions that go beyond traditional workplace health promotion programs.

Collaborative Practice Among Nursing Teams

This best practice guideline focuses on nursing teams and processes that foster healthy work environments. The focus for the development of this guideline was collaborative practice among nursing teams with the view that this may be a first stage in a multi-staged process that could eventually result in interprofessional guidelines. A healthy work environment for nurses is a practice setting that maximizes the health and well being of nurses, quality patient outcomes and organizational performance. Effective nursing teamwork is essential to the work in health care organizations. [from purpose]

Providing Health Care Under Adverse Conditions: Health Personnel Performance and Individual Coping Strategies

This resulted in a collection of papers with very different viewpoints and formats, reflecting the different professional and geographical backgrounds of the participants. First a set of papers describes the performance of health personnel in a number of countries and attempts to improve it. A second part looks more closely at the various coping strategies health care workers, medical and paramedical, clinical and managerial, actually apply to deal with difficult working and living conditions.

Strategy for the Rapid Start-Up of the HIV/AIDS Program in Namibia: Outsourcing the Recruitment and Management of Human Resources for Health

In response to the HIV/AIDS crisis, Namibia’s public health sector is carrying out a comprehensive strategy to rapidly hire and deploy professional and non-professional health workers with the aim of providing comprehensive care, counseling and testing, as well as antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT). [from executive summary]

Multisectoral Responses to HIV/AIDS: A Compendium of Promising Practices from Africa

This document brings together the promising practices identified by the PVO community. Our definition of promising is purposefully broad to include the many ideas and experiences of different organizations that seem likely to combat HIV/AIDS successfully. [from foreword]

Nursing Management Today: an ICN Viewpoint

Population-based healthcare has become the focus of healthcare services around the world so there is an ever-increasing need to train and support nurse managers who can led and nurture nurses as they work towards providing optimum levels of satisfaction and safety in the care they give to their patients. [abstract]

Rwanda Human Resources Assessment for HIV/AIDS Services Scale-Up: Summary Report

This report examines the workforce issues surrounding HIV/AIDS service delivery. At the request of the Government of Rwanda, data were collected on current health sector staffing and from 20 public and private facilities of various sizes and characteristics on the time required to provide HIV/AIDS services and the quality of those services. The report presents data relative to the numbers of clients needing different types of HIV/AIDS services, providers’ degree of compliance with service delivery standards, and the time it takes to provide services.

What are the Best Ways that Health Care Leaders Can Train Managers to Train Others?

Training managers within hospitals and health services do not just rely on transmitting packets of knowledge in a formal setting. This article argues that successful training should contain an emotional element to ensure engagement with the message. Immersion in real life circumstances is also important and leaders must develop training around shared objectives and team building. [abstract]

Challenges to Creating Primary Care Teams in a Public Sector Health Centre: a Cooperative Inquiry

Effective teamwork between doctors and clinical nurse practitioners (CNP) is essential to the provision of quality primary care in the South African context. The Worcester Community Health Centre (CHC) created dedicated practice teams offering continuity of care, family-orientated care, and the integration of acute and chronic patients. The teams depended on effective collaboration between the doctors and the CNPs. This inquiry focuses on the question of how more effective teams of doctors and clinical nurse practitioners offering clinical care could be created within a typical CHC. [adapted f

Effective Healthcare Teams Require Effective Team Members: Defining Teamwork Competencies

Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers. [from abstract]

Attracting, Retaining and Managing Nurses in Hospitals: NSW Health

The NSW Department of Health is responsible for managing nurse supply. It needs to identify the extent and nature of shortages and develop ways to attract, retain and best manage nurses working in public hospitals. This audit looks at how nurses are managed in four of our public hospitals and examines how the Department has responded to expected nurse shortages. It also highlights actions that have helped reduce the number of nurses leaving hospitals. [from foreword]

Nurse Wages and Their Context: Database Summary (Asia)

These yearly summary reports provide information on nurse wages and the comparitive buying power of these wages in Hong Kong, Japan, Korea, Macau, Malaysia, Philippines, Singapore, Taiwan and Thailand. The data are results from a survey of 11 National Nurses’ Associations. [from introduction]

What You Need to Know about Senior Employment Opportunities and Contracts

For employment contracts not covered by collective agreements, individual nurses must be able to negotiate salaries and conditions of employment commensurate with their position and job functions. The purpose of these guidelines is to assist nurses in applying for senior positions and includes a review of the position, the application processes in its broader context and a clarification of both individual and collective employment contracts and how these relate to senior positions. [from preface]

Working Practices and Incomes of Health Workers: Evidence from an Evaluation of a Delivery Fee Exemption Scheme in Ghana

This article describes a survey of health workers and traditional birth attendants (TBAs) which was carried out in 2005 in two regions of Ghana. The objective of the survey was to ascertain the impact of the introduction of a delivery fee exemption scheme on both health workers and those providers who were excluded from the scheme (TBAs).

Clinical Supervision in the Workplace: Guidance for Occupational Nurses

This leaflet has been designed as an introduction to clinical supervision. It aims to stimulate ideas and to encourage occupational health nurses to set up supervision practice in their workplaces. Clinical supervision isn’t a management tool, but can be used as a support and prompt to professional practice in a creative way. [from introduction]

Guidance for Nurse Staffing in Critical Care

These documents aim for a level of staffing and skill mix that is determined by patient need and level of dependency to ensure that patients’ needs are met. Therefore, effective workforce planning is essential. This guidance looks at the considerations for employers, senior nurses and others planning staffing needs at ward, unit and organisational level. [from introduction]

Applying Benchmarking in Health

The task of improving quality is a demanding job. It requires focusing on clients, using data, working collaboratively with other team members, and maintaining an overarching view of the health system in which we work. Benchmarking is a process for finding, adapting, and applying best practices. [adapted from author]

It's Your Career: Take Charge: Career Planning and Development

This document is directed towards individual nurses to help them take charge and be in control of their careers within the ever-changing world of health care. These guidelines highlight the key dimensions of career planning and development and offer guidance to those who wish to evaluate the present and shape their future. [adapted from introduction]

Maximizing Access and Quality through Management and Supervision

The objectives of this presentation are to provide participants with an understanding of the role of leaders and managers in promoting quality services and to have participants identify action steps/interventions to promote quality at different levels of the health system. [from author’s description]

Achieving a More Efficient Health Care Workforce

This presentation was part of the 2006 Global Health Mini-University. A key approach to address the global shortage of healthcare providers is to improve the productivity of existing workers, thereby improving the quality and coverage of services. Improving the work environment and task shifting of health functions to different cadres of providers are two promising interventions that are being used for this purpose. This session will describe and discuss these and some of the other innovative solutions to enhance the capacity and productivity of the current workforce and to build coherence into the management of human resources for stronger health systems. [publisher’s description]