575: Successful adoption and acceptance of a full-time laborist model in a community-based hospital

Open Works is a newly established community-based makerspace in the Greenmount West Neighborhood District of Baltimore, Maryland. The space, located in a completely renovated building especially designed as a makerspace, encompasses 34,000 square feet and has an impressive array of new equipment, specialty shops, public spaces, and 140 micro-studios for creatives and entrepreneurs in the community. Open Works offers a variety of face-to-face courses to certify makers in five out of the seven studio spaces and relies heavily on the six full-time staff and fellows to run the space. Open Works is grappling with the need to increase paid memberships as a mechanism for sustainability and at the same time trying to meet the needs of a disadvantaged community. This chapter explores Open Works.

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Sociodemographic and clinical correlates of migrant status in adults with psychotic disorders: data from the Australian Survey of High Impact Psychosis

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796014000535 ◽

2014 ◽

Vol 24 (6) ◽

pp. 534-541 ◽

Cited By ~ 5

Author(s):

S. Saha ◽

V. A. Morgan ◽

D. Castle ◽

D. Silove ◽

J. J. McGrath

Keyword(s):

Psychotic Disorders ◽

Population Based ◽

Demographic Variables ◽

High Impact ◽

Full Time ◽

Migrant Status ◽

Community Based ◽

Prevalence Survey ◽

Clinical Correlates ◽

Catchment Areas

Objective.The links between migrant status and psychosis have attracted considerable attention in recent decades. The aim of the study was to explore the demographic and clinical correlates of migrant v. Australia-born status in individuals with psychotic disorders using a large community-based sample.Method.Data were drawn from a population-based prevalence survey of adults with psychotic disorders. Known as the Survey of High Impact Psychosis (SHIP), it was conducted in seven Australian catchment areas in 2010. Logistic regression was used for the main analyses, examining associations of migrant status with sociodemographic and clinical variables.Results.Of the 1825 participants with psychotic disorders, 17.8% (n = 325) were migrants, of whom 55.7% (n = 181) were male. Compared to Australia-born individuals with psychosis, migrants were more likely to be currently married, to have completed a higher level at school, to have left school later, and to be employed with full-time jobs. Migrants with psychosis were either no different from or less impaired or disadvantaged compared to their Australian-born counterparts on a range of clinical and demographic variables.Conclusions.In a sample of individuals with psychotic disorders, there was no evidence to suggest that migrant status was associated with worse clinical or socio-economic outcomes compared to their native-born counterparts.

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Community-based free clinics: opportunities for interprofessional collaboration, health promotion, and complex care management

Journal of Chiropractic Education ◽

10.7899/jce-15-2 ◽

2016 ◽

Vol 30 (1) ◽

pp. 25-29 ◽

Cited By ~ 2

Author(s):

Martha A. Kaeser ◽

Cheryl Hawk ◽

Michelle L. Anderson ◽

Richard Reinhardt

Keyword(s):

Mental Health ◽

Health Promotion ◽

Health Professional ◽

Mental Health Professional ◽

Pain Medication ◽

Self Report ◽

Full Time ◽

Diverse Populations ◽

Community Based ◽

Cross Sectional

Objective: Free or outreach clinics offer students the opportunity to work with diverse patient populations. The objective of this study was to describe the demographics and clinical characteristics of a sample of chiropractic patients at a free community-based clinic to assess clinical and educational opportunities for students to work with diverse populations, collaborate with other professions and practice health promotion through patient education. Methods: This was a prospective, descriptive cross-sectional study conducted over 2 months. Data on demographics, health status, and health risks were collected from patients and their interns. Results: Of the 158 patients, 50.6% were women and 50.6% African-American, while only 20.9% were employed full-time. Of the 24.7% tobacco users, 48.7% expressed interest in cessation. Of 80.0% overweight or obese patients, 48.8% expressed interest in weight loss. By self-report, 16.5% were diabetic, 10.1% took hypertension medication, 36.7% used prescription pain medication (9.4% opiate use), 33.5% used nonprescription pain medication, and 9.4% were under the care of a mental health professional. Conclusion: This patient population is demographically diverse. A high proportion of patients who used tobacco, or were overweight or obese expressed interest in information on those topics. A substantial proportion reported being under care with a mental health professional. This clinic provides opportunities for students to work with diverse populations, collaborate with other professions, and practice health promotion.

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Can we improve community adjuvant treatment reporting to a hospital tumor registry?

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.34_suppl.136 ◽

2012 ◽

Vol 30 (34_suppl) ◽

pp. 136-136

Author(s):

Nina Bickell ◽

Jill Wellner ◽

Rebeca Franco ◽

Ann McAlearney

Keyword(s):

Adjuvant Treatment ◽

Full Time ◽

Breast Cancer Patients ◽

Community Based ◽

Tumor Registry ◽

Hospital Leadership ◽

Medical Oncologists ◽

Potential Impact ◽

Outpatient Settings ◽

Pilot Intervention

136 Background: Accurate cancer treatment reporting to a hospital tumor registry (TR) is critical as data measurement is the foundation for improvement. Yet as adjuvant treatment moves to outpatient settings, reporting is problematic. We undertook a solutions-focused exercise to identify reporting barriers and facilitators and devise a pilot intervention to improve reporting. Methods: We convened a multidisciplinary group of community-based surgical and medical oncologists, TR staff, and hospital leadership. The group identified 3 key barriers: 1) inability to identify correct managing MD, 2) poor communication, and 3) manual reporting burden. The intervention focused on the 1st 2 barriers—those with easy fixes and great potential impact: TR obtained correct information, changed contact forms, worked with pathology to ascertain cases in real-time, tracked and reported practice responses weekly; MDs primed office staff to respond to TR requests. Results: Pre-intervention, the TR identified none of 20 pilot patients’ managing medical oncologist or adjuvant treatment. During the April to May 2012 intervention, 22 breast cancer patients listed our volunteer surgeon as managing MD. The TR sent 22 treatment letters to the surgeon’s office, received 20 (91%) responses with managing MD data provided for all. Patients were referred to full-time (26%) and community (74%) medical oncologists; 64% of required adjuvant treatment was reported. 47% of cases were closed; 53% remain open. Closed cases required 5.9 contacts (38.9 mins; sd=8.99), open cases had 8.2 contacts (48.4 mins; sd=2.85). Surgical staff spent ~1/2 hour per case to identify the oncologist prescribing adjuvant treatment. Conclusions: The solutions-focused exercise successfully improved identification of managing oncologists from 0% to 86% for patients treated by community oncologists. Treatment reporting increased from 2.6% to 64%. The pilot did not address the burden of reporting which remains great for both TR and community oncologists. While electronic access can reduce this burden through direct interface between an EMR and TR software, this approach is not currently feasible for community-based oncologists.

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Adult foster care of older people

International Journal of Care and Caring ◽

10.1332/239788220x15864994310333 ◽

2020 ◽

Vol 4 (3) ◽

pp. 441-446

Author(s):

Raija Leinonen ◽

Maria Kuukkanen

Keyword(s):

Foster Care ◽

Older People ◽

Care Service ◽

Full Time ◽

Community Based ◽

Term Care ◽

Public Care ◽

Adult Foster Care ◽

Part Time

The focus of this article is to introduce the community-based adult foster care of older people in Finland. Although adult foster care is a public care service, it is organised in a private home, either in the foster carer’s home or in the older person’s home. The foster carer and the county make a commission agreement. Adult foster care can be full-time long-term care or short-term full-time or part-time care.

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Modern work patterns of “classic” versus millennial family doctors and their effect on workforce planning for community-based primary care: a cross-sectional survey

Human Resources for Health ◽

10.1186/s12960-020-00508-5 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Lindsay Hedden ◽

Setareh Banihosseini ◽

Nardia Strydom ◽

Rita McCracken

Keyword(s):

Primary Care ◽

British Columbia ◽

Workforce Planning ◽

Cross Sectional Study ◽

Full Time ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Family Doctors ◽

Primary Care Practices

Abstract Background There are ongoing accessibility challenges in primary care in British Columbia, Canada, with 17% of the population not having a regular source of care. Anecdotal evidence suggests that physicians are moving away from a community-based comprehensive practice model, which could contribute to shortages. Thus, we aimed to identify and describe how family physicians are currently organizing their primary care practices in a large health region in British Columbia and to examine differences between newer graduates and more established physicians. Methods Data for this cross-sectional study were drawn from an annual physician privileging survey. N = 1017 physicians were invited to participate. We categorized practice style into five distinct groupings and compared features across respondent groups, including personal and practice location characteristics, hospital and teaching work, payment and appointment characteristics, and scope of practice. We discuss the implications of styles of practice and associated characteristics on health workforce policy and planning. Results We received responses from 525 (51.6%) physicians. Of these, 355 (67.6%) reported doing at least some community-based primary care. However, only 112 (21.3%) provided this care full time. Most respondents supplemented community-based work with part-time hours in focused practice, hospitals, or inpatient facilities. We found diversity in the scope and style of practice across practice models. Compared to established physicians, new graduates (in practice less than 10 years) work more weekly hours (more patient care, and paperwork in particular). However, we found no difference between new and established physicians in the odds of providing any or full-time community-based primary care. Conclusions Despite a lack of formalized structural reform in British Columbia’s primary care system, most physicians are finding alternative ways to model their practice and shifting away from work at single-location, community-based clinics. This shift challenges assumptions that are relied on for workplace planning that is intended to ensure adequate access to longitudinal, community-based family medicine.

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Quality and Extent of Locum Tenens Coverage in Pediatric Surgical Practices

The American Surgeon ◽

10.1177/000313481508100428 ◽

2015 ◽

Vol 81 (4) ◽

pp. 377-380 ◽

Cited By ~ 6

Author(s):

Tracy L. Nolan ◽

Jessica J. Kandel ◽

Don K. Nakayama

Keyword(s):

Pediatric Surgery ◽

Surgical Care ◽

Full Time ◽

Short Term ◽

Community Based ◽

Surgical Workforce ◽

Strongly Agree ◽

Do So

The prevalence and quality of locum tenens coverage in pediatric surgery have not been determined. An Internet-based survey of American Pediatric Surgical Association members was conducted: 1) practice description; 2) use and frequency of locum tenens coverage; 4) whether the surgeon provided such coverage; and 5) Likert scale responses (strongly disagree, disagree, neutral, agree, strongly agree) to statements addressing its acceptability and quality (two x five contingency table and χ2 analyses, significance at P < 0.05). Three hundred sixteen of 1163 members (27.2% response rate) responded. One-fourth (24.1%) used a locum tenens regularly. Reasons were long-term inability to recruit a full-time surgeon (35.2%) and short-term vacancies (32.4%). One-fifth (20.4%) did locum tenens work; one-fourth (27.0%) plan to do so in the future. Two-thirds (64.2%) believe that surgical care in a locum tenens situation does not provide the same level of care as a full-time community-based surgeon. Most support locum tenens for short-term coverage (87.3%) and recruitment problems (72.1%), but not long-term vacancies (38.8%; P < 0.001) or permanent coverage (27.0%; P < 0.001). Locum tenens coverage is an established feature of pediatric surgery. Most view it as a stopgap solution to the surgical workforce shortage.

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Student and supervisor perspectives on the effectiveness of community-based placements for occupational therapy students

BMC Medical Education ◽

10.1186/s12909-021-02492-3 ◽

2021 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Anat Golos ◽

Esti Tekuzener

Keyword(s):

Occupational Therapy ◽

Personal Development ◽

Qualitative Data ◽

Full Time ◽

Online Questionnaire ◽

Community Based ◽

Occupational Therapy Students ◽

Part Time ◽

Therapy Services ◽

Personal Skills

Abstract Background Using a community-based model as an integral part of occupational therapy students' practice experiences can enable the development of new emerging practices within the community. The aims of this study were to examine the experiences of students and supervisors in community-based role-emerging practice placements, and to compare the two types of placements (full-time and part-time). Methods Data was collected from 41 undergraduate occupational therapy students and seven supervisors using pre-post questionnaires, as well as qualitative data through focus groups and a short online questionnaire. Conventional content analysis was used for qualitative data, Wilcoxon tests were used to examine the change in scores, and Mann-Whitney tests compared the two types of placements. Results A significant decrease was evident in students' scores from pre- to post-placement regarding setting and supervision (z = -3.557, p < .001), with a non-significant decrease regarding community. Significant increases in scores were seen regarding students' personal and professional skills (z = -2.805, -3.152, p < .01). Close-to-significant differences in personal skills scores were found between role-emerging types. Overall, students and supervisors expressed positive impressions, while students addressed challenges relating to setting and supervision. Conclusions Community-based role-emerging practice placements may contribute to the professional and personal development of occupational therapy students. The results supported the positive aspects of role-emerging practice placements; they also identified the challenges of such placements with regard to students' expectations from the settings and supervision. Exposing students to role-emerging models, and seeking better compatibility with their expectations from community partnerships and supervisors, may contribute to their professional development, which can in turn develop and expand areas of practice in the community. Additionally, role-emerging practice placements can serve as a valuable contribution to professionals and stakeholders within communities, who do not as yet benefit from occupational therapy services.

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Modelling Target Workforce Estimates For Community-Based Mental Health Services In Lebanon

10.21203/rs.3.rs-1192774/v1 ◽

2021 ◽

Author(s):

Wissam Kheir ◽

Edwina Zoghbi ◽

Rachel Bteich ◽

Alissar Rady ◽

Rabih El Chammay

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Human Resources ◽

Health System ◽

Service Use ◽

Psychosocial Care ◽

Full Time ◽

Care Providers ◽

Community Based

Abstract Background: Mental health services in Lebanon are weakly integrated in the health system due to a huge political unrest, cultural and societal stigma, and more importantly, due to the inappropriate planning of human resources. A shift of the mental health services in Lebanon from hospital-based care into community-based care and efficient planning of human resources became a priority given the increasing burden of mental health disorders as a consequence of socio-political and economic crises: the bordering Syrian war, the massive influx of refugees, the huge inflation rate and above all the Beirut explosion. Methods: The WHO-ATLAS was conducted in 2019 as well as the WHO-AIMS in 2015 to map mental health services in Lebanon. Data from those two reports was plugged into the service needs calculator; an economic tool including epidemiology of eight priority mental health packages and target population, outpatient service use/needs and inpatient service use/needs. Total full-time equivalents (FTE) were calculated for psychiatrists, nurses and psychosocial care providers. All formulas were extracted from the WHO “Planning and Budgeting to deliver mental health services” module of the Mental Health Policy and Service Guidance Package. Results: For an effective community-based mental health system in Lebanon, there is additional need for 182 (+16%) psychiatrists, 762 (+68%) nurses and 184 (+16%) psychosocial care providers; a total increase of 1,128 mental health workforce. Conclusions: A proper workforce skill mix for an optimal utilization of the existing staff is recommended. New models will need to account for task shifting to attempt to close the gap between what is needed and what is available.

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Personal Care Aides as Household Employees and Independent Contractors: Estimating the Size and Job Characteristics of the Workforce

Innovation in Aging ◽

10.1093/geroni/igab049 ◽

2021 ◽

Author(s):

Joy Jeounghee Kim

Keyword(s):

Service Industry ◽

Job Characteristics ◽

Economic Security ◽

Full Time ◽

Negative Consequences ◽

Personal Care ◽

Community Based ◽

Independent Contractors ◽

Care Aides ◽

Using Data

Abstract Background and Objectives Although studies pointed out that the number of personal care aides (PCAs) at risk of being in informal employment arrangements is sizeable, little is known about its size and worker characteristics. This study aimed to estimate the share of PCAs working as household employees or independent contractors. It also aimed to compare their basic job characteristics against the job characteristics of those working as agency and government employees. Research Design and Methods Using data from the 2014-2018 American Community Surveys, a sample of 43,287 PCAs working for pay in the Home and Community-Based Service industry was identified, and their job characteristics - full-time weekly work (i.e., working at least 35 hours per week), year-round work (i.e., working at least 50 weeks a year), and annual gross earning – were analyzed by their employment arrangement. Results Analyses found that (1) close to a quarter of aides in the Home and Community-Based Service industry work as household employees or independent contractors while their share in the workforce varies by state and that (2) the work hours and earnings of full-time year-round working household employees or independent contractors are greater than those of their agency counterparts. The results shed light on why some aides may work as household employees or independent contractors. Discussion and Implications The presence of household employees and independent contractors has important implications for PCAs’ job characteristics and labor shortage in the U.S. home care industry. Considering the potentially negative consequences for both the aides’ economic security and the quality of care that consumers can receive, attention should be paid to ways to bring the aides into a more formal employment arrangement.

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