Expanding Roles of Healthcare Epidemiology and Infection Control in Spite of Limited Resources and Compensation

2010 ◽  
Vol 31 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Sharon B. Wright ◽  
Belinda Ostrowsky ◽  
Neil Fishman ◽  
Valerie M. Deloney ◽  
Leonard Mermel ◽  
...  
Keyword(s):  
Infection Control ◽  
Emergency Preparedness ◽  
Hospital Setting ◽  
The United States ◽  
Median Number ◽  
Full Time ◽  
Master Of Public Health ◽  
Infection Control Practitioner ◽  
Survey Responses ◽  
Healthcare Epidemiology

Objective.Data on the resources and staff compensation of hospital epidemiology and infection control (HEIC) departments are limited and do not reflect current roles and responsibilities, including the public reporting of healthcare-associated infections. This study aimed to obtain information to assist HEIC professionals in negotiating resources.Methods.A 28-question electronic survey was sent via e-mail to all Society for Healthcare Epidemiology of America (SHEA) members in October 2006 with the use of enterprise feedback management solution software. The survey responses were analyzed using Microsoft Excel.Results.Responses were received from 526 (42%) of 1,255 SHEA members. Of the respondents, 84% were doctors of medicine (MDs) or doctors of osteopathy (DOs), 6% were registered nurses, and 21% had a master of public health or master of science degree. Sixty-two percent were male (median age range, 50-59 years). Their practice locations varied across the United States and internationally. Two-thirds of respondents practiced in a hospital setting, and 63% were the primary or associate hospital epidemiologist. Although 91% provided HEIC services, only 65% were specifically compensated. In cases of antimicrobial management, patient safety, employee health, and emergency preparedness, 75%-80% of respondents provided expertise but were compensated in less than 25% of cases. Of the US-based MD and DO respondents, the median range of earnings was $151,000-$200,000, regardless of their region (respondents selected salary ranges instead of specifying their exact salaries). Staffing levels varied: the median number of physician full-time equivalents (FTEs) was 1.0 (range, 1-5); only about 25% of respondents had 3 or more infection control practitioner FTEs.Conclusions.Most professionals working in HEIC have had additional training and provide a wide, growing range of services. In general, only traditional HEIC work is compensated and at levels much less than the time dedicated to those services. Most HEIC departments are understaffed. These data are essential to advocate for needed funding and resources as the roles of HEIC departments expand.

Variation in pediatric stereoelectroencephalography practice among pediatric neurosurgeons in the United States: survey results

2021 ◽  
pp. 1-9
Author(s):  
Benjamin C. Kennedy ◽  
Joshua Katz ◽  
Jacob Lepard ◽  
Jeffrey P. Blount
Keyword(s):  
United States ◽  
The United States ◽  
Median Number ◽  
Pediatric Epilepsy ◽  
Case Volume ◽  
Median Response ◽  
Younger Patients ◽  
Electronic Survey ◽  
Survey Results ◽  
Survey Responses

OBJECTIVE Stereoelectroencephalography (SEEG) has become widespread in the United States during the past decade. Many pediatric neurosurgeons practicing SEEG may not have had experience with this technique during their formal training, and the literature is mostly limited to single-center series. As a result, implementation of this relatively new technique may vary at different institutions. The authors hypothesized that aspects of SEEG experience, techniques, and outcomes would vary widely among programs across the country. METHODS An electronic survey with 35 questions addressing the categories of training and experience, technique, electrode locations, and outcomes was sent to 128 pediatric epilepsy surgeons who were potential SEEG users. RESULTS Sixty-one pediatric fellowship-trained epilepsy surgeons in the United States responded to the survey. Eighty-nine percent were actively using SEEG in their practice. Seventy-two percent of SEEG programs were in existence for less than 5 years, and 68% were using SEEG for > 70% of their invasive monitoring. Surgeons at higher-volume centers operated on younger patients (p < 0.001). Most surgeons (70%) spent 1–3 hours per case planning electrode trajectories. Two-thirds of respondents reported a median implant duration of 5–7 days, but 16% reported never having an implant duration > 5 days, and 16% reported having had implants stay in place for > 4 weeks. The median response for the median number of electrodes initially implanted was 12 electrodes, although 19% of respondents reported median implants of 5–8 electrodes and 17% reported median implants of 15–18 electrodes. Having a higher volume of SEEG cases per year was associated with a higher median number of electrodes implanted (p < 0.001). Most surgeons found SEEG helpful in defining an epileptic network and reported that most of their SEEG patients undergo focal surgical treatment. CONCLUSIONS SEEG has been embraced by the pediatric epilepsy surgery community. Higher case volume is correlated with a tendency to place more electrodes and operate on younger patients. For most parameters addressed in the survey, responses from surgeons clustered around a norm, though additional findings of substantial variations highlight differences in implementation and philosophy among pediatric epilepsy programs.

Examining the influence of professional emergency management coordinators driving preparedness and resilience on university campuses

2018 ◽  
Vol 16 (2) ◽  
pp. 126
Author(s):  
Stephen A. Murphy, PhD, MPH, MBA ◽  
Maureen Lichtveld, MD, MPH
Keyword(s):  
At Risk ◽  
Emergency Management ◽  
Disaster Management ◽  
Web Sites ◽  
Emergency Preparedness ◽  
Compliance Rate ◽  
The United States ◽  
Full Time ◽  
Accessible Information ◽  
The Web

Objective: To characterize the compliance with disaster management recommendations of ensuring a full-time, dedicated professional is responsible for coordinating disaster management programs. This research targets a subset of institutions of higher education (IHEs) in the United States at risk of annual hurricane threats or having experienced an active shooter incident near campus.Design: A comprehensive Web-based assessment was conducted to determine the Web presence of emergency management of 265 IHEs with student enrollment greater than 2,000 in coastal states at risk of annual Atlantic Hurricane landfalls. Results were displayed spatially using ArcGIS. Results: Although the Web sites of 91 percent of IHEs with enrollment greater than 20,000 displayed easily accessible information on a dedicated professional leading emergency management, only 42 percent of the Web sites of those IHEs with enrollment between 10,000 and 20,000 did so. As enrollment declined, the compliance rate declined. Compliance rates for IHEs with different enrollments were as follows: 6,001-9,999, 30 percent; 3,001-6,000, 23 percent; 2,000-3,000, 13 percent.Conclusions: A full-time, dedicated professional coordinating emergency preparedness is a best practice as evidenced by various accrediting bodies, but this practice is not mandated for IHEs. Our results suggest that proximity to significant annual hurricane threats does not influence the adoption of this recommendation. Despite IHEs being core stakeholders in assuring disaster resilience, gaps exist in preparedness practice.

scholarly journals Clinical Trial Metrics: The Complexity of Conducting Clinical Trials in North American Cancer Centers

2020 ◽  
pp. OP.20.00501
Author(s):  
Carrie Lee ◽  
Theresa L. Werner ◽  
Allison M. Deal ◽  
Cassandra J. Krise-Confair ◽  
Tricia Adrales Bentz ◽  
...  
Keyword(s):  
United States ◽  
Clinical Trial ◽  
Clinical Trials ◽  
North America ◽  
Clinical Research ◽  
The United States ◽  
Median Number ◽  
Steering Committee ◽  
Full Time ◽  
Cancer Centers

PURPOSE: Cancer clinical trials offices (CTOs) support the investigation of cancer prevention, early detection, and treatment at cancer centers across North America. CTOs are a centralized resource for clinical trial conduct and typically use research staff with expertise in four functional areas of clinical research: finance, regulatory, clinical, and data operations. To our knowledge, there are no publicly available benchmark data sets that characterize the size, cost, volume, and efficiency of these offices, nor whether the metrics differ by National Cancer Institute (NCI) designation. The Association of American Cancer Institutes (AACI) Clinical Research Innovation (CRI) steering committee developed a survey to address this knowledge gap. METHODS: An 11-question survey that addressed CTO budget, accrual and trial volume, full-time equivalents (FTEs), staff turnover, and activation timelines was developed by the AACI CRI steering committee and sent to 92 academic cancer research centers in North America (n = 90 in the United States; n = 2 in Canada), with 79 respondents completing the survey (86% completion rate). RESULTS: The number of FTE employees working in the CTOs ranged from 4.5 to 811 (median, 104). The median number of analytic cases (ie, newly diagnosed or received first course of treatment) reported by the main center was 3,856. Annual CTO budgets ranged from $250,000 to $23,900,000 (median, $8.2 million). The median trial activation time, based on 61 centers, was 167 days. The median number of accruals per center was 480 (range, 5-6,271) and median number of trials per center was 282 (range, 31-1,833). Budget and FTE ranges varied by NCI designation. CONCLUSION: The response rate to the survey was high. These data will allow cancer centers to evaluate their CTO infrastructure, funding, portfolio, and/or accrual goals as compared with peers. A wide range in each of the outcomes was noted, in keeping with the wide variation in size and scope of cancer center CTOs across the United States and Canada. These variations may warrant additional investigation.

Prevalence and Characteristics of Antimicrobial Stewardship Programs at Freestanding Children's Hospitals in the United States

2014 ◽  
Vol 35 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Jason G. Newland ◽  
Jeffrey S. Gerber ◽  
Scott J. Weissman ◽  
Samir S. Shah ◽  
Chelsea Turgeon ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
The United States ◽  
Median Number ◽  
Audit And Feedback ◽  
Full Time ◽  
Children's Hospitals ◽  
Data Analyst ◽  
Children’S Hospitals ◽  
Program Characteristics ◽  
Prospective Audit And Feedback

Background and Objective.Antimicrobial stewardship programs (ASPs) are a mechanism to ensure the appropriate use of antimicrobials. The extent to which ASPs are formally implemented in freestanding children's hospitals is unknown. The objective of this study was to determine the prevalence and characteristics of ASPs in freestanding children's hospitals.Methods.We conducted an electronic survey of 42 freestanding children's hospitals that are members of the Children's Hospital Association to determine the presence and characteristics of their ASPs. For hospitals without an ASP, we determined whether stewardship strategies were in place and whether there were barriers to implementing a formal ASP.Results.We received responses from 38 (91%) of 42. Among responding institutions, 16 (38%) had a formal ASP, and 15 (36%) were in the process of implementing a program. Most ASPs (13 [81%] of 16) were started after 2007. The median number of full-time equivalents dedicated to ASPs was 0.63 (range, 0.1–1.8). The most common antimicrobials monitored by ASPs were linezolid, vancomycin, and carbapenems. Many hospitals without a formal ASP were performing stewardship activities, including elements of prospective audit and feedback (9 [41%] of 22), formulary restriction (9 [41%] of 22), and use of clinical guidelines (17 [77%] of 22). Antimicrobial outcomes were more likely to be monitored by hospitals with ASPs (100% vs 68%; P = .01), although only 1 program provided support for a data analyst.Conclusions.Most freestanding children's hospitals have implemented or are developing an ASP. These programs differ in structure and function, and more data are needed to identify program characteristics that have the greatest impact.

scholarly journals Effects of a Dedicated Inpatient Diabetes Management Service on Glycemic Control in a Community Hospital Setting

2021 ◽  
pp. 193229682199319
Author(s):  
Andrew P. Demidowich ◽  
Kristine Batty ◽  
Teresa Love ◽  
Sam Sokolinsky ◽  
Lisa Grubb ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Community Hospital ◽  
Diabetes Management ◽  
Hospital Setting ◽  
The United States ◽  
Cost Of Care ◽  
Management Service ◽  
Full Time ◽  
Inpatient Diabetes ◽  
Inpatient Diabetes Management

Background: Community hospitals account for over 84% of all hospitals and over 94% of hospital admissions in the United States. In academic settings, implementation of an Inpatient Diabetes Management Service (IDMS) model of care has been shown to reduce rates of hyper- and hypoglycemia, hospital length of stay (LOS), and associated hospital costs. However, few studies to date have evaluated the implementation of a dedicated IDMS in a community hospital setting. Methods: This retrospective study examined the effects of changing the model of inpatient diabetes consultations from a local, private endocrine practice to a full-time endocrine hospitalist on glycemic control, LOS, and 30-day readmission rates in a 267-bed community hospital. Results: Overall diabetes patient days for the hospital were similar pre- and post-intervention (20,191 vs 20,262); however, the volume of patients seen by IDMS increased significantly after changing models. Rates of hyperglycemia decreased both among patients seen by IDMS (53.8% to 42.5%, P < .0001) and those not consulted on by IDMS (33.2% to 29.9%; P < .0001). When examined over time, rates of hypoglycemia steadily decreased in the 24 months after dedicated IDMS initiation ( P = .02); no such time effect was seen prior to IDMS ( P = .34). LOS and 30DRR were not significantly different between IDMS models. Conclusions: Implementation of an endocrine hospitalist-based IDMS at a community hospital was associated with significantly decreased hyperglycemia, while avoiding concurrent increases in hypoglycemia. Further studies are needed to investigate whether these effects are associated with improvements in clinical outcomes, patient or staff satisfaction scores, or total cost of care.

A Descriptive Study of Transplant Coordinator Job Satisfaction

2021 ◽  
pp. 152692482110246
Author(s):  
Stacee M. Lerret ◽  
Gail Stendahl ◽  
Susan Alexander ◽  
Amanda Pendegraft ◽  
Haley Hoy
Keyword(s):  
Job Satisfaction ◽  
Career Development ◽  
Research Question ◽  
Hospital Setting ◽  
The United States ◽  
Full Time ◽  
Female Population ◽  
Substantial Growth ◽  
Study Participants ◽  
Personal Fulfillment

Introduction: Substantial growth in the field of transplantation in recent years has increased the need for transplant coordinators. The growing need for these highly skilled clinicians warrants a review of characteristics that increase job satisfaction, an important consideration for transplant centers. Research question: The study described transplant coordinators’ perceptions of job satisfaction in their current positions. Design: This study evaluated transplant coordinator job satisfaction conducted on 3 separate occasions at US geographically diverse sites. Two instruments, the Vermont Nurses: Job Analysis and Retention Survey and an investigator-designed role and demographic survey, were used to capture study participants’ attitudes regarding elements of job satisfaction, design, and involvement. Results: Demographic characteristics of study participants (N = 133) reveal a largely female population (n = 113, 85%) employed full time (n = 124, 93%) in a hospital setting (n = 106, 80%). Scores for items related to job satisfaction, design, and involvement were generally positive. Participants reported being less satisfied for characteristics including promotion opportunities, fringe benefits, and attention to career development provided by employers. Conclusion: As annual rates of transplants continue to increase across the United States, the need for growing and retaining talented staff in transplant care settings is even more critical. Results of the study suggest that while transplant coordinators remain largely satisfied with the challenges and personal fulfillment associated with their positions, opportunities for professional development may improve retention and recruitment. Specifically, supporting career development and providing formalized evaluation and supervision were identified as areas of improvement within this specialized group of clinicians.

scholarly journals The Retention of Experienced Faculty in Online Distance Education Programs: Understanding Factors that Impact their Involvement

2009 ◽  
Vol 10 (3) ◽  
Author(s):  
Tim Green ◽  
Jeffery Alejandro ◽  
Abbie H. Brown
Keyword(s):  
Distance Education ◽  
Online Courses ◽  
The United States ◽  
Full Time ◽  
University Administrators ◽  
Education Faculty ◽  
Online Distance Education ◽  
Part Time ◽  
Online Distance ◽  
Survey Responses

The study sought to determine factors that affect faculty decisions regarding their involvement in teaching online distance education courses. A survey was administered to online distance education faculty across the United States to determine those factors that encourage or discourage them from continuing to teach online courses. The factors were examined and reported from the standpoint of each of four faculty groups: (1) tenured, (2) tenure-track, (3) full-time non-tenured/fixed term, and (4) part-time/adjunct. From the survey responses (N = 135), a list of retention strategies that university administrators may use for retention of online distance education faculty are offered.

scholarly journals Part-time Pediatric Practice: Demographic and Medical Practice Characteristics and Implications for State Medical Boards

2017 ◽  
Vol 103 (4) ◽  
pp. 17-23
Author(s):  
Mary E. Rimsza ◽  
Holly Ruch-Ross ◽  
William B. Moskowitz ◽  
Harold K. Simon ◽  
Kelly Towey ◽  
...  
Keyword(s):  
The United States ◽  
Full Time ◽  
Electronic Survey ◽  
Quality Patient Care ◽  
Practice Characteristics ◽  
Part Time ◽  
Small Cohort ◽  
Appointment Availability ◽  
Survey Responses ◽  
State Medical Boards

The increasing number of part-time physicians in pediatrics and other specialties has major implications for state medical boards. This study examines the demographic and practice characteristics of part-time pediatricians compared to full-time pediatricians and the implications of these characteristics on licensure requirements. An electronic survey on workforce topics was developed by the American Academy of Pediatrics' Committee on Pediatric Workforce. The survey responses of part-time pediatricians were compared to the responses of pediatricians working full-time. Approximately 31% of the part-time pediatricians plan to continue to work part-time for &gt; 10 years. A small cohort of part-time pediatricians (4.7%) were working &lt; 11 hours per week. The demographic and practice characteristics of part-time pediatricians differ significantly from full-time pediatricians but there was no difference in reported appointment availability between part-time and full-time pediatricians. These findings have implications for the regulatory community regarding the number of hours a physician must work to provide quality patient care and be considered an active physician in good standing. They also have important implications for projecting the number of pediatricians needed to ensure that all children have access to care in the United States.

scholarly journals Dual MD–MPH Degree Students in the United States: Moving the Medical Workforce Toward Population Health

2021 ◽  
pp. 003335492097842
Author(s):  
Jo Marie Reilly ◽  
Christine M. Plepys ◽  
Michael R. Cousineau
Keyword(s):  
Public Health ◽  
United States ◽  
Population Health ◽  
Health Care Policy ◽  
The United States ◽  
Extensive Literature ◽  
Master Of Public Health ◽  
Telephone Interviews ◽  
Public Health Training ◽  
The Impact

Objective A growing need exists to train physicians in population health to meet the increasing need and demand for physicians with leadership, health data management/metrics, and epidemiology skills to better serve the health of the community. This study examines current trends in students pursuing a dual doctor of medicine (MD)–master of public health (MPH) degree (MD–MPH) in the United States. Methods We conducted an extensive literature review of existing MD–MPH databases to determine characteristics (eg, sex, race/ethnicity, MPH area of study) of this student cohort in 2019. We examined a trend in the MD community to pursue an MPH career, adding additional public health and health care policy training to the MD workforce. We conducted targeted telephone interviews with 20 admissions personnel and faculty at schools offering MD–MPH degrees in the United States with the highest number of matriculants and graduates. Interviews focused on curricula trends in medical schools that offer an MD–MPH degree. Results No literature describes the US MD–MPH cohort, and available MD–MPH databases are limited and incomplete. We found a 434% increase in the number of students pursuing an MD–MPH degree from 2010 to 2018. The rate of growth was greater than the increase in either the number of medical students (16%) or the number of MPH students (65%) alone. Moreover, MD–MPH students as a percentage of total MPH students more than tripled, from 1.1% in 2010 to 3.6% in 2018. Conclusions As more MD students pursue public health training, the impact of an MPH degree on medical school curricula, MD–MPH graduates, and MD–MPH career pursuits should be studied using accurate and comprehensive databases.

The Politics of Part-Time Work: Gender, Employment Status, and Preferences for Redistribution

2020 ◽  
pp. 1-38
Author(s):  
David S. Pedulla ◽  
Michael J. Donnelly
Keyword(s):  
Employment Status ◽  
General Social Survey ◽  
The United States ◽  
Limited Attention ◽  
Full Time ◽  
Cross Sectional ◽  
Preferences For Redistribution ◽  
Time Work ◽  
Part Time ◽  
Part Time Work

Abstract The social and economic forces that shape attitudes toward the welfare state are of central concern to social scientists. Scholarship in this area has paid limited attention to how working part-time, the employment status of nearly 20% of the U.S. workforce, affects redistribution preferences. In this article, we theoretically develop and empirically test an argument about the ways that part-time work, and its relationship to gender, shape redistribution preferences. We articulate two gender-differentiated pathways—one material and one about threats to social status—through which part-time work and gender may jointly shape individuals’ preferences for redistribution. We test our argument using cross-sectional and panel data from the General Social Survey in the United States. We find that the positive relationship between part-time employment, compared to full-time employment, and redistribution preferences is stronger for men than for women. Indeed, we do not detect a relationship between part-time work and redistribution preferences among women. Our results provide support for a gendered relationship between part-time employment and redistribution preferences and demonstrate that both material and status-based mechanisms shape this association.

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