Health workforce strategies in response to major health events: a rapid scoping review with lessons learned for the response to the COVID-19 pandemic

Background The early weeks of the COVID-19 pandemic brought multiple concurrent threats—high patient volume and acuity and, simultaneously, increased risk to health workers. Healthcare managers and decision-makers needed to identify strategies to mitigate these adverse conditions. This paper reports on the health workforce strategies implemented in relation to past large-scale emergencies (including natural disasters, extreme weather events, and infectious disease outbreaks). Methods We conducted a rapid scoping review of health workforce responses to natural disasters, extreme weather events, and infectious disease outbreaks reported in the literature between January 2000 and April 2020. The 3582 individual results were screened to include articles which described surge responses to past emergencies for which an evaluative component was included in the report. A total of 37 articles were included in our analysis. Results The reviewed literature describes challenges related to increased demand for health services and a simultaneous decrease in the availability of the workforce. Many articles also described impacts on infrastructure that hindered emergency response. These challenges aligned well with those faced during the early days of the COVID-19 pandemic. In the published literature, the workforce strategies that were described aimed either to increase the numbers of health workers in a given area, to increase the flexibility of the health workforce to meet needs in new ways, or to support and sustain health workers in practice. Workforce responses addressed all types and cadres of health workers and were executed in a wide range of settings. We additionally report on the barriers and facilitators of workforce strategies reported in the literature reviewed. The strategies that were reported in the literature aligned closely with our COVID-specific conceptual framework of workforce capacity levers, suggesting that our framework may have heuristic value across many types of health disasters. Conclusions This research highlights a key deficiency with the existing literature on workforce responses to emergencies: most papers lack substantive evaluation of the strategies implemented. Future research on health workforce capacity interventions should include robust evaluation of impact and effectiveness.

Health Workforce Strategies in Response to Major Health Events: A Rapid Scoping Review with Lessons Learned for the Response to the COVID-19 Pandemic

Background: The early weeks of the COVID-19 pandemic brought multiple concurrent threats – high patient volume and acuity and, simultaneously, increased risk to health workers. Healthcare managers and decision-makers needed to identify strategies to mitigate these adverse conditions. This paper reports on the health workforce strategies implemented in relation to past large-scale emergencies (including natural disasters, extreme weather events, and infectious disease outbreaks).Methods: We conducted a rapid scoping review of health workforce responses to natural disasters, extreme weather events, and infectious disease outbreaks reported in the literature between January 2000 and April 2020. The 3582 individual results were screened to include articles which described surge responses to past emergencies for which an evaluative component was included in the report. A total of 37 articles were included in our analysis.Results: The reviewed literature describes challenges related to increased demand for health services and a simultaneous decrease in the availability of the workforce. Many articles also described impacts on infrastructure that hindered emergency response. These challenges aligned well with those faced during the early days of the COVID-19 pandemic. In the published literature, the workforce strategies that were described aimed either to increase the numbers of health workers in a given area, to increase the flexibility of the health workforce to meet needs in new ways, or to support and sustain health workers in practice. Workforce responses addressed all types and cadres of health workers and were executed in a wide range of settings. We additionally report on the barriers and facilitators of workforce strategies reported in the literature reviewed. The strategies that were reported in the literature aligned closely with our COVID-specific conceptual framework of workforce capacity levers, suggesting that our framework may have heuristic value across many types of health disasters.Conclusions: This research highlights a key deficiency with the existing literature on workforce responses to emergencies: most papers lack substantive evaluation of the strategies implemented. Future research on health workforce capacity interventions should include robust evaluation of impact and effectiveness.

Innovation in rural workforce strategies by a national surgical society

Health services exist to address the health needs of the community. But in Australia at present there are not enough detailed data to tell us to what extent, community by community, our highly regarded health system is meeting those needs. We know that demand for health care services is growing faster than the overall economy, and that we no longer have a general shortage of doctors, but most problematically there is a significant geographic maldistribution of those doctors away from rural and regional areas.iFor plastic surgery services, there is very little understanding of what the aggregate needs of rural communities are, or how these needs vary by community. We know by anecdote that there is significant inequity in plastic surgery services and that rural and regional locations often have unfilled positions and diminished services. We note that 80 per cent of specialist plastic surgeons live and work wholly within the five largest Modified Monash level 1 (MM1) Australian cities.1 Only 8.5 per cent of specialist plastic surgeons are permanently based outside those five cities. We also note that this is a more serious negative divergence than other comparable surgical specialties.While we briefly explore the basis for some ‘innovative’ solutions in this paper, we are constantly reminded that a prerequisite of any ‘solution’ should be an in-depth study of what Australian rural communities need or want in terms of plastic surgery services.

Factors influencing retention among hospital nurses: systematic review

Background: Recruitment and retention of nursing staff is the biggest workforce challenge faced by healthcare institutions. Across the UK, there are currently around 50 000 nursing vacancies, and the number of people leaving the Nursing and Midwifery Council register is increasing. Objective: This review comprehensively compiled an update on factors affecting retention among hospital nursing staff. Methods: Five online databases; EMBASE, MEDLINE, SCOPUS, CINAHL and NICE Evidence were searched for relevant primary studies published until 31 December 2018 on retention among nurses in hospitals. Results: Forty-seven studies met the inclusion criteria. Nine domains influencing staff turnover were found: nursing leadership and management, education and career advancement, organisational (work) environment, staffing levels, professional issues, support at work, personal influences, demographic influences, and financial remuneration. Conclusion: Identified turnover factors are long-standing. To mitigate the impact of these factors, evaluation of current workforce strategies should be high priority.

Mentoring Programs by and for a New Generation of Latino Investigators in Behavioral-Social Science HIV Research

Latinos represent a critical resource of talent that could be cultivated to expand the HIV research workforce. However, their rapid growth, as the largest and fastest growing ethnic minority group in the US population, has yet to translate into a significant increase in Latino health academic researchers. Historically, strategies to build a diverse research workforce have grouped together individuals from underrepresented minority populations obscuring significance between and within group differences. This limits ap­proaches that are responsive to the diversity of needs and experiences of emerging investigators from underrepresented groups.In this article, we discuss challenges associ­ated with heterogeneity of Latinos and bar­riers that impede research independence/ career success in the context of a review of Latino-investigator targeted mentorship approaches on the behavioral-social science of HIV infection. Mentorship workforce strategies could benefit from a personal­ized framework emphasizing individualized and tailored approaches to address the limitations and gaps in knowledge regard­ing Latino research development. This perspective encourages increased emphasis on organizational and structural processes to aid in overcoming institutional-level barriers that impede research and career develop­ment. Recommendations are proposed for features and components of effective mentorship programs that will lead to robust outcomes for strengthening the Latino research workforce in the HIV research field and elsewhere.Ethn Dis. 2020;30(2):305- 312; doi:10.18865/ed.30.2.305.

Aligning Technology and Talent Development: Recommendations from the APLU- and NCMS-led Expert Educator Team

Manufacturing is becoming more cutting-edge every day, requiring that workers have advanced math skills and scientific prowess to join the workforce and continue driving innovation. At the same time, manufacturing occupations are becoming more complex, the sheer demand for this talent is also increasing. Looking specifically at lightweight technologies—those that help us make vehicles, ships, airplanes, and other equipment lighter and thereby increase efficiency and reduce cost—the need for skilled workers has increased in recent years and is expected to continue to increase going forward. In Lightweight Innovations for Tomorrow’s (LIFT) five-state region of Michigan, Ohio, Indiana, Tennessee and Kentucky, there were more than 2.68 million workers in lightweighting-related occupations in 2018. Since LIFT started tracking lightweight related employment in 2012, online ads for these jobs have almost doubled across this same region. To this end, the Aligning Technology and Talent Development initiative was developed as an effort to “bring upstream” the conversation about education and workforce strategies around emerging technologies. That is, the effort sought to begin planning for education and workforce needs related to emerging technologies at LIFT while the technologies were in development, rather than waiting until technologies were fully developed and deployed. Led by the Association of Public and Land-grant Universities (APLU) and the National Center for Manufacturing Sciences (NCMS), in partnership with the Lightweight Innovations for Tomorrow (LIFT) manufacturing institute, the initiative included an Expert Educator Team (EET) from universities and community colleges to help identify the knowledge, skills, and abilities workers at all levels will need to deploy the technologies, materials, and processes created at LIFT