Trains, Buses, and Basic Skills: Learning in—and from—a Union Education Program for Transit Workers

This article begins with a brief history of two decades of U.S. workplace basic skills efforts that laid a foundation of goals, content, policies, and practices for subsequent worker education programs. It then draws on program records to present a case study of a work-related basic skills program in the New York City public transit workers’ union in the early 2000s. It describes why and how the program was begun, learners served, jobs focused on, stakeholders involved, practices used, and shorter and longer term results. It concludes with reflections on how stakeholders can use worker education to serve workers, their families and communities, employers, and unions while supporting economic and societal renewal.

First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality

Healthcare systems across the world and especially those in low-resource settings (LRS) are under pressure and one of the first priorities must be to prevent any harm done while trying to deliver care. Health care workers, especially department leaders, need the diagnostic abilities to identify local safety concerns and design actions that benefit their patients. We draw on concepts from the safety sciences that are less well-known than mainstream quality improvement techniques in LRS. We use these to illustrate how to analyse the complex interactions between resources and tools, the organisation of tasks and the norms that may govern behaviours, together with the strengths and vulnerabilities of systems. All interact to influence care and outcomes. To employ these techniques leaders will need to focus on the best attainable standards of care, build trust and shift away from the blame culture that undermines improvement. Health worker education should include development of the technical and relational skills needed to perform these system diagnostic roles. Some safety challenges need leadership from professional associations to provide important resources, peer support and mentorship to sustain safety work.

The American Heart Association’s Call to Action for Reducing the Global Burden of Rheumatic Heart Disease: A Policy Statement From the American Heart Association

Rheumatic heart disease (RHD) affects ≈40 million people and claims nearly 300 000 lives each year. The historic passing of a World Health Assembly resolution on RHD in 2018 now mandates a coordinated global response. The American Heart Association is committed to serving as a global champion and leader in RHD care and prevention. Here, we pledge support in 5 key areas: (1) professional healthcare worker education and training, (2) technical support for the implementation of evidence-based strategies for rheumatic fever/RHD prevention, (3) access to essential medications and technologies, (4) research, and (5) advocacy to increase global awareness, resources, and capacity for RHD control. In bolstering the efforts of the American Heart Association to combat RHD, we hope to inspire others to collaborate, communicate, and contribute.

Ensuring quality of health workforce education and practice: strengthening roles of accreditation and regulatory systems

Regulation of the health workforce and accreditation of educational institutions are intended to protect the public interest, but evidence of the impact of these policies is scarce and occasionally contradictory. The body of research that does exist primarily focuses on policies in the global north and on the major health professions. Stress on accreditation and regulatory systems caused by surges in demand due to the COVID-19 pandemic, privatization of education, rising patient expectations, and emergence of new health worker categories has created urgency for innovation and reform. To understand and evaluate this innovation, we look forward to receiving manuscripts which contribute to the evidence base on the implementation, management, and impact of health worker education and practice regulation, including the intersection of education accreditation and workforce regulation policy. We particularly look forward to manuscripts from underrepresented parts of the globe and underrepresented health workforce sectors that address policy effectiveness, explore different models of regulation, and present innovations that we can all learn from.