adequate staffing
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2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1055-1056
Author(s):  
Amy Meehan ◽  
Renee Shield ◽  
Caroline Madrigal ◽  
Joan Brazier ◽  
Emily Gadbois

Abstract As COVID-19 has resulted in a skilled nursing facility (SNF) staffing crisis, administrators attempt to maintain adequate staffing and stem decreasing patient census levels. We conducted four repeated interviews to date (n=130) at 3-month intervals with administrators from 40 SNFs in eight diverse healthcare markets across the United States. We used thematic analysis to examine their perspectives over time, including the perceived impact on staffing. Results include: 1) the impact of COVID-19 on staffing levels, and 2) strategies used in response to this crisis. Staffing levels have decreased throughout the pandemic, and struggles to maintain adequate staffing levels and patient census numbers have continued as the pipeline of potential new staff constricts. Facilities turned to agencies, many for the first time. Since agencies offer higher salaries, staff are drawn away from employment by SNFs, leading to a cycle of wage wars, and agencies are also challenged to provide staff. SNF administrators describe their responses to this crisis, such as flexible schedules, increased paid time off, sharing of non-direct-patient-care tasks, financial incentives (referral, sign-on, “no-call out”, and other general bonuses); wage analyses, and enhanced employee benefit packages. Some hire recruitment specialists, collaborate with nearby administrators, use creative advertising, or work with local schools. The vaccine mandate worries administrators; as one stated: “I can't afford to lose one person, let alone 20 because of this mandate...”. Given the dwindling pool of potential employees, we present NH administrators’ strategies to attract and retain staff.


2021 ◽  
Vol 16 (2) ◽  
pp. 85-93
Author(s):  
Rohit B. Sangal, MD, MBA ◽  
Arjun K. Venkatesh, MD, MBA, MHS ◽  
Jeremiah Kinsman, MPH ◽  
Meir Dashevsky, MD ◽  
Jean E. Scofi, MD, MBA ◽  
...  

Objective: During pandemics, emergency departments (EDs) are challenged by the need to replace quarantined ED staff and avoid staffing EDs with nonemergency medicine (EM) trained physicians. We sought to design and examine three feasible ED staffing models intended to safely schedule EM physicians to staff three EDs within a health system during a prolonged infectious disease outbreak.Methods: We conducted simulation analyses examining the strengths and limitations of three ED clinician staffing models: two-team and three-team fixed cohort, and three-team unfixed cohort. Each model was assessed with and without immunity, and by varying infection rates. We assumed a 12-week pandemic disaster requiring a 2-week quarantine.Main outcome: The outcome, time to staffing shortage, was defined as depletion of available physicians in both 8- and 12-hour shift duration scenarios. Results: All staffing models initially showed linear physician attrition with higher infection rates resulting in faster staffing shortages. The three-team fixed cohort model without immunity was not viable beyond 11 weeks. The three-team unfixed cohort model without immunity avoided staffing shortage for the duration of the pandemic up to an infection rate of 50 percent. The two-team model without immunity also avoided staffing shortage up to 30 percent infection rate. When accounting for immunity, all models behaved similarly initially but returned to adequate staffing during week 5 of the pandemic. Conclusions: Simulation analyses reveal fundamental tradeoffs that are critical to designing feasible pandemic disaster staffing models. Emergency physicians should test similar models based on local assumptions and capacity to ensure adequate staffing preparedness for prolonged pandemics.


Author(s):  
Renata Cristina Gasparino ◽  
Thelen Daiana Mendonça Ferreira ◽  
Henrique Ceretta Oliveira ◽  
Daniela Fernanda dos Santos Alves ◽  
Alexandre Pazetto Balsanelli

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  

Purpose The purpose of the research was to assess whether hiring temporary staff at NHS hospitals had a negative impact on the quality of work of the permanent staff. The authors wanted to test the hypothesis that taking advantage of the flexibility of temps was a “false economy” because it distracted permanent staff from focusing fully on their own tasks Design/methodology/approach The authors selected two London hospitals with different approaches to temporary staff recruitment. Hospital A was a major NHS Foundation Trust and teaching hospital. It used NHS Professionals (NHSP) for the provision of bank and agency nurses, as well as doctors and locums. Meanwhile, Hospital B used its own internal bank staff as temps. Managers at both hospitals were asked to assess the work of the temps and its impact on permanent staff. Findings Results showed the generally negative effect of using temporary staff on permanent staff. But it depended on the nature of the temps. The more experienced temps could generally be trusted to get on with the job, whereas the inexperienced ones required more supervision. Other potential problems included the temps’ unfamiliarity with procedures that slowed down their work, and sometimes a lack of motivation as they were only there for a short time. Originality/value Based on the results, the authors proposed an approach to improved practice beginning with “macro-level managers.” They said that they may usefully be tasked with maintaining service quality as a higher priority than contracting costs, and ensuring that policies reflect the need for adequate staffing levels. They could also encourage permanent staff to do occasional temporary shifts.


2020 ◽  
pp. bmjspcare-2020-002774
Author(s):  
Mervyn Yong Hwang Koh ◽  
Hwee Sing Khoo ◽  
Marysol Dalisay Gallardo ◽  
Allyn Hum

ContentBurnout occurs commonly in palliative care. Building resilience helps to mitigate the effects of burnout. Little is known about the importance of leaders, teams and organisations in preventing burnout and promoting resilience in palliative care.ObjectivesWe studied palliative care clinicians with more than a decade’s experience looking into their experiences on the role leaders, teams and organisations play in burnout and resilience.Patients and methodsThis is a thematic analysis focusing on how leaders, teams and organisations influence burnout and resilience. 18 palliative care clinicians—5 doctors, 10 nurses and 3 social workers—who worked in various palliative care settings (hospital, home hospice and inpatient hospice) were interviewed using semistructured questionnaires. The mean age of the interviewees was 52 years old, and the mean number of years practising palliative care was 15.7 years (ranging from 10 to 25 years). The interviews were recorded verbatim and were transcribed and analysed using a thematic analysis approach.ResultsThe following themes featured prominently in our study. For leaders: being supportive, caring and compassionate, being a good communicator and showing protective leadership. With teams: being like-minded, caring for the team, sharing the burden and growing together. For organisations: having a strong commitment to palliative care, supporting staff welfare and development, open communication, adequate staffing and organisational activities promoting staff well-being were described as protective against burnout and promoting resilience.ConclusionLeaders, teams and organisations play an important role in helping palliative care teams to reduce burnout and promote resilience.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marketa Kubickova ◽  
Rebecca Neal

Purpose This study aims to provide a deeper look into why luxury resorts engage in the H-2B visa program and the opportunities and challenges from the human resources employee perspective. Adequate staffing is a well-documented challenge for luxury resorts due to their location, seasonality and access to qualified labor. Many resorts turn to the H-2B non-immigrant visa to mitigate the issue. Design/methodology/approach This study consists of in-depth interviews with human resource employees. An additional survey centering on descriptive statistics, the level of engagement, cost and experience with H-2B visa programs was collected. Findings The findings of this study provide a deeper understanding why luxury resorts use H-2B employees in their operations. The results shed a deeper light on issues centering around the H-2B visa process, its uncertainty, cost and complexity. Practical implications Temporary H-2B workers are essential to the success of resort operation. Collaboration between the resort management and government agencies is essential as strategic solutions must be implemented. Resorts must explore diversified recruitment opportunities and the use of technology while keeping human labor in the center of its core operation. Originality/value The first exploratory study providing a deeper look into the many challenges’ luxury resorts face when using the H-2B visa program from the human resources employee perspective. A call for change is being made as the respondents established the need for H-2B workers, however, the system in place makes it difficult to obtain such employees and to continue resort operations.


Author(s):  
Mohamed Rashid Abdi ◽  
Paul Sang

Project implementation has been a major concern to project teams, financiers and beneficiaries. This may be attributed to the fact that a number or projects that have been rolled out have failed to achieve the desired goals. Some have stalled at different stages of their development while others are completed but do not bring the anticipated impact whether financial, social, economic, physical or even institutional. Therefore, this study aimed to establish the effect of project planning on implementation of project in safaricom limited in Mombasa County, Kenya. The study specific objectives were to establish the effect of communication management, personnel management, stakeholder’s involvement and resource planning on the implementation by safaricom projects in Mombasa County. The theories guiding the study were cybernetics Theory, Resource-Based Theory and Stakeholders Theory. The study targeted 99 Safaricom projects in Mombasa County and data was collected from 99 project managers. Questionnaires were used to collect the primary data. Majority of the project managers to a very great extent indicated that communication is an integral part in projects in their organization. It was illustrated that to a very great extent the project managers ensured effective communication in all partners and respondent further presented that to a high extent Safaricom Plc adopted both external as well as internal communication. The findings indicated that majority of the project managers to a very great extent indicated that there was competent project team, to a high extent adequate staffing was availed, to a very high extent training and development was done and adequate remuneration was done. The study findings indicated majority of the respondents indicated to a very great extent that resource identification, sharing of resources, resource budgeting and resource control was effectively done. The results indicated that to a very great extent there exist high participations of stakeholder in project delivery, to a very great extent they allocated enough funds and skills to projects, to a very great extent project managers ensured stakeholder engagement in projects to enhance project performance and that to a very great extent involvement of majority of stakeholders helps to efficiency of a project. The study concluded that most of the project managers accord communication management as an important role that aims to improve project implementation. The study concluded that competent project team, adequate staffing, training and development and adequate remuneration are significant in explaining changes in project implementation. The study concluded that resource identification, sharing of resources, resource budgeting and resource control contributes enormously to the success of the projects. The study concluded that high participations of stakeholder in project delivery, allocation of enough funds and skills to projects, ensuring stakeholder engagement in projects enhances project performance. The study recommended that Safaricom Plc should equip the project managers through appropriate and constant training programs addressing the importance and modes of communication. Estimating the costs of individual activities based on execution conditions will assist to generate correct overall cost estimation. Project personnel planning, personnel management should focus on ensuring that projects are within time and budget. Early detection of deviations on resource utilization especially materials will enable necessary actions by the project team. The study recommended that project managers should encourage high participations of stakeholder in project delivery, allocation of enough funds and training.


2020 ◽  
Author(s):  
Michael E DeWitt

Contact tracing is a well-known tool for public health professionals to trace and isolate contacts of known infectious persons. During a pandemic contact tracing is critical to ending an outbreak, but the volume of cases makes tracing difficult without adequate staffing tools. Hospitals equipped with electronic medical records can utilize these databases to automatically link cases into possible transmission chains and surface potential new outbreaks. While this automatic contact tracing does not have the richness of contact tracing interviews, it does provide a way for health systems to highlight potential super-spreader events and support their local health departments. Additionally, these data provide insight into how a given infection is spreading locally. These insights can be used to inform policy at the local level.


2020 ◽  
Vol 48 (6) ◽  
pp. 609-614
Author(s):  
LaxmiTej Wundavalli ◽  
Uma Shanker Agrawal ◽  
Sidhartha Satpathy ◽  
Baby Rani Debnath ◽  
Th Asanai Agnes

2020 ◽  
Vol 9 (2) ◽  
pp. e000910 ◽  
Author(s):  
Jehni Robinson ◽  
Melody Porter ◽  
Yara Montalvo ◽  
Carol J Peden

Inefficient clinic systems leading to prolonged wait times at primary care clinics are a source of frustration for patients, physicians, staff and administration. Measuring and shortening cycle time has the potential to improve patient experience, staff satisfaction and patient access by moving more patients through in a shorter cycle time. Limited studies have demonstrated that improvements can be made to cycle time and may result in improved patient satisfaction. Most of these studies have focused their efforts on improving efficiency at the front end of the cycle. Our aim was to improve cycle time for the whole visit to less than 60 min within 1 year by engaging our team in brainstorming solutions, presenting regular measurements to our team for review and holding regular meetings to plan rapid improvement cycles. Over the course of 1 year (2017), we were able to reduce cycle time by 12% from 71 to 65 min and to improve patient satisfaction with care. Despite the reduction in cycle time, we maintained high satisfaction scores from patients who felt that the doctor spent enough time with them. We learnt the value of engaging our team, frequent measurement for reporting, adequate staffing at the beginning of clinic, and the value of MA staff acting in a flow coordinator role. We have not only maintained this improvement but also made further small gains over the subsequent 2 years, and by April 2019, our cycle time is at 60 min, despite a marked increase in patient volume. Additional work on the time after the patient is roomed and waiting for a doctor, and further analysis of the physician workflow would be important next steps to drive further improvement.


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