Professional care workforce: a rapid review of evidence supporting methods of recruitment, retention, safety, and education.

BACKGROUND: Across the care economy there are major shortages in the health and care workforce, as well as high rates of attrition and ill-defined career pathways. The aim of this study was to evaluate current evidence regarding methods to improve care worker recruitment, retention, safety, and education, for the professional care workforce. METHODS: A rapid review of comparative interventions designed to recruit, retain, educate and care for the professional workforce in the following sectors: disability, aged care, health, mental health, family and youth services, and early childhood education and care was conducted. Embase and MEDLINE databases were searched, and studies published between January 2015 and November 2022 were included. We used the Quality Assessment tool for Quantitative Studies and the PEDro tools to evaluate study quality. RESULTS: 5594 articles were initially screened and after applying the inclusion and exclusion criteria, 30 studies were included in the rapid review. Studies most frequently reported on the professional nursing, medical and allied health workforces. Some studies focused on the single domain of care worker education (n = 11) while most focused on multiple domains that combined education with recruitment strategies, retention strategies or a focus on worker safety. Study quality was comparatively low with a median PEDro score of 5/10, and 77% received a weak rating on the Quality Assessment tool for Quantitative Studies. Four new workforce strategies emerged; early career rural recruitment supports rural retention; workload management is essential for workforce well-being; learning must be contextually relevant; and there is a need to differentiate recruitment, retention, and education strategies for different professional health and care workforce categories as needs vary. CONCLUSIONS: Given the critical importance of recruiting and retaining a strong health and care workforce, there is an immediate need to develop a cohesive strategy to address workforce shortfalls. This paper presents initial evidence on different interventions to address this need, and to inform care workforce recruitment and retention. Rapid Review registration PROSPERO 2022 CRD42022371721 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022371721.

Action research with caseworkers: Responding to and reflecting on the impacts of COVID-19 on birth family contact.

Social distancing due to COVID-19 forced changes to contact with birth relatives for children in out-of-home care. This required a shift to using technologies, which was previously underutilized and viewed as risky. In an action research study, 33 caseworkers in New South Wales, Australia, reflected upon adapting their practices. Three key themes characterized the changes in caseworker practices and how these impacted upon social interactions between children and their birth and carer families: communication, not location; shared not separate spaces and spontaneous not restricted interaction. First, caseworkers described how contact via technologies involved fewer logistical arrangements, shifting the focus on interactions among children and their two families and encouraging these to be flexible and child-centred. Second, caseworkers discussed how spending time together virtually could build trust, as carers and birth relatives could forge relationships around shared commitment to the child's wellbeing. Third, caseworkers noted that technology-facilitated communication enabled greater choice and control for children while requiring renegotiating boundaries. The findings reflect a shift in caseworker perceptions of technology-facilitated contact from a risk to opportunity framework as a result of COVID-19 conditions, consistent with social shaping of technology theory. Beyond the pandemic, contact with birth relatives can be enhanced through technology.

From maid to mother: transforming facilities, staff training, and caregiver dignity in an institutional facility for young children in Nepal.

This article provides a case study of a project to improve the health, safety, and development of children birth to 6 years old in a large orphanage in Nepal. Two interventions were conducted: improvement of physical infrastructure and training, mentoring, and support for caregiving staff. As a result of these interventions, positive outcomes in terms of children's health and development have been observed, including reduction of communicable diseases and increased social interactions with caregivers. As part of the new training initiative, the caregivers began to meet regularly to share their ideas and experiences, and came to realize their vital role in the holistic development of the children in their care. One important change was a greater sense of dignity for the caregivers. The caregivers were formerly called Maids (Aaya), but asked to be called Mothers (Aama). The project also faced challenges, including communication barriers related to organizational structure.

Policy Capacity Is Necessary but Not Sufficient Comment on "Health Reform Requires Policy Capacity".

Policy capacity focuses on the managerial and organizational abilities to inform policy decisions with sound research and analysis, and facilitate policy implementation with operational efficiency. It stems from a view of the policy process that is rational and positivistic, in which optimal policy choices can be identified, selected, and implemented with objectivity. By itself, however, policy capacity neglects the political aspects of policy-making that can dominate the process, even in health policies. These technical capabilities are certainly needed to advance reforms in health policies, but they are not sufficient. Instead, they must be complemented with public engagement and policy advocacy to ensure support from the public that policies are meant to serve.