Impact of the Lack of Diversity Within Surgery Career Pathways and Mitigating Factors.

The lack of diversity in surgical career pathways impacts the cultural competence of the learning and working environment, the variety of leadership styles found within surgical leadership, and the ability of an organization to achieve equity in the workplace due to ongoing mistrust and untouched bias. Leading mitigating factors include developing pathways for greater numbers of diverse people at the high school and college level and implicit bias training. Though educators have had some success with these factors in the initial stages of diversifying early pathways, these factors are not yet correlated to entry into a surgical career. Future solutions to the lack of diversity in surgery will be predicated on surgeons collectively valuing justice, equity, diversity, and inclusion.

Política Nacional de Recursos Humanos en Salud del Paraguay 2020-2030 / National Policy of Human Resources in Health of Paraguay 2020-2030

La Política Nacional de Recursos Humanos en Salud (PNRHS) 2020-2030 constituye el instrumento de más alto nivel del Paraguay que enmarca y define de manera integral e integradora las estrategias y las acciones para el desarrollo y la gestión de los Recursos Humanos en Salud (RHS). Se construyó en consonancia con los valores, principios y estrategias de la Política Nacional de Salud (PNS) 2015 -2030, que busca avanzar hacia el Acceso Universal a la Salud y la Cobertura Universal de Salud (AUS-CUS) para reducir las inequidades y mejorar la calidad de vida de la población en el marco de un desarrollo humano sostenible. Su formulación, liderada por el Ministerio de Salud Pública y Bienestar Social (MSPBS) con el apoyo de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) en Paraguay, se basó en un proceso participativo al que fueron convocados sectores gubernamentales y no gubernamentales relacionados a los RHS, de los ámbitos de la formación, la prestación de servicios, las sociedades científicas y las asociaciones gremiales; los cuales participaron en la elaboración y validación del documento

Reliability and Validity of a Further Tested Appreciative Management Scale.

BACKGROUND AND PURPOSE: Managers need evidence-based methods to evaluate their management skills. To further test the appreciative management scale (AMS 1.0) to create a practical instrument to be used in evaluating appreciative management. METHODS: For further testing, a new survey was conducted among social and healthcare managers (n = 734) in Finland. Confirmatory factor analysis (CFA) was used to assess the scale validity and Cronbach's alpha coefficients the internal consistency. RESULTS: The validated AMS 2.0 scale includes 24 items. The values measuring validity and reliability were good, with an Rool Mean Square Error of Approximation (RMSEA) of 0.072, Average Variance Extracted (AVE) values between 0.532 and 0.634, and Composite Reliability (CR) values ranging between 0.850 and 0.914. The Cronbach's alpha of the whole scale was 0.944. CONCLUSIONS: AMS 2.0 is a reliable and valid means to measure appreciative management as proved by confirmatory factor analysis.

Linking Human Resources Management Practices with Commitment to Service Quality and the Interacting Role of Service Climate in the Private Hospitals: A Study in India.

This paper examines the role of service climate (SC) in the link connecting human resource management practices (HRMP) to commitment to service quality (CSQ). Data were collected from 1236 hospital staff working in different private hospitals in India. The model linking HRMP to CSQ with the moderation of SC was tested using Hayes PROCESS. Results revealed that human resource management practices found to be influencing CSQ and with the interaction of SC the effect is further augmented. The interacting role service climate has been found to be significant at mean and high levels.

The Conceptual Structure of the Management by Nurses of the Ego Integrity of Residents of Nursing Homes.

BACKGROUND: The number of older people admitted to nursing homes has continued to rise with the recent expansion of the Republic of Korea's long-term care system. Maintaining ego integrity is a major task for older people approaching the end of life. As efforts to maintain ego integrity include the final stages of life, this concept is critically important for older people in nursing homes. This study was designed to assess issues related to ego integrity in the nursing home environment to determine how nurses should play a key role in managing this important life task. PURPOSE: The management by nurses of the ego integrity of residents of nursing homes is a new phenomenon that is central to promoting long-term, quality care. This study was designed to clarify and conceptualize this management phenomenon in the context of nursing homes. METHODS: A hybrid model of concept development was used to analyze the ways in which nurses manage the ego integrity of residents of nursing homes. In the theoretical phase, a working definition of the management by nurses of residents' ego integrity is developed using a literature review. In the fieldwork phase, in-depth interviews are conducted with eight nurses from six nursing homes in Seoul and three other provinces. Finally, in the final analytical phase, the theoretical and fieldwork findings are interpreted and compared. RESULTS: Two components, assessment and intervention, of the approach by nurses to managing the ego integrity of residents of nursing homes were identified. Assessment incorporates 10 attributes in the following three dimensions: "identifying the extent to which residents' basic needs are being fulfilled," "determining how residents achieve friendly relationships with others," and "determining how each resident creates a harmonious view of his or her life." Intervention incorporates nine attributes in the following two dimensions: "helping residents develop a positive view of life" and "helping residents make the best use of their remaining functional abilities." CONCLUSIONS/IMPLICATIONS FOR PRACTICE: By managing the ego integrity of residents, nurses have a significant influence on residents' sociopsychological adaptation, especially in the challenging environment of a nursing home. This study supports that managing the ego integrity of residents of nursing homes is an important and practical component of the role played by nurses and of the aid and care they provide. Furthermore, the findings verify the effectiveness of intervention studies in examining assessment tools and developing guidelines for ego-integrity management.

O impacto da ansiedade em informação nas Startups de Inovação / La información como un recurso de ansiedad en las organizaciones / Information as a source of anxiety in organizations

O presente trabalho tem como objetivo identificar o impacto da informação no contexto da construção de conhecimento em trabalhadores de startups. Nesse sentido, ao observarmos o atual cenário das organizações, analisamos que a informação é capaz de modificar o comportamento dos sujeitos de diferentes maneiras. Dessa forma, ao mesmo tempo em que devemos considerar a informação como um recurso para as organizações, também é necessário compreender o seu impacto na saúde geral dos trabalhadores, que vai desde a sensação de incapacidade em absorver múltiplas informações na produção de conhecimento, entre outros problemas (doenças somáticas, síndrome de esgotamento etc.), o que interfere na saúde mental, tanto quanto à saúde física. O uso da informação provoca inúmeros desencadeamentos nas organizações, todavia, destacamos um comportamento desenvolvido pelos trabalhadores que necessita ser analisado: a ansiedade informacional. Diante desse cenário, a presente pesquisa buscou compreender o comportamento informacional dos trabalhadores do conhecimento nas startups. Para tanto, foi escolhido o método 'estudo de caso', aplicando-se a triangulação, ou seja, aplicando diferentes técnicas de coleta e análise de dados, tornando a pesquisa mais consistente, validando assim os dados e análises realizadas. A população da pesquisa consiste em 18 sujeitos de 4 diferentes empresas de tecnologia da informação que foram enquadradas como startups. Com as informações colhidas, foi possível construir parâmetros baseados em estratégias de Gestão de Pessoas de Ribeiro et al (2019) capazes de minimizar o impacto da ansiedade em informação nos trabalhadores dessas startups(AU)

Este documento tiene como objetivo identificar el impacto de la información en el contexto de la creación de conocimiento en los trabajadores de nuevas empresas. En este sentido, al observar el escenario actual de las organizaciones, analizamos que la información puede modificar el comportamiento de los sujetos de diferentes maneras. Por lo tanto, si bien debemos considerar la información como un recurso para las organizaciones, también es necesario comprender su impacto en la salud general de los trabajadores desde la sensación de incapacidad para absorber información múltiple en la producción de conocimiento; entre otros problemas, enfermedades somáticas, síndrome de agotamiento, etcétera, que interfieren con la salud mental y la salud física. El uso de la información causa numerosos factores desencadenantes en las organizaciones; sin embargo, destacamos un comportamiento desarrollado por los trabajadores que debe analizarse: la ansiedad informativa. Dado este escenario, la presente investigación buscó comprender el comportamiento informativo de los trabajadores del conocimiento en las nuevas empresas. Para esto, se eligió el método "estudio de caso", aplicando la triangulación, es decir, diferentes técnicas de recolección y análisis de datos, haciendo que la investigación sea más consistente, para validar los datos y el análisis realizado. La población de la investigación consistió en 18 sujetos de 4 compañías diferentes de tecnología de la información que fueron clasificadas como startups. Con la información recopilada, fue posible construir parámetros basados ​​en las estrategias de gestión de personas de Ribeiro y otros (2019), capaces de minimizar el impacto de la ansiedad por la información en los trabajadores de estas nuevas empresas(AU)

The purpose of the study was to identify the impact of information in the context of knowledge creation among workers from startup enterprises. Based on observation of the current scenario of organizations, we analyzed the fact that information may modify the behavior of subjects in different ways. Thus, while we should consider information as a resource for organizations, we should also understand its impact on workers' general health in terms of a feeling of inability to grasp multiple information in the process of knowledge production. Among other problems, somatic diseases and the burnout syndrome interfere with mental and physical health. Given this scenario, the study aimed to understand the information behavior of knowledge workers in the new enterprises. To achieve this goal, the case study method was applied, which included the use of triangulation, i.e. different data collection and analysis techniques contributing greater consistency to the study when validating the data and the analysis performed. The study population was 18 subjects from 4 different information technology companies classified as startups. With the information collected, parameters could be constructed on the basis of the people management strategies developed by Ribeiro et al (2019), capable as they are of minimizing the impact of information anxiety among workers from these new enterprises(AU)

Quality of supervisor behaviour, workplace social capital and psychological well-being.

BACKGROUND: Employees with a higher level of workplace social capital (i.e. relationships, trust and reciprocity at work) have a lower risk of mental health problems. Supervisor behaviour may be a predictor of workplace social capital. AIMS: To examine the associations between supervisor behaviour, workplace social capital and psychological well-being. METHODS: We conducted a secondary analysis of the sixth European Working Conditions Survey. The study sample included 28 900 employees in 35 European countries with an immediate line manager. Depression was assessed with the WHO-5 Well-Being Index. Supervisor behaviour quality and workplace social capital were each measured with a 6-item question. Association between quality of supervisor behaviour and workplace social capital was analysed using a hierarchical linear modelling. A mediation analysis was conducted by using hierarchical logistic models of depression with and without workplace social capital index. RESULTS: A higher supervisor behaviour quality index was associated with an increased workplace social capital index (ß, 0.55; 95% confidence interval [CI], 0.51-0.59). A higher workplace social capital index was associated with lower odds of depression (odds ratio [OR], 0.89; 95% CI, 0.87-0.90). A higher supervisor behaviour quality index was associated with lower odds of depression (OR, 0.90; 95% CI, 0.89-0.92); 58% of the effect was mediated by workplace social capital. CONCLUSIONS: Our findings support the hypothesis that better supervisor behaviour quality increases workplace social capital and contributes to psychological well-being of employees. This may be useful for planning organizational interventions to enhance mental health of workers.

Sports Medicine Staffing Across National Collegiate Athletic Association Division I, II, and III Schools: Evidence for the Medical Model.

CONTEXT: The ratio of clinicians to patients has been associated with health outcomes in many medical contexts but has not been explored in collegiate sports medicine. The relationship between administrative and financial oversight models and staffing is also unknown. OBJECTIVE: To (1) evaluate staffing patterns in National Collegiate Athletic Association sports medicine programs and (2) investigate whether staffing was associated with the division of competition, Power 5 conference status, administrative reporting structure (medical or athletic department), or financial structure (medical or athletic department). DESIGN: Cross-sectional study. SETTING: Collegiate sports medicine programs. PATIENTS OR OTHER PARTICIPANTS: Representatives of 325 universities. MAIN OUTCOME MEASURE(S): A telephone survey was conducted during June and July 2015. Participants were asked questions regarding the presence and full-time equivalence of the health care providers on their sports medicine staff. The number of athletes per athletic trainer was determined. RESULTS: Responding sports medicine programs had 0.5 to 20 full-time equivalent staff athletic trainers (median = 4). Staff athletic trainers at participating schools cared for 21 to 525 athletes per clinician (median = 100). Both administrative and financial oversight from a medical department versus the athletics department was associated with improved staffing across multiple metrics. Staffing levels were associated with the division of competition; athletic trainers at Division I schools cared for fewer athletes than athletic trainers at Division II or III schools, on average. The support of graduate assistant and certified intern athletic trainers varied across the sample as did the contributions of nonphysician, nonathletic trainer health care providers. CONCLUSIONS: In many health care settings, clinician : patient ratios are associated with patient health outcomes. We found systematic variations in clinician : patient ratios across National Collegiate Athletic Association divisions of competition and across medical versus athletics organizational models, raising the possibility that athletes' health outcomes vary across these contexts. Future researchers should evaluate the relationships between clinician : patient ratios and athletes' access to care, care provision, health care costs, health outcomes, and clinician job satisfaction.

Recomendaciones de medidas de protección para los trabajadores de saneamiento. Aguas residuales, desechos municipales, reciclaje y los residuos de las instalaciones de atención médica, 11 de mayo del 2020 / Recommendations of Protective Measures for Sanitation Workers. Waste Water, Municipal Waste, Recycling, and Healthcare Waste, 11 May 2020

This technical note presents the main recommendations on personal protective equipment and its use. It is aimed at personnel in the area of ​​environmental sanitation, and covers individual hygiene precautions and how to properly handle tools and equipment. It also includes indications on best practices for the protection of workers' health, guidelines for the disposal of dangerous elements for the community, and a guide for preparing sodium hypochlorite solutions for use in 0.1% disinfection.

Asegurar que se aplique las medidas de protección para los trabajadores en el manejo de aguas residuales y desechos sólidos. SARS-COV-2 requiere la aplicación de las normas existentes para la protección de la salud de los trabajadores.

Reflective practice facilitation within occupational therapy supervision processes: A mixed method study.

INTRODUCTION: Supervisors of occupational therapists play a key role facilitating reflective practice with their supervisees. Through reflective practice, supervisees can optimise their skills in professional reasoning and decision making. The aim of this study was to describe to what degree reflective practice is facilitated within occupational therapy supervision processes. METHODS: A mixed methods study design was used, collecting data via online surveys and focus groups. Quantitative data were initially analysed using descriptive statistics. Qualitative and quantitative data were then thematically analysed to identify hindering and enabling mechanisms to reflective practice facilitation. RESULTS: Eighteen supervisees and 17 supervising occupational therapists completed the surveys and 14 supervisors participated in a focus group. Half of the supervisees reported that reflective practice was facilitated through supervision only "rarely" or "sometimes." A hindering mechanism to reflective practice facilitation was the awareness of reflective practice models. Enabling mechanisms for reflective practice facilitation included understanding the benefits of reflective practice; recognising the attributes of a reflective practice practitioner; setting up an optimal supervision environment; and flexibly facilitating reflective practice. CONCLUSION: Findings suggest that reflective practice is not always regularly facilitated through supervision. This may limit opportunities for supervisees to optimise the development of their professional reasoning and clinical skills in the early stages of their careers.

Improving healthcare service quality through performance management.

PURPOSE: Healthcare service quality in the USA has gained importance under value-based payment models. Providing feedback to front-line staff is a vital component of managing service performance, but complex organizational dynamics can prevent effective communication. This work explored the performance management of appointment desk staff at Mayo Clinic Arizona, identified barriers to effective management and sought to standardize the process for monitoring service performance. DESIGN/METHODOLOGY/APPROACH: Multiple data sources, including qualitative inquiry with 31 employees from the primary care and surgery departments, were used. The research was conducted in two phases - facilitated roundtable discussions with supervisors and semi-structured interviews with supervisors and staff six months after implementation of service standards. Participants were probed for attitudes about the service standards and supervisor feedback after implementation. FINDINGS: While all staff indicated a positive work environment, there was an unexpected and pervasive negative stigma surrounding individual feedback from one's supervisor. Half the participants indicated there had been no individual feedback regarding the service standards from the supervisor. Presenting service standards in a simple, one-page format, signed by both supervisor and the patient service representative (PSR), was well received. ORIGINALITY/VALUE: Combining rapid-cycle quality improvement methodology with qualitative inquiry allowed efficient development of role-specific service standards and quick evaluation of their implementation. This unique approach for improving healthcare service quality and identifying barriers to providing individual feedback may be useful to organizations navigating a more value- and consumer-driven healthcare market.

Human resource technology disruptions and their implications for human resources management in healthcare organizations.

Concern among the public and policymakers about current and future major staff shortages is increasing. Strengthening Human Resource (HR) practices and adopting HR technologies such as Human Resource Information Systems (HRIS), that can collect, store and report workforce data are often described as a potential solution to this problem. Indeed, examples from other industries show that HRIS can help to launch or manage, as well as provide ongoing insights concerning the whole career cycle of an employee. However, few of the existing studies that discuss technology or its impacts on the future of work have focused on health organizations, and those that do have not received sufficient attention in health literature. Furthermore, such contributions as there have been have either prioritized a particular type of technology or focused mainly on the effect of automation on health professionals' work. They have thus overlooked the full range of possible uses of these technologies and, specifically, have neglected the topic of HR for Health (HRH) management in health organizations. The primary aim of this paper is to address this lacuna, with specific reference to the existing categorization of HR technological disruptions. To conclude, health organizations and the health and HR professionals who work within them need to use HRIS responsibly, finding a balance between the drive for innovation, productivity and efficiency and respect for all potential legal, ethical and compliance issues, as well as taking account of the importance of HRH wellbeing and satisfaction.

Primary healthcare accreditation standards: a systematic review.

PURPOSE: Accreditation is an essential component in primary healthcare (PHC) systems. The purpose of this paper is to investigate the most suitable PHC accreditation models and standards, worldwide, and to prepare a comprehensive and unbiased summary from research on these models. DESIGN/METHODOLOGY/APPROACH: A systematic search was undertaken using Web of Science, Scopus, Science Direct, Springer, PubMed and ProQuest databases in August 2016 and updated in January 2018. English language studies addressing PHC accreditation standards and models, published between 1995 and January 2018, were included, resulting in 9051 citations. After excluding duplicates and irrelevant studies, 19 were included in the final review. Two independent reviewers critically appraised the studies. Consequently, accreditation standards in the models were extracted and compared. FINDINGS: Results indicate that USA, Australia, Canada, UK and New Zealand (non-eastern Mediterranean regions (EMR)) and Jordan, Saudi Arabia, Lebanon and Egypt (EMR) had well-developed and high-quality PHC accreditation models. The Jordanian, Egyptian and Saudi models had the highest diversity in their PHC standards domains. Community-oriented care, safe care, high-quality care, care continuity and human resource management had the highest priority among PHC accreditation programs. ORIGINALITY/VALUE: The authors provide PHC accreditation benchmarks and determine high priority practical domains in accreditation standards. The findings should help health system managers and policymakers design new PHC accreditation programs and promote PHC service quality.

Career orientation and its impact factors of general practitioners in Shanghai, China: a cross-sectional study.

OBJECTIVES: To understand the career orientation and impact factors of general practitioners (GPs) in Shanghai. DESIGN: A cross-sectional study was carried out from August 2014 to December 2015 using the Career Orientations Inventory (short form). SETTING AND PARTICIPANTS: We conducted a cross-sectional study of 1159 GPs, of which 1067 (92.06%) completed the assessment tools, from 223 community healthcare centres in Shanghai RESULTS: The top career orientation was organisational job security (71.60%), followed by technical competence (12.18%). Compared with female GPs, male GPs scored higher in managerial competence (p<0.001), creativity and entrepreneurship (p<0.001), and lower in organisational job security (p=0.034). Compared with GPs younger than 40, those aged 40 years and older scored higher in sense of service (p=0.003) and lower in autonomy (p=0.022) and lifestyle integration (p=0.039). Compared with GPs with lower education levels, those with at least a bachelor's degree scored higher in managerial competence (p=0.001 and autonomy (p=0.025). In addition, those with fewer than 10 years of work experience scored higher in managerial competence (p=0.008) and scored lower in geographical security (p=0.032) compared with GPs with longer durations of work experience. GPs with senior professional positions scored higher in technical competence (p=0.012) compared with those with lower professional positions. CONCLUSIONS: The search for job stability and the lack of career prospect planning are two factors that impact community GP growth. Individualised skills training and career development planning should be provided to GPs of specific genders, educational background and vocational competence, in order to enhance their job satisfaction and service quality, thereby achieving retention of this staff group.

Dual normative commitments mediating the relationship between perceived investment in employees' development and intention to leave among the healthcare workforce in underserviced areas of Taiwan.

INTRODUCTION: To study the factors affecting the intent to leave of healthcare workers who serve in underserviced areas of Taiwan, the authors tested the mediating role of both professional and organizational commitment in the relationship between perceived investment of employee development and intention to leave among these healthcare workers. METHOD: This study was designed as a cross-sectional study using a well-organized questionnaire with major study variables consisting of perceived investment in employees' development (PIED), Meyer's occupational and organizational normative commitment, and intent to leave. In total, 692 healthcare workers from 48 health centers were enrolled for study; 616 people, including 415 (68.9%) from mountainous areas and 187 (31.1%) from isolated islands, responded and were valid for analysis. The response rate was 87%. RESULTS: The healthcare worker's PIED was positively correlated with both professional normative commitment and organizational normative commitment and negatively correlated with an individual's intent to leave. The dual normative commitments mediate completely the relationship between PIED and intention to leave in those health workers with government subsidy, while no such effect was noted in those without. CONCLUSION: The employee's dual commitments of professional and organizational normative commitment mediated the relationship between perceived investment of employee development and intention to leave. The government's investment in on-the-job training and career planning for the healthcare workers in both remote areas and isolated islands is important to enforce their professional and organizational normative commitment, and to retain the workforce in these underserviced areas.