Addressing the health human resources crisis: Strategies for retaining women health care professionals in organizations.

Globally, healthcare systems are contending with a pronounced health human resource crisis marked by elevated rates of burnout, heightened job transitions, and an escalating demand for the limited supply of the existing health workforce. This crisis detrimentally affects the quality of patient care, contributing to long wait times, decreased patient satisfaction, and a heightened frequency of patient safety incidents and medical errors. In response to the heightened demand, healthcare organizations are proactively exploring solutions to retain their workforce. With women comprising over 70% of health human resources, this study seeks to gain insight into the unique experiences of women health professionals on the frontlines of healthcare and develop a conceptual framework aimed at facilitating organizations in effectively supporting the retention and advancement of women in healthcare frontline roles. We used grounded theory in this qualitative study. From January 2023 to May 2023, we conducted individual semi-structured interviews with 27 frontline HCWs working in Canada and representing diverse backgrounds. The data underwent thematic analysis, which involved identifying and comprehending recurring patterns across the information to elucidate emerging themes. Our analysis found that organizational, professional, and personal factors shape women's intentions to leave the frontline workforce. Reevaluating organizational strategies related to workforce, fostering a positive work culture, and building the capacity of management to create supportive work environment can collectively transform the work environment. By creating conditions that enable women to perform effectively and find satisfaction in their professional roles, organizations can enhance their ability to retain valuable talent.

Role of graduate courses in promoting educational scholarship of health care professionals.

PROBLEM ADDRESSED: Many courses are offered to health care professionals to improve educational scholarship and scholarly teaching. The literature on the effect of such courses on promoting educational scholarship and scholarly teaching is currently suboptimal. OBJECTIVE OF PROGRAM: To evaluate scholarly productivity of health care professional learners participating in 2 graduate courses in which curricula and assignments facilitated experiential learning. PROGRAM DESCRIPTION: A retrospective analysis of course assignments and publications of learners from 2007 to 2014 was conducted. Learners' current positions were identified through Google Scholar searches, and publication of course work was identified through PubMed or EMBASE author searches. There were 137 learners, with a male to female ratio of 3:7, consisting of physicians (73%) and other health care professionals (27%). During the 7 years, 50% completed both courses, 42% only the first course, and 8% only the second course. Of the learners whose current positions could be identified, 66% worked at academic centres, 20% at community hospitals or office practices, and 5% were in senior leadership positions. Current positions were unidentifiable through public records for 9% of learners. Sixty-eight percent of learners (93 of 137) published 1050 articles in peer-reviewed journals. Twenty-six percent of learners (35 of 137) published 1 or more articles based on their course assignments, for a total of 49 peer-reviewed articles; 80% of articles were published within 3 years of completing the course. CONCLUSION: Experiential learning facilitated by curricular design and assignments coupled with mentorship stimulated scholarly publications. Educational courses should design curricula to promote scholarship in learners and evaluate their effect.

Managing Children With Autism Spectrum Disorders in Emergency Departments.

Taking care of children with autism spectrum disorders is not uncommon in emergency departments as they visit hospital for acute medical and psychiatric conditions. The current prevalence and increasing incidence of autism spectrum disorders will increase the demand for hospital and outpatient services for these children, necessitating education of health care professionals and system adaptations. This paper describes a patient with autism spectrum disorder who had some challenging behavior in the emergency department when he presented with anaphylaxis and discusses management strategies that would help in caring for children with autism spectrum disorders.

The cost and impact of the interim federal health program cuts on child refugees in Canada.

INTRODUCTION: On June 30, 2012, Interim Federal Health Program (IFHP) funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. METHODS: We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. RESULTS: There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (p<0.001). INTERPRETATION: After the cuts to the IFHP, The Hospital for Sick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased.

Pain in children: assessment and nonpharmacological management.

Pain perception in children is complex, and is often difficult to assess. In addition, pain management in children is not always optimized in various healthcare settings, including emergency departments. A review of pain assessment scales that can be used in children across all ages, and a discussion of the importance of pain in control and distraction techniques during painful procedures are presented. Age specific nonpharmacological interventions used to manage pain in children are most effective when adapted to the developmental level of the child. Distraction techniques are often provided by nurses, parents or child life specialists and help in pain alleviation during procedures.

Knowledge to action: scholarship for faculty and staff.

INTRODUCTION: This study was undertaken to evaluate the influence of a continuing education course in facilitating the development and implementation of educational projects of course participants. METHODS: This is a case study evaluating a full-year course that consisted of 11 monthly seminars, each 4 hours in length, including practice in a computer laboratory. The class size was limited to 12 participants. Needs-assessment surveys at the beginning of the course, student evaluations, and midterm and final progress reports were analyzed. RESULTS: Seven staff physicians, 3 clinical fellows, a nurse educator, and a research assistant enrolled in the course. Initial needs-assessment surveys indicated that most people had adequate computer skills-11 (90%)-but only 2 (17%) were able to type well, 11 (90%) had no statistical knowledge, and 10 (83%) had limited literature-searching skills. The mean score on speaker evaluations for lectures was 4.5 on a scoring scheme of 1-5 where 1 was poor and 5 was outstanding. Ten participants (83%) had a complete proposal for an educational project written by midterm. Nine participants applied for external grants and 2 of them received external funding for their projects. Five participants (42%) completed a publishable educational project by the end of the 11-month course, and submitted it for presentation at scientific meetings. DISCUSSION: Like many adults, health care professionals experience limited time for involvement in formal education. This study shows that a limited-time-commitment course could facilitate health care professionals to develop and successfully implement educational projects translating ideas into action.

Pediatric resident education and needs assessment in clinical pharmacology.

OBJECTIVE: To identify perceived and unperceived educational needs of residents to organize a seminar series in clinical pharmacology. METHOD: All pediatric residents (48) and all attending general pediatric staff (20) were sent structured questionnaires with potential seminar topics. Data from previous pharmacy chart audits and complaints lodged with patient care representatives were analyzed as the environmental scans. RESULTS: There was a 75% response rate from both residents and staff. The responses were very similar and the only significant difference was the response to a seminar on correcting electrolyte imbalances which the residents favoured (p = 0.005). The environmental scans identified pain management as one of the main areas needing improvement. CONCLUSION: Perceived learning needs of residents are similar but not identical to those identified by the faculty. Environmental scanning can be used to identify unperceived learning needs.

Needs Assessment in Postgraduate Medical Education: A Review.

Although the concept of needs assessment in continuing medical education is well accepted, there is limited information on needs assessment in postgraduate medical education. We discuss the learning needs of postgraduate trainees and review the various methods of needs assessment such as: questionnaire surveys, interviews, focus groups, chart audits, chart-stimulated recall, standardized patients, and environmental scans in the context of post graduate medical education.