A Sensibility Assessment of the Job Demands and Accommodation Planning Tool (JDAPT): A Tool to Help Workers with an Episodic Disability Plan Workplace Support.

Purpose Sensibility refers to a tool's comprehensiveness, understandability, relevance, feasibility, and length. It is used in the early development phase to begin assessing a new tool or intervention. This study examined the sensibility of the job demands and accommodation planning tool (JDAPT). The JDAPT identifies job demands related to physical, cognitive, interpersonal, and working conditions to better target strategies for workplace supports and accommodations aimed at assisting individuals with chronic health conditions. Methods Workers with a chronic health condition and workplace representatives were recruited from health charities, workplaces, and newsletters using convenience sampling. Cognitive interviews assessed the JDAPT's sensibility. A 70% endorsement rate was the minimum level of acceptability for sensibility concepts. A short screening tool also was administered, and answers compared to the complete JDAPT. Results Participants were 46 workers and 23 organizational representatives (n = 69). Endorsements highly exceeded the 70% cut-off for understandability, relevance, and length. Congruence between screening questions and the complete JDAPT suggested both workers and organizational representatives overlooked job demands when completing the screener. Participants provided additional examples and three new items to improve comprehensiveness. The JDAPT was rated highly relevant and useful, although not always easy to complete for someone with an episodic condition. Conclusions This study highlights the need for tools that facilitate accommodations for workers with episodic disabilities and provides early evidence for the sensibility of the JDAPT.

The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses.

(1) Background: While the association between nurse mental health and quality and safety of patient care delivery was well documented pre-pandemic, fewer research studies have examined this relationship in the context of COVID-19. This study examines the impact of various mental health symptoms experienced by nurses on quality and safety before and during the COVID-19 pandemic; (2) Methods: A secondary analysis of cross-sectional survey data from 4729 and 3585 nurses in one Canadian province between December 2019 and June-July 2020 was conducted. Data were analyzed using between group difference tests and logistic regression; (3) Results: Compared to pre-COVID-19, during COVID-19 nurses reported a higher safety grade, a greater likelihood of recommending their units for care and lower quality of nursing care. Most mental health symptoms were higher during COVID-19 and higher levels of mental health symptoms were correlated with lower ratings of quality and safety both pre- and during COVID-19; (4) Conclusion: Mental health symptoms have implications for nurses' quality and safety of patient care delivery, with the association between mental health symptoms and quality and safety following a dose-response relationship before and during COVID-19. These findings suggest that it is worthwhile for nurse mental health symptoms to be included as hospital level performance metrics.

A Systematic Review: Effectiveness of Interventions to De-escalate Workplace Violence against Nurses in Healthcare Settings.

Workplace violence (WPV) is an increasing cause of concern around the globe, and healthcare organizations are no exception. Nurses may be subject to all kinds of workplace violence due to their frontline position in healthcare settings. The purpose of this systematic review is to identify and consider different interventions that aim to decrease the magnitude/prevalence of workplace violence against nurses. The standard method by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, 2009) has been used to collect data and assess methodological quality. Altogether, twenty-six studies are included in the review. The intervention procedures they report on can be grouped into three categories: stand-alone trainings designed to educate nurses; more structured education programs, which are broader in scope and often include opportunities to practice skills learned during the program; multicomponent interventions, which often include organizational changes, such as the introduction of workplace violence reporting systems, in addition to workplace violence training for nurses. By comparing the findings, a clear picture emerges; while standalone training and structured education programs can have a positive impact, the impact is unfortunately limited. In order to effectively combat workplace violence against nurses, healthcare organizations must implement multicomponent interventions, ideally involving all stakeholders.

Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS).

PURPOSE: The substantial economic burden of work-related injury and illness, borne by workers, employers and social security programmes, is primarily attributed to the durations of work disability among workers whose recovery requires a period of absence from work, with the majority of costs arising from the minority of workers with the longest duration absences. The objective of the Ontario Life After Workplace Injury Study is to describe the long-term health and labour market outcomes of workers disabled by work injury or illness after they are no longer receiving benefits or services from the work disability insurance authority. PARTICIPANTS: Workers disabled by a work-related injury or illness were recruited from a sample frame of disability benefit claimants with oversampling of claimants with longer benefit durations. Characteristics of workers, their employers and claimant benefits were obtained from baseline administrative data. Interviews completed at 18 months post injury (T1) and to be completed at 36 months (T2) measure return-to-work and work status; income; physical and mental health; case manager and healthcare provider interactions and employer accommodations supporting return-to-work and sociodemographic characteristics. Of eligible claimants, 40% (1132) participated in the T1 interview, with 96% consenting to participate in the T2 interview. FINDINGS TO DATE: Preliminary descriptive analyses of T1 data have been completed. The median age was 50 years and 56% were male. At 18 months following injury, 61% were employed by their at-injury employer, 16% had changed employment and 23% were not working. Past-year prescription opioid use was prevalent (34%), as was past-year cannabis use (31%). Longer duration claimants had poorer function, recovery and health and more adverse labour market outcomes. FUTURE PLANS: Multivariate analyses to identify modifiable predictors of adverse health and labour market outcomes and a follow-up survey of 96% of participants consenting to follow-up at 36 months are planned.

Quality incentives: the case of U.K. general practitioners.

The United Kingdom is implementing major changes to the national contract for general practitioners (GPs). A central plank of the new arrangements is an ambitious scheme to reward high-quality care. Each general practice will be scored on 146 performance indicators according to the measured quality of care it delivers, and its accumulated score will determine the magnitude of the quality payment it receives. About 18 percent of practice earnings will be at risk. This paper describes the incentive scheme, discusses its potential benefits and risks, and draws out the implications for evaluation.

A study of female nurses combining partner and parent roles with working a continuous threeshift roster: The impact on sleep, fatigue and stress.

This study of female nurses working a continuous 3-shift roster found that the average sleep duration per 24-hours across the roster is almost one hour less for nurses who combine shiftwork, partner and parent roles. In particular, they are not free to use the later starting afternoon shift as an opportunity to repay the sleep debt incurred on night shift.The results show an interaction between work and family roles resulting in chronic fatigue that is a risk factor especially when combined with the acute fatigue associated with night work.The sleep record data is supported by interview data which highlight shiftwork as a stressor that reduces the opportunity for participation in social and leisure activities by all three of the groups studied: single, partnered and partnered with children.The strain of shiftwork on personal and social relationships reduces the resources available for coping with the emotional and physical stressors encountered by nurses in their work and family roles.

Некоторые размышления о приоритетных направлениях работы по укреплению систем здравоохранения в Европейском регионе ВОЗ

В этом документе обобщена информация о тех мерах по повышению подотчетности систем здравоохранения, которые государства-члены Европейского региона ВОЗ приняли в период после принятия Таллиннской хартии: Системы здравоохранения для здоровья и благосостояния (2008 г.) и стратегии Здоровье-2020 (2012 г.). В этот период системы здравоохранения в странах Европейского региона ВОЗ испытали значительные трудности, включая экономический кризис, увеличение потребностей в медицинских услугах, а также дефицит ресурсов. Однако несмотря на сложную ситуацию, государства-члены во всех частях Региона приняли множество мер по повышению подотчетности систем здравоохранения. Настоящий документ содержит обобщенный анализ опыта государств-членов в этой области. Работа в этом направлении основывается на положениях Таллиннской хартии и стратегии Здоровье-2020 и на использовании таких подходов, как постановка четких количественных целей и измерение и оценка эффективности деятельности системы здравоохранения. Эта публикация была представлена для обсуждения в качестве справочного документа на Шестьдесят пятой сессии Европейского регионального комитета ВОЗ, Вильнюс, 14–17 сентября 2015 г.

Some reflections on priorities for health systems strengthening in the WHO European Region

This report takes stock of the measures that Member States of the WHO European Region have put in place to strengthen health system accountability since the Tallinn Charter: Health Systems for Health and Wealth (2008) and the Health 2020 policy framework (2012) were adopted. These last years have been undoubtedly marked by significant challenges facing the health systems in the Region, including international and national environments affected by an economic crisis, increased health needs, as well as resource scarcity. However, and in spite of the challenging context, Member States across the Region have taken abundant and significant steps to improve health system accountability. This report summarizes the experiences of Member States strengthening health system accountability in the context of the momentum created by the Tallinn Charter and Health 2020 through rigorous goal setting, as well as health system performance measurement and review. This publication was tabled as a background document during the Sixty-fifth session of the Regional Committee for Europe, Vilnius, 14–17 September 2015.