Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 66.686
Rural Remote Health ; 22(1): 7050, 2022 02.
Article in English | MEDLINE | ID: mdl-35119906


INTRODUCTION: Past studies examined factors associated with rural practice, but none employed newer machine learning (ML) methods to explore potential predictors. The primary aim of this study was to identify factors related to practice in a rural area. Secondary aims were to capture a more precise understanding of the demographic characteristics of the healthcare professions workforce in Utah (USA) and to assess the viability of ML as a predictive tool. METHODS: This study incorporated four datasets - the 2017 dental workforce, the 2016 physician workforce, the 2014 nursing workforce and the 2017 pharmacy workforce - collected by the Utah Medical Education Council. Supervised ML techniques were used to identify factors associated with practice location, the outcome variable of interest. RESULTS: The study sample consisted of 11 259 healthcare professionals with an average age of 46.6 years, of which 36.6% were males and 94.5% Caucasian. Four ML methods were applied to assess model performance by comparing accuracy, sensitivity, specificity and area under the receiver operating characteristic (ROC) curve. Of the methods used, support vector machine performed the best (accuracy 99.7%, precision 100%, sensitivity 100%, specificity 99.4% and ROC 0.997). The models identified income and rural upbringing as the top factors associated with rural practice. CONCLUSION: By far, income emerged as the most important factor associated with rural practice, suggesting that attractive income offers might help rural communities address health professional shortages. Rural upbringing was the next most important predictive factor, validating and updating earlier research. The performance of the ML algorithms suggests their usefulness as a tool to model other databases for individualized prediction.

Rural Health Services , Delivery of Health Care , Health Personnel , Humans , Machine Learning , Male , Middle Aged , Professional Practice Location , Workforce
Hum Resour Health ; 20(1): 50, 2022 06 04.
Article in English | MEDLINE | ID: mdl-35659250


BACKGROUND: Human Resources for Health (HRH) are essential for making meaningful progress towards universal health coverage (UHC), but health systems in most of the developing countries continue to suffer from serious gaps in health workforce. The Global Strategy on Human Resources for Health-Workforce 2030, adopted in 2016, includes Health Labor Market Analysis (HLMA) as a tool for evidence based health workforce improvements. HLMA offers certain advantages over the traditional approach of workforce planning. In 2018, WHO supported a HLMA exercise in Chhattisgarh, one of the predominantly rural states of India. METHODS: The HLMA included a stakeholder consultation for identifying policy questions relevant to the context. The HLMA focused on state HRH at district-level and below. Mixed methods were used for data collection and analysis. Detailed district-wise data on HRH availability were collected from state's health department. Data were also collected on policies implemented on HRH during the 3 year period after the start of HLMA and changes in health workforce. RESULTS: The state had increased the production of doctors but vacancies persisted until 2018. The availability of doctors and other qualified health workers was uneven with severe shortages of private as well as public HRH in rural areas. In case of nurses, there was a substantial production of nurses, particularly from private schools, however there was a lack of trusted accreditation mechanism and vacancies in public sector persisted alongside unemployment among nurses. Based on the HLMA, pragmatic recommendations were decided and followed up. Over the past 3 years since the HLMA began an additional 4547 health workers including 1141 doctors have been absorbed by the public sector. The vacancies in most of the clinical cadres were brought below 20%. CONCLUSION: The HLMA played an important role in identifying the key HRH gaps and clarifying the underlying issues. The HLMA and the pursuant recommendations were instrumental in development and implementation of appropriate policies to improve rural HRH in Chhattisgarh. This demonstrates important progress on key 2030 Global Strategy milestones of reducing inequalities in access to health workers and improving financing, retention and training of HRH.

Health Workforce , Rural Population , Humans , India , Public Sector , Workforce
Hum Resour Health ; 20(1): 51, 2022 06 10.
Article in English | MEDLINE | ID: mdl-35689228


BACKGROUND: Investing in the health workforce is key to achieving the health-related Sustainable Development Goals. However, achieving these Goals requires addressing a projected global shortage of 18 million health workers (mostly in low- and middle-income countries). Within that context, in 2016, the World Health Assembly adopted the WHO Global Strategy on Human Resources for Health: Workforce 2030. In the Strategy, the role of official development assistance to support the health workforce is an area of interest. The objective of this study is to examine progress on implementing the Global Strategy by updating previous analyses that estimated and examined official development assistance targeted towards human resources for health. METHODS: We leveraged data from IHME's Development Assistance for Health database, COVID development assistance database and the OECD's Creditor Reporting System online database. We utilized an updated keyword list to identify the relevant human resources for health-related activities from the project databases. When possible, we also estimated the fraction of human resources for health projects that considered and/or focused on gender as a key factor. We described trends, examined changes in the availability of human resources for health-related development assistance since the adoption of the Global Strategy and compared disease burden and availability of donor resources. RESULTS: Since 2016, development assistance for human resources for health has increased with a slight dip in 2019. In 2020, fueled by the onset of the COVID-19 pandemic, it reached an all-time high of $4.1 billion, more than double its value in 2016 and a 116.5% increase over 2019. The highest share (42.4%) of support for human resources for health-related activities has been directed towards training. Since the adoption of the Global Strategy, donor resources for health workforce-related activities have on average increased by 13.3% compared to 16.0% from 2000 through 2015. For 47 countries identified by the WHO as having severe workforce shortages, the availability of donor resources remains modest. CONCLUSIONS: Since 2016, donor support for health workforce-related activities has increased. However, there are lingering concerns related to the short-term nature of activities that donor funding supports and its viability for creating sustainable health systems.

COVID-19 , Pandemics , COVID-19/epidemiology , Developing Countries , Global Health , Health Resources , Humans , Sustainable Development , Workforce
Hum Resour Health ; 20(1): 53, 2022 06 13.
Article in English | MEDLINE | ID: mdl-35698191


BACKGROUND: The World Health Organization adopted the Global Strategy on Human Resources for Health Workforce 2030 in May 2016. It sets specific milestones for improving health workforce planning in member countries, such as developing a health workforce registry by 2020 and ensuring workforce self-sufficiency by halving dependency on foreign-trained health professionals. Canada falls short in achieving these milestones due to the absence of such a registry and a poor understanding of immigrants in the health workforce, particularly nursing and healthcare support occupations. This paper provides a multiscale (Canada, Ontario, and Ontario's Local Health Integration Networks) overview of immigrant participation in nursing and health care support occupations, discusses associated enumeration challenges, and the implications for health workforce planning focusing on immigrants. METHODS: Descriptive data analysis was performed on Canadian Institute for Health Information dataset for 2010 to 2020, and 2016 Canadian Census and other relevant data sources. RESULTS: The distribution of nurses in Canada, Ontario, and Ontario's Local Health Integration Networks reveal a growth in Nurse Practitioners and Registered/Licensed Practical Nurses, and contraction in the share of Registered Nurses. Immigrant entry into the profession was primarily through the practical nurse cadre. Mid-sized communities registered the highest growth in the share of internationally educated nurses. Data also pointed towards the underutilization of immigrants in regulated nursing and health occupations. CONCLUSION: Immigrants comprise an important share of Canada's nursing and health care support workforce. Immigrant pathways for entering nursing occupations are complex and difficult to accurately enumerate. This paper recommends the creation of an integrated health workforce dataset, including information about immigrant health workers, for both effective national workforce planning and for assessing Canada's role in global health workforce distribution and utilization.

Emigrants and Immigrants , Canada , Delivery of Health Care , Humans , Occupations , Ontario , Workforce
Article in Spanish | PAHO-IRIS | ID: phr-56069


[RESUMEN]. Objetivos. Sistematizar y analizar las acciones de respuesta relacionadas con los recursos humanos en salud durante la pandemia reportadas por 20 países de la Región de las Américas en la evaluación de medio término del Plan de acción sobre recursos humanos para el acceso universal a la salud y la cobertura universal de salud 2018-2023 (Organización Panamericana de la Salud, 2018), y valorar la trascendencia de las políticas y la gestión de los recursos humanos expresadas en la Estrategia y el Plan de recursos humanos durante emergencias sanitarias y en tiempos normales. Métodos. Se seleccionaron y sistematizaron reportes sobre las acciones contra la COVID-19 y los recursos humanos en salud de 20 países de la Región. Se clasificaron las acciones en acciones inmediatas de contingencia, acciones relacionadas con capacidades instaladas y acciones emergentes. Resultados. Las capacidades de planificar y gestionar los recursos humanos en salud en los países dependen de las estructuras y competencias instaladas y funcionales. La pandemia visibilizó la necesidad de disponer de nuevos perfiles laborales, mejorar las condiciones laborales y contractuales precarias, visibilizar la perspectiva de género y solucionar brechas numéricas en determinadas áreas y niveles de atención. Conclusiones. La vinculación de acciones contra la COVID-19 con el monitoreo del Plan demostró la importancia de la gobernanza, la gestión y las capacidades instaladas en recursos humanos de salud para dar respuestas en emergencias sanitarias y en tiempos normales. El análisis invita a la revisión de las políticas públicas existentes, los modelos de atención necesarios para orientar las necesidades actuales y futuras de recursos humanos de salud, los perfiles requeridos, las condiciones laborales y la cobertura de brechas numéricas existentes, entre otros temas. La pandemia permitió innovaciones en los países para responder a la demanda. La Estrategia y el Plan siguen vigentes para orientar y fortalecer el desempeño de los recursos humanos en salud.

[ABSTRACT]. Objectives. Systematize and analyze the response actions related to human resources for health during the pandemic, reported by 20 countries of the Region of the Americas in the mid-term evaluation of the Plan of Action on Human Resources for Universal Access to Health and Universal Health Coverage 2018–2023 (Pan American Health Organization, 2018), and assess the importance of the policies on human resources for health (HRH) and on HRH management expressed in the Plan of Action and in the Strategy on Human Resources for Universal Access to Health and Universal Health Coverage during health emergencies and in normal times. Methods. Reports on actions taken in 20 countries of the Region against COVID-19 and for HRH were selected and systematized. These were classified as immediate contingency actions, actions related to installed capacities, and emerging actions. Results. The capacity to plan and manage HRH in countries depends on their installed, functional structures and competencies. The pandemic highlighted the need to have new job profiles, improve precarious working and contractual conditions, emphasize the gender perspective, and address numerical gaps in certain areas and levels of care. Conclusions. Linking the monitoring of the Plan of Action with the COVID-19 response demonstrated the importance of HRH governance, management, and installed capacities when responding to health emergencies and in normal times. The analysis suggests a need to review existing public policies, models of care that can guide current and future needs in HRH, the profiles required, working conditions, and ways to close numerical gaps, among other issues. The pandemic enabled countries to innovate in response to demands. The Strategy and the Plan of Action remain in place to guide and strengthen the performance of human resources for health.

[RESUMO]. Objetivos. Sistematizar e analisar as ações de resposta relacionadas aos recursos humanos para a saúde durante a pandemia, relatadas por 20 países da Região das Américas na avaliação intermediária do Plano de ação sobre recursos humanos para o acesso universal à saúde e a cobertura universal de saúde 2018-2023 (Organização Pan-Americana da Saúde, 2018), e avaliar a importância das políticas e da gestão de recursos humanos expressas na estratégia e no plano durante emergências de saúde e em tempos normais. Métodos. Foram selecionados e sistematizados relatórios sobre ações contra a COVID-19 e recursos humanos para a saúde de 20 países da Região. As ações foram classificadas em ações imediatas de contingência, ações relacionadas às capacidades instaladas e ações emergentes. Resultados. As capacidades de planejamento e gestão de recursos humanos para a saúde nos países dependem das estruturas e das competências instaladas e funcionais. A pandemia tornou visível a necessidade de ter novos perfis de trabalho, melhorar as precárias condições de trabalho e contratuais, tornar visível a perspectiva de gênero e solucionar lacunas numéricas em determinadas áreas e níveis de atenção. Conclusões. A vinculação das ações contra a COVID-19 com o monitoramento do plano demonstrou a importância da governança, da gestão e das capacidades instaladas relacionadas aos recursos humanos para a saúde, para responder a emergências de saúde e em tempos normais. A análise convida à revisão das políticas públicas existentes, dos modelos de atenção necessários para orientar as necessidades atuais e futuras dos recursos humanos para a saúde, os perfis exigidos, as condições de trabalho e a cobertura das lacunas numéricas existentes, entre outras questões. A pandemia permitiu inovações nos países para responder à demanda. A estratégia e o plano continuam vigentes para orientar e fortalecer o desempenho dos recursos humanos para a saúde.

Workforce , Health Workforce , Health Strategies , Health Policy , COVID-19 , Americas , Workforce , Health Workforce , Health Policy , Americas , Health Workforce , Health Strategies
Washington, D.C.; OPAS; 2022-06-01. (OPAS/HSS/HR/22-0012).
in Portuguese | PAHO-IRIS | ID: phr-56063


Os enfermeiros são atores-chave na promoção da saúde e na prevenção de doenças e a espinha dorsal dos sistemas de saúde em todo o mundo. Os enfermeiros trabalham na linha de frente da prevenção de doenças, promoção da saúde e gestão da saúde e, muitas vezes, são os heróis não mencionados nos serviços de saúde e na resposta a emergências. Apesar do papel crítico que desempenham no cuidado da saúde, existe uma escassez de enfermeiros em todo o mundo que afetará a prestação de cuidados de enfermagem. Este documento destaca as principais áreas de ação para investimentos direcionados na força de trabalho de enfermagem e faz um chamado para os Estados-Membros fortalecerem a enfermagem no contexto de seus esforços nacionais. São fornecidas sugestões de ação e estratégias para fortalecer a força de trabalho de enfermagem nos serviços primários de saúde por meio de investimentos em educação, empregos, liderança e prestação de serviços. O documento também fornece informações para tomadores de decisão sobre a abordagem das barreiras de acesso à saúde e no atendimento às necessidades de saúde da população, especialmente grupos que vivem em condições de vulnerabilidade, em comunidades rurais e remotas, e em locais com baixa densidade de outros profissionais de saúde. O objetivo é facilitar os esforços das partes interessadas na implementação dos recursos necessários para ajudar os países da Região das Américas a promover a saúde universal e o alcance dos Objetivos de Desenvolvimento Sustentável (ODS) através do avanço da capacidade da força de trabalho de enfermagem. Isto inclui governos e legisladores, assim como instituições acadêmicas e educadores; profissionais de enfermagem; sindicatos, conselhos e associações profissionais de enfermagem; e órgãos reguladores. Este documento de orientação para políticas foi desenvolvido pela OPAS através de novas análises, consenso de especialistas e referência a orientações e literatura existente da OPAS e da OMS sobre investimentos na força de trabalho de enfermagem na Região das Américas.

Workforce , Nurses , Nursing , Disease Prevention , Health Care Costing Systems , Personnel Management , Americas
Nurs Clin North Am ; 57(2): 179-189, 2022 06.
Article in English | MEDLINE | ID: mdl-35659981


Nurse staffing involves determining, allocating, and delivering nursing resources and care to residents in order to achieve the desired and required quality of care and life for residents. A comprehensive evidence-based framework for nurse staffing in nursing homes is presented to be considered beyond the number of nurse staff and consequently the nurse staffing strategies needed to address care quality in nursing homes.

Nursing Staff , Humans , Nursing Homes , Personnel Staffing and Scheduling , Quality of Health Care , Workforce
Neonatal Netw ; 41(3): 168-171, 2022 May 01.
Article in English | MEDLINE | ID: mdl-35644363


Advanced practice registered nurses (APRNs) play a critical role in alleviating provider shortages and expanding access to health care services for medically underserved populations. To meet these shortages, the APRN workforce is growing faster than the average for all occupations. This creates a critical need for effective transitioning from the role of student to APRN provider. Unfortunately, transitioning to the APRN role is not seamless and role confusion or challenges in role exposition can contribute to job stress and even role exodus. A recent quality improvement project supported student understanding of APRN roles and anticipation of role transition challenges for neonatal students preparing for roles as nurse practitioner and clinical nurse specialist. This strategy has the potential to contribute to successful role transition of neonatal nurse practitioner and neonatal clinical nurse specialist students.

Advanced Practice Nursing , Nurse Practitioners , Humans , Infant, Newborn , Students , Workforce
BMC Public Health ; 22(1): 1073, 2022 May 31.
Article in English | MEDLINE | ID: mdl-35641949


Emerging infectious diseases are a growing threat in sub-Saharan African countries, but the human and technical capacity to quickly respond to outbreaks remains limited. Here, we describe the experience and lessons learned from a joint project with the WHO Regional Office for Africa (WHO AFRO) to support the sub-Saharan African COVID-19 response.In June 2020, WHO AFRO contracted a number of consultants to reinforce the COVID-19 response in member states by providing actionable epidemiological analysis. Given the urgency of the situation and the magnitude of work required, we recruited a worldwide network of field experts, academics and students in the areas of public health, data science and social science to support the effort. Most analyses were performed on a merged line list of COVID-19 cases using a reverse engineering model (line listing built using data extracted from national situation reports shared by countries with the Regional Office for Africa as per the IHR (2005) obligations). The data analysis platform The Renku Project ( ) provided secure data storage and permitted collaborative coding.Over a period of 6 months, 63 contributors from 32 nations (including 17 African countries) participated in the project. A total of 45 in-depth country-specific epidemiological reports and data quality reports were prepared for 28 countries. Spatial transmission and mortality risk indices were developed for 23 countries. Text and video-based training modules were developed to integrate and mentor new members. The team also began to develop EpiGraph Hub, a web application that automates the generation of reports similar to those we created, and includes more advanced data analyses features (e.g. mathematical models, geospatial analyses) to deliver real-time, actionable results to decision-makers.Within a short period, we implemented a global collaborative approach to health data management and analyses to advance national responses to health emergencies and outbreaks. The interdisciplinary team, the hands-on training and mentoring, and the participation of local researchers were key to the success of this initiative.

COVID-19 , Africa South of the Sahara/epidemiology , COVID-19/epidemiology , Disease Outbreaks/prevention & control , Humans , Public Health , Workforce
BMJ ; 377: o1486, 2022 06 16.
Article in English | MEDLINE | ID: mdl-35710119

Clergy , Technology , Humans , Workforce
Aust Health Rev ; 46(3): 260-261, 2022 06.
Article in English | MEDLINE | ID: mdl-35653272

Telemedicine , Humans , Workforce
PLoS One ; 17(6): e0270051, 2022.
Article in English | MEDLINE | ID: mdl-35727762


BACKGROUND: Practice-integrated education and professional development programs (also known as residencies), have been available to pharmacists in America and the United Kingdom for many years. In 2016, the Society of Hospital Pharmacists of Australia launched Australia's novel Foundation Residency Program to support the development of early-career pharmacists, and has been implemented across many hospitals nationally. This model was adopted by the South Australian (SA) public hospital pharmacy statewide service and was granted full accreditation. The study aimed to explore key stakeholders' expectations and early perceptions of the structure, role and impact of the SA program and in that process, to identify key influencing factors and strategies informing future program planning and design. METHODS: Purposeful sampling was adopted to recruit participants who oversee preceptors and residents, across all employment levels and pharmacy service sites. Stakeholders participated in individual semi-structured interviews. Each interview was audio-recorded and transcribed verbatim. The transcribed dataset was managed using NVivo softwareTM (version 10) and analysed using reflexive thematic analysis through the lens of the PRECEDE-PROCEED logic model framework. RESULTS: Thirty-three staff consented to participate. Participants were de-identified with a randomly assigned code number. Three key themes were identified using reflexive thematic analysis; alignment of program goals and visions, culture shift to prioritising workforce development as core business, program structure supports focused workforce development. CONCLUSIONS: Participants view the residency as beneficial for development of the residents, preceptors, and the hospital pharmacy workforce. The multisite structure was a strength of the program. Whilst it was acknowledged that the rotations, cross-site rotations, and research project presented challenges, they were deemed worth the investment. Overall, it was felt that incremental increases in program capacity will occur over time, as culture changes, and as investing in workforce development becomes core business. The findings have led to several key recommendations to guide program expansion.

Internship and Residency , Pharmacists , Australia , Hospitals , Humans , Professional Role , Workforce
Rev Esc Enferm USP ; 56: e20210533, 2022.
Article in English, Portuguese | MEDLINE | ID: mdl-35730716


This is a theoretical-reflective essay, which aimed to reflect on the centralization of Patient Classification Systems in workload and hospital nursing staff sizing. The reflexive interpretations were guided by two axes: Patient Classification Systems : constitution and utilities; and "Hidden" nursing activities in workload measurement. The first evidences the importance and the role of these instruments in workload identification and in hospital nursing staff sizing, exemplifying several possibilities to be used by nurses. On the other hand, with the second axis, it is clear that there are many nursing activities that are not sensitive to the application (even if systematic) of these means of patient assessment. Therefore, nursing workload measurement may be underestimated. It was inferred that the complexity of practice environments requires a macro and micro institutional look at the nursing workload measurement, especially when considered for workforce planning/sizing purposes.

Nursing Staff, Hospital , Workload , Humans , Personnel Staffing and Scheduling , Workforce
Cien Saude Colet ; 27(7): 2543-2552, 2022 Jul.
Article in Portuguese, English | MEDLINE | ID: mdl-35730826


The article analyzes which were the actors who participated in the insertion in the governmental agenda of the issue of insufficiencies in the supply and training of medical doctors for the SUS and the adoption of the Mais Médicos Program (PMM) as a solution. Documental and bibliographic analysis and semi-structured interviews were carried out in the methodological perspective of process tracing. Theoretical resources from studies on political processes and from the theories of gradual institutional change and multiple streams were used. Outstanding results were the identification of factors related to the entry of the issue on the agenda, such as the aggravation of the issue, increase in its public perception and change of government. It was found that the action of the President and policy entrepreneurs was decisive for the process of formulating the PMM based on historical legacies of previous policies. We challenge studies that regard the PMM as a hastily formulated solution to an old problem to respond the street demonstrations known as "June Journeys". The inauguration of municipal governments, in 2013, and the electoral calendar were also important factors and taken into account in the strategic action of the actors who led the formulation of the PMM, with strong opposition from medical entities.

O artigo analisa quais atores participaram e como atuaram na inserção na agenda governamental da questão das insuficiências na oferta e formação de médicos para o SUS e da adoção do Programa Mais Médicos (PMM) como solução. A análise documental, bibliográfica e a realização das entrevistas semiestruturadas com informantes-chave foram trabalhadas na perspectiva metodológica do process tracing. Foram usados recursos teóricos dos estudos sobre o processo político e das teorias da mudança institucional gradual e dos múltiplos fluxos. Destacam-se como resultados a identificação de fatores relacionados à entrada da questão na agenda, como o agravamento do tema, o aumento de sua percepção pública e a mudança de governo. Constatou-se que a ação da presidenta Dilma Rousseff e de empreendedores da política foi decisiva para o processo de formulação do PMM com base em legados históricos de políticas anteriores. Contesta-se a explicação de uma vertente da literatura que considera que o PMM foi uma solução construída às pressas, para enfrentar um problema antigo, em resposta às "Jornadas de Junho". Observou-se que a posse dos novos prefeitos em 2013 e o calendário eleitoral também foram fatores importantes para a ação estratégica dos atores que lideraram a formulação do programa, com forte oposição das entidades médicas.

Government Programs , Physicians , Brazil , Delivery of Health Care , Humans , Local Government , Workforce
Pediatr Allergy Immunol Pulmonol ; 35(2): 49-57, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35723661


Background: Children with respiratory technologies, particularly those with mechanical ventilation, represent a growing population that require complex home nursing, medical equipment, outpatient medical and habilitative supports to live and thrive in their community. Care coordination is essential to support these children and their families to navigate and integrate key community-based health and educational services, however, care is often fragmented and care coordination needs unmet. Therefore, to fully support children with respiratory technologies, it is critical to understand the role of care coordinators (CCs) and how to sustain this workforce. The aim of this article is to describe CCs' perspective on (1) their role in supporting families in a home care program for children with respiratory technologies and home nursing, and (2) the core components of recruiting into and sustaining the CC workforce. Methods: Semistructured interviews were conducted with 15 CC from the Division of Specialized Care for Children (DSCC) Home Care program for children with technology dependence and home nursing in Illinois. Two independent coders utilized a modified template approach and discussed to agreement to analyze transcripts. Results: CC averaged 6.6 years of CC experience; the majority had social work or nursing backgrounds. CCs' job satisfaction was derived from their role supporting hospital discharge, seeing children improve over time, and navigating challenges with families. CCs enjoyed working in a collaborative environment where they could draw from their colleagues' experience to solve problems. Job dissatisfaction and job turnover stemmed from difficult family interactions, high caseloads, and redundant and time-intensive administrative tasks, which interfered with family engagement. Conclusions: CCs for children with respiratory technologies require diverse skills, but interdisciplinary teams enable collaborative support of families. Seeing children thrive can sustain the workforce, however, CCs report challenges due to high caseloads and administrative tasks, which impede direct family involvement.

Home Care Services , Home Nursing , Child , Humans , Social Work , Technology , Workforce