Diversifying the Mohs Workforce: Understanding Barriers of Applicants to Mohs Micrographic Surgery Fellowship.

BACKGROUND: The population of the United States is becoming increasingly diverse, yet dermatology, especially Mohs micrographic surgery (MMS), lags behind. OBJECTIVE: This survey study investigates perceived barriers of underrepresented groups in medicine (URM) who are pursuing fellowship in Mohs micrographic surgery and dermatologic oncology (MSDO). METHODS AND MATERIALS: An IRB-approved survey was distributed electronically to accredited dermatology residencies between December 2020 and April 2021. RESULTS: One hundred and thirty-three dermatology residents responded to the survey and of the participants, 21% identified as a URM. There was no significant difference in those interested in applying for MSDO fellowship between URMs and non-URMs. URMs rated the following factors significantly higher when deciding to pursue MSDO fellowship: lack of perceived diversity in target patient population (mean 3.61, SD 1.66), race/ethnicity/gender of past MSDO fellows (mean 3.25, SD 1.71), perceived attitudes of MSDO fellowships towards an applicant’s race or ethnicity (mean 3.25, 1.65 SD), and lack of diversity of trainees and faculty in MMS (mean 3.61, SD 1.47). CONCLUSION: This study is one of the first to evaluate perceived barriers to diversifying the MMS workforce. The perceived barriers we have identified are complex and require concerted efforts for improvement. J Drugs Dermatol. 2023;22(5): doi:10.36849/JDD.7083.

Enhancing disaster response of emergency medical teams through "TEAMS 3.0" training package-Does the multidisciplinary intervention make a difference?

Background: In the aftermath of disasters, Emergency Medical Teams (EMTs) are dispatched to help local rescue efforts. Although EMTs are recognized to be a critical component of the global health workforce, concerns have emerged over their functioning and effectiveness. For example, lack of cooperation and coordination between different EMTs has been a longstanding issue, resulting in fragmented disaster management. Methods: To enhance the provision of EMT's field teamwork, the Training for Emergency Medical Teams and European Medical Corps (TEAMS) project was established, and later further updated with novel scenarios and exercises (i.e., adapting EMT operations to a sudden disaster; becoming a modular team; reflecting on ethical dilemmas) in the complementary "TEAMS 3.0" project where a more comprehensive training package was developed. The aim of this study was to assess the effectiveness and quality of the TEAMS 3.0 training package in four training programs in Portugal, Germany, Norway, and Turkey. Participants completed a set of questionnaires designed to assess self-efficacy, teamwork, and quality of training. Results: The results from all the trainings suggest an improvement for both teams' self-efficacy and teamwork. The mean score among all the participants (N = 100) for both the self-efficacy scale and teamwork scale was 3.217 (±0.223) prior to training and 3.484 (±0.217) following the training, and 2.512 (±1.313) prior to training and 3.281 (±0.864), respectfully, with statistically significant differences according to Wilcoxon paired samples test (p < 0.05). The quality of training is regarded as high and deemed as an appropriate tool package for addressing the objectives of the project and the perceived needs of EMT disaster deployment. Conclusion: Thus far, the TEAMS 3.0 project has demonstrated to be effective in promoting EMT teamwork capacities.

Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes.

GOAL: The purpose of this study was to examine nurse staffing while describing the relationships that exist in staffing and quality associated with nursing care during the COVID-19 pandemic, a significantly challenging time for nurse staffing. We examined the relationship between permanent registered nurse (RN) and travel RN staffing during the pandemic and the nursing-sensitive outcomes of catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), falls, and hospital-acquired pressure injuries (HAPIs) and length of stay and compared the cost of CAUTIs, CLABSIs, falls, and HAPIs in fiscal years 2021 and 2022. METHODS: We used a descriptive, observational design to retrospectively examine permanent nurse staffing volume and CAUTI, CLABSI, HAPI, and fall counts from October 1, 2019, to February 28, 2022, and travel nurse volume for the most current 12 months, April 1, 2021, to March 31, 2022. Descriptive statistics, Pearson correlation, and statistical process control analyses were completed. PRINCIPAL FINDINGS: Pearson correlation showed a statistically significant, moderately strong negative correlation (r = -0.568, p = .001) between the active registered nurse full-time equivalents (RN FTEs) and average length of stay (ALOS), and a moderately strong positive correlation (r = 0.688, p = .013) between the travel RN FTEs and ALOS. Pearson correlations were not statistically significant, with low to moderate negative correlations for CAUTIs (r = -0.052, p = .786), CLABSIs (r = -0.207, p = .273), and falls (r = -0.056, p = .769). Pearson correlation for active RN and HAPI showed a moderately strong, statistically significant positive correlation (r = 0.499, p = .003). We observed common cause variation in CAUTIs and CLABSIs, with HAPIs and falls showing special cause variation via statistical process control. PRACTICAL APPLICATIONS: Despite the challenges associated with the lack of available nurse staffing accompanied by increasing responsibilities including unlicensed tasks, positive clinical outcomes can be maintained by staff adherence to evidence-based quality improvement.

A Multicenter Survey of Pediatric-Neonatal Transport Teams in the United States to Assess the Impact of the Coronavirus Disease 2019 Pandemic on Staffing.

OBJECTIVE: The coronavirus disease 2019 pandemic has resulted in unprecedented burnout in frontline health care providers. However, the impact of the pandemic on interfacility pediatric and neonatal transport team members has not been studied. The current study uses a survey design to document the impact of the pandemic on pediatric and neonatal transport team members with a focus on staffing and resilience promotion strategies. METHODS: Data for this study came from a short cross-sectional survey distributed to members of the American Academy of Pediatrics Section on Transport Medicine. RESULTS: Sixty-six teams responded (around 45%). Forty-one respondents (62%) reported vacancies on their transport teams, with 35 (53.8%) reporting more vacancies during the pandemic. Forty percent of highly trained registered nurses and respiratory therapists from specialty teams left their positions for those with better compensation during the pandemic. Forty-two percent of respondents were not trained to recognize burnout, stress, or compassion fatigue. CONCLUSION: Our study shows that half of the respondents had more vacancies during the pandemic than in previous years and reported difficulty in filling those positions. We were unable to link the vacancies to the pandemic and burnout because hospitalizations and transports in the pediatric facilities decreased during the pandemic; however, we do report that coronavirus disease 2019 exposure before the vaccine was a source of stress for team members. There are opportunities to improve the identification of burnout and to foster resilience and boost retention of this highly skilled niche workforce.

Employees' support strategies for mental wellbeing during and beyond the COVID-19 pandemic: Recommendations for employers in the UK workforce.

Throughout the COVID-19 pandemic, and beyond for many businesses, employees have had to adapt to new ways of working due to disruptions in traditional practices. It is therefore crucial to understand the new challenges that employees are facing when it comes to taking care of their mental wellbeing at work. To that end, we distributed a survey to full-time UK employees (N = 451) to explore how supported they felt throughout the pandemic, and to identify whether there are any additional types of support they would like to receive. We also compared employees' intentions to seek help before versus during the COVID-19 pandemic, and assessed their current attitudes toward mental health. Based on direct employee feedback, our results show remote workers felt more supported throughout the pandemic compared to hybrid workers. We also found that employees who had previously experienced an episode of anxiety or depression were significantly more likely to want extra support at work compared to those who had not. Furthermore, employees were significantly more likely to seek help for their mental health during the pandemic compared to before. Interestingly, the largest increase in intentions to seek help during the pandemic compared to before was with digital health solutions. Finally, we found that the strategies managers have adopted to better support their employees, an employee's mental health history, and their attitude to mental health all contributed to significantly increasing the likelihood that an employee would disclose a mental health concern to their line manager. We provide recommendations that encourage organisations to make changes to better support their employees, and we highlight the importance of mental health awareness training for both managers and employees. This work is of particular interest to organisations who are looking to tailor their current employee wellbeing offer to a post-pandemic world.

Training the public health emergency response workforce: a mixed-methods approach to evaluating the virtual reality modality.

OBJECTIVES: To produce and evaluate a novel virtual reality (VR) training for public health emergency responders. DESIGN: Following a VR training designed to test key public health emergency responder competencies, a prospective cohort of participants completed surveys rating self-assessed skill levels and perceptions of training methods. SETTING: The VR training sessions were administered in a quiet room at the US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia. PARTICIPANTS: All participants volunteered from a list of CDC emergency international surge responders. OUTCOME MEASURES: Perceived impact of the training on responder skills was self-reported via a Likert 5-point scale questionnaire. Assessments were modelled according to the Expanded Technology Acceptance Model measuring participant perceived usefulness of and intention to use the new technology. Inductive coding of qualitative feedback resulted in the identification of central themes. RESULTS: From November 2019 to January 2020, 61 participants were enrolled. Most (98%) participants self-rated above neutral for all skills (mean 4.3; range 1.21-5.00). Regression modelling showed that the perceived ease of use of the VR and ability to produce demonstrable results as likely drivers of further use. Participants agreed that others would benefit from the training (97%), it was representative of actual response scenarios (72%) and they would use lessons learnt in the field (71%). Open-response feedback highlighted feeling being immersed in the training and its utility for public health responders. CONCLUSIONS: At a time when a trained emergency public health workforce is a critical need, VR may be an option for addressing this gap. Participants' impressions and feedback, in the setting of their high skill level and experience, highlighted the utility and benefit of using VR to deliver training. Further research is needed to determine skill acquisition through VR training among a pool of future responders with limited to no response experience.

Drivers of retention of the HIV workforce transitioned from PEPFAR support to the Uganda government payroll.

BACKGROUND: Health worker (HW) retention in the public health sector in Uganda is an enduring health system constraint. Although previous studies have examined the retention of in-service HWs, there is little research focusing on donor-recruited HWs. The objective of this study was to explore drivers of retention of the HIV workforce transitioned from PEPFAR support to the Uganda government payroll between 2015 and 2017. METHODS: We conducted ten focus group discussions with HWs (n = 87) transitioned from PEPFAR support to the public sector payroll in 10 purposively selected districts across Uganda. In-depth interviews were conducted with national-level stakeholders (n = 17), district health and personnel officers (n = 15) and facility in-charges (n = 22). Data were analyzed by a hybrid approach of inductive and deductive thematic development based on the analytical framework by Schaefer and Moos regarding individual-level and organizational-context drivers. RESULTS: At the individual level, job security in the public sector was the most compelling driver of health worker retention. Community embeddedness of HWs in the study districts, opportunities for professional development and career growth and the ability to secure salary loans due to 'permanent and pensionable' terms of employment and the opportunity to work in 'home districts', where they could serve their 'kinsmen' were identified as enablers. HWs with prior private sector backgrounds perceived public facilities as offering more desirable challenging professional work. Organizational context enablers identified include perceptions that public facilities had relaxed supervision regimes and more flexible work environments. Work environment barriers to long-term retention include frequent stock-out of essential commodities, heavy workloads, low pay and scarcity of rental accommodation, particularly in rural Northern Uganda. Compared to mid-cadres (such as nurses and midwives), higher calibre cadres, such as physicians, pharmacists and laboratory technologists, expressed a higher affinity for seeking alternative employment in the private sector in the immediate future. CONCLUSIONS: Overall, job security was the most compelling driver of retention in public service for the health workforce transitioned from PEPFAR support to the Uganda government payroll. Monetary and non-monetary policy strategies are needed to enhance the retention of upper cadre HWs, particularly physicians, pharmacists and laboratory technologists in rural districts of Uganda.

Association between inequalities in human resources for health and all cause and cause specific mortality in 172 countries and territories, 1990-2019: observational study.

OBJECTIVE: To explore inequalities in human resources for health (HRH) in relation to all cause and cause specific mortality globally in 1990-2019. DESIGN: Observational study. SETTING: 172 countries and territories. DATA SOURCES: Databases of the Global Burden of Disease Study 2019, United Nations Statistics, and Our World in Data. MAIN OUTCOME MEASURES: The main outcome was age standardized all cause mortality per 100 000 population in relation to HRH density per 10 000 population, and secondary outcome was age standardized cause specific mortality. The Lorenz curve and the concentration index (CCI) were used to assess trends and inequalities in HRH. RESULTS: Globally, the total HRH density per 10 000 population increased, from 56.0 in 1990 to 142.5 in 2019, whereas age standardized all cause mortality per 100 000 population decreased, from 995.5 in 1990 to 743.8 in 2019. The Lorenz curve lay below the equality line and CCI was 0.43 (P<0.05), indicating that the health workforce was more concentrated among countries and territories ranked high on the human development index. The CCI for HRH was stable, at about 0.42-0.43 between 1990 and 2001 and continued to decline (narrowed inequality), from 0.43 in 2001 to 0.38 in 2019 (P<0.001). In the multivariable generalized estimating equation model, a negative association was found between total HRH level and all cause mortality, with the highest levels of HRH as reference (low: incidence risk ratio 1.15, 95% confidence interval 1.00 to 1.32; middle: 1.14, 1.01 to 1.29; high: 1.18, 1.08 to 1.28). A negative association between total HRH density and mortality rate was more pronounced for some types of cause specific mortality, including neglected tropical diseases and malaria, enteric infections, maternal and neonatal disorders, and diabetes and kidney diseases. The risk of death was more likely to be higher in people from countries and territories with a lower density of doctors, dentistry staff, pharmaceutical staff, aides and emergency medical workers, optometrists, psychologists, personal care workers, physiotherapists, and radiographers. CONCLUSIONS: Inequalities in HRH have been decreasing over the past 30 years globally but persist. All cause mortality and most types of cause specific mortality were relatively higher in countries and territories with a limited health workforce, especially for several specific HRH types among priority diseases. The findings highlight the importance of strengthening political commitment to develop equity oriented health workforce policies, expanding health financing, and implementing targeted measures to reduce deaths related to inadequate HRH to achieve universal health coverage by 2030.

Factors Affecting Remote Workers' Job Satisfaction in Utah: An Exploratory Study.

With structural changes in work arrangements, employee retention becomes more important for organizational success. Guided by the Ability, Motivation, Opportunity (AMO) framework, this study investigated the factors affecting remote workers' job satisfaction and personal wellbeing in Utah. From a sample of n = 143 remote workers, the study used a correlational design to identify the significant predictors of job satisfaction and personal wellbeing. It mapped the relationships between significant predictors of job satisfaction and personal wellbeing and explored the role of human resources (HR) policies and organizational culture in a remote work environment. Results showed intrinsic motivation, affective commitment, opportunity, and amotivation affected employee job satisfaction, while self-efficacy, amotivation, and job satisfaction affected personal wellbeing. A structural equation model (SEM) showed that remote workers with higher levels of self-efficacy, lower amotivation, and higher job satisfaction were likely to have greater personal wellbeing compared to others. When exploring the role of HR, findings showed that HR bundles and organizational culture indirectly affected job satisfaction but had a direct effect on the most important predictors of job satisfaction and personal wellbeing. Overall, results demonstrated the interconnectivity of HR practices, AMO factors, job satisfaction, and personal wellbeing.

Experiences of Doctor of Nursing Practice (DNP)-prepared nurses choosing to pursue a Doctor of Philosophy (PhD) degree.

BACKGROUND: Increasingly, nurses with a Doctor of Nursing Practice (DNP) degree are seeking a Doctor of Philosophy (PhD) degree. This subset of students may provide valuable insight for bolstering the PhD-prepared workforce, which is in decline. PURPOSE: The purpose of this research was to understand the essence of the lived experience of DNP-prepared nurses choosing to pursue a PhD degree. METHOD: An existential phenomenological study was undertaken, with 10 DNP-to-PhD students interviewed. RESULTS: The DNP-to-PhD experience is about being On a Mission. The Nursing Hierarchy was an implicit force influencing students' missions, and their experiences were characterized by five themes: (a) Having Needs the DNP Can't Meet: "I had to go back and do more," (b) Considering Dreams and Circumstances: "Now's the time," (c) Developing Confidence: "You can do this!" (d) "I've been very supported"/"I had no support," and (e) "It had to be an internal drive for me." CONCLUSIONS: Study findings demonstrate profound effects of the nursing hierarchy on students' decisions as well as misperceptions that still surround DNP and PhD education and careers. Nursing academicians, organizational leaders, and researchers must address PhD program disinterest, intimidation, and imposter syndrome and improve messaging about both degrees.

Building a dementia-capable nursing workforce.

BACKGROUND: Undergraduate nursing students will play a pivotal role in caring for the rising numbers of older adults and people living with dementia (PLWD). However, many do not receive training in geriatrics or dementia and do not enter this field post-graduation, contributing to the workforce shortage. OBJECTIVE: We aimed to capture students' interest and intention to work with PLWD, their suggestions about training, and to evaluate interest in a new elective long-term care (LTC) externship. METHODS: We developed and administered a survey to Bachelor of Science in Nursing students consisting of questions modified from the Dementia Attitude Scale and related to respondents' health care experience, attitudes about caring for older adults, comfort working with PLWD, and willingness to develop geriatric and dementia care skills. We then conducted focus groups about desired curricular and clinical content. RESULTS: Seventy-six students completed the survey. The majority reported low interest in working with and low knowledge of caring for older adults and PLWD. Six focus group participants expressed interest in participating in hands-on learning opportunities. Participants identified specific training components to attract students to geriatrics education. CONCLUSIONS: Our findings informed the development, piloting, and evaluation of a new LTC externship at the University of Washington Schoool of Nursing.

The abiding, hidden, and pervasive centrality of the health research workforce.

Research for health and development (R4HD) acknowledges that many of the determinants of health lie outside the boundaries of the health system. The size and quality of the health and care workforce (HCWF) are key drivers towards the future trajectory of many of these factors. We consider researchers for health and development an abiding, pervasive but neglected constituent part of this HCWF. This workforce straddles many professional groups and sectors. The diversity of occupations, lack of standardization in occupational cadres, the complexity and gendered aspects of the labour market, and the variable demographic, epidemiological, socio-economic and health systems' contexts in the global south and the global north, led to a kaleidoscopic perception of the health research workforce that have kept it hidden from public opinion. This led to neglect by science as well as health policymakers and created an orphan sub-set of the HCWF. Understanding the health researchers' labour market will help to identify means to develop, retain and utilize the health research workforce, addressing size, composition, role, skills transferability, careers and social impact through building, enabling or sustaining its research functions, capacity, employment opportunities and career tracks, among other issues. This thematic series of the Human Resources for Health Journal, calls for papers that go beyond narrow conceptual approaches and professional understandings of health care workers and the health research workforce, and requests that contributors examine important workforce issues through the broad lens of R4HD within a sustainable development goals framework.

Tips for managing a remote workforce.

With the initial disruption of COVID-19 now settling down, organisations are finding themselves in a new situation, where some of their previously onsite workforce is now fully remote or working according to a hybrid model of onsite and remote work, and some new employees have been hired as fully remote. This new model of dispersed employees presents managers, supervisors and leaders with fresh challenges when it comes to checking in on employees and providing them with the guidance, they need to perform their daily functions. This paper supplies key tips for the successful management of remote workforces. As well as how to balance the team dynamic with employees in multiple locations and differing work types, such as, fully remote, hybrid and onsite, the paper will also explore the use of various technologies and methods for ensuring employees are working to the best of their ability and continue to be content and productive in whatever environment they find themselves working.

Staffing levels and hospital mortality in England: a national panel study using routinely collected data.

OBJECTIVES: Examine the association between multiple clinical staff levels and case-mix adjusted patient mortality in English hospitals. Most studies investigating the association between hospital staffing levels and mortality have focused on single professional groups, in particular nursing. However, single staff group studies might overestimate effects or neglect important contributions to patient safety from other staff groups. DESIGN: Retrospective observational study of routinely available data. SETTING AND PARTICIPANTS: 138 National Health Service hospital trusts that provided general acute adult services in England between 2015 and 2019. OUTCOME MEASURE: Standardised mortality rates were derived from the Summary Hospital level Mortality Indicator data set, with observed deaths as outcome in our models and expected deaths as offset. Staffing levels were calculated as the ratio of occupied beds per staff group. We developed negative binomial random-effects models with trust as random effects. RESULTS: Hospitals with lower levels of medical and allied healthcare professional (AHP) staff (e.g, occupational therapy, physiotherapy, radiography, speech and language therapy) had significantly higher mortality rates (rate ratio: 1.04, 95% CI 1.02 to 1.06, and 1.04, 95% CI 1.02 to 1.06, respectively), while those with lower support staff had lower mortality rates (0.85, 95% CI 0.79 to 0.91 for nurse support, and 1.00, 95% CI 0.99 to 1.00 for AHP support). Estimates of the association between staffing levels and mortality were stronger between-hospitals than within-hospitals, which were not statistically significant in a within-between random effects model. CONCLUSIONS: In additional to medicine and nursing, AHP staffing levels may influence hospital mortality rates. Considering multiple staff groups simultaneously when examining the association between hospital mortality and clinical staffing levels is crucial. TRIAL REGISTRATION NUMBER: NCT04374812.

The improvement effect of working through the Silver Human Resources Center on pre-frailty among older people: a two-year follow-up study.

BACKGROUND: Although the health benefits of working in old age are well known, no research has examined them among older people with pre-frailty. We examined the improvement effect of working through the Silver Human Resources Center (SHRC) on pre-frailty among older people in Japan. METHODS: We carried out a two-year longitudinal survey from 2017 to 2019. Among 5,199 older people, the analysis included 531 participants who were judged to be of pre-frailty status at baseline and who completed both surveys. We utilized the records of participants' work through the SHRC from 2017 to 2019. The evaluation of the frequency of working through the SHRC was categorized as "less-working" (i.e., less than a few times a month), "moderate-working" (i.e., one to two times a week), and "frequent-working" (i.e., more than three times a week). The transition of frailty status was classified as "improved" (from pre-frailty to robust) and "non-improved" (from pre-frailty to pre-frailty or frailty). Logistic regression was used to assess the influence of the frequency of working through the SHRC on the improvement of pre-frailty. The analysis model was adjusted for age, sex, working for financial reward, years of membership, community activities, and health status at baseline. Inverse-probability weighting was used to correct for survival bias in the follow-up period. RESULTS: The improvement rate of pre-frailty during follow-up was 28.9% among the less-working, 40.2% in the moderate-working, and 36.9% in the frequent-working groups. The improvement rate in the less-working group was significantly lower than that in the other two groups (φ = -2.4). Multivariable logistic regression analysis showed that individuals in the moderate-working group had significantly higher odds of pre-frailty improvement than those in the less-working group (OR: 1.47, 95% CI: 1.14-1.90), and no significant differences were found between the frequent-working and less-working groups. CONCLUSIONS: We found that the participants engaged in moderate working through the SHRC significantly increased their rate of pre-frailty improvement, while frequent working showed no significant association. Therefore, in the future it is important to provide moderate work to older people with pre-frailty according to their health status.

How Does Shortage of Health IT Professionals Impact on the Digital Health Transformation?

BACKGROUND: The need for software suppliers to react swiftly to the plethora of application requests and constantly shifting market requirements is one of the major problems facing the health IT business in the context of digital health transformation. This can only be achieved when the necessary staff and resources are available. OBJECTIVES: The objective of this work is to identify challenges health IT companies are confronted with related to personnel capacities and skilled workers. METHODS: Using a questionnaire distributed through newsletters and social media among representatives of software companies and hospitals we collected information on current hurdles of health software providers and their strategies to overcome these in order to address the demands of the digital health transformation. RESULTS: The main findings of the survey are that scarce resources in software development are among the reasons for not achieving strategic goals on time in the health IT sector and for not being able to react flexibly to market changes. A strategy to overcome missing expert knowledge and own resources without free capacity is to hire external resources. CONCLUSIONS: With the ever-changing landscape of digital health, it is essential to have skilled workers with knowledge on the peculiarities of clinical workflows. The existing shortage of skilled workers leads to a reduction of innovative power in the health IT sector, potentially slowing down the digital health transformation.

E-nursing homes: transforming access to nurses in nursing homes in response to the staffing crisis.

The UK is facing a nationwide staffing crisis within adult social care, due to difficulties in recruiting and retaining registered nurses. Current interpretation of legislation means nursing homes must always have the physical presence of a registered nurse on duty within the home. With the shortage of registered nurses increasing, reliance on agency workers is commonplace, a practice impacting service cost and continuity of care. Lack of innovation to tackle this issue means the question of how to transform service delivery to combat staffing shortages is open for debate. The potential for technology to augment the provision of care was highlighted during the COVID-19 pandemic. In this article the authors present one possible solution focused on the provision of digital nursing care within nursing homes. Anticipated benefits include enhanced accessibility of nursing roles, reduced risk of viral spread and opportunities for upskilling staff. However, challenges include the current interpretation of legislation.

Effects of the COVID-19 pandemic on health surveillance work. / Efeitos da pandemia de COVID-19 no trabalho em vigilância sanitária.

The COVID-19 pandemic has challenged managers and exposed weaknesses in health systems. In Brazil, the pandemic emerged amid difficulties to work in the Brazilian Unified Health System (SUS) and in health surveillance (HS). The purpose of this article is to analyze the effects of COVID-19 on the organization, working conditions, management, and performance of HS, according to the perception of capital city managers from three regions of Brazil. This is an exploratory, descriptive research with qualitative analysis. The Iramuteq software was used in the treatment of the textual corpus and analysis of descending hierarchical classification, which generated four classes: characteristics of HS work during the pandemic (39.9%), HS organization and working conditions during the pandemic (12.3%), effects of the pandemic on work (34.4%), and the class of the health protection of workers and the population (13.4%). HS implemented remote work, expanded work shifts, and diversified its actions. However, it faced difficulties with personnel, infrastructure, and insufficient training. The present study also pointed out the potential for joint actions concerning HS.

A pandemia de COVID-19 desafiou gestores e explicitou fragilidades dos sistemas de saúde. No Brasil, a pandemia surgiu em meio a dificuldades para o trabalho no SUS e na vigilância sanitária (VISA). O objetivo deste artigo é analisar os efeitos da COVID-19 sobre a organização, as condições de trabalho, a gestão e a atuação de VISA, conforme a percepção de gestores de capitais de três regiões do Brasil. É uma pesquisa exploratória, descritiva, com análise qualitativa. Utilizou-se o software Iramuteq no tratamento do corpus textual e a análise de classificação hierárquica descendente gerou quatro classes: características do trabalho de VISA na pandemia (39,9%), organização e condições de trabalho de VISA na pandemia (12,3%), efeitos da pandemia sobre o trabalho (34,4%) e proteção da saúde de trabalhadores e da população (13,4%). A VISA implantou trabalho remoto, ampliou turnos de trabalho e diversificou suas ações. Entretanto, enfrentou dificuldades de pessoal, infraestrutura e capacitação insuficiente. O estudo apontou as potencialidades das ações conjuntas para a VISA.