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1.
BMC Infect Dis ; 19(Suppl 1): 785, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31526381

RESUMO

BACKGROUND: In June 2015, South Africa introduced early infant HIV diagnosis (EID) at birth and ten weeks postpartum. Guidelines recommended return of birth results within a week and ten weeks postpartum results within four weeks. Task shifting was also suggested to increase service coverage. This study aimed to understand factors affecting return of EID results to caregivers. METHODS: Secondary analysis of data gathered from 571 public-sector primary health care facilities (PHCs) during a nationally representative situational assessment, was conducted. The assessment was performed one to three months prior to facility involvement in the 2010 evaluation of the South African programme to prevent mother-to-child HIV transmission (SAPMTCTE). Self-reported infrastructural and human resource EID-related data were collected from managers and designated staff using a structured questionnaire. The main outcome variable was 'EID turn-around-time (TAT) to caregiver' (caregiver TAT), measured as reported number of weeks from infant blood draw to caregiver receipt of results. This was dichotomized as either short (≤3 weeks) or delayed (> 3 weeks) caregiver TAT. Logit-based risk difference analysis was used to assess factors associated with short caregiver TAT. Analysis included TAT to facility (facility TAT), defined as reported number of weeks from infant blood draw to facility receipt of results. RESULTS: Overall, 26.3% of the 571 PHCs reported short caregiver TAT. In adjusted analyses, short caregiver TAT was less achieved when facility TAT was > 7 days (versus ≤7 days) (adjusted risk difference (aRD): - 0.2 (95% confidence interval - 0.3-(- 0.1)), p = 0.006 for 8-14 days and - 0.3 (- 0.5-(- 0.1)), p = 0.006 for > 14 days), and in facilities with staff nurses (compared to those without) (aRD: - 9.4 (- 16.6-(- 2.2), p = 0.011). CONCLUSION: Although short caregiver TAT for EID was only reported in approximately 26% of facilities, these facilities demonstrate that achieving EID TAT of ≤3 weeks is possible, making timely ART initiation within 3 weeks of diagnosis feasible within the public health sector. Our adjusted analyses underpin the need for quick return of results to facilities. They also raise questions around staff mentoring: we hypothesise that facilities with staff nurses were likely to have fewer professional nurses, and thus inadequate senior support.


Assuntos
Cuidadores , Infecções por HIV/diagnóstico , HIV/imunologia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Laboratórios Hospitalares/organização & administração , Recursos Humanos/organização & administração , Sorodiagnóstico da AIDS , Estudos Transversais , Diagnóstico Precoce , Feminino , Humanos , Recém-Nascido , Programas de Rastreamento , Análise Multivariada , Enfermeiras Neonatologistas , Parto/sangue , Período Pós-Parto , Gravidez , Autorrelato , África do Sul
3.
BMC Health Serv Res ; 19(1): 554, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391052

RESUMO

BACKGROUND: Historically, governmental hospital organisation consisted in a heterogeneous distribution of staff and a fragmented logistical organisation without cross-functionality or sharing of resources between departments. This organisation could not last in a context of an evolving healthcare environment, changing patient profiles and hospital expenditure constraints. Cost-effective workforce regulation for optimal patient quality of care was urgently needed. The purpose of the study was to describe the reorganization that led to resource management no longer based on what has been achieved but based on a daily measured workload. METHODS: This prospective study used nursing intensity indicator, mirroring patient care needs, which was reported daily using VALPAReSO® software. Indirect care activities were recorded in departments of medicine, surgery and obstetrics. Based on data collected in 2012, a new organisation strategy was implemented and evaluated in 2015. RESULTS: Nursing intensity indicator analysis led to a reallocation of workforce per department, and the reinforcement unit (float pool) was managed based on this decision-aid tool for replacement and daily adequate staffing. The healthcare workflow audit resulted in the revision of five working tasks: time spent on handover, working time management, connections between services and the pharmacy, housekeeping, and food management. The reorganization took place at the same time as the transition to the development of very short-term care, resulting in a decrease in the number of full inpatient beds, which were therefore mainly occupied by heavier care profile patients. With the integrated strategy, this transition was achieved with constant staffing, and good overall patient satisfaction and working conditions were maintained. CONCLUSION: The reorganisation strategy was managed in a context of institutional commitment, coaching leadership built on close manager-employee interaction, a defragmented management between healthcare and all service providers, and a seamlessly dissemination and sharing of indicator information between healthcare managers, nurses and healthcare assistants. The process optimization allowed a better allocation of tasks and enabled nurses to refocus on patient care. Nursing intensity and indirect care indicators, when widely accepted, can be used as decision support tools for daily adequate staffing.


Assuntos
Hospitais , Melhoria de Qualidade/organização & administração , Recursos Humanos/organização & administração , Análise Custo-Benefício , Técnicas de Apoio para a Decisão , Feminino , Administração Hospitalar , Humanos , Gravidez , Estudos Prospectivos
4.
Ann Thorac Surg ; 108(4): 1000-1005, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31430462

RESUMO

Despite an ever-diversifying United States population, women and underrepresented minorities lack proportionate membership in the cardiothoracic surgery workforce. Many Society of Thoracic Surgeons (STS) members view achieving a diverse cardiothoracic surgery workforce as important. To address the needs of our specialty to better reflect and understand (cultural competence) our evolving communities, the STS created the Workforce on Diversity and Inclusion. The Workforce's mission is to cultivate an environment of inclusion and diversity within the STS as well as the cardiothoracic surgical specialty. This report will discuss the background for the creation of the Workforce on Diversity and Inclusion, describe the "return on investment" in diversity, the current state of diversity in surgery, illustrate STS members' views on the importance of a diverse specialty, and present current and future activities of the Workforce on Diversity and Inclusion.


Assuntos
Especialidades Cirúrgicas/organização & administração , Cirurgia Torácica/organização & administração , Recursos Humanos/organização & administração , Humanos , Inquéritos e Questionários , Estados Unidos
5.
Rev Peru Med Exp Salud Publica ; 36(2): 312-318, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31460646

RESUMO

Healthcare Human Resources (HHR) are key for the success of any health system; its development and performance are fundamental to ensure quality care. Despite this reality, HHR are often absent from health reform processes. In Peru, in the last 30 years, there have been several reforms that have included, to a greater or lesser extent, improvements in HHR policies aimed at providing a better quality of care to the population. This article seeks to make a brief analysis of the advances in the field of management and development of human resources in the healthcare sector in recent years, highlighting their importance in the quality of care. Through considerable effort, we would achieve competent, equitably-distributed HHR committed to delivering quality care to all individuals.


Assuntos
Assistência à Saúde/organização & administração , Reforma dos Serviços de Saúde/organização & administração , Qualidade da Assistência à Saúde , Recursos Humanos/organização & administração , Reforma dos Serviços de Saúde/normas , Pessoal de Saúde/organização & administração , Humanos , Peru
6.
J Infect Chemother ; 25(9): 653-656, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31182329

RESUMO

Implementation of antimicrobial stewardship programs (ASPs) with multidisciplinary antimicrobial stewardship teams (ASTs) is critical for appropriate antimicrobial use at healthcare facilities. Although the Japanese medical reimbursement system was revised to allow fees for ASP implementation, several concerns remain, including understaffing and enforcement of the recommendations on ASTs and ASPs in practice. Furthermore, there are no recommendations on full-time equivalents (FTEs) of the core members in ASTs in Japan. This committee report presents our recommendations on ASTs based on an analysis of the nationwide survey on implemented ASPs and staff FTEs at 1358 healthcare facilities conducted by the Japanese Society of Chemotherapy. Our report provides a directive for structural and financial support of ASTs and should aid in planning for the enhancement of AST practices and the organization of new ASTs.


Assuntos
Gestão de Antimicrobianos/organização & administração , Anti-Infecciosos , Instalações de Saúde , Humanos , Japão , Inquéritos e Questionários , Recursos Humanos/organização & administração
8.
Front Health Serv Manage ; 35(4): 3-10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31124795

RESUMO

Healthcare is facing a world of change. New regulations, rapid advances in information technology, shifts in payment from volume to value, consumer demands for better access to care, increased public scrutiny of outcomes, patient safety concerns, and business consolidation all add increasing degrees of difficulty to the work that healthcare leaders do. Effective management of a diverse workforce can make a significant impact on all of these challenges.This article covers four aspects of workforce management: talent, leadership, technology, and culture. Each is described, along with tactics to address it. The recommendations are based on both my research of human capital management and my experience as a senior human resource officer and healthcare executive, now with the nation's third-largest nonprofit health system, Catholic Health Initiatives.


Assuntos
Assistência à Saúde/organização & administração , Pessoal de Saúde/organização & administração , Liderança , Recursos Humanos/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
9.
Front Health Serv Manage ; 35(4): 11-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31124796

RESUMO

The challenges that healthcare leaders face are many, and workforce challenges are among the most important. For most healthcare entities, the workforce is their largest expense. Fortunately, many issues can be avoided with proper planning and review.Workforce planning is both a science (analysis) and an art (execution). It comprises a set of business processes for analyzing the supply and demand of talent in an organization and determining how that supply and demand might change over time. Turnover rates, retirement projections, and retention data are some of the tools commonly used in the workforce planning process. Because the increase in healthcare jobs is expected to outpace growth in all other fields and industries, recruitment and retention will be matters of special interest to all healthcare leaders during the next several years.


Assuntos
Assistência à Saúde/organização & administração , Pessoal de Saúde/organização & administração , Liderança , Papel Profissional , Recursos Humanos/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
10.
Glob Health Action ; 12(1): 1609825, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31117889

RESUMO

Background: Low-income countries with relatively weak-health systems are highly vulnerable to public health threats. Effective public health system with a workforce to investigate outbreaks can reduce disease impact on livelihoods and economic development. Building effective public health partnerships is critical for sustainability of such a system. Uganda has made significant progress in responding to emergencies during the past quarter century, but its public health workforce is still inadequate in number and competency. Objectives: To reinforce implementation of priority public health programs in Uganda and cultivate core capacities for compliance with International Health Regulations. Methods: To develop a competent workforce to manage epidemics and improve disease surveillance, Uganda Ministry of Health (MoH) established an advanced-level Field Epidemiology Training Program, called Public Health Fellowship Program (PHFP); closely modelled after the US CDC's Epidemic Intelligence Service. PHFP is a 2-year, full-time, non-degree granting program targeting mid-career public health professionals. Fellows spend 85% of their field time in MoH placements learning through service delivery and gaining competencies in major domains. Results: During 2015-2018, PHFP enrolled 41 fellows, and graduated 30. Fellows were placed in 19 priority areas at MoH and completed 235 projects (91 outbreaks, 12 refugee assessments, 50 surveillance, and 60 epidemiologic studies, 3 cost analysis and 18 quality improvement); made 194 conference presentations; prepared 63 manuscripts for peer-reviewed publications (27 published as of December 2018); produced MoH bulletins, and developed three case studies. Projects have resulted in public health interventions with improvements in surveillance systems and disease control. Conclusion: During the 4 years of existence, PHFP has contributed greatly to improving real-time disease surveillance and outbreak response core capacities. Enhanced focus on evidence-based targeted approaches has increased effectiveness in outbreak response and control, and integration of PHFP within MoH has contributed to building a resilient and sustainable health system in Uganda.


Assuntos
Assistência à Saúde/organização & administração , Bolsas de Estudo/organização & administração , Administração em Saúde Pública/métodos , Recursos Humanos/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Uganda , Adulto Jovem
11.
Inquiry ; 56: 46958019837430, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30983455

RESUMO

Although the hospital managers always try to improve the quality of the medical services, sometimes their efforts might affect reversely and push the system in what is so commonly called as "the death spirals of quality." The most important reason of falling into these spirals is the lack of a systemic thought that considers the feedback relationships between the numerous effective variables in the system performance, such as human resources service capacity. In this regard, the purpose of the present research is to design and simulate a dynamic human resources service capacity-based model to demonstrate the death spirals of quality phenomenon based on the service time per service and the possibility of error generation along with identifying the policies to cope with them. The system dynamics simulation approach is used to show the dynamics of the capacity of service from the standpoint of human resources. A model is simulated for the services of a hospital clinic as a case study. The simulation results of the designed dynamic model express that applying the desired policies for the case study can provide a good basis for fighting these spirals in a dynamic situation.


Assuntos
Assistência à Saúde/organização & administração , Formulação de Políticas , Recursos Humanos/organização & administração , Simulação por Computador , Retroalimentação , Hospitais , Humanos , Estudos de Casos Organizacionais , Qualidade da Assistência à Saúde
12.
Educ Prim Care ; 30(3): 128-132, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30945981

RESUMO

Recruitment and selection are critical components of human resource management. They influence both the quantity and quality of the healthcare workforce. In this article, we use two different examples of primary care workers, General Practitioners in the UK and Community Health Workers in low- and middle- income countries, to illustrate how recruitment and selection are, and could be, used to enhance the primary care workforce in each setting. Both recruitment and selection can be costly, so when funding is limited, decisions on how to spend the human resources budget must be made. It could be argued that human resource management should focus on recruitment in a seller's market (an insufficient supply of applicants) and on selection in a buyer's market (sufficient applicants but concerns about their quality). We use this article to examine recruitment and selection in each type of market and highlight the interactions between these two human resource management decisions. Recruitment and selection, we argue, must be considered in both types of market; particularly in sectors where workers' labour impacts upon population health. We note the paucity of high-quality research in recruitment and selection for primary care and the need for rigorous study designs such as randomised trials.


Assuntos
Seleção de Pessoal/métodos , Recursos Humanos/organização & administração , Agentes Comunitários de Saúde/provisão & distribução , Países em Desenvolvimento , Feminino , Humanos , Masculino , Médicos de Atenção Primária/provisão & distribução , Reino Unido
13.
BMC Health Serv Res ; 19(1): 239, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31014349

RESUMO

BACKGROUND: Health systems are complex and continually changing across a variety of contexts and health service levels. The capacities needed by health managers and leaders to respond to current and emerging issues are not yet well understood. Studies to date have been country-specific and have not integrated different international and multi-level insights. This review examines the current and emerging challenges for health leadership and workforce management in diverse contexts and health systems at three structural levels, from the overarching macro (international, national) context to the meso context of organisations through to the micro context of individual healthcare managers. METHODS: A rapid review of evidence was undertaken using a systematic search of a selected segment of the diverse literature related to health leadership and management. A range of text words, synonyms and subject headings were developed for the major concepts of global health, health service management and health leadership. An explorative review of three electronic databases (MEDLINE®, Pubmed and Scopus) was undertaken to identify the key publication outlets for relevant content between January 2010 to July 2018. A search strategy was then applied to the key journals identified, in addition to hand searching the journals and reference list of relevant papers identified. Inclusion criteria were independently applied to potentially relevant articles by three reviewers. Data were subject to a narrative synthesis to highlight key concepts identified. RESULTS: Sixty-three articles were included. A set of consistent challenges and emerging trends within healthcare sectors internationally for health leadership and management were represented at the three structural levels. At the macro level these included societal, demographic, historical and cultural factors; at the meso level, human resource management challenges, changing structures and performance measures and intensified management; and at the micro level shifting roles and expectations in the workplace for health care managers. CONCLUSION: Contemporary challenges and emerging needs of the global health management workforce orient around efficiency-saving, change and human resource management. The role of health managers is evolving and expanding to meet these new priorities. Ensuring contemporary health leaders and managers have the capabilities to respond to the current landscape is critical.


Assuntos
Assistência à Saúde/organização & administração , Administradores de Instituições de Saúde/organização & administração , Internacionalidade , Liderança , Administração de Recursos Humanos , Recursos Humanos/organização & administração , Humanos
14.
Aust J Rural Health ; 27(2): 132-138, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31006952

RESUMO

OBJECTIVE: This two-phase study aimed to explore the influence of a university rural curriculum and clinical placements on pharmacists' choice to practise in a rural or remote area. DESIGN: A sequential mixed-methods approach involved the design of both a questionnaire and semistructured in-depth interviews to collect quantitative and qualitative data. SETTING: Regional, rural and remote practice areas according to the Pharmacy Access/Remoteness Index of Australia classifications. PARTICIPANTS: Ninety-two pharmacists from varied areas of practice, working in rural and remote locations across Australia, participated in the study. MAIN OUTCOME MEASURES: University curriculum and clinical placements during the degree and their influence on the current rural workforce. RESULTS: In the survey sample, two-thirds of the current rural pharmacy workforce's choice of practice location was significantly influenced by positive rural placement experiences. Rural practice was, however, not included in the curriculum for 50% of the rural workforce in the sample, although graduates from regional universities experienced up to 80% more exposure to rural curricula. In this sample, rural origin was also not found to be a significant determinant of rural practice, while rural lifestyle, family commitments, remuneration, career opportunities and other contractual agreements have had a greater influence than university education. CONCLUSION: Although the positive influence of rural placements has been identified, there is still a way to go in terms of the development of a meaningful rural curriculum. This highlights that universities have a role to play in addressing this issue to produce graduates who are better prepared for the opportunities and challenges of rural pharmacy practice.


Assuntos
Escolha da Profissão , Educação em Farmácia/organização & administração , Assistência Farmacêutica/organização & administração , Farmacêuticos/psicologia , Área de Atuação Profissional , Serviços de Saúde Rural/organização & administração , Recursos Humanos/organização & administração , Adulto , Austrália , Currículo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Farmacêuticos/estatística & dados numéricos , População Rural/estatística & dados numéricos , Adulto Jovem
15.
Healthc Q ; 21(4): 21-27, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30946650

RESUMO

Five Alberta family practices achieved accreditation with Accreditation Canada in 2013-2015. This study conducted a workload and cost analysis of achieving accreditation. Human resources (HR) comprised 95% of the total cost. Document preparation constituted 76% of workload and 68% of total HR costs. Centralized content experts were tasked with document write-up. Clinics focused on survey preparation: 56% of staff participated, with the workload being the heaviest on managers. In CAD (2018 $ value), per capita cost was the highest for the 2-physician clinic ($65.78) and lower for the 11-physician ($19.44) clinic. Other cost determinants included culture, organizational structure, physician/staff engagement and pre-existing compliance to standards. A cost-benefit analysis shall provide insights into system-level benefits.


Assuntos
Acreditação/economia , Acreditação/estatística & dados numéricos , Medicina de Família e Comunidade/organização & administração , Acreditação/organização & administração , Alberta , Análise Custo-Benefício , Medicina de Família e Comunidade/economia , Humanos , Recursos Humanos/economia , Recursos Humanos/organização & administração , Carga de Trabalho/estatística & dados numéricos
16.
J Am Coll Radiol ; 16(4 Pt B): 624-630, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30947897

RESUMO

In this article, the authors review the evolving state of diversity in the field of radiology. The authors discuss several early and recent historical legislative milestones that increased the equitable delivery of health care in the United States, such as Title VI of the Civil Rights Act of 1964, which ensured that funds for Medicare reimbursement would be available only to desegregated hospitals. Furthermore, the authors examine the current state of diversity and representation in radiology, in which underrepresented minorities represent 8.3% of training and practicing radiologists, and women represent 27.8% of radiologists. Finally, the authors present arguments for diversity in the current medical education system, analyze hurdles to increasing representation in radiology, and consider the future of diversity and inclusiveness in the field.


Assuntos
Diversidade Cultural , Disparidades nos Níveis de Saúde , Grupos Minoritários/estatística & dados numéricos , Médicas/tendências , Radiologistas/organização & administração , Recursos Humanos/organização & administração , Escolha da Profissão , Direitos Civis , Feminino , Humanos , Masculino , Motivação , Estados Unidos
17.
Am J Epidemiol ; 188(5): 830-835, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30877297

RESUMO

Applied epidemiology training occurs throughout an epidemiologist's career, beginning with academic instruction before workforce entry, continuing as professional development while working, and culminating with mentoring the next generation. Epidemiologists need ongoing training on advancements in the field and relevant topics (e.g., informatics, laboratory science, emerging topics) to maintain and improve their skills. Even epidemiologists with advanced skills often want training on methodologic innovations or to practice a skill. Effective applied epidemiology training includes blended learning components of instruction that incorporate hands-on experiences such as simulations and experiential learning, allowing for real-time workflows and incorporation of feedback. To prepare epidemiologists for the future, public health training courses in applied epidemiology must consider the evolution in public health toward a focus on including informatics, technologic innovation, molecular epidemiology, multidisciplinary teams, delivery of population health services, and global health security. Supporting efforts by epidemiologists to increase their skills as part of their career paths ensures a strong workforce that able to tackle public health issues. We explore how to meet current training challenges for the epidemiology workforce, especially given limited resources, based on research and our experience in workforce development across federal agencies and state/local health departments, as well as with international governments and organizations.


Assuntos
Epidemiologia/educação , Epidemiologia/organização & administração , Administração em Saúde Pública/métodos , Recursos Humanos/organização & administração , /organização & administração , Comportamento Cooperativo , Difusão de Inovações , Educação Continuada/organização & administração , Epidemiologia/normas , Humanos , Sistemas de Informação , Saúde da População , Aprendizagem Baseada em Problemas/organização & administração , Administração em Saúde Pública/normas , Desenvolvimento de Pessoal/organização & administração , Estados Unidos , Recursos Humanos/normas
18.
Curr Opin Anaesthesiol ; 32(2): 123-128, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30817383

RESUMO

PURPOSE OF REVIEW: Many hospitals, particularly large academic centers, have begun to provide 24-h in-house intensive care attending coverage. Proposed advantages for this model include improved patient care, greater provider, nursing and patient satisfaction, better communication, and greater cost-effectiveness. This review will evaluate current evidence with respect to 24/7 coverage, including patient outcomes, cost-effectiveness, and impact on training/education. RECENT FINDINGS: Evidence surrounding 24-h intensivist staffing has been mixed. Although a subset of studies suggest a possible benefit to 24-h intensivist coverage, recent prospective studies have shown no difference in major patient outcomes, including mortality and ICU length of stay between patients in ICUs with and those without 24-h intensivist coverage. SUMMARY: Although some studies cite increased caregiver and patient satisfaction, outcome studies find no consistent effect on patient-centered outcomes such as mortality or length of stay. Downsides to in-house nighttime attending staffing include physician burnout, adverse effects on physician health, decreased trainee autonomy, and effects on trainee specialty choices because of undesirable lifestyle considerations. Tele-ICU and other novel approaches may allow for attending supervision without physical presence.


Assuntos
Cuidados Críticos/organização & administração , Unidades de Terapia Intensiva/organização & administração , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Recursos Humanos/organização & administração , Anestesiologia/educação , Anestesiologia/organização & administração , Anestesiologia/estatística & dados numéricos , Análise Custo-Benefício , Cuidados Críticos/economia , Cuidados Críticos/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva/economia , Unidades de Terapia Intensiva/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Recursos Humanos/economia , Recursos Humanos/estatística & dados numéricos
19.
Crit Care Med ; 47(4): e286-e291, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30855331

RESUMO

OBJECTIVES: Critical care medicine is a medical specialty where women remain underrepresented relative to men. The purpose of this study was to explore perceived drivers (i.e., influencing factors) and implications (i.e., associated consequences) of gender inequity in critical care medicine and determine strategies to attract and retain women. DESIGN: Qualitative interview-based study. SETTING: We recruited participants from the 13 Canadian Universities with adult critical care medicine training programs. PARTICIPANTS: We invited all faculty members (clinical and academic) and trainees to participate in a semistructured telephone interview and purposely aimed to recruit two faculty members (one woman and one man) and one trainee from each site. Interviews were transcribed verbatim, and two investigators conducted thematic analysis. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Three-hundred seventy-one faculty members (20% women, 80% men) and 105 trainees (28% women, 72% men) were invited to participate, 48 participants were required to achieve saturation. Participants unanimously described critical care medicine as a specialty practiced predominantly by men. Most women described experiences of being personally or professionally impacted by gender inequity in their group. Postulated drivers of the gender gap included institutional and interpersonal factors. Mentorship programs that span institutions, targeted policies to support family planning, and opportunities for modified role descriptions were common strategies suggested to attract and retain women. CONCLUSIONS: Participants identified a gender gap in critical care medicine and provided important insight into the impact for personal, professional, and group dynamics. Recommended improvement strategies are feasible, map broadly onto reported drivers and implications, and are applicable to critical care medicine and more broadly throughout medical specialties.


Assuntos
Escolha da Profissão , Medicina de Emergência/organização & administração , Médicas/organização & administração , Recursos Humanos/organização & administração , Adulto , Canadá , Cuidados Críticos/organização & administração , Feminino , Humanos , Liderança , Masculino , Pesquisa Qualitativa , Fatores Sexuais , Sexismo/estatística & dados numéricos
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