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Delayed access to inpatient beds for admitted patients contributes significantly to emergency department (ED) boarding and crowding, which have been associated with deleterious patient safety effects. To expedite inpatient bed availability, some hospitals have implemented discharge lounges, allowing discharged patients to depart their inpatient rooms while awaiting completion of the discharge process or transportation. This conceptual article synthesizes the evidence related to discharge lounge implementation practices and outcomes. Using a conceptual synthesis approach, we reviewed the medical and gray literature related to discharge lounges by querying PubMed, Google Scholar, and Google and undertaking backward reference searching. We screened for articles either providing detailed accounts of discharge lounge implementations or offering conceptual analysis on the subject. Most of the evidence we identified was in the gray literature, with only 3 peer-reviewed articles focusing on discharge lounge implementations. Articles generally encompassed single-site descriptive case studies or expert opinions. Significant heterogeneity exists in discharge lounge objectives, features, and apparent influence on patient flow. Although common barriers to discharge lounge performance have been documented, including underuse and care team objections, limited generalizable solutions are offered. Overall, discharge lounges are widely endorsed as a mechanism to accelerate access to inpatient beds, yet the limited available evidence indicates wide variation in design and performance. Further rigorous investigation is required to identify the circumstances under which discharge lounges should be deployed, and how discharge lounges should be designed to maximize their effect on hospitalwide patient flow, ED boarding and crowding, and other targeted outcomes.
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Leitos/provisão & distribuição , Serviço Hospitalar de Emergência/organização & administração , Alta do Paciente/tendências , Leitos/estatística & dados numéricos , Aglomeração/psicologia , Serviço Hospitalar de Emergência/tendências , Implementação de Plano de Saúde/métodos , Humanos , Pacientes Internados , Admissão do Paciente , Alta do Paciente/normas , Segurança do Paciente/normas , Revisão por Pares/tendências , Fatores de Tempo , Reino Unido/epidemiologia , Estados Unidos/epidemiologiaRESUMO
Despite data supporting the benefits of early reading interventions, there has been little evaluation of the long-term educational impact of these interventions, with most follow-up studies lasting less than two years (Suggate, 2010). This study evaluated reading outcomes more than a decade after the completion of an 8-month reading intervention using a randomized design with second and third graders selected on the basis of poor word-level skills (Blachman et al., 2004). Fifty-eight (84%) of the original 69 participants took part in the study. The treatment group demonstrated a moderate to small effect size advantage on reading and spelling measures over the comparison group. There were statistically significant differences with moderate effect sizes between treatment and comparison groups on standardized measures of word recognition (i.e., Woodcock Basic Skills Cluster, d = 0.53; Woodcock Word Identification, d = 0.62), the primary, but not exclusive, focus of the intervention. Statistical tests on other reading and spelling measures did not reach thresholds for statistical significance. Patterns in the data related to other educational outcomes, such as high school completion, favored the treatment participants, although differences were not significant.
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BACKGROUND: High burnout and low retention rates among trainee doctors threaten the future viability of the UK medical workforce. This study empirically examined factors that can sustain trainee doctors. METHOD: A total of 323 trainee doctors from 25 National Health Service (NHS) Trusts in England and Wales completed an online survey on their training and employment experiences. A mixed method approach was employed. RESULTS: Structural equation modelling revealed that perceived compassionate leadership of hospital senior leaders (CLSL) (i.e., doctors in senior clinical and management positions, and senior managers) is directly and negatively associated with trainee doctors' burnout and intention to quit. We propose the associations may be indirectly strengthened through two mediating pathways: increased psychological contract fulfilment (PCF) of training/organisational support and reduced worry about the state of the NHS; however, only the former is supported. The model can explain a substantial 37% of the variance in reported burnout and 28% of intention to quit among trainee doctors. Being a Foundation Year (FY) trainee was significantly associated with poor PCF and burnout. Rich qualitative data further elaborated on their experiences in terms of senior leaders' awareness of their training/working experiences, listening to and acting on. CONCLUSIONS: Active and demonstrable CLSL plays a vital role in trainee doctors' retention. It has both direct (through support) and indirect effects through improving trainee doctors' PCF to reduce burnout and intention to quit. This seems particularly valuable among FY doctors. Implications for the development and management of the medical workforce are discussed.
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IMPORTANCE: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to communication errors and gaps in information exchange. OBJECTIVE: To design and implement a standardised accept note to improve communication during medical service transfers, and evaluate its impact on patient outcomes. DESIGN: Prospective interventional cohort study. SETTING: A 792-bed tertiary care hospital. PARTICIPANTS: All patient transfers from any acute care hospital to the general medicine, cardiology, oncology and intensive care unit (ICU) services between August 2020 and June 2022. INTERVENTIONS: A standardised accept note template was developed over a 9-month period with key stakeholder input and embedded in the electronic health record, completed by nurses within the hospital's Access Centre. MAIN OUTCOMES AND MEASURES: Primary outcome was clinician-reported medical errors collected via surveys of admitting clinicians within 72 hours after IHT patient admission. Secondary outcomes included clinician-reported failures in communication; presence and 'timeliness' of accept note documentation; patient length of stay (LOS) after transfer; rapid response or ICU transfer within 24 hours and in-hospital mortality. All outcomes were analysed postintervention versus preintervention, adjusting for patient demographics, diagnosis, comorbidity, illness severity, admitting service, time of year, hospital COVID census and census of admitting service and admitting team on date of admission. RESULTS: Of the 1004 and 654 IHT patients during preintervention and postintervention periods, surveys were collected on 735 (73.2%) and 462 (70.6%), respectively. Baseline characteristics were similar among patients in each time period and between survey responders and non-responders. Adjusted analyses demonstrated a 27% reduction in clinician-reported medical error rates postimplementation versus preimplementation (11.5 vs 15.8, adjusted OR (aOR) 0.73, 95% CI 0.53 to 0.99). Secondary outcomes demonstrated lower adjusted odds of clinician-reported failures in communication (aOR 0.88; 0.78 to 0.98) and rapid response/ICU transfer (aOR 0.57; 0.34 to 0.97), and improved presence (aOR 2.30; 1.75 to 3.02) and timeliness (-21.4 hours vs -8.7 hours, p<0.001) of accept note documentation. There were no significant differences in LOS or mortality. CONCLUSIONS AND RELEVANCE: Among 1658 medical patient transfers, implementing a standardised accept note was associated with improved presence and timeliness of accept note documentation, clinician-reported medical errors, failures in communication and clinical decline following transfer, suggesting that improving communication during IHT can improve patient outcomes.
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Comunicação , Hospitais , Humanos , Estudos Prospectivos , Estudos de Coortes , Transferência de PacientesRESUMO
Introduction: The use of artificial intelligence (AI) for national defense is a matter of high societal significance and ongoing public discourse, but very little is known about public acceptance of AI in defense contexts. Currently, there is no reliable and valid measure of attitudes towards AI in defense, and more general attitudinal measures on AI use are unlikely to capture relevant perceptions and opinions. A measure was therefore developed for the assessment of Attitudes towards AI in Defense (AAID), and this work presents the initial validation of this scale. Methods: A total of 1,590 participants (aged 19-75, M = 45.7, SD = 16.1) completed a self-report questionnaire which included an initial item pool of 29 attitudinal statements related to the use of AI in defense. An additional general attitude towards AI scale was also included to assess the concurrently validity of the AAID scale. The AAID underwent initial statistical validation via exploratory factor analysis and confirmatory factor analysis to test the underlying structure of the newly developed scale. Results: Items reduction and exploratory factor analysis resulted in a final scale consisting of 15 items. A final two factor solution explained 42.52% of the variance (Factor 1 = 22.35%, Factor 2 = 20.17%). Factor 1 was termed "Positive outcomes" and reflected the potential and anticipated consequences of implementing AI in defense. Factor 2 was termed "Negative Outcomes" and reflected the potential negative outcomes for AI in defense. The scale also exhibited acceptable internal reliability and current validity. Discussion: The newly developed AAID presents a new measurement tool which has the capacity to assess current attitudes towards AI in defense. Such work is essential if further developments in AI in defense are to continue with the support of the public. However, the work also notes that there are some key concerns and barriers that could block further developments in the area, with further work needed to explore how such anxieties are driven by narratives related to the topic.
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As a part of the growing strand of employee-centered HRM research, employee well-being is suggested to be a key mechanism that may help to explain the relationship between HRM and performance. To investigate how an employee's well-being mediates the HRM-performance relationship, we distinguish between two types of well-being identified in prior work, happiness well-being and health well-being, and present arguments for differences in their effects on individual performance. Building on Job Demands-Resources (JDR) theory, we propose that happiness well-being positively mediates the relationship between perceived High-Performance Work Systems (HPWS) and individual task performance, while health well-being negatively mediates this focal relationship. Thus, happiness well-being fits the "mutual gains" perspective. In contrast, health well-being fits the "conflicting outcomes" perspective, and thus may be harmed by the HPWS to enhance the performance. We find partial support for our arguments in an analysis of longitudinal survey data of 420 participants spanning a total of four waves of data collection.
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Despite a growing evidence base on the effectiveness of community-based physical activity interventions for mental health, there is a lack of studies that focus on those affected by severe mental illness (SMI), who often experience poorer physical health, and are less physically active than the wider population. The use of peer support groups in this context is also understudied, despite benefits being documented in other contexts. This study examined the impact and process of a nationwide project to embed physical activity into peer support groups for those affected by SMI. Following the embedding of physical activity within peer support groups, interviews and focus groups were conducted to explore the experiences of those involved with the project and analysed using reflexive thematic analysis. The key findings related to: 1) the social aspects of embedding physical activity in the groups; 2) the focus on peer support and informal physical activity (rather than organised sport) being beneficial; 3) doing things differently and lessons to learn; and 4) the impact of the COVID-19 pandemic. Overall, we found that peer support is an important feature to include in projects encouraging those severely affected by mental illness to become more physically active.
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COVID-19 , Transtornos Mentais , Humanos , Pandemias , COVID-19/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Grupo Associado , Grupos de Autoajuda , Exercício FísicoRESUMO
There is emerging research that considers presenteeism as a neutral behavior that has both positive and negative predictors and outcomes for individuals and organizations. This neutral perspective diverges from the traditional negative view of presenteeism and is aligned with the Health-Performance Framework of Presenteeism (HFPF) in which presenteeism is considered to be an adaptive behavior that aims to balance health limitations and performance demands. This proof-of-concept study aims to investigate the existence of different profiles of presentees based on their common health problems (mental and physical) and performance, and differences in attendance and job stressors among these subgroups. Latent profile analysis with 159 clerical employees and managers from the UK private sector supported the HPFP and revealed four profiles: those reporting a good health and high performance were labeled functional presentees (who represented 19% of the sample), those with poor health and low performance were the dysfunctional presentees (14%), those with relatively high performance but poor health were labeled overachieving presentees (22%), and those with average scores on both dimensions were the average Joe/Jane presentees (45%; a new profile based on this sample). There was no profile in the present sample that corresponded to therapeutic presenteeism, characterized by low performance but relatively good health. Although average Joe/Jane presentees were comparable to functional presentees in exposure to most job stressors, they reported poorer pay and benefits, and more health problems than the latter. Average Joe/Jane presentees reported the lowest number of days of presenteeism. No difference was found in absenteeism across profiles, highlighting difficulties in measuring presenteeism using a count-measure, since three profiles presented a similar number of days of presenteeism yet contrasted health-performance configurations. Dysfunctional presentees were systematically more exposed to job stressors compared to functional presentees. The results support the HPFP proposition for different subgroups of presentees who are influenced by their work environment. The study takes a person-centered approach, disentangle presenteeism from the total count of presenteeism days, offering implications for management and intervention practice. Presenteeism can have a bright side and be functional in certain contexts when the appropriate resources are available.
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The quality of work organization may be responsible not only for reduced productivity but also for an increased risk of mental and physical disorders. This study was aimed at testing this hypothesis. Workers of a local health unit in Italy were asked to fill out the Work Organization Assessment Questionnaire (WOAQ) during their periodic medical examinations in the second half of 2018. On the same occasion, they also completed the Demand/Control/Support (DCS) measure of job strain, the Effort/Reward Imbalance (ERI) questionnaire, and the General Health Questionnaire (GHQ12) to assess psychological health. A total of 345 workers (85.8%) completed the survey. Linear regression analysis showed that the quality of work organization was inversely proportional to psychological health problems (p < 0.001). Occupational stress, measured both by job strain and ERI, was a moderating factor in this relationship. The relationship between the WOAQ and psychological health, moderated by job strain or ERI, remained highly significant even after adjustment for sex, age, social support, and overcommitment. Regression models explained over 40% of the shared variance of the association between quality of work organization and psychological health. The quality of work organization significantly predicted the risk of sickness absence for musculoskeletal disorders (OR = 0.984, CI95% 0.972-0.996) and for other health problems (OR = 0.977, CI95% 0.967-0.988). A continuous improvement of work organization must consider not only the clients' or production needs but also the well-being of workers.
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Absenteísmo , Estresse Psicológico , Humanos , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Recompensa , Pessoal de Saúde , Satisfação no Emprego , Carga de Trabalho/psicologiaRESUMO
Due to the COVID-19 pandemic having radically changed the way we now work, many recent studies have focused on employees' experiences and well-being, their performance and job satisfaction (JSA), and ways to ensure the best support for them when working from home (WFH). However, less attention has been given to managers' experiences in adapting to the new role of distance management and supporting them with this transition. This study aims to explore how managers experienced distance management, and the perceived organizational support (POS), and the effect of organizational support has on their JSA during the first year of the COVID-19 pandemic. Data from 1,016 line, middle and top managers in Danish workplaces were collected in March 2021, 1 year after the start of the COVID-19 pandemic. We applied descriptive statistics, ANOVA, and partial least square structural equation modeling to investigate the relation of perceived organizational support (POS) and the JSA of distance managers. Control variables were the respondents' demographic characteristics, specifically gender, age, and management level. The study offers insights into the managerial experiences of becoming a distance manager, helps to understand the relationship between POS and managers' JSA, and shows a positive relationship similarly for the managers as for employees. The study shows that most managers found their work as distance managers more demanding and worked more hours. The data demonstrate that managers received the most support from their own employees and manager peers, whereas administrative support was largely lacking. The data also show that the majority (67%) of the managers prefer to manage from the office, but similarly, they can continue managing from a distance if needed post-pandemic. The study adds to the literature on workplaces' transitioning to distance management and hybrid work and contributes to understanding the role of POS and managers' JSA during this transition. Consequently, if an organization aims to offer hybrid work, improving support from top management and in-house support functions would help maintain or increase managers' JSA.
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BACKGROUND: Developing reliable tools to tap into all the behavioral dimensions of individual job performance and identifying the right sub-dimensions is necessary for both research and practice. OBJECTIVE: This study aimed at developing and validating an IJPQ that addresses shortcomings of existing questionnaires. METHODS: After a comprehensive systematic literature review, a framework consisting of four dimensions, including task performance (TP), contextual performance (CP), counterproductive work behavior (CWB), and adaptive performance (AP) was structured for measuring IJP. As well, 45 sub-dimensions were identified for measuring IJP's dimensions. Content and face validity were evaluated, and item impact score (IS), content validity index (CVI), Kappa, and content validity ratio (CVR) were calculated. For reliability and confirmatory factor analysis (CFA), 525 workers completed the validated questionnaire and Cronbach alpha and goodness of fit indexes were determined, respectively. RESULTS: Of the 62 items generated to measure dimensions, 53 were approved. Based on item-level CVI, of the 53 items, only 45 items were accepted. Finally, the results of item level CVR led to the extraction of 27 questions to evaluate IJP. The obtained scale level CVI and scale level CVR were 0.91 and 0.68, respectively. Based on the results obtained from 525 Iranian workers, values of Cronbach's Alpha, X2/df, RMSEA, and P-value were in the acceptable range. CONCLUSIONS: Conclusively, a questionnaire containing 20 items was developed and validated for measuring IJP of Iranian worker's culture. The four dimensions of TP, CO, CWB, and AP consisted of 6, 5, 5, and 4 items each, respectively. Overall, IJPQ is a theory-based, reliable, and valid instrument for assessing job performance.
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Desempenho Profissional , Humanos , Irã (Geográfico) , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Introduction: The COVID-19 pandemic has led to a significant increase in the proportion of employees for whom teleworking became mandatory. Presenteeism, or the behavior of working while ill, has hardly been studied in the context of telework. The pandemic forced millions of workers to abruptly transition to working from home for a prolonged period of time, leaving employers often unaware of their health status or work capacity of the workers. This change also eroded the work experience itself, the workplace, and their protective impact on both individual health and work outcomes. This study focused on the longitudinal relationships among psychosocial safety climate (PSC), a lead indicator of workplace conditions, psychological demands, an indicator of quality of work, and presenteeism among a representative sample of teleworkers. PSC was expected to have an indirect impact on presenteeism with psychological demands as a mediator of this impact. Method: We collected the data from a representative sample of teleworkers in the first months (T1: April, T2: June, and T3: December 2020) of the pandemic using a three-wave online survey (n = 275). We tested a model of PSC as a determinant of presenteeism in teleworkers with psychological demands as a mediator. A cross-lagged panel model was estimated to test cross-sectional and longitudinal relationships. Findings: As expected, psychological demands increased over time. Contrary to expectations, the prevalence of presenteeism remained unchanged while PSC increased over time. The data fully supported the mediating effect of psychological demands such that a higher evaluation of PSC at T1 led to lower psychological demands at T2, which led to reduced presenteeism at T3. We also found a reciprocal relationship, with higher psychological demands at T2 leading to decreased evaluation of PSC at T3. These results show that the perception of teleworkers on their organization as giving a high priority to their psychological health is an important determinant of their work experience, ultimately influencing their decision to work while ill. The context of the pandemic has highlighted the importance of a positive workplace climate and working conditions for reducing the behaviors that can be harmful to health and productivity. Implications for theory and practice, beyond the pandemic, are discussed.
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United Kingdom Police custody is one of the most challenging of work environments, liable to excessive demands and reduced well-being. Being difficult to access, it is also a much-neglected area of research that has focused on one or two roles, rather than the full range available, and on individual-level research, rather than a more comprehensive multilevel understanding of how organizational culture and climate can simultaneously influence a range of well-being outcomes. The present longitudinal study explored all types of roles, in both the public and private sectors, across seven English police forces and 26 custody sites (N = 333, response rate 46.57%, with repeated returns = 370). The Integrated Multilevel Model of Organizational Culture and Climate (IMMOCC) was applied to examine the organizational-level influences on individual well-being. Results indicated that (1) custody sergeants were most vulnerable to low well-being, followed by publicly contracted detention officers; (2) shared leadership (a source of team cohesion) was linked to four of six well-being outcomes; (3) two sub-components of culture reflected tensions never acknowledged before, especially in respect of role; and (4) reverse relationships existed between well-being outcomes and the dimensions of culture and climate. The findings inform practical recommendations, including resilience training and the need to raise the status of police custody, while also highlighting concerns about private sector scrutiny that may be relevant to other professions.
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Polícia , Prisioneiros , Humanos , Estudos Longitudinais , Cultura Organizacional , Reino UnidoRESUMO
Cells are mechanical as well as chemical machines, and much of the energy they consume is used to apply forces to each other and to the extracellular matrix around them. The cytoskeleton, the cell membrane, and the macromolecules composing the extracellular matrix form networks that in concert with the forces generated by the cell create dynamic materials with viscoelastic properties unique to each tissue. Numerous recent studies suggest that the forces that cells create and are subjected to, as well as the mechanical properties of the materials to which they adhere, can have large effects on cell structure and function that can act in concert with or override signals from soluble stimuli. This brief review summarizes recent studies of the effects of substrate mechanics on cell motility, differentiation, and proliferation, and discusses possible mechanisms by which a cell can probe the stiffness of its surroundings. Cell Motil. Cytoskeleton, 2009. (c) 2009 Wiley-Liss, Inc.
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Fenômenos Biomecânicos/fisiologia , Células/citologia , Células/metabolismo , Animais , Diferenciação Celular/fisiologia , Movimento Celular/fisiologia , Proliferação de Células , Humanos , Mecanotransdução Celular/fisiologia , Modelos BiológicosRESUMO
Poor communication during inter-hospital transfer (IHT, the transfer of patients between acute care hospitals) is common. Clinicians often report feeling unprepared to care for IHT patients due to inadequate advance notification. The aim of this project was to improve advance notification of general medicine service patient transfers to a tertiary care referral hospital. We used quality improvement principles to design and implement two interventions: (1) Use of a checklist; (2) Redesign role/responsibilities within the Access Center and Bed Control Department. Data on frequency of advance notification was collected over 9 months and plotted on a statistical process control chart with evaluation for special cause variation. We also evaluated barriers/facilitators to implementation and surveyed clinicians on information received with the advance notification. 103 patients underwent IHT during the study. Frequency of advance notification increased from a baseline of 63.6%-85.4% post-intervention. Several contributors to successful implementation were identified, including ensuring key stakeholder input and leveraging existing systems structure, among others. Survey results highlighted potential targets for future IHT improvements such as improved clinical information available to admitting clinicians in advance of patient transfer. In conclusion, we successfully improved advance notification of IHT, an essential step to improve communication. Next steps include sustainment and automation of these efforts and ongoing targeted process improvement efforts with an ultimate goal of improving patient outcomes during IHT.
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Comunicação , Hospitais/normas , Transferência de Pacientes/normas , Hospitais/tendências , Humanos , Transferência de Pacientes/métodos , Transferência de Pacientes/tendências , Melhoria de QualidadeRESUMO
Psychosocial hazards in mental healthcare contribute to the development of compassion fatigue in mental health professionals. Compassion fatigue has a negative impact on the mental health and wellbeing of professionals that can impair the quality of services provided to clients. The majority of research on compassion fatigue has focused on individual-level variables such as gender, history of trauma and age, among others. It is also imperative to understand the role played by alterable work-related characteristics in contributing to the development of compassion fatigue in order to attenuate its impact on mental health professionals and their clients. The present review examined articles exploring work-related factors associated with compassion fatigue. Fifteen quantitative studies were included and their quality was assessed using a checklist. An inductive content-analysis approach was adopted to synthesise the themes emerging from the data. The results suggested a theoretical model consistent with the Job Demands-Resources model, wherein job demands (such as workplace trauma, workload and therapeutic settings) are associated with compassion fatigue, and job resources (such as supervisors', coworkers' and organisational support) mitigate the impact of job demands. In addition to person-oriented factors, work-related factors are critical for the prevention of compassion fatigue.
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Esgotamento Profissional , Fadiga de Compaixão , Criança , Fadiga de Compaixão/epidemiologia , Feminino , Pessoal de Saúde , Humanos , Satisfação no Emprego , Masculino , Saúde Mental , Qualidade de Vida , Inquéritos e Questionários , Local de TrabalhoRESUMO
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has caused the coronavirus disease 2019 (COVID-19) pandemic represents the greatest international biopsychosocial emergency the world has faced for a century, and psychological science has an integral role to offer in helping societies recover. The aim of this paper is to set out the shorter- and longer-term priorities for research in psychological science that will (a) frame the breadth and scope of potential contributions from across the discipline; (b) enable researchers to focus their resources on gaps in knowledge; and (c) help funders and policymakers make informed decisions about future research priorities in order to best meet the needs of societies as they emerge from the acute phase of the pandemic. The research priorities were informed by an expert panel convened by the British Psychological Society that reflects the breadth of the discipline; a wider advisory panel with international input; and a survey of 539 psychological scientists conducted early in May 2020. The most pressing need is to research the negative biopsychosocial impacts of the COVID-19 pandemic to facilitate immediate and longer-term recovery, not only in relation to mental health, but also in relation to behaviour change and adherence, work, education, children and families, physical health and the brain, and social cohesion and connectedness. We call on psychological scientists to work collaboratively with other scientists and stakeholders, establish consortia, and develop innovative research methods while maintaining high-quality, open, and rigorous research standards.
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Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Psicologia/tendências , Adulto , COVID-19 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Projetos de PesquisaRESUMO
This cross-sectional study uses a national data set of medical prescription claims to examine contraception service and workforce changes from January 2019 through December 2022 in the US.
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Anticoncepção , HumanosRESUMO
Biodegradable scaffolds play an important role in tissue engineering by providing physical and biochemical support for both differentiated and progenitor cells. Here, we describe a novel method for incorporating proteins in 3D biodegradable scaffolds by utilizing protein-loaded microspheres as the building blocks for scaffold formation. Poly(l,d-lactic-co-glycolic acid) (PLGA) microspheres containing bovine serum albumin (BSA) were fused into scaffolds using dichloromethane vapor for various time intervals. Microspheres containing 0, 0.4, 1.5, 4.3% BSA showed that increased protein loading required increased fusion time for scaffold fabrication. Protein release from the scaffolds was quantified in vitro over 20 days and compared to that of loose microspheres. Scaffolds had a slightly lower (up to 20%) release over the first 10 days, however, the cumulative release from both microspheres and scaffolds at the end of the study was not statistically different and the rate of release was the same, indicating that microsphere release can be predictive of scaffold kinetics. Scaffolds fused from larger (113.3 +/- 58.0 microm) rather than smaller (11.15 +/- 11.08 microm) microspheres, generated pores on the order of 200 microm as compared to 20 microm, respectively, showing control over pore size. In addition, four dyes (carbon black, acid green, red 27, and fast green FCF) were encapsulated in PLGA microspheres and fused into homogeneous and partitioned scaffolds, indicating control over spatial distribution within the scaffold. Finally, the scaffolds were seeded with fibroblast cells, which attached and were well spread over the polymer surface after 4h of incubation. These results highlight the versatility of this simple scaffold fusion method for incorporating essentially any combination of loaded microspheres into a 3D structure, making this a powerful tool for tissue engineering and drug delivery applications.