From staff-mix to skill-mix and beyond: towards a systemic approach to health workforce management

Throughout the world, countries are experiencing shortages of health care workers. Policy-makers and system managers have developed a range of methods and initiatives to optimise the available workforce and achieve the right number and mix of personnel needed to provide high-quality care. Our literature review found that such initiatives often focus more on staff types than on staff members' skills and the effective use of those skills. Our review describes evidence about the benefits and pitfalls of current approaches to human resources optimisation in health care. We conclude that in order to use human resources most effectively, health care organisations must consider a more systemic approach - one that accounts for factors beyond narrowly defined human resources management practices and includes organisational and institutional conditions

Acute pancreatitis in marrow transplant patients: Prevalence at autopsy and risk factor analysis

Pancreatitis has been described as an infrequent complication of marrow transplantation. This study investigated the prevalence of pancreatitis at autopsy in marrow transplant patients and determined risk factors for its development. We reviewed consecutive autopsy reports from 1991 to 1993. Medical records and laboratory reports were reviewed for analysis of clinical variables. Autopsy findings and clinical variables were correlated with the autopsy diagnosis of pancreatitis. Pancreatitis was found in 51 of 184 (28%) patients at autopsy. Of those with pancreatitis, 35% had abdominal pain, 10% had measurements of serum pancreatic enzymes, and 20% had abdominal imaging studies in the week prior to death. By univariable analysis, risk factors associated with development of pancreatitis included clinical grades 3 and 4 GVHD, GVHD at autopsy, liver GVHD at autopsy, major infection at autopsy, and increasing days of survival.By multivariable analysis, independent risk factors for its development included any GVHD at autopsy, increasing length of survival after transplantation, and major infection at autopsy. We conclude that pancreatitis is a common but often subclinical complication of marrow transplantation. Its development may be associated with a high prevalence of biliary sludge and prolonged treatment of GVHD with cyclosporine and prednisone.link_to_subscribed_fulltex

Cross-cultural variations in climate for autonomy, stress and organizational productivity relationships:A comparison of Chinese and UK manufacturing organizations

Cross-cultural researchers have questioned the extent to which European– American management practices can be transported to major markets in Asia, such as the People’s Republic of China. Applying employee involvement theory, we examined the relationships between climate for autonomy, work demands climate, employee stress and organizational productivity in a crossnational study of 51 UK and 104 Chinese manufacturing organizations. We predicted and found that climate for autonomy was positively and negatively related to stress in the Chinese and UK contexts, respectively. The interaction of climate for autonomy and work demands climate was significant: climate for autonomy was positively related to organizational productivity only when work demands climate was low

An Investigation of Production Workers’ Performance Variations and the Potential Impact of Attitudes

In most manufacturing systems the contribution of human labour remains a vital element that affects overall performance and output. Workers’ individual performance is known to be a product of personal attitudes towards work. However, in current system design processes, worker performance variability is assumed to be largely insignificant and the potential impact of worker attitudes is ignored. This paper describes a field study that investigated the extent to which workers’ production task cycle times vary and the degree to which such variations are associated with attitude differences. Results show that worker performance varies significantly, much more than is assumed by contemporary manufacturing system designers and that this appears to be due to production task characteristics. The findings of this research and their implications are discussed

Managing team innovation in the research and development (R&D) organization : critical determinants of team effectiveness

Teams are the principal vehicle in developing new drug development strategy and executing the tasks required to accomplish those objectives. This project evaluated the key drivers for team innovation performance (defined as outcomes). Team outcomes included new information creation, compression of development time, expansion of image, learning, capability development, growth satisfaction, and overall effectiveness. The two key research questions related to how team innovation performance are assessed in the branded pharmaceutical industry, and what the drivers for optimal team performance outcomes were. Results revealed that while good correlations individually existed between team outcomes (dependent variable) and tested independent variables (autonomy, coaching, climate, proactive personality, empowering leadership, and transactive memory systems), the best predictors identified through multivariate regression analysis were leader and peer coaching and transactive memory systems. The implications of these findings are examined and specific recommendations proposed. The limitations and avenues for further research are elaborated

A Nonlinear Multicriteria Model for Team Effectiveness

The study of team effectiveness has received significant attention in recent years. Team effectiveness is an important subject since teams play an increasingly decisive role on modern organizations. This study is inherently a multicriteria problem as different criteria are typically required to assess team effectiveness. Among the different aspects of interest on the study of team effectiveness one of the utmost importance is to acknowledge, as accurately as possible, the relationships that team resources and team processes establish with team effectiveness. Typically, these relationships are studied using linear models which fail to explain the complexity inherent to group phenomena. In this study we propose a novel approach using radial basis functions to construct a multicriteria nonlinear model to more accurately capture the relationships between the team resources/processes and team effectiveness. By combining principal component analysis, radial basis functions interpolation, and cross-validation for model parameter tuning, we obtained a data fitting method that generated an approximate response with reliable trend predictions between the given data points