Wage Continuation During Sickness: Observations on Paid Sick Leave Provisions in Times of Crises

[Excerpt] The economic costs of working while sick go far beyond increased health care costs due to treating a significantly higher number of people showing more severe signs of ill health. They also involve costs due to lower productivity and subsequent impacts on economic growth and development, in addition to collective costs of growing health and social inequalities. However, many aspects of social health protection including the role, patterns and costs of paid sick leave are misunderstood or underappreciated especially during times of economic crisis and recession. It is often said that paid sick leave schemes are open to abuse, especially if the benefit levels appear generous. This is undoubtedly a danger, and points to the need for strong administration. However, it is all too easy to overstate the case. ILO analyses of stimulus packages and policies addressing the crises reveal that cuts of social and health budgets are among the first national responses to recover the costs of bailing out those that have contributed to the crisis. Concerned are social health protection measures that provide access to health services and financial protection in case of sickness, such as paid sick leave. Limited evidence is available for governments, employers and workers’ unions on the consequences of gaps in providing for paid sick leave and costs of failing to address the needs of the vulnerable. Developing reliable internationally comparable data is constrained by the complex interplay of health and socio-economic conditions including regulations, labour market structure and vulnerability when taking up paid sick leave. Against this background, this paper seeks to focus on the existing national and international evidence and provides some insights into the concepts, patterns and affordability of paid sick leave in countries throughout the world. Further, it is argued that providing for sick leave and related income replacement is a key component of decent work and should be considered within national social protection floors

Implementation and maintenance of a pain management quality assurance program at intensive care units: 360 degree feedback of physicians, nurses and patients.

BACKGROUND:Pain management quality assurance programs (PMQP) have been successfully implemented in numerous hospitals across Europe. We aimed to evaluate the medium-term sustainability of a PMQP implemented at intensive care units (ICUs). METHODS:Two surveys, the first in 2012, immediately after introduction of the PMQP, and the second in 2015, were carried out amongst patients, physicians and nurses. Demographic parameters of all participants were assessed. Patients were asked after their pain levels during ICU stay. Staff members answered a questionnaire regarding familiarity with standards and processes of PMQP and self-perception of their knowledge as well as contentment with interdisciplinary communication. RESULTS:In total (2012/2015), 267 (125/142) patients, 113 (65/48) physicians and 510 (264/246) members of the nursing staff participated. Minimum and maximum pain levels of patients did not differ between both surveys. Patients' tolerance of pain 24 hours before the survey was better (p = 0.023), and vomiting occurred less often (p = 0.037) in 2015. Physicians' and nurses' contentment with the own knowledge about pharmacological pain treatment had increased from 2012 to 2015 (p = 0.002 and 0.004). Satisfaction with communication between nurses and physicians was better in 2015 (p<0.001 and p = 0.002). Familiarity with PMQP standards and processes remained stable in both collectives. CONCLUSION:The implementation of our PMQP achieved a high standard of care, guarantying a high patient and staff member satisfaction. Continuous education, ongoing training, regular updates and implementation of feedback-loops ensure continuity, in some parameters even an increase in knowledge and competencies. This is mirrored in high patient and staff member satisfaction