RN4CAST: Human Resources Forecasting in Europe Luk Bruyneel.
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Transcript of RN4CAST: Human Resources Forecasting in Europe Luk Bruyneel.
RN4CAST: Human Resources Forecasting in Europe
Luk Bruyneel
RN4CAST.EU | CONTENTS1
1. INTERNATIONAL CONTEXT OF THE NURSING
WORKFORCE
2. RN4CAST: FP7-FUNDED RESEARCH ON THE
NURSING WORKFORCE
3. PRELIMINARY RESULTS
4. FURTHER PROGRESS
RN4CAST.EU | INTERNATIONAL CONTEXT | RATIO NURSES/PHYSICIANS 2
Source: OESO 2005 – for Belgium (exact): J.Pacolet, 2006
Ratio nurses/physicians
RN4CAST.EU | INTERNATIONAL CONTEXT | NURSING LITERATURE3
Worldwide numeric, skill and geographic imbalances in
the nursing workforce
Joint effects of staffing and various practice environment
elements on patient outcomes (Aiken et al., 2002)
Poor nursing workforce planning and associated
shortages in any country threaten the stability of the
nurse workforce in neighbouring countries and beyond
through distortions in patterns of international nurse
migration
RN4CAST.EU | INTERNATIONAL CONTEXT | NURSING LITERATURE4
Surgical patients in hospital with better nurse work
environments have 13% lower odds on dying
Patients in hospitals with better staffing (two fewer
patients per nurse) have 11% lower odds on dying
Patients in hospitals with better educated nurses (20%
more BSNs) have 8% lower odds on dying
Surgical patients in hospitals that are better on all three
have roughly 30% lower odds on dying
RN4CAST.EU | FP-7 FUNDED RESEARCH | CO-ORDINATION5
RN4CAST: nurse forecasting in Europe
Timeframe: 2009-2011
Budget: 3 mio Euros
Co-ordination:
Co-ordinator: Walter Sermeus (K.U.Leuven, Belgium)
Vice-coordination: Linda Aiken (Upenn, USA)
Partners: 15 (+1): 11(+1) in Europe, USA, 3 ICPC
RN4CAST.EU | FP-7 FUNDED RESEARCH | EUROPEAN PARTNERS6
BelgiumKatholieke Universiteit Leuven
FinlandKuopio University
GermanyTechnische Universität Berlin
GreeceUniversity of Athens
IrelandDublin City University
The NetherlandsUMC St Radboud
PolandJagiellonian University Krakow
SpainInstitute of Health Carlos III
SwedenKarolinska Institutet
SwitzerlandBasel University
United KingdomKing’s College London
Norway is an official reference partner
University of Pennsylvania, USA: previousexpertiseInternational Cooperating Partner Countriesof the European Union: China Botswana South-Africa
7 RN4CAST.EU | FP-7 FUNDED RESEARCH | PARTNERS WORLDWIDE
8
To refine current forecasting models for manpowerplanning of the nursing workforce with new elements:
1.Various aspects of the nursing work environment2.Impact of nurse deployment on recruitment, retention and productivity of nurses and on patient outcomes
And to present mid-term and long-term projections on a European and national level
RN4CAST.EU | FP-7 FUNDED RESEARCH | OBJECTIVE
9
Hospitals: acute hospitals (at least 30 per country)
Nursing units: general medicine and surgery (cf. Kane et al., 2007)
Patient questionnaire
Nurse questionnaire
Hospital characteristics
Hospital discharge data
RN4CAST.EU | FP-7 FUNDED RESEARCH | METHODS
10
Country Nurse survey Patient survey
Hospitals Nurses RR Nurses Hospitals Patients RR Patients
Belgium 56 3186 72.07% 51 2323 68.00%
China 181 9774 97.50% 179 6540 92.50%
Finland 32 1130 45.39% 32 1952 52.03%
Germany * 49 3628 40.19% 12 390 64.87%
Greece * 26 500 38%-81% 26 800 55%-60%
Ireland * 31 2495 56.00% 10 300 ?
Netherlands * 23 3163 69.00% No No No
Norway 35 6600 56.85% No No No
* In progress
RN4CAST.EU | PRELIMINARY RESULTS | DATA COLLECTION
11
* In progress § Estimated
RN4CAST.EU | PRELIMINARY RESULTS | DATA COLLECTION
Country Nurse survey Patient survey
Hospitals Nurses RR Nurses Hospitals Patients RR Patients
Poland 30 2605 97.31% 30 4136 93.66%
South-Africa * 54 2063 43.80% No No No
Sweden * 60-70 10000 69.00% No No No
Switzerland * 35 2222 71.20% 35 1458 66.05%
UK * 32 6169 32.00% No No No
Spain 61 6560 84.00% 29 960 94.00%
TOTAL EU § 470 48000 225 12000
TOTAL NON EU § 235 11800 179 6540
How satisfied are you with your current job in this hospital?
Very unsatisfied 2.8%
Unsatisfied 18.7%
Satisfied 69.7%
Very satisfied 9.8%
Job dissatisfaction
12 RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
If possible, would you leave your current hospital within the next year as a result of job dissatisfaction?
Intention to leave
29.5% of the Belgian nurses say they would leave their current hospital within the next year as a result of job dissatisfaction Nursing
…in another hospital 40%…not in a hospital 27.9%
Unclear 2.4%Non-nursing 29.7%
13 RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
Min
10th Pctl
25th Pctl
50th Pctl
75th Pctl
90th Pctl Max
3.2 7.4 13.3 17.3 30.4 44.1 68.2
Variation between hospitals
Intention to leave
Variation between hospitals
Min
10th Pctl
25th Pctl
50th Pctl
75th Pctl
90th Pctl Max
13 16.0 21.2 28.6 37.5 45.7 55.9
14
Job dissatisfaction
RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
Correlation between job dissatisifaction and
intention to leave at the hospital level
r=0.81
Intention-to-leave
Job dissatisfaction
Emotional Exhaustion
Depersonalisatoins
Personal accomplishment
Intention-to-leave the hospital 1Job dissatisfactie 0.81 1Emotional exhaustion 0.79 0.84 1Depersonalisation 0.68 0.77 0.88 1Personal accomplishment -0.49 -0.65 -0.74 -0.74 1
15 RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
Hospital Intention-to-leave
Job dissatisfaction
HOS 2 13.11 % 3.23 %
HOS 7 13.51 % 5.41 %
HOS 11 13.21 % 7.41 %
HOS 18 13.51 % 8.11 %
Hospital Intention-to-leave
Job dissatisfaction
HOS 45 45.57 % 47.50 %
HOS 47 41.18 % 52.94 %
HOS 53 55.88 % 44.12 %
HOS 37 54.55 % 68.18 %
Top 4
Bottom 4
16 RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
Top 4 Bottom 4
Educational opportunities
Wages
Professional status
Independence at work
Opportunities for advancement
Work schedule flexibility
Educational opportunities
Wages
Professional status
Independence at work
Opportunities for advancement
Work schedule flexibility
17 RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
A nurse manager who backs up the nursing
staff in decision making, even if the conflict is
with a physician
Praise and recognition for a job well done.
A nurse manager who is a good manager and
leader.
A supervisory staff that is supportive of nurses.
Top 4 Bottom 4
A nurse manager who backs up the nursing
staff in decision making, even if the conflict is
with a physician
Praise and recognition for a job well done.
A nurse manager who is a good manager and
leader.
A supervisory staff that is supportive of nurses.
18 RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
2009
EU PROPOSAL PROTOCOL FINALISATION DATA COLLECTION DATA ANALYSIS AND POLICY IMPLICATIONS
2007-2008
19
2010 2011
RN4CAST.EU | FURTHER PROGRESS | 3-YEAR TIMELINE
RN4CAST.EU | FURTHER PROGRESS | POLICY MAKING20
Traditional forecasting
models
RN4CAST data
Patient safety
Nursing work
environment
Nurse deployment
& More accurate idea of the required personnel
deployment in terms of number of qualification for
safe patient care and a healthy work environment
for nurses
Macro-economic data
Data on migration
Other European projects: MohProf,
PROMeTHEUS
Other European projects: MohProf,
PROMeTHEUS
Policy Making
21
AWARENESS – INVOLVEMENT – POLICY IMPLICATIONS
RN4CAST.EU | FURTHER PROGRESS | STAKEHOLDER INVOLVEMENT
22
GREEN PAPER ON THE
EUROPEAN WORKFORCE ON HEALTH
MINISTERIAL CONFERENCE IN
LA HULPE BELGIUM
CONSULTATION REPORT
COUNCIL CONCLUSIONS
POLICY BRIEFS
Assessing future health workforce needs
1. Life-long learning
2. Work environments
3. Audit and feedback
Leuven, April 2010
126 participants
25 countries
14 international organisations
POLICY DIALOGUES
RN4CAST.EU | FURTHER PROGRESS | EU ACTION
www.RN4CAST.eu…-calendar-news-publications-partners-…