Developing the Primary Palliative Care Workforce in Australia

Current healthcare models promote the equitable provision of palliative care to oncology patients with advancing disease, in the setting of their usual care, often in conjunction with anti-cancer therapies. This has resulted in specialist cancer services, as well as primary care across metropolitan, rural and remote communities, being called upon to integrate palliative care principles into their practice. To meet this increased demand for skilled health care professionals several national strategies have been initiated over the last five years. In this paper two projects are discussed in detail: the Palliative Care Curriculum for Undergraduates and the Program of Experience in the Professional Approach.

Empowerment as a framework for Indigenous workforce development and organisational change

Relative powerlessness resulting from colonial dispossession and associated passive welfare policies has long been recognised as a critical factor influencing the health and wellbeing of Indigenous Australians, yet it is hard to find well-evaluated health and social interventions that take an explicit empowerment approach. This paper presents the findings of a Family Wellbeing Empowerment programme pilot delivered to Cairns Region Department of Families Indigenous youth workers and family and community workers in 2003/2004. The aim of the pilot was to build the capacity of these workers to address personal and professional issues as a basis for providing better support for their clients. The pilot demonstrated the effectiveness of the programme as a tool for worker empowerment and, to a lesser degree, organisational change.

Sustaining a healthy workforce

The changing demographics of the mining workforce and the increasing demand for skilled workers increases the importance of sustaining a healthy workforce now and for the future. Although health is strongly related to safety, the two areas are not well integrated and the relationship is poorly understood. As such there is an important need to raise the profile of health within the Occupational Health and Safety (OH&S) domain. The mining industry carries health and safety risks, often greater than other occupations. Whilst the mining industry is regulated by stringent OH&S controls, the very nature of the work and environmental influences expose employees to a greater number of injury risk factors than many other industries. In contrast to its excellent safety record, compared to most other industries, the mining workforce has a high proportion of chronic health problems. These problems can be exacerbated by the ageing of the workforce, regional location of sites and organisational issues influencing work demands. A major focus has been on the treatment of these conditions with relatively limited attention to prevention strategies. An important prevention strategy is the raising of awareness among the workforce of health issues and the significant increase in the volume of health related information has provided an excellent opportunity to access relevant information. Unfortunately, this information is of varying quality, may not be evidence based, and may provide the wrong guidance to the development of interventions designed to improve health. Limited time of most employees and potential lack of knowledge of ability to differentiate quality information presents additional problems or barriers to increasing awareness of health issues...

E-learning : aging workforce versus technology-savvy generation

Purpose – The purpose of this paper is to provide description and analysis of how a traditional industry is currently using e-learning, and to identify how the potential of e-learning can be realised whilst acknowledging the technological divide between younger and older workers. Design/methodology/approach – An exploratory qualitative methodology was employed to analyse three key questions: How is the Australian rail industry currently using e-learning? Are there age-related issues with the current use of e-learning in the rail industry? How could e-learning be used in future to engage different generations of learners in the rail industry? Data were collected in five case organisations from across the Australian rail industry. Findings – Of the rail organisations interviewed, none believed they were using e-learning to its full potential. The younger, more technologically literate employees are not having their expectations met and therefore retention of younger workers has become an issue. The challenge for learning and development practitioners is balancing the preferences of an aging workforce with these younger, more “technology-savvy”, learners and the findings highlight some potential ways to begin addressing this balance. Practical implications – The findings identified the potential for organisations (even those in a traditional industry such as rail) to better utilise e-learning to attract and retain younger workers but also warns against making assumptions about technological competency based on age. Originality/value – Data were gathered across an industry, and thus this paper takes an industry approach to considering the potential age-related issues with e-learning and the ways it may be used to meet the needs of different generations in the workplace.

Can a childcare practicum encourage degree qualified staff to enter the childcare workforce?

Concern to ensure that all children have access to high quality educational experiences in the early years of life has instigated moves to increase qualifications of staff in the childcare workforce, in particular to increase the number of degree qualified teachers. However existing data suggest that work in the childcare sector is viewed less favourably by those undertaking early childhood education degrees. For most, childcare is not a preferred place of employment. This study asked whether a practicum in a childcare setting would improve attitudes to childcare and willingness to consider working in childcare settings. In a study of a cohort of Bachelor of Education (Early Childhood) students, measures of attitudes to childcare and willingness to work in childcare were taken before and after practicum. Additionally students provided accounts of their practicum experiences. Results indicate a trend in which there was a group increase in positive attitudes and willingness to consider work in childcare but considerable individual differences influenced by the quality of the practicum experience. The relationship with, and model provided by, centre directors and the group leader in the practicum class was identified as key influencing factors. Results are discussed in term of models of pedagogical leadership.

A wound management education and training needs analysis of health consumers and the relevant health workforce and stocktake of available education and training activities and resources

The goals of this project were to determine the education and training needs of health consumers and the relevant health workforce and to identify and map the available education and training activities and resources. The methods used to collect the data included online surveys and one on one interviews of relevant patients and their carers. The project manager actively sought to engage with the key wound management leaders and advanced clinicians to gain their support and views on the priority education and training issues. The response to all data collection methods was pleasing with almost five hundred responses to the general wound workforce online survey. The data supported the need for more wound management education and training and identified some particular topics of need, such as utilising wound investigations and understanding wound products, pharmaceuticals and devices. The occupational groups with the highest need appear to be those working in primary health care, such as practice nurses and GPs, and those working in residential aged care facilities. The education and training stocktake identified a wide range of activities currently available, the majority being provided in a face to face format. The next stage of the project will be to form some clear and achievable priority action areas based on the available data. An online directory of wound management education and training activities and resources will be developed and further development will be undertaken on a knowledge and skills framework for the wound management workforce. Additionally, transfer of learning factors in the general practice environment will be assessed and strategies will be developed to improve the pre-entry or undergraduate wound management training within relevant higher education programs.

Reshaping our protective systems : issues and options

Australia's systems for protecting children from child abuse and neglect are undergoing reform in light of the National Framework for Protecting Australia's Children and innumerable judicial and other inquiries into their operations and outcomes. This article examines the current context for child protection practice and critically examines the dominant policy and practice frameworks, highlighting issues confronting policy makers and practitioners. Within the current systematic reform agendas, it is posited, there are key priorities that must be attended to in order to bring about necessary change, workforce support and a renewed emphasis on quality professional practice and re-orientation of practice approaches. Also required is the embedding of ethics into a relationship-based practice framework, and revitalising localised community involvement in a protective web of care that provides practical, compassionate and accessible help to needy and vulnerable children and families.

A Literature Review of Wellness, Wellbeing and Quality of Life Issues as they impact upon the Australian Mining Sector

Australia’s mining boom Global demand for minerals and energy products has fuelled Australia’s recent resources boom and has led to the rapid expansion of mining projects not only in remote locations but increasingly in settled traditionally agricultural rural areas. A fundamental shift has also occurred in the provisioning of skilled and semi-skilled workers. The huge acceleration in industry demand for labour has been accompanied by the entrenchment of workforce arrangements largely dependent on fly-in, fly-out (FIFO) and drive–in, drive–out (DIDO) non-resident workers (NRWs). While NRWs are working away from their homes, they are usually accommodated in work camps or ‘villages’ for the duration of their work cycle which are normally comprised of many consecutive days of 12-hour day- and night-shifts. The health effects of this form of employment and the accompanying lifestyle is increasingly becoming contentious. Impacts on personal wellness, wellbeing and quality of life essentially remain under-researched and thus misunderstood. Sodexo in Australia Sodexo began operations in Australia in 1982, and has since become a leader in providing Quality of Life (QOL) services to businesses across the country. The 6,000 Australian employees are part of a global Sodexo team of 413,000 people. Sodexo in Australia designs, delivers and manages on-site their QOL services at 320 diverse site locations, including remote sites. Sodexo operates in a range of sectors, including the mining industry. Service plans are tailored to suit the individual needs of organisations. Sodexo Remote Sites has previously conducted unpublished research among mining workers in Australia. The results highlighted needs and expectations of Australian mining workers. Main insights about workers’ requirements were directed towards: • contacts with closest; • warm rest time around proper and varied meals; • additional services to help them better enjoy their life onsite and/or make the most of it; • organise their transportation; • promote community living; and • finding balance between professional and personal life. The brief for this current research is aimed at building upon this knowledge. Research brief Expectations for quality of life and wellness and wellbeing services are increasing dramatically. It's getting costlier and more difficult to retain valuable employees. This is particularly the case in the Australian mining sector. Given the level of interest in ensuring healthy workplaces in Australia, Sodexo has commissioned QUT to conduct a literature review. The objectives as specified by Sodexo are: Objective 1: To define the concepts of wellness and wellbeing and quality of life in Australia Objective 2: To examine how wellness and wellbeing are developed within organisations in Australia and how they impact on employee and organizational performance. More specifically, to review the literature that could be sourced about: • challenges of the mining environment; • the mining lifestyle – implications for health, wellness and daily life; • personal health and wellness of Australian mining workers; • factors affecting health in mines and perceived support for health and wellness; and • the impact of employer investment in health on perceptions and behaviour of employees. Objective 3: To determine what impact employee wellness and well-being has on the performance of mining workers. More specifically, to review the literature that could be sourced about: • impact of obesity, alcohol, tobacco use on companies; and • links between employee engagement and satisfaction and company productivity. Accordingly this review has attempted to ascertain what factors an organisation should focus on in order to reduce absenteeism and turnover and increase commitment, satisfaction, safety and productivity, with specific reference to the mining industry in Australia. The structure of the report aligns with the stated objectives in that each of the first three parts address an objective. Part IV summarises prominent issues that have arisen and offers some concluding observations and comments.

Using competences and competence tools in workforce development

The NHS Knowledge and Skills Framework (KSF) has been a driving force in the move to competence-based workforce development in the NHS. Skills for Health has developed national workforce competences that aim to improve behavioural performance, and in turn increase productivity. This article describes five projects established to test Skills for Health national workforce competences, electronic tools and products in different settings in the NHS. Competences and competence tools were used to redesign services, develop job roles, identify skills gaps and develop learning programmes. Reported benefits of the projects included increased clarity and a structured, consistent and standardized approach to workforce development. Findings from the evaluation of the tools were positive in terms of their overall usefulness and provision of related training/support. Reported constraints of using the competences and tools included issues relating to their availability, content and organization. It is recognized that a highly skilled and flexible workforce is important to the delivery of high-quality health care. These projects suggest that Skills for Health competences can be used as a 'common currency' in workforce development in the UK health sector. This would support the need to adapt rapidly to changing service needs.

Global Nursing Issues and Development: Analysis of World Health Organization Documents

Purpose To analyze World Health Organization (WHO) documents to identify global nursing issues and development. Design Qualitative content analysis. Methods Documents published by the six WHO regions between 2007 and 2012 and with key words related to nurse/midwife or nursing/midwifery were included. Themes, categories, and subcategories were derived. The final coding reached 80% agreement among three independent coders, and the final coding for the discrepant coding was reached by consensus. Findings Thirty-two documents from the regions of Europe (n = 19), the Americas (n = 6), the Western Pacific (n = 4), Africa (n = 1), the Eastern Mediterranean (n = 1), and Southeast Asia (n = 1) were examined. A total of 385 units of analysis dispersed in 31 subcategories under four themes were derived. The four themes derived (number of unit of analysis, %) were Management & Leadership (206, 53.5), Practice (75, 19.5), Education (70, 18.2), and Research (34, 8.8). Conclusions The key nursing issues of concern at the global level are workforce, the impacts of nursing in health care, professional status, and education of nurses. International alliances can help advance nursing, but the visibility of nursing in the WHO needs to be strengthened. Clinical Relevance Organizational leadership is important in order to optimize the use of nursing competence in practice and inform policy makers regarding the value of nursing to promote people's health.

An interactive method for engaging the public health workforce with evidence

Introduction Systematic review authors are increasingly directing their attention to not only ensuring the robust processes and methods of their syntheses, but also to facilitating the use of their reviews by public health decision-makers and practitioners. This latter activity is known by several terms including knowledge translation, for which one definition is a ‘dynamic and iterative process that includes synthesis, exchange and ethically sound application of knowledge’.1 Unfortunately—and despite good intentions—the successful translation of knowledge has at times been inhibited by the failure of reviews to meet the needs of decision-makers, and the limitations of the traditional avenues by which reviews are disseminated.2 Encouraging the utilization of reviews by the public health workforce is a complex challenge. An unsupportive culture within the workforce, a lack of experience in assessing evidence, the use of traditional academic language in communication and the lack of actionable messages can all act as barriers to successful knowledge translation.3 Improving communication through developing strategies that include summaries, podcasts, webinars and translational tools which target key decision-makers such as HealthEvidence.org should be considered by authors as promising actions to support the uptake of reviews into practice.4,5 Earlier work has also suggested that to better meet the research evidence needs of public health professionals, authors should aim to produce syntheses that are actionable, relevant and timely.2 Further, review authors must interact more with those who will, or could use their reviews; particularly when determining the scope and questions to which a review will be directed.2 Unfortunately, individual engagement, ideal for examining complex issues and addressing particular concerns, is often difficult, particularly when attempting to reach large groups where for efficiency purposes, the strategy tends to be didactic, ‘lecturing’ and therefore less likely to change attitudes or encourage higher order thinking.6 …

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: Stakeholder perspectives, barriers, supports, and incentives

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. © 2014 Morris et al.

Application of an evolutionary fuzzy system for the estimation of workforce deployment and cross-training in an assembly environment

Owing to the increased customer demands for make-to-order products and smaller product life-cycles, today assembly lines are designed to ensure a quick switch-over from one product model to another for companies' survival in market place. The complexity associated with the decisions pertaining to the type of training and number of workers and their exposition to the different tasks especially in the current era of customized production is a serious problem that the managers and the HRD gurus are facing in industry. This paper aims to determine the amount of cross-training and dynamic deployment policy caused by workforce flexibility for a make-to-order assembly. The aforementioned issues have been dealt with by adopting the concept of evolutionary fuzzy system because of the linguistic nature of the attributes associated with product variety and task complexity. A fuzzy system-based methodology is proposed to determine the amount of cross-training and dynamic deployment policy. The proposed methodology is tested on 10 sample products of varying complexities and the results obtained are in line with the conclusions drawn by previous researchers.

Building the 21st Century Aerospace Workforce

Begin with a call to action. Present evidence on the dimensions of an employment crisis in the Aerospace Industry. Understand the links to issues of instability and lean. Focus dialogue on high leverage, mutual gains options for all stakeholders in the industry. Identify specific next steps. Under the auspices of LAI. In other forums as appropriate.

Nurses' perceived training needs in child protection issues

Purpose – The purpose of this research is to explore nurses' perceptions of their current skills and knowledge and training needs to identify cases of child abuse and their understanding of their roles and responsibilities in relation to child abuse. Nurses, including health visitors and midwives, have been recognised as having a key role in the protection and care of children, especially in identifying and referring possible cases of child abuse and neglect.

Design/methodology/approach – A structured questionnaire concerning knowledge and training needs in child protection was sent to all nurses employed in a Scottish NHS Primary Care Trust (approximately 1,900), of whom one-third (667) responded. These survey results were complemented by semi-structured interviews with 99 members of the nursing workforce.

Findings – Almost all training in child protection had been confined to health visitors, resulting in the Trust giving an implicit message that child protection is not a role in which other nurses need have any involvement. In general, those nurses who both worked with children and had involvement in child protection issues, considered themselves to be most in need of knowledge around child protection work, to have the greatest level of knowledge and to consider further training a priority.

Research limitations/implications – Nurses who had an interest or involvement in child protection work were more likely to participate in the research, which may have biased the results.

Practical implications – Training strategies need to address the diversity of nurses' involvements in child protection work through the development of training programmes which are appropriate for different workplaces and different occupational groupings. Nurses in some settings will need to be first convinced they have the potential to play an important role in protecting children from abuse and neglect.

Originality/value – Many NHS Trusts have in recent years introduced mandatory training in child protection for all staff in contact with children. However, previously published studies have considered training issues only in respect of nurses identified as working directly with children, whereas this study explores child protection issues for all nurses employed in a primary care NHS Trust.