Search results

This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing health care. It proposes solutions to some of these problems.

This paper addresses this sensitive subject through the methodology of a literature review, drawing on a variety of relevant published literature to inform a modern understanding of the current health challenges faced by this population.

This paper discusses issues around criminalisation of commercial sex workers, complexities of family planning, sexually transmitted infection prevention, mental health and substance abuse and how increasing health-care worker awareness of the health needs of this vulnerable population can be a positive step in building trust within this relationship. Although adoption of the proposed recommendations put forth in this paper may help to eliminate some of the barriers encountered by female sex workers, further research is recommended.

The subject of commercial sex worker health care is neglected in the academic literature. This review explores the topic in an open and balanced manner and presents a broad and updated overview of the current health-care challenges faced by FSWs as well as opportunities for optimising access and quality of sex worker health care.

The COVID-19 pandemic stressed the health care sector's longstanding pain points, including the poor quality of frontline work and the staffing challenges that result from it. This has renewed interest in technology-centered approaches to achieving not only the “Triple Aim” of reducing costs while raising access and quality but also the “Quadruple Aim” of doing so without further squeezing wages and abrading job quality for frontline workers.

How can we leverage technology toward the achievement of the Quadruple Aim? I view this as a “grand challenge” for health care managers and policymakers. Those looking for guidance will find that most analyses of the workforce impact of technological change consider broad classes of technology such as computers or robots outside of any particular industry context. Further, they typically predict changes in work or labor market outcomes will come about at some ill-defined point in the medium to long run. This decontextualization and detemporization proves markedly problematic in the health care sector: the nonmarket, institutional factors driving technology adoption and implementation loom especially large in frontline care delivery, and managers and policymakers understandably must consider a well-defined, near-term, i.e., 5–10-year, time horizon.

This study is predicated on interviews with hospital and home health agency administrators, union representatives, health care information technology (IT) experts and consultants, and technology developers. I detail the near-term drivers and anticipated workforce impact of technological changes in frontline care delivery. With my emergent prescriptions for managers and policymakers, I hope to guide sectoral actors in using technology to address the “grand challenge” inherent to achieving the Quadruple Aim.

Drawing on the pay-for-performance (P4P) and job satisfaction literatures through an analysis of qualitative studies published on the topic, the purpose of this study is to investigate the effect of a P4P-based system on job satisfaction and dissatisfaction among health care workers.

A meta-synthesis of the qualitative literature was conducted to investigate health care workers' opinions, perceptions and behaviors and fully understand what processes generate job satisfaction or dissatisfaction under P4P systems.

The findings suggest that P4P systems impact the job (dis-)satisfaction of health care workers based on the institutional, organizational, geographic and cultural context of reference. Specifically, job satisfaction – and thus motivation, occupational well-being and work engagement – can occur when the context is supportive, whereas job dissatisfaction – and thus work stress and pressure, burnout and work-life balance issues and distraction – is generated in the case of unsupportive contexts. Moreover, the findings suggest a virtuous/vicious circle whereby job satisfaction leads to positive performance and further fuels job satisfaction, while conversely job dissatisfaction generates worse performance, and this further worsens worker satisfaction.

There is a lack of studies comparing and analyzing current evidence on the job (dis-)satisfaction of health care workers operating in different contexts based on the reward system. This is the first research to analyze a significant number of studies with reference to the relation between P4P and job (dis-)satisfaction, which are topics in need of further study and investigation in health care settings around the world.

This study seeks to explore health workers' perceptions and experiences on incentives for motivating and retaining them in primary health-care facilities in rural Ghana.

Phenomenological research design was used to explore health workers’ experiences and perceptions on their incentive packages. Sixty-eight in-depth interviews were conducted with health-care workers in primary health-care facilities and analyzed using thematic analysis approach.

The findings show health-care workers’ perceptions on their incentives, ranging from low awareness, unfair distribution, favoritism, means of punishment and incentives regarded unattractive. The preferred incentive packages identified were salary increase, housing availability, recognition, adequate supplies, and risk and responsibility allowances. Health-care workers suggested for the modification of incentives including vehicle importation waiver, reduction in study leave years and opportunity to pursue desired courses.

The findings suggest that incentives that align with health-care workers’ preferences can potentially improve their motivation and influence retention. Health-care workers’ concern on incentives having been used as favors and punishment as well as unfair distribution should be addressed by health managers and policymakers, to achieve the desired purpose of motivating and retaining them in rural areas. Appropriate internal monitoring mechanisms are needed for incentives regulation and to improve health workers’ retention in rural Ghana.

The purpose of this paper is to investigate the relationship between organizational safety climate and organizational health performance outcomes (i.e. absenteeism, presenteeism, health care utilization) mediated by individual worker health. The authors used three pathways to examine this relationship: a physical pathway starting with physical safety climate and mediated by musculoskeletal disorders (MSDs), a psychosocial pathway starting with psychosocial safety climate and mediated by emotional exhaustion, and a combined pathway starting with psychosocial safety climate and mediated by both MSDs and emotional exhaustion.

Three mediational multilevel analyses were conducted using a sample of 8,761 employees working in 177 health care organizations.

Although the findings did not support the hypothesized physical pathway, they showed that the psychosocial pathway worked satisfactorily for two of the three health performance outcomes (absenteeism and presenteeism). The combined physical and psychosocial pathway explained differences in the third outcome: health care utilization.

This is one of the few studies to include both physical and psychosocial pathways that lead to employee health and organizational performance. The results underscore the importance of paying attention to psychological health and safety in the health care workplace. Not only for the psychological health of employees, but also to improve their physical health and subsequent organizational health performance.

Drawing on closed and open-ended interview data (n=79), this paper explores the health care experiences of a purposive sample of sex industry workers in a medium-sized metropolitan area of British Columbia, Canada. The respondents reported high average health care utilization and many reported satisfactory access to health care, including a positive relationship with a regular health provider. However, several respondents reported feeling intimidated and shamed in health care settings (felt stigma) and many choose to withhold information relevant to their health care due to fear of discrimination (enacted stigma) by health professionals.

The aim of this paper is to present a conceptual model on foreign-born health care workers from developing countries working in the US. The model covers their motivations for migration, the consequences in terms of the inequality and exclusion they may experience and the role of institutional responses at micro-, macro- and meso-level of intervention.

The paper is based on: (1) in-depth review of key literature studies on the foundation theories of international migration including sociology, economics, anthropology, psychology and human resource management, (2) analysis of theoretical approaches to medical migration across disciplines, (3) analysis of the international and national documentary sources of micro-, macro- and meso-level policies on migration and (4) analysis of evidence on best practices, solutions and aspirational changes across different levels of institutions.

(1) Migration of international medical graduates (IMGs) from developing countries to the US can be explained from a micro-, macro- and meso-level of analysis. (2) IMGs who identify as racial/ethnic minorities may experience unfair discrimination differently than their US-born counterparts. (3) Although political/legislative remedies have had some successes, proactive initiatives will be needed alongside enforcement strategies to achieve equity and inclusion. (4) While diversity management initiatives abound in organizations, those designed for the benefit of IMGs from developing countries are rare. (5) Professional identity groups and some nonprofits may challenge structural inequities, but these have not yet achieved economies of scale.

Although it is well-documented in the US health care literature how ethnic/racial minorities are unfairly disadvantaged in work and career, the studies are rarely disaggregated according to sub-groups (e.g. non-White IMGs and US-born MGs). The implication is that Black IMG immigrants have been overlooked by the predominant narratives of native-born, Black experiences. In placing the realities of native-born Blacks on the entire Black population in America, data have ignored and undermined the diverse histories, identities and experiences of this heterogeneous group.

An awareness of the challenges IMGs from developing countries face have implications for managerial decisions regarding recruitment and selection. Besides their medical qualifications, IMGs from developing countries offer employers additional qualities that are critical to success in health care delivery. Considering organizations traditionally favor White immigrants from Northern and Southern Europe, IMGs from developed countries migrate to the US under relatively easier circumstances. It is important to balance the scale in the decision-making process by including an evaluation of migration antecedents in comprehensive selection criteria.

The unfair discrimination faced by IMGs who identify as racial/ethnic minority are multilayered and will affect them in ways that are different compared to their US-born counterparts. In effect, researchers need to make this distinction in research on racial discrimination. Since IMGs are not all uniformly impacted by unfair discrimination, organization-wide audits should be in tune with issues that are of concerns to IMGs who identify as racial/ethnic minorities. Likewise, diversity management strategies should be more inclusive and should not ignore the intersectionality of race/ethnicity, nationality, country of qualification and gender.

Immigrant health care workers from developing countries are integral to the health care industry in the United States. They make up a significant proportion of all workers in the health care industry in the US. Although the literature is replete with studies on immigrant health care workers as a whole, research has rarely focused on immigrant health care workers from developing countries. The paper makes a valuable contribution in drawing attention to this underappreciated group, given their critical role in the ongoing pandemic and the need for the US health industry to retain their services to remain viable in the future.

Occupational injury in the health care sector in the United States rates among the highest of all industries. Specific to hospital support service workers (e.g., Food & Nutrition, Environmental Services), studies have shown that injury rates for support service workers tend to be among the highest of hospital personnel, and yet there is a shortage of research investigating the safety climate of these workers. Therefore, the purpose of this study is to examine safety perceptions of support service workers. Surveys were used to measure safety climate leadership factors (per the AHRQ's Survey of Patient Safety Culture) to determine if they are related to individual safety perceptions, as well as ratings of work unit safety. Following established safety climate research, we examined the role of the work environment (e.g., supervisor support and work unit culture) on safety perceptions. We found that both supervisor and organizational safety leadership are positively related to individual safety perceptions and supervisor support. Organizational safety leadership and work unit culture were positively related to work unit safety rating. Our findings demonstrate that the antecedent factors and pathways that promote a positive safety climate among health care providers functions in a similar manner for support service workers. These findings contribute to a better understanding of occupational safety of this understudied work group and provide evidence to hospital administration that developing a strong safety climate among support service workers is not entirely different from what is required to promote a robust safety climate across an organization.

While the extant literature has mainly examined either organisational justice or performance appraisal on employee attitudes, studies assessing the effect of performance appraisal justice (PAJ) on employee work attitudes are very limited. Hence, this study aims to investigate the effects of PAJ on employee work attitudes (job satisfaction and employee commitment) using empirical insights from health-care workers in Ghana.

The study collected data from 302 workers in six selected health-care institutions and used multiple regression and bootstrapping mediation methods for the analyses.

This study found that interpersonal and procedural PAJ has significant positive effects on job satisfaction, but distributive PAJ showed an insignificant positive outcome. Then, while distributive and procedural PAJ has significant positive effects on employee commitment, interpersonal PAJ was insignificant. Moreover, job satisfaction significantly mediated the relationship between employee commitment and the three dimensions of PAJ.

This implies that PAJ can trigger positive employee work attitudes such as job satisfaction and commitment to facilitate the realisation of positive health-care outcomes if fairness and justice are effectively integrated into performance appraisal practices in health-care institutions.

The study contributes to extending organisation and human resource theories in the context of health-care services by applying the organisational justice theory to understand the job attitudes of workers in the health-care sector and institutions: a highly under-research context with respect to the topic.

This paper aims to illustrate the complexity of understanding and managing violent behaviour in health care. The authors will show how different perceptions of the reasons for violent behaviour, and linkages between violent behaviour and illness have contributed to the creation of a wicked problem and added significant complexity to the management of violence towards staff within health-care settings. This paper will conclude with a call for strong multi-disciplinary action to address this ongoing issue.

A narrative review was undertaken to explore the ways that violence has been perceived in health care and the ways in which the concept of violence has moved from being seen as a criminal issue to being within the realms of disease. This paper will show the importance of understanding who is perpetrating violence in health care, why and in what settings. It will expound on the idea that considering violence as a consequence of disease necessarily adds a layer of complexity to both individual and organisational responses to violence towards health-care staff.

Understanding the complexity in preventing and managing violence against health-care staff can assist policymakers and managers to develop multi-faceted approaches to violence prevention, including better recognition and understanding of perpetrators of violence.

This paper provides a unique perspective on thinking about violence in health care and the implications of its complexity.