Hospital staff shortage: the role of the competitiveness of pay of different groups of nursing staff on staff shortage

Shortages of nursing staff in OECD countries have been a preoccupation for policy makers. Shortages of staff may be the consequence of uncompetitive pay. In the private sector, employers in different regions can offer different pay rates to reflect local amenities and cost of living. Hospitals in the UK however cannot set the pay for their employees, and as a result they might therefore incur staff shortages. Moreover, occupational groups do not operate in isolation. Shortages of staff may also be the consequence of the competitiveness of pay of an alternative group of staff. This is investigated using two distinct groups of nursing staff: assistant nurses (ANs) and registered nurses (RNs) working in English hospitals in 2003–2005 using national-level data sets. We find that an increase by 10% of the pay competitiveness of RNs decreases the shortage of both the RNs and of ANs by 0.6% and 0.4%, respectively.     

A fuzzy goal programming approach to analyse sustainable development goals of India

Energy policy, environmental planning and economic development play a key role in sustainable development. Sustainable development requires suitable and strategic policies satisfying multiple and conflicting objectives. Fuzzy goal programming (FGP) is a well-known approach in multi-criteria decision-making for its practical application. In this article, a FGP approach is proposed to analyse environmental, energy and sustainability goals of India by the year 2030 with reference to the key economic sectors of India. The presented model analyses the improvement opportunities, requirement of efforts and implementation of the sustainable development plans. Numerical illustration is also provided for validation and application of the proposed model.     

An institutional approach to national development planning

The increasingly turbulent and unstable international environment requires new approaches to development planning. Current methods need to be reformulated, perhaps by employing an “institutional approach.” Three possible directions are discussed: the need to enlarge the scope of anticipatory decisions covered by the planning process; the need to reinterpret and redefine the concept of the planning horizon, transcending the limitations of the distinctions between short-, medium-, and long-term planning; and the imperative of dispersing planning capabilities throughout society.     

From families to formal contracts: An approach to development

This paper develops a theory in which individuals can use one of two types of human/social capital to enforce contracts: “Local capital” relies on families and other personal networks; “market capital” relies on impersonal market institutions such as auditors and courts. Local capital is efficient when most trading is local, but only market capital can support trading between strangers that allows extensive division of labor and industrialization. We show that economies with a low cost of accumulating local capital (say, because people live close together) are richer than economies with a high cost of accumulation when long distance trade is difficult, but are slower to transition to impersonal market exchange (industrialize) when long distance trade becomes feasible. The model provides one way to understand why the wealthiest economies in 1600 AD, China, India, and the Islamic Middle East, industrialized more slowly than the West. We report an array of historical evidence documenting the pre-industrial importance of family and kinship networks in China, India, and the Islamic world compared to Europe, and the modernization problems linked to local capital.     

A systems approach to policy analysis and development planning: Construction sector in the Turkish 5-year development plans

In this study, we propose a new model for systems analysis ‘of’ policy and systems analysis ‘for’ policy with the example of construction sector in the Turkish 5-year development plans.Our proposed model—integrated development management model (IDMM)—is conceptually based on the principles of systems thinking and integrated management approach.We present and discuss the results of our work in which we extracted all construction-related policies and strategies from eight 5-year development plans and analyzed them using the IDMM. In the light of the analyses, we give several answers to the question: “Why did the development plans fail to meet their targets in Turkey?” We propose that any development plan has to have claritas–unitas–integritas–consonantia between the management levels (normative, strategic, and operational) and components (goals, structures, and behavior) of IDMM.The paper is the first work that brings the concepts of development planning and foresight together. In a complementary stance, the time of integrating foresight and development planning has come.     

End-of-life care in nursing homes: the high cost of staff turnover

Nursing home staff turnover results in high cost--both economic and personal--and has a negative impact on the quality of care provided to residents at the end of life. Reducing staff turnover in nursing homes would benefit both the cost to the U.S. health care system, and, most importantly, the care residents receive in the vulnerable period leading to death. There is rising pressure on nursing homes to improve their palliative and end-of-life care practices and reduce transfers to hospital for situations and conditions that can be safely managed on site. Nursing care staff deserve an investment in the specific training necessary for them to give the highest quality care to dying residents. This training should be multifaceted and include the physiological, psychological, spiritual, interpersonal, and cultural (including ethnic) aspects of dying. Empowerment with these necessary knowledge, skills, and attitudes will not only result in better care for residents but likely also will reduce the burnout and frustration staff experience in caring for residents near death.     

Capacity planning in hospital nursing: a model for minimum staff calculation

An aging population, emerging technology, heightening patient expectations, rising health care costs, shorter patient stays, and growing pressure to improve quality have made the management of nursing resources even more critical today. While approaching a model for staffing levels, the authors considered factors such as patient acuity, work redesign, and minimum quality standards. The methodology for analysis included estimating the time needed to complete nursing tasks and calculating the average number of tasks per patient. With respect to nursing quality measures, the study examined the adequacy of nursing documentation including admission history, assessments, nursing procedures, and discharge report as well as nursing-driven outcomes such as fall and phlebitis rates. Lastly, the authors determined the theoretical number of staff needed to provide nursing care according to quality standards.     

A multivariate approach in measuring socio-economic development of MENA countries

Socio-economic development of countries is a complex problem that has been constantly elaborated upon over the past few decades. An analysis of a country's welfare cannot be limited to either economic or social factors; it must be determined by combining both of these aspects. As technology has advanced, those indicators crucial for describing this phenomenon have also changed. internet connectedness has been introduced as an indicator of socio-economic development. Furthermore, the development of a health system is essential for a country's development. The aim of this paper has been to present one synthesized indicator that is able to quantitatively demonstrate any country's welfare. The statistical I-distance method is thoroughly explained and has been applied to 22 countries. Crucial indicators for ranking are also elaborated.     

医护人员良好职业素养养成研究

医护人员职业素养对于其自身职业长远发展、切实改善医患关系、形成优良医院企业文化具有重要意义。作为医护人员,要努力提高自己的医术,用精湛的技术帮助病患解除病痛,注重自身外部形象的塑造,以高度的责任心、耐心,细心对待病人及其家属,从而养成良好的职业素养。     

Success factors for sustainable urban brownfield development: A comparative case study approach to polluted sites

In the context of sustainable city planning, we observe in recent years an increasing policy interest in urban environmental quality management in relation to land use. The potential for sustainable land use solutions in urban areas is often severely hampered by the existence of unacceptably high levels of soil pollution. The present paper aims to identify the critical success factors for an effective clean-up policy for these areas. After a review of issues, backgrounds and prospects, the paper attempts to offer a qualitative impact assessment model, which encapsulates an expert system for brownfield development in relation to clean-up targets for polluted sites. Next, a case study approach to various soil pollution cases in The Netherlands is carried out to test the feasibility of the above-mentioned analytical framework. A subsequent step consists of the use of modern meta-analytic techniques for comparative research and research synthesis in order to trace the drivers of failure or success in brownfield development policy in urban areas. The particular method employed here, rough set analysis, appears to be able to identify the conditions—in terms of packages of drivers—under which such urban policies are likely to be successful.     

A discrete approach to continuum economies

Summary We consider a perfectly competitive economy in which only a finite number of different agents' characteristics can be distinguished. We associate this economy with ann-agents' economy with an ordered Banach commodity space, and we prove that the continuum and the discrete approach to the equilibrium problem can be considered equivalent.The authors are indebted to Javier Ruiz-Castillo for his helpful suggestions to an earlier version of this paper. We would like to thank Nicholas C. Yannelis and an anonymous referee for helpful suggestions and ecomments.     

A signaling approach to soft budgets

A new explanation for soft budget constraints is given. Projects of an agent are often the more profitable, the more confident the agent is in the principal's competence and/or supports. Principals can signal support and/or competence through a soft budget constraint.     

A compatibility approach to scenario evaluation

This article presents a novel approach for evaluating scenarios that represent combinations of a given set of possible events. The approach utilizes compatibility assessment, a heuristic method for inferring relative compatibilities of different scenario combinations. An illustration of its application is taken from a technology assessment study prepared for the National Science Foundation.     

A new approach to portfolio theory

The differential geometry of families of distributions is used to develop a Riemannian geometric approach to portfolio theory. The geometry of Arrow-Debreu securities is seen to be that of the sphere.