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As a member of the Population Health Research Network Australia, being an Australian collaboration established to support the use of linked data for research and other purposes, the Tasmanian Data Linkage Unit [TDLU) provides linked-data services in Australia’s smallest state, and as part of the Menzies Institute for Medical Research at the state’s only University, the University of Tasmania. The TDLU works in close collaboration with the Tasmanian Government Department of Health and other key stakeholders both in Tasmania and Australia representing government, education, research, and the community sector. The TDLU is one of the newest data linkage services in Australia, and the smallest node of the PHRN having operated for almost nine years by less than three full time equivalent staff. However, despite its size and relative maturity as a provider of linked-data services, the TDLU continues to grow the number of datasets linked on a routine and ad-hoc basis, the number of projects completed, the size of its Master Linkage Map and number of ‘keys’ stored in this Map. The TDLU places high-emphasis on security, privacy preservation, innovation, quality assurance, stakeholder engagement and providing responsive and exemplary services to users of linked-data.}

Background Practice standards in nursing provide minimum expectations to enable the provision of high quality and safe care. There are currently no practice standards for post-registration graduate emergency nursing programs in Australia, leading to variation in graduate attributes and clinical expectations on completion of their program. Objectives The aim of this study was to establish consensus-based practice standards for graduate emergency nursing programs in Australia. Design Delphi approach. Participants Australian nurses who identified as an emergency nurse and currently worked, or previously worked, in an emergency care environment. Methods A modified two-round Delphi method was used. The survey was divided into four sections of data collection, including demographics, graduate emergency nursing course entry requirements, graduate expectations, and clinical care capabilities. Data were analysed using descriptive statistics including calculation of content validity index (CVI). Results There were 204 respondents in Round One and 153 respondents in Round Two. Respondents agreed that nurses wanting to undertake graduate studies in emergency nursing require prior experience in the emergency care environment and should be working a minimum of 0.5 full time equivalent (FTE) whilst completing their studies. Thirty-nine statements presented under graduate attributes achieved a CVI of >0.8. All 70 clinical care capability statements presented in Round Two achieved a CVI of >0.8. Conclusion This study generated the evidence to establish minimum practice standards for Australian graduate emergency nursing programs. The standards centre around three key areas: graduate entry requirements, graduate attributes and clinical care capabilities. The standards provide a clear guide for employers, educators and clinicians, and inform capabilities for early career emergency nurses.

Background In Sierra Leone (SL), a low-income country in West Africa, dental care is very limited, largely private, and with services focused in the capital Freetown. There is no formal dental education. Ten dentists supported by a similar number of dental care professionals (DCPs) serve a population of over 7.5 million people. The objective of this research was to estimate needs-led requirements for dental care and human resources for oral health to inform capacity building, based on a national survey of oral health in SL. Methods A dedicated operational research (OR) decision tool was constructed in Microsoft Excel to support this project. First, total treatment needs were estimated from our national epidemiological survey data for three key ages (6, 12 and 15 years), collected using the ‘International Caries Classification and Management System (ICCMS)’ tool. Second, oral health needs were extrapolated to whole population levels for each year-group, based on census demographic data. Third, full time equivalent (FTE) workforce capacity needs were estimated for mid-level providers in the form of Dental Therapists (DTs) and non-dental personnel based on current oral disease management approaches and clinical timings for treatment procedures. Fourth, informed by an expert panel, three oral disease management scenarios were explored for the national population: (1) Conventional care (CC): comprising oral health promotion (including prevention), restorations and tooth extraction; (2) Surgical and Preventive care (S5&6P and S6P): comprising oral health promotion (inc. prevention) and tooth extraction (D5 and D6 together, & at D6 level only); and (3) Prevention only (P): consisting of oral health promotion (inc. prevention). Fifth, the findings were extrapolated to the whole population based on demography, assuming similar levels of treatment need. Results To meet the needs of a single year-group of childrens’ needs, an average of 163 DTs (range: 133–188) would be required to deliver Conventional care (CC); 39 DTs (range: 30–45) to deliver basic Surgical and Preventive care (S6P); 54 DTs for more extended Surgical and Preventive care (S5&6P) (range 38–68); and 27 DTs (range: 25–32) to deliver Prevention only (P). When scaled up to the total population, an estimated 6,147 DTs (range: 5,565–6,870) would be required to deliver Conventional care (CC); 1,413 DTs (range: 1255–1438 DTs) to deliver basic Surgical and Preventive care (S6P); 2,000 DTs (range 1590–2236) for more extended Surgical and Preventive care (S5&6P) (range 1590–2236); and 1,028 DTs to deliver Prevention only (P) (range: 1016–1046). Furthermore, if oral health promotion activities, including individualised prevention, could be delivered by non-dental personnel, then the remaining surgical care could be delivered by 385 DTs (range: 251–488) for the S6P scenario which was deemed as the minimum basic baseline service involving extracting all teeth with extensive caries into dentine. More realistically, 972 DTs (range: 586–1179) would be needed for the S5&6P scenario in which all teeth with distinctive and extensive caries into dentine are extracted. Conclusion The study demonstrates the huge dental workforce needs required to deliver even minimal oral health care to the Sierra Leone population. The gap between the current workforce and the oral health needs of the population is stark and requires urgent action. The study also demonstrates the potential for contemporary epidemiological tools to predict dental treatment needs and inform workforce capacity building in a low-income country, exploring a range of solutions involving mid-level providers and non-dental personnel.

Background Strong associations between diet and maternal and child outcomes emphasise the importance of evidence-based care for women across preconception, antenatal and postnatal periods. A 2008 survey of Australian maternal health dietetic services documented critically low resourcing with considerable variation in staffing levels and models of care. This study repeated the survey to examine resourcing in Australian maternal health services. Methods A cross-sectional online survey was emailed to publicly-funded Australian maternal health dietetic services in May 2018. Quantitative and qualitative variables collected across preconception to postnatal services (including diabetes) included; births per year (BPY), number of beds, staffing (full time equivalents; FTE), referral processes, and models of care. Results were collated in > 5000; 3500 and 5000; and Results Forty-three eligible surveys were received from seven states/territories. Dietetic staffing levels ranged from 0 to 4.0 FTE (> 5000 BPY), 0–2.8 FTE (3500–5000 BPY), and 0–2.0 FTE ( Conclusions Ten years after the initial survey and recommendations there remains an identified role for dietitians to advocate for better staffing and for development, implementation, and evaluation of service models to influence maternal nutrition.

Objective: Continuous process improvements enhance accuracy and productivity in a clinical laboratory setting. This study aimed to investigate the accuracy and efficiency of a new autoverification (AV) system designed to improve the consistency and uniformity of reported laboratory test results. Methods: Limit checks, delta checks, and consistency checks were established, and then retrospective data from 500 requested tests were used to evaluate the accuracy of AV rules compared to manual verification, which was performed by five experienced medical technologists. Efficiency was evaluated by comparing turnaround time (TAT), error rates, workload, and staff satisfaction between before and after AV implementation. Results: AV had 100% sensitivity, 77.6% specificity, and a 22% false-positive rate. The AV passing rate was 95%, 85%, 42%, and 39% for chemistry, coagulation, microscopy, and hematology, respectively. The overall passing rate was 65%. After implementation, the mean overall TAT decreased from 54.2±26.6 to 52.4±24.2 min (p

Background and importance The aim of the falsified medicines directive (FMD 2011/62/EU) is to prevent the entry of illegitimate medicines into the legal supply chain. Despite its proposed benefits, the indepth evaluation of cost implications for hospital pharmacies is still lacking. Aim and objectives Our study evaluated the current practice of serialisation and the financial impact of the FMD in a representative sample of Hungarian hospitals. Material and methods Based on literature review and interviews with hospital pharmacy experts, a 41 item questionnaire was developed to evaluate the implementation process leading up to February 2019, and the stabilisation period that followed. Questions regarding institutional data, human resource requirements, infrastructural and IT developments, and authentication procedures were sent out to all (n=96) Hungarian hospital pharmacies in September 2019. Results A high response rate (n=43, 44,8%) allowed representative data evaluation of Hungarian hospitals. By the initial launch date of FMD, the average increase in pharmacist workload was 0.92 (±0.98) hours/day, and it was estimated to increase further by 1.13 (±1.65), equalling 0.25 pharmacist full time equivalents (FTE)/institution. Additionally, FMD seemed to increase technician workload significantly compared with pharmacists (p Conclusion and relevance Our results illustrated that the FMD had notable short and long term impact on hospital pharmacies. Our aim is to adapt this methodology to other EU countries and identify good practices in serialisation at an international level. References and/or acknowledgements Conflict of interest Corporate sponsored research or other substantive relationships: The project was supported by the European Union, co-financed by the European Social Fund (EFOP-3.6.1.-16-2016-00004) and by the UNKP-19 new national excellence programme of the Ministry of Human Capacities.

Objectives Clinical pharmacy practices in Vietnam have not been well studied. We aimed to describe clinical pharmacy practices in terms of workforce, activities and the recruitment demand for clinical pharmacists (CPs) in hospitals. Methods A cross-sectional survey was conducted, and 123 questionnaires were distributed to Heads/Deputy heads of Pharmacy department and Boards of directors in all of hospitals in Ho Chi Minh City, Vietnam between August 2018 and June 2019. Results There were 187 CPs in 79 participating hospitals, whereas the ratio of CPs per 100 patient beds was 0.67. The median number of CPs was 2 (1-4), with a significantly low median full time equivalent [0.4 (1, 2)]. The income of CPs was significantly low. Antibiotics were the most common medications that CPs discussed with physicians (93.06%). Interventions commonly performed by CPs were "Checking drug interactions" (77.78%), "Counseling physicians about the route of administration" (61.11%), "Checking drug allergies" (51.39%). The median number of CPs needed to recruit according to Heads/Deputy heads of Pharmacy Department and Boards of directors was 2 (1-3) and 2 (1-3.5), respectively. Conclusion The shortage of CPs, which was likely attributable to low income, might lead to numerous obstacles for delivering comprehensive healthcare services. Thus, the hospital recruitment strategies should focus on salary and benefits to attract more CPs, especially those with postgraduate degree.

Background: Evidence to support coaching in medical education has grown over the past decade leading educators to search for resources to aid the development of their own coaching programs. A sample of medical schools in the USA were surveyed to describe coaching programs to assist other institutions in the development and implementation of programs. Methods: Participants representing 32 medical schools attending a coaching conference in October 2018 were surveyed via email regarding their undergraduate medical education (UME) coaching programs. The 19-item instrument contained questions on program demographics, program characteristics, coach characteristics, coach training and coach assessment and program evaluation. Results: The response rate was 100% (32/32 programs). Nearly all respondents had a coaching program (53%, 17/32) or were developing one (44%, 14/32) with the majority being implemented in the past five years (82%, 14/17). Professional identity formation (80%, 20/25), professionalism (76%, 19/25), and academic performance (76%, 19/25) were the most commonly identified programmatic goals. The majority of coaches (64%, 16/25) received between 5-25% full time equivalent effort to support their role. Coaches did not formally assess students in any domain at most programs (84%, 21/25) or directly observe their students clinically (76%, 19/25). The majority of programs had formal coach training (88%, 22/25). Conclusion: These results demonstrate that coaching is being used to improve performance, professionalism, and professional identity formation in UME. This sample of coaching programs informs the discussion of coaching in medical education as educators strive to implement effective coaching programs.

Background Administrative costs (AC) are a relevant spending category in health care, and several approaches exist on how to define and measure them. Based on available AC studies, this paper aims to provide a map for this multifaceted research topic. Methods A scoping review was conducted using the databases MEDLINE, EconLit, and Business Source Premier. Literature was screened focussing on the research question: What is known about the methodology of AC research from scientific publications? Results Definition concepts mostly rely on national cost documentations. The international cost reporting framework of the Systems of Health Accounts was a critical reference point in six studies. Indications on how to operationalise AC independently from periodical cost reports were suggested by ten publications. In this context, time and full time equivalents are the most common cost measurements. Conclusions The results indicate a lack of evidence regarding patients’ perceptions of administrative issues in health care. Also, research on administrative impact on working conditions for health care employees beyond hospitals and physicians’ offices is underrepresented. A systematic approach to reporting AC studies is needed. Reporting should include the appointment of entities actually empowered to change administrative resource usage. This would help to promote principles of a balanced administration.

Quantifying the workload for a hospital-based physician can be a challenge. We developed a novel approach to providing equity and flexibility for physicians working in a large system with heterogeneous clinical activities. In developing this points-based system, expected clinical work hours were calculated for a full-time equivalent. A point value was assigned to each clinical service based upon the hours, complexity and intensity of the work. A hypothetical work schedule was created using the expected clinical hours and translated into points needed for a full-time clinician. Faculty appreciate the flexibility and feel appropriately valued and equitably paid. Our system serves as a recruitment tool and enables the division to better understand resource needs and predict the need for additional staff. Development of a point-based model for calculating clinical work has successfully created a homogeneous system to define and measure physician work expectations in a heterogeneous clinical environment.

IntroductionEach year, Emergency Medical Services (EMS) personnel respond to over 30 million calls for assistance in the United States alone. These EMS personnel have a rate of occupational fatality comparable to firefighters and police, and a rate of non-fatal injuries that is higher than the rates for police and firefighters and much higher than the national average for all workers. In Australia, no occupational group has a higher injury or fatality rate than EMS personnel. Emergency Medical Services personnel in the US have a rate of occupational violence injuries that is about 22-times higher than the average for all workers. On average, more than one EMS provider in the US is killed every year in an act of violence.Hypothesis/ObjectiveThe objective of this epidemiological study was to identify the risks and factors associated with work-related physical violence against EMS personnel internationally.MethodsAn online survey, based on a tool developed by the World Health Organization (WHO; Geneva, Switzerland), collected responses from April through November 2016.ResultsThere were 1,778 EMS personnel respondents from 13 countries; 69% were male and 54% were married. Around 55% described their primary EMS work location as “urban.” Approximately 68% described their employer as a “public provider.” The majority of respondents were from the US.When asked “Have you ever been physically attacked while on-duty?” 761 (65%) of the 1,172 who answered the question answered “Yes.” In almost 10% (67) of those incidents, the perpetrator used a weapon. Approximately 90% of the perpetrators were patients and around five percent were patient family members. The influence of alcohol and drugs was prevalent. Overall, men experienced more assaults than women, and younger workers experienced more assaults than older workers.Conclusions:In order to develop and implement measures to increase safety, EMS personnel must be involved with the research and implementation process. Furthermore, EMS agencies must work with university researchers to quantify agency-level risks and to develop, test, and implement interventions in such a way that they can be reliably evaluated and the results published in peer-reviewed journals.MaguireBJ, BrowneM, O’NeillBJ, DealyMT, ClareD, O’MearaP. International survey of violence against EMS personnel: physical violence report. Prehosp Disaster Med. 2018;33(5):526–531.

Background The American Society of Echocardiography Committee on Pediatric Echocardiography Laboratory Productivity was formed in 2011 to study institutional factors that could influence the clinical productivity of physicians and sonographers in academic pediatric echocardiography laboratories. In the previous two surveys, staff clinical productivity remained stable while total echocardiography volumes increased. This third survey was designed to assess how clinical productivity is associated with laboratory infrastructure elements such as training, administrative tasks, quality improvement, research, and use of focused cardiac ultrasound (FCU). Methods Survey questions were sent by e-mail to North American laboratories. The aims were to assess (1) educational and training obligations, (2) academic productivity and research, (3) laboratory medical director satisfaction, (4) quality improvement, (5) laboratory leadership roles, and (6) impact and use of FCU. Survey responses were compared with clinical productivity metrics defined in the first two surveys. Results There were 38 responses. Academic productivity was higher at institutions with more dedicated imaging personnel, personnel with dedicated protected academic time, and advanced imaging fellows. Academic productivity did not correlate with clinical productivity and was not significantly affected by the presence of dedicated research sonographers. The satisfaction level of laboratory medical directors was related to dedicated administrative time and an administrative stipend. The majority of administrative roles were tasked to the laboratory medical director with support of the technical director. FCU was listed as a hospital privilege at four institutions (13%). Twenty-two (58%) were training FCU providers in one or more subspecialties. FCU was not associated with clinical or academic productivity. Conclusion This third survey gathered supplemental data to complement the clinical productivity data collected from the first two surveys. Together, the results of these surveys further describe the range of factors that can affect North American academic pediatric echocardiography laboratories.

Purpose A survey was created by NRG to assess a medical physicists' percent full time equivalent (FTE) contribution to multi-institutional clinical trials. A 2012 American Society for Radiation Oncology report, "Safety Is No Accident," quantified medical physics staffing contributions in FTE factors for clinical departments. No quantification of FTE effort associated with clinical trials was included. Methods To address this lack of information, the NRG Medical Physics Subcommittee decided to obtain manpower data from the medical physics community to quantify the amount of time medical physicists spent supporting clinical trials. A survey, consisting of 16 questions, was designed to obtain information regarding physicists' time spent supporting clinical trials. The survey was distributed to medical physicists at 1996 radiation therapy institutions included on the membership rosters of the 5 National Clinical Trials Network clinical trial groups. Results Of the 451 institutions who responded, 50% (226) reported currently participating in radiation therapy trials. On average, the designated physicist at each institution spent 2.4 hours (standard deviation [SD], 5.5) per week supervising or interacting with clinical trial staff. On average, 1.2 hours (SD, 3.1), 1.8 hours (SD, 3.9), and 0.6 hours (SD, 1.1) per week were spent on trial patient simulations, treatment plan reviews, and maintaining a Digital Imaging and Communications in Medicine server, respectively. For all trial credentialing activities, physicists spent an average of 32 hours (SD, 57.2) yearly. Reading protocols and supporting dosimetrists, clinicians, and therapists took an average of 2.1 hours (SD, 3.4) per week. Physicists also attended clinical trial meetings, on average, 1.2 hours (SD, 1.9) per month. Conclusion On average, physicist spent a nontrivial total of 9 hours per week (0.21 FTE) supporting an average of 10 active clinical trials. This time commitment indicates the complexity of radiation therapy clinical trials and should be taken into account when staffing radiation therapy institutions.

Author(s): Nguyen, Vy; Daniel, Marlon; Joskow, Renee; Lu, Connie; Chen, Xiao; Zhou, Weihao; Lin, Sue; Sripipatana, Alek; Nair, Suma; Pourat, Nadereh | Abstract: ObjectivesThis study aims to assess the impact of Health Resources and Services Administration (HRSA) investment in oral health through the HRSA FY16 Oral Health Service Expansion (OHSE) funding on workforce, access, and quality in health centers (HCs) from 2015 to 2017.MethodsAnalyses were conducted using data from the Uniform Data System from 2015 and 2017, and the 2015 Area Health Resource File. Change in indicators of oral health workforce, access, and quality of care by the receipt of OHSE funding received by HCs in 2016 were examined. Regression models for 1,345 HCs were developed to conduct a difference-in-difference analyses of the comparative change from 2015 to 2017 in the dependent variables among OHSE and non-OHSE awardees while controlling for confounders.ResultsOHSE awardees showed a significant difference in the oral health workforce with a higher mean number increase by 0.6 full time equivalent (FTE) dentists, 0.4 dental hygienists, 1.1 dental assistants, and 2.3 for other dental staff compared to non-OHSE awardees. Compared to non-OHSE awardees, OHSE awardees showed a mean increase of 712 dental patients served who received 1,402 dental visits, representing a 9-percentage point increase in the percentage of HCs that had an oral health program and a 3-percentage point increase in the ratio of dental patients to total patients.ConclusionsFunding dedicated to oral health service expansion in HCs may result in outcomes ranging from increasing workforce to reduction in access and financial barriers. Retrospective analysis demonstrated improved capacity for oral healthcare delivery attributable to HRSA support to HCs.

Background In December 2015, §132g was introduced into Social Code Book V. It provides financial coverage of advance care planning (ACP) for residents in long-term care institutions and institutions for persons with disabilities. At the end of 2017, the sickness funds and care home providers defined the details of the implementation in a mutual agreement. Methods Policy analysis with description and critical reflection of the relevant regulations and the current status of ACP implementation in Germany. Results Since early 2018, German care homes can get reimbursement for ACP-facilitators (1/4 full time equivalent for 100 residents), who can be either employed by the care home, by its carrier or by a regional cooperating partner. The mutual agreement specifies the structure and content of the planning process and defines the qualification requirements for ACP-facilitators, but not for facilitator trainers. Furthermore, the agreement calls for intra- and inter-institutional coordination, but does not provide for adequate workforce. Since 2016, there have been courses qualifying some 270 ACP-facilitators and 35 trainers, and several institutional ACP implementations. To promote the quality of the ACP-implementations, a German ACP-association (the DiV-BVP e.V.) was founded in 2017 to further develop facilitator and trainer curricula using simulated patient supported role plays, the contents of ACP-conversations, and of their adequate documentation. Conclusions While §132g Social Code Book V provides a historic opportunity to implement ACP in German care homes, there are still major challenges to overcome, especially regarding facilitator qualification and institutional and regional implementation of the ACP system.

Background Antimicrobial stewardship programs (ASPs) have been shown to reduce inappropriate antimicrobial use and its consequences. However, these programs lack legislative requirements in many places and it can be difficult to determine what human resources are required for these programs and how to create a business case to present to hospital administrators for program funding. The objectives of the current paper were to review legislative requirements and outline human resource requirements for ASPs, and to create a base business case for ASPs. Methods A working group of antimicrobial stewardship experts from across Canada met to discuss the necessary components for creation of a business case for antimicrobial stewardship. A narrative review of the literature of the regulatory requirements and human resource recommendations for ASPs was conducted. Informed by the review and using a consensus decision-making process, the expert working group developed human resource recommendations based on a 1000 bed acute care health care facility in Canada. A spreadsheet based business case model for ASPs was also created. Results Legislative and /or regulatory requirements for ASPs were found in 2 countries and one state jurisdiction. The literature review and consensus development process recommended the following minimum human resources complement: 1 physician, 3 pharmacists, 0.5 program administrative and coordination support, and 0.4 data analyst support as full time equivalents (FTEs) per 1000 acute care beds. Necessary components for the business case model, including the human resource requirements, were determined to create a spreadsheet based model. Conclusions There is evidence to support the negative outcomes of inappropriate antimicrobial use as well as the benefits of ASPs. Legislative and /or regulatory requirements for ASPs are not common. The available evidence for human resource recommendations for ASPs using a narrative review process was examined and a base business case modelling scenario was created. As regulatory requirements for ASPs increase, it will be necessary to create accurate business cases for ASPs in order to obtain the necessary funding to render these programs successful. Electronic supplementary material The online version of this article (10.1186/s13756-018-0396-z) contains supplementary material, which is available to authorized users.

Data were collected from 10 universities in the United States on declared academic majors and gender of students enrolled in seven different soil science courses over a 5-yr period. Combined trends for all courses and trends for each individual course were evaluated. Data were also collected on the number of students participating in soil judging as well as tenure track and non-tenure track full time equivalent (FTE) soil science faculty positions. Environmental science, crop science/horticulture/agronomy, and other agricultural students enrolled in soil science courses in the greatest numbers. Environmental science and engineering students showed rapid increases in enrollment, while crop science/horticulture/agronomy and soil science student enrollment declined. Soil physics was the only class where declared soil science students were the single largest enrolled group. Soil judging numbers were consistent, while FTE faculty showed a slight decline. Students from many different academic majors took soil science courses at the universities investigated, and the most common majors in these courses depended on the course and the material it addressed. Overall student enrollment increased in all subject areas investigated except soil physics. While the results from this study are somewhat mixed, the overall growth in student enrollment in soil science courses at the investigated universities, as well as the broad range of majors enrolled in soil science coursework, indicate an upward trajectory in soil science education at these universities.

Biobanks face increasing demands for research materials of consistent quality, which can be used in collaborative studies. Several countries and some international agencies have made formal efforts to standardize biobank operations and outputs. These include the establishment of best practice guidelines for collection management, and certification programs. Such guidelines and programs increase biobanks' opportunities for participation in high impact research and funding. However, they also impose economic and time costs, which may burden biobanks. This study aimed to estimate the costs of gaining certification and maintaining certification (i.e., committing extra resources to continue standards) for three cancer biobanks participating in a biobank certification program in New South Wales, Australia. To gather cost data for a range of cancer biobanks, we recruited three with different full time equivalent (FTE) staff levels (1.0-3.0), recognizing FTE staff level as an indicator of resources and operating scale. In extended interviews with staff, we gathered biobanks' expected costs in obtaining and annually maintaining certification. The biobank with the highest staff level reported the lowest expected costs in gaining certification, due to the strong prealignment of its present operations with certification requirements. The other biobanks expected higher costs as their operations required greater adjustments. Overall, relative costs of gaining certification were between 2% and 6% of current total annual wage costs. To the authors' knowledge, this is the first such costing study of a biobank certification program. Supplementary Data include the interview schedule that other biobanks may use to estimate their own economic certification costs.

A Review of: Johannessen, H. T. D. (2018). The need to grow, learn and develop – how does management affect motivation for professional development? LIBER Quarterly, 28(1), 1–16. https://doi.org/10.18352/lq.10238 Abstract Objective – This study explores whether there is a correlation between academic library leaders’ support for professional development and their employees’ professional self-esteem and motivation to participate in professional development. Design – Survey questionnaire. Setting – Academic libraries in Norway. Subjects – 1,637 full time equivalent (FTE) staff. Methods – The theoretical framework for this study is knowledge management. The author defines this as “The creation and subsequent management of an environment which encourages knowledge to be created, shared, learnt, enhanced, and organized for the benefit of the organization and its customers” (Sarrafzadeh, Martin, & Hazeri, 2006, p. 624, quoted on p. 3). An anonymous quantitative survey was made available to staff working in Norwegian academic libraries. The survey included questions about to what extent their leader encourages them to attend conferences, to what extent their leader understands their skills and competencies, personal belief in their own skills and competencies to perform their work tasks, and number of professional development activities they attended in 2015 (including conferences, continuing education seminars, and interdepartmental seminars). Main Results – 626 survey responses were collected, for a 38% response rate. The responses were analyzed using descriptive statistics. Over 50% of all survey respondents reported high satisfaction with their professional skills and competencies. There is a difference when broken down by gender, with 77% of men reporting confidence in their professional skills versus 63% of women. Education level, on the other hand, does not make a difference. The study found a correlation between perception by library staff that their library leader has a “good overview” of their professional skills and staff members’ confidence in their ability to perform their job well. Library staff with leaders who encouraged professional development were more likely to participate in external professional development activities. Participation in internal professional development activities was not affected by library leaders’ encouragement. Conclusion – When library staff are encouraged by library leadership to participate in professional development, they are more likely to do so. Library staff who perceive that their library’s leaders recognize and value their professional skills and competencies have a higher sense of professional self-esteem. Library leaders can use knowledge management to come to a better understanding of the knowledge and skills their staff members already possess, and to encourage communities of practice and the sharing of knowledge in the organization. This recognition can result in employees who are happier and more motivated to learn.

COVID-19 pandemic has severely affected regular public health interventions including population-based cancer screening. Impacts of such screening delays on the changes in structure and screening process and the resultant long-term outcomes are unknown. It is therefore necessary to develop a systematic framework to assess theses impacts related to these components of quality. Using population-based cancer screening with fecal immunochemical test (FIT) as an illustration, the main analysis was to assess how various scenarios of screening delays were associated with the capacity for primary screening and full time equivalent (FTE) for colonoscopy and impact long-term outcomes based on a Markov decision tree model on population level. The second analysis was to quantify how the extent of COVID-19 epidemic measured by social distancing index affected capacity and FTE that were translated to delays with an exponential relationship. COVID-19 epidemic led to 25%, 29%, 34%, and 39% statistically significantly incremental risks of late cancer for the delays of 0.5-year, 1-year,1.5-year, and 2-year, respectively compared with regular biennial FIT screening. The corresponding statistically findings of four delayed schedules for death from colorectal cancer (CRC) were 26%, 28%, 29%, and 30%, respectively. The higher social distancing index led to a lower capacity of uptake screening and a larger reduction of FTE, resulting in longer screening delay and longer waiting time, which further impacted long-term outcomes as above. In summary, a systematic modelling approach was developed for demonstrating the strong impact of screening delays caused by COVID-19 epidemic on long-term outcomes illustrated with a Taiwan population-based FIT screening of CRC.

Human Resources (HR) has an important role in a company. PT. Rosy Ceramindo is one of the companies engaged in manufacturing tableware. So we need to optimize the number of employees in accordance with their workload through workload analysis. Mapping employee competencies is made based on the job description of each position then compared to the Indonesian National Qualification Framework (KKNI). The method used is the Full Time Equivalent method using Java. The optimal number of employees based on FTE calculations for the Production Department is 94 people. Mapping of competencies based on job description and KKNI for the position of Section Chief is at level 6 equivalent to S1 or D4. For the positions of Mold Operators, Body Raw Material Milling Operators, Glaze Raw Material Milling Operators, Painting Operators, Pressure Casting Operators, Casting Operators, Finishing Operators, Decal Operators, Glazing Operators, and Roll Kiln Operators and Packing Operators at the levels. 2 is equivalent to SMA / SMK / MA.Keywords : FTE, SDM, JAVA, KKNI, Productivity .

The paper aims to provide an insight into the significance of having a simulation model to forecast the supply of registered nurses for health workforce planning policy using System Dynamics. A model is highly in demand to predict the workforce demand for nurses in the future, which it supports for complete development of a needs-based nurse workforce projection using Malaysia as a case study. The supply model consists of three sub-models to forecast the number of registered nurses for the next 15 years: training model, population model and Full Time Equivalent (FTE) model. In fact, the training model is for predicting the number of newly registered nurses after training is completed. Furthermore, the population model is for indicating the number of registered nurses in the nation and the FTE model is useful for counting the number of registered nurses with direct patient care. Each model is described in detail with the logical connection and mathematical governing equation for accurate forecasting. The supply model is validated using error analysis approach in terms of the root mean square percent error and the Theil inequality statistics, which is mportant for evaluating the simulation results. Moreover, the output of simulation results provides a useful insight for policy makers as a what-if analysis is conducted. Some recommendations are proposed in order to deal with the nursing deficit. It must be noted that the results from the simulation model will be used for the next stage of the Needs-Based Nurse Workforce projection project. The impact of this study is that it provides the ability for greater planning and policy making with better predictions.

Indonesian Red Cross (PMI) province of DKI Jakarta, Indonesia as the social organization is required to always be ready to meet all the needs of society. However, there are some problems in its implementation, such as fundraising target that has not been achieved, there is no Standard Operating Procedure (SOP), and there are some jobs that have not been implemented. Hence, workload analysis is required to determine the composition of the right amount of employees. The purposes of this study are: 1) Describing the business process on PMI’s Internal Headquarter Unit and Observer Squad; 2) Composing more accurately job descriptions; 3) Analyzing more efficiently and more effectively the workloads on the Internal Headquarter Unit and Observer Squad; and 4) Giving recommendation about the ideal employee numbers on the Internal Headquarter Unit and Observer Squad. The processing data method which used in this study was Full Time Equivalent (FTE). The result of workload analysis shows that new recruitment is not necessary, but downsizing in storage and pantry staff in general affairs should be conducted.

Objective This study was conducted to compare human resource requirement among manual, automated, and modified automated dispensing systems. Methods Data were collected from the pharmacy department at the 2100-bed university hospital (Siriraj Hospital, Bangkok, Thailand). Data regarding the duration of the medication distribution process were collected by using self-reported forms for 1 month. The data on the automated dispensing machine (ADM) system were obtained from 1 piloted inpatient ward, whereas those on the manual system were the average of other wards. Data on dispensing, returned unused medication, and stock management processes under the traditional manual system and the ADM system were from actual activities, whereas the modified ADM system was modeled. The full-time equivalent (FTE) of each model was estimated for comparison. Results The result showed that the manual system required 46.84 FTEs of pharmacists and 132.66 FTEs of pharmacy technicians. By adding pharmacist roles on screening and verification under the ADM system, the ADM system required 117.61 FTEs of pharmacists. Replacing counting and filling medication functions by ADM has decreased the number of pharmacy technicians to 55.38 FTEs. After the modified ADM system canceled the return unused medication process, FTEs requirement for pharmacists and pharmacy technicians decreased to 69.78 and 51.90 FTEs, respectively. Conclusions The ADM system decreased the workload of pharmacy technicians, whereas it required more time from pharmacists. However, the increased workload of pharmacists was associated with more comprehensive patient care functions, which resulted from the redesigned work process.

BackgroundThe process of deinstitutionalization (community-based care) has been shown to be associated with better quality of life for those with longer-term mental health problems compared to long stay hospitals. This project aimed to investigate the relationship between national progress towards deinstitutionalization and (1) quality of longer-term mental health care (2) service users’ ratings of that care in nine European countries.MethodsQuality of care was assessed in 193 longer-term hospital- and community-based facilities in Bulgaria, Germany, Greece, Italy, the Netherlands, Poland, Portugal, Spain and the UK. Data on users’ ratings of care were collected from 1579 users of these services. Country level variables were compiled from publicly available data. Multilevel models were fit to assess associations with quality of care and service user experiences of care.ResultsSignificant positive associations were found between deinstitutionalization and (1) five of seven quality of care domains; and (2) service user autonomy. A 10% increase in expenditure was associated with projected clinically important improvements in quality of care.ConclusionsGreater deinstitutionalization of mental health mental health services is associated with higher quality of care and better service user autonomy.

Introduction: A variety of formulas that can be done to count the needs of nursing staff in inpatient rooms include Ministry of Health Republic of Indonesia method, Gillies, Nina Formulation, Douglas, and Full Time Equivalent (FTE). The purpose of this study was to recommend the formula for calculating nurse staff needs in implementation of team nursing model of care delivery. Method: The design used in this study was a time and motion study. Data was collected by observations and questionnaires. The population was the nurses who work at Kediri Baptist Hospital inpatient wards. The observation and questionnaires to the resource persons utilized as a data collection method. Two inpatient wards were the taken as simulation places, there were Ward A and Ward B. Ward A was taken as simulation place based on FTE method and Ward B was taken as simulation place based on Ministry of Health Republic of Indonesia method. Based on the calculation according to the Ministry of Health Republic of Indonesia method obtained the required number of nursing staff as many as 17 people in Ward A and 23 in Ward B. Meanwhile, according to FTE count obtained the number of nursing staff as many as 20 people in Ward A and 33 in Ward B. Result: The simulation results obtained an increase in performance of duties and job satisfaction of nurses in inpatient wards that were simulated using the FTE method. Conclusio: The inpatient ward that is simulated using the Ministry of Health Republic of Indonesia method obtained an increase in performance of duties but a decrease in job satisfactions. It can be concluded that the FTE method is more appropriate to use than Ministry of Health Republic of Indonesia.

The objective of this study was to investigate whether the investment in maize research was adequate and balanced in Nepalese context. Resource use in maize research was empirically studied with standard congruency analysis by using Full Time Equivalent (FTE) of researchers as a proxy measure of investment. The number of researchers involved in maize was 61 but it was only 21.25 on FTE basis, indicating that full time researchers were very few as compared to the cultivated area of maize in the country. Statistical analysis revealed that the investment in maize research was higher in Tarai and lower in the Hills. Congruency index on actual production basis was found low across the eco-zones and even lower across the geographical regions indicating that the investment in maize research was a mismatch and not justified. While adjusted with the equity factor and the research progress factor in the analysis substantial difference was not found in congruency index. This study recommends that substantial increase in investment in maize research is needed with balanced and justified manner across the eco-zones and the geographical regions. Hills need special attention to increase the investment as maize output value is higher in this eco-zone. Eastern and western regions also need increased investment in maize according to their contribution in the output value.

Introduction Cancer registration is an important activity for informing cancer control activities. Cancer registries in Sub-Saharan Africa have limited resources to effectively operate because of competing priorities. To date, there has not been an assessment of the resources and funding needed to perform all the activities essential for cancer registration in Kenya. Evidence will help registries to quantify and advocate for the funds needed to sustain, enhance, and expand high quality cancer registration in Kenya. Methods In this study, we used the Centers for Disease Control and Prevention's (CDC's) International Registry Costing Tool ( IntRegCosting Tool ) to evaluate the funding, cost, and labor resources used to perform the cancer registry operations in Nairobi County for two annual periods between July 2012 and June 2014. Results Funding from grants, research studies, and international organizations provided 70% of the registry operations' cost. For both time periods, the most-costly registry activities were related to administration, management, and training, along with data acquisition activities such as data abstraction, entry, and validation. Even among these core registry activities, however, substantial variations existed. Conclusions Stable funding for cancer registry operations is necessary to sustain core registry activities in other to deliver high-quality data, which in turn is necessary to foster evidence-based policies to improve cancer outcomes. As stakeholders look into expanding the Nairobi Cancer Registry into a national program, the cost data provided in this study will help justify the funding required for sustaining and expanding registry activities.

Objectives Australians are among the world's highest consumers of complementary medicine. Research is vital to ensure the safe and effective use of complementary medicines and practices and their appropriate integration into mainstream healthcare. In 2014, the National Institute of Complementary Medicine (NICM) undertook a survey to determine the extent of complementary medicine academic research in Australia from 2008 to 2013. This survey builds upon aspects of previous research undertaken by NICM in 2005 and 2008. Methods The surveys were conducted using the Survey Monkey™ program and distributed electronically by email, made available on the NICM website, provided in the NICM newsletter and sent to industry associations, who agreed to promulgate the link. The survey included 20 items assessing the size and scope of the industry in Australia in terms of the research workforce, the nature of research activities, funding mechanisms and quantum of research funds and resources and facilities available to researchers. Results Based on survey responses reporting on the 6 year period 2008–2013, 160 respondents provided information on 295 active CM research projects employing a total quantum of $31.3 million. The greatest quantum provided for active projects came from NHMRC (36%) while universities supported the greatest number of projects (27%). 238 of the 296 projects reported on their workforce, this represented 429 academic researchers and 167 full time equivalent (FTE) research students. $29.5M in new funding was awarded to new projects over this period. Conclusions Whilst the total reported quantum of research funding for expenditure on CM projects in the period January 2008–December 2013 was $31.3M, the annual funding of new CM research projects decreased considerably in the latter part of the survey period. Australia has a well-developed CM research sector; however it is insufficiently supported given the size of the Australian industry and the level of consumer use.

The key aims of this study were to identify sources of support for cancer registry activities, to quantify resource use and estimate costs to operate registries in low- and middle-income countries (LMIC) at different stages of development across three continents.Using the Centers for Disease Control and Prevention's (CDC's) International Registry Costing Tool (IntRegCosting Tool), cost and resource use data were collected from eight population-based cancer registries, including one in a low-income country (Uganda [Kampala)]), two in lower to middle-income countries (Kenya [Nairobi] and India [Mumbai]), and five in an upper to middle-income country (Colombia [Pasto, Barranquilla, Bucaramanga, Manizales and Cali cancer registries]).Host institution contributions accounted for 30%-70% of total investment in cancer registry activities. Cancer registration involves substantial fixed cost and labor. Labor accounts for more than 50% of all expenditures across all registries. The cost per cancer case registered in low-income and lower-middle-income countries ranged from US $3.77 to US $15.62 (United States dollars). In Colombia, an upper to middle-income country, the cost per case registered ranged from US $41.28 to US $113.39. Registries serving large populations (over 15 million inhabitants) had a lower cost per inhabitant (less than US $0.01 in Mumbai, India) than registries serving small populations (under 500,000 inhabitants) [US $0.22] in Pasto, Colombia.This study estimates the total cost and resources used for cancer registration across several countries in the limited-resource setting, and provides cancer registration stakeholders and registries with opportunities to identify cost savings and efficiency improvements. Our results suggest that cancer registration involve substantial fixed costs and labor, and that partnership with other institutions is critical for the operation and sustainability of cancer registries in limited resource settings. Although we included registries from a variety of limited-resource areas, information from eight registries in four countries may not be large enough to capture all the potential differences among the registries in limited-resource settings.

Background Maintaining population-based registries requires adequate and sustained resources; however, to date there has been no systematic evaluation to identify the resource needs for cancer registration in most countries, including Colombia. A systematic assessment of the costs can quantify the funding required and identify processes to improve efficiency of cancer registries. Methods The Centers for Disease Control and Prevention's (CDC's) International Registry Costing Tool ( IntRegCosting Tool) was tailored specifically for the Colombian registries and was used to collect resource use data from five regional population-based cancer registries: Barranquilla, Bucaramanga, Cali, Manizales, and Pasto. The registries provided cost data for the year 2013 and cancer cases corresponding to the year 2010. Results We identified an almost threefold variation in the average cost per case (77,932 to 214,082 Colombian pesos or US $41 to US $113 in 2013) across the registries, but there were also substantial differences in data collection approaches, types of data collected, and activities performed. Cost per inhabitant varied between 95 and 415 Colombian pesos (US $0.05 to US $0.22). Between 20% and 45% of the total cost was due to fixed cost activities. Conclusions The detailed economic information presented in this study constitutes a valuable source of activity-based cost data that registries can use to compare operations, assess key factors that lead to differences in cost per case, and identify potential approaches to improve efficiencies. Furthermore, the knowledge gained from studying the Colombian registries can help inform the planning and operations of other registries in the region.

Di dunia industri yang semakin maju membuat para pelaku industri semakin berkompetitif dalam bersaing. Dalam persaingan dunia industri harus bisa mengatur sistem manjemennya dengan baik agar bisa dapat bersaing dengan industri lainnya. Masalah yang terjadi di home industry UD. Prasetya Rangga adalah terjadi ketidaksesuaian antara beban kerja dan jumlah pekerja yang mengakibatkantidak efisiensinya kerja juga peningkatan beban kerja. Penelitian ini bertujuan untuk mengukur waktu normal sebagai acuan perhitungan beban kerja sebagai dasar perhitungan jumlah tenaga kerja sekaligus membuat alur produksi. Metode yang digunakan FTE (Full Time Equivalent) untuk melakukan evaluasi kebutuhan tenaga kerja. Hasil dari penelitian ini didapatkan bahwa beban kerja yang diterima pada departemen pengadonan dan pencetakan yaitu 35%, pada departemen pengovenan yaitu 146%, beban kerja pada departemen packing yaitu 39%. Dari hasil perhitungan metode FTE kebutuhan tenaga kerja yang optimal pada UD. Prasetya Rangga bagian produksi departemen pengadonan dan pencetakan jumlah tenaga kerja usulan adalah 1 orang sedangkan aktualnya adalah sebanyak 2 orang. Kemudian pada departemen pengovenan jumlah tenaga kerja usulan adalah 2 orang sedangkan aktualnya adalah 1 orang dan pada departemen packing jumlah tenaga kerja usulan adalah 1 orang sedangkan aktualnya adalah 2 orang.

More non-GP clinical staff now work in general practice in England than GPs, an analysis has shown.1 The fourth annual NHS workforce report from the Health Foundation shows that the number of non-GP clinical staff has grown more quickly than the number of permanent qualified GPs over the past three years. In March 2016 there were 6% fewer non-GP clinical staff than GPs, the report said. By March 2019, however, non-GP clinical staff had overtaken GPs to outnumber them by 8% (29 459 full time equivalent (FTE) other clinical staff including …

Introduction Geographic measures of accessibility can quantify inequitable distributions of health care. Although closest distance measures are often used in Aotearoa New Zealand these may not reflect patient use of health care. This research examines patterns of patient enrolment in general practitioner (GP) services from a geospatial perspective. Methods Patient enrolment records (n=137 596) from one primary health organisation were examined and geographic information systems used to determine whether patients enrolled with their closest GP service. A binomial logistic regression was performed to examine factors associated with the bypass of GP services closer to patients' homes. Results Overall 68.1% of patients in the sample bypassed the GP service closest to their home, while rates of GP bypass varied across the Waikato region and between rural and urban areas. A binary logistic regression analysis revealed that rurality of patient residence, patient ethnicity, patient age, area-level socioeconomic deprivation, sex, distance to the closest GP clinic, clinic after-hours availability, Māori service provider status, GP and nurse full time equivalent hours, and clinic fees were statistically significant predictors of increased closest-GP bypass. While residents of major urban areas had high rates of GP bypass, this was followed by patients living in rural areas - patients living more than 20 km from the closest GP service had exceptionally high rates of GP bypass. Conclusion This study suggests that most patients in the Waikato region do not enrol with the GP service closest to their home and it outlines several factors, including rurality of residence, associated with the GP bypass. Closest distance accessibility measures may be inappropriate in mixed urban-rural settings, and researchers should consider other approaches to quantifying spatial equity. Health services should also be designed to better reflect the realities of the populations they serve.

Objective To compare the academic equivalence of full-time (FT) and full-time equivalent (FTE) delivery routes for chiropractic training and to assess nontraditional education delivery as a viable method for training chiropractors. Methods A retrospective analysis of student summative assessment data was undertaken on a total of 196 FT and FTE students studying for the master's in chiropractic degree at a UK chiropractic college between 2009 and graduating by 2017. The analysis consisted of within-group comparison and between-group comparisons using the Kruskal-Wallis test and the Mann-Whitney U test. Results The demographics of the 2 student groups varied in terms of gender and age distribution. The analysis of summative data indicated no differences between the 2 routes of delivery. There was also no difference in the distribution of final degree classification outcome between the 2 routes. Conclusions While it is possible that demographic differences influence the outcomes in each training route, this preliminary study indicates that, based only on analysis of overall achievement, there is no difference in either FT or FTE programs in training chiropractors, allowing them to register with the UK regulatory body. It suggests that a nontraditional mode of delivery is an achievable route to qualification as a chiropractor, enabling a greater number of students to consider chiropractic as a career choice while managing other life commitments.

Background A training opportunity in which ongoing education is encouraged is one of the determinants in recruiting and retaining nurses in home-visit nursing care agencies. We investigated the association between ensuring training opportunities through scheduled training programs and the change in the number of nurses in home-visit nursing agencies using nationwide panel data at the agency level. Methods We used nationwide registry panel data of home-visit nursing agencies from 2012 to 2015 in Japan. To investigate the association between planning training programs and the change in the number of nurses in the following year, we conducted fixed-effect panel data regression analysis. Results We identified 4760, 5160 and 5025 agencies in 2012, 2013, and 2014, respectively. Approximately 60–80% of the agencies planned training programs for all staff, both new and former, during the study period. The means and standard deviations of the percentage change in the number of full time equivalent (FTE) nurses in the following year were 4.2 (19.8), 5.7 (23.5), and 5.8 (25.1), respectively. Overall, we found no statistically significant association between scheduled training programs and the change in the number of FTE nurses in the following year. However, the associations varied by agency size. Results of analysis stratified by agency size suggested that the first and second quartile sized agencies (2.5–4.0 FTE nurses) with scheduled training programs for all employees were more likely to see a 9.0% (95% confidence interval [CI]: 4.5, 13.5) and 8.5% (95% CI: 2.4, 14.5) increase in the number of FTE nurses in the following year, respectively. Similarly, the first and second quartile sized agencies with scheduled training programs for new employees were more likely to see a 4.7% (95% CI: 2.1, 7.2) and 3.3% (95% CI: 0.4, 6.2) increase in the number of FTE nurses in the following year, respectively. Conclusions Ensuring training opportunities through scheduled training programs for all staff, both new and former, in relatively small-sized home-visit nursing agencies might contribute to an increase in the number of nurses at each agency. Electronic supplementary material The online version of this article (10.1186/s12913-019-4225-8) contains supplementary material, which is available to authorized users.

Objective.To quantify population-level and practice-level encounters with rheumatologists over time.Methods.We conducted a population-based study from 2000 to 2015 in Ontario, Canada, where all residents are covered by a single-payer healthcare system. Annual total number of unique patients seen by rheumatologists, the number of new patients seen, and total number of encounters with rheumatologists were identified.Results.From 2000 to 2015, the percentage of the population seen by rheumatologists was constant over time (2.7%). During this time, Ontario had a stable supply of rheumatologists (0.8 full-time equivalents/75,000). From 2000 to 2015, the number of annual rheumatology encounters increased from 561,452 to 786,061, but the adjusted encounter rates remained stable over time (at 62 encounters per 1000 population). New patient assessment rates declined over time from 10 new outpatient assessments per 1000 in 2000 to 6 per 1000 in 2015. The crude volume of new patients seen annually decreased and an increasing proportion of rheumatology encounters were with established patients. We observed a shift in patient case mix over time, with more assessments for systemic inflammatory conditions. Rheumatologists’ practice volumes, practice sizes, and the annual number of days providing clinical care decreased over time.Conclusion.Over a 15-year period, the annual percentage of the population seen by a rheumatologist remained constant and the volume of new patients decreased, while followup patient encounters increased. Patient encounters per rheumatologist decreased over time. Our findings provide novel information for rheumatology workforce planning. Factors affecting clinical activity warrant further research.

The number of GPs working in England has crept up in the past year, a rise almost entirely accounted for by an increase in GP trainees. In March 2019 England’s GPs totalled 44 847, a rise of 350 (0.8%) on the same month in 2018. The full time equivalent count, which allows for some GPs working only part time, showed a similar increase, rising from 34 424 to 34 736 (0.9%).1 But closer examination of the data released by NHS Digital shows that the headcount of fully qualified GPs fell by 494 year on year, while the number of trainees increased by 760. The great majority of these new recruits to the GP workforce were trained in the UK, lending credence to NHS England’s claim that plans to increase recruitment are working. “Today’s figures highlight the good work being done locally to support GPs through retention …

Objectives To determine the current structure of experiential learning (EL) in Master of Pharmacy (MPharm) programmes in UK universities, and assess how they meet the standards specified by the General Pharmaceutical Council. Methods A cross-sectional survey of staff in charge of EL in MPharm programmes was conducted, utilising a 31-item online survey, consisting of both open-ended and close-ended questions. Variables of interest were administrative aspects and structure of the EL component, tutor issues and placement sites. To pinpoint the challenges faced with EL, the Relative Importance Index (RII) was calculated. Key findings Twenty (66.7%) universities responded. EL coordinators were mostly academic/teaching fellows (19) and spent 0.29 ± 0.31 full-time equivalents on coordination. Tutors completed training annually in 53.8% of universities, with topics focusing on placement structure (85.7%) and requirements (78.6%). Total placement hours in all practice sites over the 4 years of study ranged from 54 to 496 h, and included hospitals, community pharmacies, hospices, prisons and nursing homes. The three biggest challenges faced with regard to EL were in obtaining/retaining hospital placements (1st), financial support (2nd) and quality assurance (QA) of tutors (3rd). Conclusions While there has been an increase in the variety of placement sites and hours since the last survey in 2003, universities face challenges in terms of staffing and obtaining placement sites. There are also gaps in tutor training. More standardisation and regulation of the QA of the EL programme, placement sites and tutors is needed to ensure students obtain the most out of their placements.

Objective: To dispense medication in a form of ready to use (RTU) medication was recommended by the standards of Joint Commission International (JCI) and Standard Guidelines of Hospital Pharmacy for preventing the medication error. However, the cost and benefit were questionable. The costs may increase while benefits were unclear. Before making the implementation decision, the cost of investment and benefit between traditional (injectable medication is prepared by nurse) and RTU systems (injectable medication is prepared by pharmacy department) should be evaluated. Methods: This study compared the cost and benefit of injectable medication administration between the traditional system and the RTU system within a large academic hospital. The decision tree was designed to produce comparable data on the hospital's perspective. The t ime horizon was 10 years thus all costs were discounted at 3% annually. Sensitivity analysis was performed to test the stability of the results. Results: The cost of investment at 10-year intervals of the RTU system was lower than the traditional system by about 18,710,160 baht. The benefit was decreased 19.32 full time equivalents (FTEs) of nurse when compared with the traditional system. The result showed that the five most sensitive variables were number of doses, mixing time per dose (prepared by nurse), space for production, salary and fringe benefits of pharmacists, and mixing time per dose (prepared by pharmacist). Conclusion: The RTU system saved 1,871,016 baht per year and 19.32 FTEs of nurse. Moreover, the RTU system enhanced the opportunity of nurses and pharmacists to play more professional role and promoted the efficient health care system.

Anticoagulation clinics (ACCs) are specialty clinics that manage patients with blood clotting problems. Since labor costs usually account for a substantial portion of a healthcare organization’s budget, optimizing the number and types of staff required was often the focus, especially for ACCs, where labor-intensive staff-patient interactions occur. A significant portion of tasks performed by clinical pharmacists might be completed by clinical pharmacist technicians, which are less-expensive resources. While nurse staffing models for a hospital inpatient unit are well established, these models are not readily applicable to staffing ACCs. Therefore, the objective of this paper is to develop a framework for determining the right staff mix of clinical pharmacists and clinical pharmacy technicians that increases the efficiency of care delivery process and improves the productivity of ACC staff. A framework is developed and applied to build a semi-automated full-time equivalent (FTE) calculator and compare various staffing scenarios using a simulation model. The FTE calculator provides the right staff mix for a given staff utilization target. Data collected from the ACCs at VA Boston Healthcare System is used to illustrate the FTE calculator and the simulation model. The result of the simulation model can be used by ACC managers to easily determine the number of FTEs of clinical pharmacists and clinical pharmacy technicians required to reach the target utilization and the corresponding staffing cost.

peer-reviewed Quantifying the value of investment in medical research can inform decision-making on the prioritisation of research programmes. Existing methodologies to estimate the rate of return of medical research are inappropriate for early-phase translational research due to censoring of health benefits and time lags. A strategy to improve the process of translational research for patient benefit has been initiated as part of the UK National Institute for Health Research (NIHR) investment in Biomedical Research Centres (BRCs) in England. By providing a platform for partnership between universities, NHS trusts and industry, successful BRCs should reduce time lags within translational research whilst also providing an impetus for local economic growth through industry collaboration. We present a novel contribution in the assessment of early-phase biomedical research by estimating the impact of the Oxford Biomedical Research Centre (OxBRC) on income and job creation following the initial NIHR investment. We adopt a macroeconomic assessment approach using Input-Output Analysis to estimate the value of medical research in terms of income and job creation during the early pathway towards translational biomedical research. Inter-industry linkages are assessed by building a model economy for the South East England region to estimate the return on investment of the OxBRC. The results from the input-output model estimate that the return on investment in biomedical research within the OxBRC is 46%. Each £1 invested in the OxBRC generates an additional £0.46 through income and job creation alone. Multiplicative employment effects following a marginal investment in the OxBRC of £98m during the period 2007-2017 result in an estimated additional 196 full time equivalent positions being created within the local economy on top of direct employment within OxBRC. Results from input-output analyses can be used to inform the prioritisation of biomedical research programmes when compared against national minimum thresholds of investment

The mining environment is a place to work with a high level of risk. One of the factors that cause work accidents in the mining area is work fatigue or work fatigue. The purpose of this study was to reveal the role of sleep quality as a mediator of the relationship between workload and work fatigue in mining workers in Indonesia. Research participants were mining workers who worked in the field with a 12-hour / day shift work system (n = 232). Measurements were made using 3 scales, namely Full Time Equivalent (FTE) for workload, Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and Three-Dimensional Work Fatigue Inventory (3D-WFI) for work fatigue. The results of the analysis using bootstrapping 5000 showed that workload has a significant effect on the level of work fatigue which is mediated by sleep quality. High workload results in poor sleep quality and high levels of fatigue so that mining companies need to maintain the quality of sleep for field workers to minimize work accidents due to work fatigue.

Public health center X is one of the public health center with high outpatient loads in Malang City. On average, the daily amount of outpatients is 119. The high load of outpatient directly affects employee’s working load. One of the units considered susceptible to working load increase is the medical record unit at the registration department because they have to interact with all visiting patients. The study aimed to discover the need for medical record personnel at the outpatient registration department of public health center X using the Full-Time Equivalent (FTE) method. The study used a descriptive study design and a quantitative approach. The researchers utilized a total sampling technique with two medical record personnel at the outpatient registration department. The study instrument employed was the outpatient registration daily log of Public health center X. The study results show that the working load of medical record personnel at the BPJS patient registration department had an FTE index value of 2.24 > 1.28, categorized as overload. Meanwhile, medical record personnel at the non-BPJS patient registration department had an FTE index value of 0.96 < 0.99, categorized as underload. Therefore, it can be concluded that Public health center X requires two additional medical record personnel at the BPJS patient registration department, while the non-BPJS patient registration department did not require additional medical record personnel.