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Introduction The topic of healthcare human resource planning for diagnostic radiographers has received limited research attention to date. This research is concerned with developing a framework that can be used to determine diagnostic radiographer staffing requirements at a unit- or department level (i.e. at the micro-level). Methods An inductive approach is applied to formulate requirement specifications that inform the development of the framework. A number of verification and validation activities are performed, including theoretical verification and a case study application. Results The diagnostic radiographer staffing framework consists of seven steps that comprise a workload-based approach to determining the number of full time equivalent diagnostic radiographers that are required for each modality, or group of modalities. Both clinical and non-clinical activities are considered, and guidance is provided on calculating staffing requirements to cover leave allowances. A number of potential approaches to determining activity times are also discussed. Conclusion The framework represents a holistic approach to determining the required number of diagnostic radiographers at a practice-level, that is designed to remain relevant as technological advances are made in the field of diagnostic radiography. Implications for practice By providing a practical guideline, with accompanying examples, the framework is expected to hold value for individuals involved in the management of diagnostic radiography practices. The framework proposes an approach to a topic that affects every radiography practice in operation yet has received limited attention in literature to date.

Human resources are individuals who work as the cogs of a company and can produce ideas that are useful for the company. A company must have a department which in carrying out its duties functions to regulate planning in Human Resources and in carrying out the department concerned will calculate the number of employees who will then be given authority or responsibility for their work. Productivity and work efficiency can be disrupted if there is an employee workload. Employee workload can occur when doing tasks that exceed the ability of employees. At PT Asuransi Central Asia there is an imbalance of work in some divisions and causes delays in completing work. In addition, the distribution of employees in each work unit, there are still those who do not refer to the workload and there are also employees who do not use their productive time as well as possible. The purpose of this study is to analyze the working time of employees by using the Work Sampling method and also to analyze the amount employee needs based on workload measurement with the Full Time Equivalent method. The results of this study indicate that the effective working day for a year is 226 days and the effective working time is 1,360 hours for five working days per week. Through the Work Sampling method, it is known that the total time for productive activities is 78%, unproductive activities are 11% and personal activities are 11% with a 30% allowance. Based on the results of measuring the workload with the Full Time Equivalent method, it can be seen that there are 16 employees with an under load workload, an in load workload of 13 employees and an employee with an overloaded workload of 8 employees. Therefore, the company can take several steps to optimize its employees, namely by transferring tasks from overloaded employees to under loaded employees in the same division, companies can also increase working time with overtime wages without having to add 5 employees to save company costs, companies can also conduct employee transfers, provide training and education to improve employee skills and knowledge, and pay attention to the employee's work system. Keywords: Employee Needs, Workload, Work Sampling, Full Time Equivalent.

PT X is a company engaged in distribution and trading as its business activities. The logistics division, especially the logistics admin as a supply chain, certainly, has a big responsibility. In order to carry out this great responsibility, an appropriate number of workers is needed so that the work carried out can be executed properly. In this study, the main objective is to analyze the workload that exists in the current logistics admin employees and later from the results of the workload analysis, a human resource policy can be drawn concerning workloads setting. The method used in this study was the Full-Time Equivalent (FTE) method where this method could show how much workload is proportional to each employee. As a result, the workload received by each logistics admin employee has a different workload from one employee to another. Of the three existing logistics admin employees, 2 were overloaded and one was inloaded. Human resource policies related to workload arrangements for PT X logistics admin employees can be said to have not been maximized due to differences in workloads for each employee even though each of them does the same job.

Background Chronic wet cough in children is the hallmark symptom of protracted bacterial bronchitis (PBB) and if left untreated can lead to bronchiectasis, which is prevalent in Indigenous populations. Underrecognition of chronic wet cough by parents and clinicians and underdiagnosis of PBB by clinicians are known. Research Question We aimed to improve recognition and management of chronic wet cough in Aboriginal children using knowledge translation (KT), a methodologic approach that can be adapted for use in Indigenous contexts to facilitate effective and sustained translation of research into practice. Study Design and Methods A mixed-methods KT study undertaken at a remote-based Aboriginal primary medical service (February 2017 to December 2019). Our KT strategy included the following: (1) culturally secure (ie, ensuring Aboriginal people are treated regarding their unique cultural needs and differences) knowledge dissemination to facilitate family health seeking for chronic wet cough in children, and (2) an implementation strategy to facilitate correct diagnosis and management of chronic wet cough and PBB by physicians. Results Post-KT, health seeking for chronic wet cough increased by 184% (pre = eight of 630 children [1.3%], post = 23 of 636 children [3.6%]; P = .007; 95% CI, 0.7%-4.0%). Physician proficiency in management of chronic wet cough improved significantly as reflected by improved chronic cough-related quality of life (P Interpretation Health seeking for children with chronic wet cough can be facilitated through provision of culturally secure health information. Physician proficiency in the management of PBB can be improved with KT strategies which include training in culturally informed management, leading to better health outcomes. Comprehensive strategies that include both families and health systems are required to ensure that chronic wet cough in children is detected and optimally managed.

Background The field of infection prevention is rapidly evolving and becoming increasingly complex, as resource-intensive responses to device-associated outbreaks, global epidemics, and regulatory requirements continue to grow. This increasing complexity coupled with changing health care systems present important challenges to infection prevention staffing and resources. We describe the development of a novel infection prevention and control (IPC) staffing structure that includes both infection preventionists (IPs) and role-specific support staff to meet the evolving IPC needs and challenges of an expanding health care network. Methods The IPC department at Children's Hospital of Philadelphia underwent iterative modifications to its staffing structure between 2014 and 2018, including the development of revised job descriptions and promotional criteria, career ladders, and supporting roles. Data on key infection prevention activities, including rounding frequency and performance of audits and observations, growth metrics and infection data was evaluated for trends before and after departmental restructuring. An overall health care associated infection (HAI) index was calculated based on existing surveillance data and used to monitor patient outcomes over time. In addition, departmental employee engagement was assessed via a standard survey instrument to evaluate improvements in teamwork and professional growth opportunities over time. Results Between 2014 and 2018, the number of unique job descriptions for IPs and support staff increased from 4 to 9, creating a 3-tier career ladder for IPs and increasing full time equivalents from 8.2 to 11.6. Additional support roles included a Hand Hygiene Program Manager, Infection Prevention Associates and a Clinical Practice Analyst; these roles, along with increased IP staffing, expanded the education and consultative range of the department, as measured by a 33% increase in environmental rounding and a 7-fold increase in performance of isolation audits. Team diversity also expanded, changing from a team with predominantly nursing backgrounds, to one with an equal distribution of nursing, public health, and laboratory scientists. Results from serial engagement surveys showed an increase in teamwork and professional growth by 7.4% and 5.4%, respectively. Over this time period, the total HAI index decreased by 23%, while patient days, central line days, and ventilator days increased each year, and there was a statistically significant reduction in rates of harm across 5 key HAI indicators. Conclusions Role diversity and varying professional backgrounds within IPC programs offer a complement of strengths and increase capacity to support patient care activities, improving patient outcomes. This strategy leads to a more cost-effective, robust IPC program that supports the growing needs and evolving challenges of the field.

Despite an increased burden from chronic mental health conditions, access to effective mental health services in rural and remote areas is limited, and these services remain spatially undefined. We examine the spatial availability of mental health nurses across local government areas in Australia and identify gaps in mental health service delivery capacity in a finer-grained level than the state/territory data. A spatial distribution of mental health nurses was conducted. We utilized the 2017 National Health Workforce Dataset which was aggregated to LGA level based on the 2018 Australian Bureau Statistics (ABS) Data. The availability of mental health nurses was measured using the full time equivalent (FTE) rates per 100 000 population. We calculated the proportion of LGAs with zero total FTE rates based on remoteness categories. We also compared the mean of total FTE rates based on remoteness categories using analysis of variance. A spatial distribution of mental health nurses was visualized using GIS software for total FTE rates. Our analysis included 544 LGA across Australia, with 24.8% being defined as remote and very remote. The mean total FTE for mental health nurses per 100 000 populations is 56.6 (±132.2) with a median of 17.4 (IQR: 61.8). A wide standard deviation reflects unequal distribution of mental health nurses across LGAs. The availability of total FTE rates for mental health nurses per 100 000 populations is significantly lower in remote and very remote LGAs in comparison with major cities. As many as 35.1% of LGAs across Australia have no FTE for mental health nurses with 46% are remote and very remote. Our study reflects the existing unequal distribution of mental health nurses between metropolitan/urban setting and rural and remote areas. We suggest three broad strategies to address these spatial inequities: improving supply and data information systems; revisiting task-shifting strategies, retraining the existing health workforce to develop skills necessary for mental health care to rural and remote communities; and incorporating the provision of mental health services within expanding innovative delivery models including consumer-led, telemedicine and community-based groups.

Background Staffing ratios based on hospital beds and norms do not adequately address the requirement of infection preventionists (IP) in hospitals. We, therefore, aimed to determine staffing of IP (nursing category) based on actual workload involved. Methods The study design was quantitative and longitudinal conducted for 1 year. The study was structured around the steps of the World Health Organization's Workload Indicators of Staffing Need (WISN). Results We identified infection control activities, support activities and additional activities to be performed by 4 IP with a total available working time of 6,132 hours for an annual workload of 6,238.25 (±372) hours in an acute care hospital with 182 beds and 69,331 annual admissions. Core infection control activities consumed 78% time. Support and additional activities consumed the remaining 22% time. Active surveillance required 44% time and education consumed 32% time. WISN ratio of available staff and required staff was 0.75. Discussion A WISN ratio less than 1 suggests inadequate staffing. Therefore, the WISN method recommends 4 IP instead of 3 based on existing workload. We compared our results with the existing quantification-based staffing studies. Conclusions WISN is a valuable method to measure all infection control activities and translate workload into IP (nursing) full time equivalents.

Objective To determine the relationship of the emotional exhaustion domain of burnout with care team composition in a Midwestern primary care practice network. Participants and Methods We studied 420 family medicine clinicians (253 physicians and 167 nurse practitioners/physician assistants [NP/PAs]) within a large integrated health system throughout 59 Midwestern communities. The observational cross-sectional study utilized a single-question clinician self-assessment of the emotional exhaustion domain of burnout on a scale of 0 (never) to 6 (daily) conducted between March 1 and April 2, 2018, and administrative data collected between January 1, 2017, and December 31, 2017. We used a multivariable linear mixed model for data analysis, adjusted for clinical- and team-level factors, including clinician sex, panel size and complexity, clinician type (physician or NP/PA), clinician full-time equivalent (FTE), total care team panel size, and number of clinicians on the care team. Results Among 217 survey respondents (51.7%), the median frequency of the emotional exhaustion domain of burnout was once per week. Adjusted analyses revealed that a greater proportion of physician FTE on the care team was associated with a lower emotional exhaustion domain of burnout among individual clinicians (P=.05). Female clinicians had a higher emotional exhaustion domain of burnout than male clinicians (P=.05). None of the other variables in the model were associated with emotional exhaustion. Conclusion Primary care teams containing both physicians and NP/PAs had lower levels of emotional exhaustion with increasing proportion of physician FTE. More work is needed to explore what other variables may be associated with burnout in primary care team-based practices.

Objective To assess adherence to and individual or systematic deviations from predicted physician compensation by gender or race/ethnicity at a large academic medical center that uses a salary-only structured compensation model incorporating national benchmarks and clear standardized pay steps and increments. Participants and Methods All permanent staff physicians employed at Mayo Clinic medical practices in Minnesota, Arizona, and Florida who served in clinical roles as of January 2017. Each physician's pay, demographics, specialty, full-time equivalent status, benchmark pay for the specialty, leadership role(s), and other factors that may influence compensation within the plan were collected and analyzed. For each individual, the natural log of pay was used to determine predicted pay and 95% CI based on the structured compensation plan, compared with their actual salary. Results Among 2845 physicians (861 women, 722 nonwhites), pay equity was affirmed in 96% (n=2730). Of the 80 physicians (2.8%) with higher and 35 (1.2%) with lower than predicted pay, there was no interaction with gender or race/ethnicity. More men (31.4%; 623 of 1984) than women (15.9%; 137 of 861) held or had held a compensable leadership position. More men (34.7%; 688 of 1984) than women (20.5%; 177 of 861) were represented in the most highly compensated specialties. Conclusion A structured compensation model was successfully applied to all physicians at a multisite large academic medical system and resulted in pay equity. However, achieving overall gender pay equality will only be fully realized when women achieve parity in the ranks of the most highly compensated specialties and in leadership roles.

Objectives, setting and participantsIn July 2011, the EU adopted the Falsified Medicines Directive (FMD) primarily aiming to prevent the infiltration of falsified medicines into the legitimate supply chain. Our aim was to measure the cost elements of FMD implementation and operation using an internationally adaptable tool among Hungarian hospital pharmacies.DesignA 41-item questionnaire was developed to evaluate the implementation process and associated cost consequences leading up to February 2019, and the stabilisation period.ResultsOur representative data are supported by the high response rate, as 44.8% of the Hungarian hospital pharmacies have completed the survey. Human resource requirements related to decommissioning activities were measured as working hours and were expressed in full time equivalent (FTE). We have found an increased workload with extra 0.25 pharmacist and 0.75 technician FTE/institution at the end of the stabilisation period. The entire infrastructural and IT implementation costs were determined as €2173, on average (SD: €3366) and the median was €1506 (range: €0–€20 723). The total IT investment cost per institution was valued at €1410 (SD: €335). We identified a positive correlation (R=0.663) in consideration of the costs, the number of beds and the number of hospital locations with a multivariate linear regression model. At the time of our survey, 76.7% of the respondents experienced drug shortages, 58.1% reported suspected increase in drug costs regarding serialised medications, and 53.5% noticed an increase in packaging size.ConclusionsNotably, our research is the first complex study depicting FMD cost implications in the hospital pharmacy sector in Central Europe, indicating decommissioning significantly impacted workflow referencing human resources and IT.

PT. Indah Kiat Pulp & Paper is one of the subsidiaries under the Sinarmas Group that the led is Mr. Eka Tjipta Wijaya. The company is a manufacturing company engaged in pulp and paper production. The company location is located at Jl. Raya Perawang - Minas km 26, Desa Pinang Sebatang kec. Tualang district. Siak, Riau Province. PT. IKPP has 106 divisions and 284 sections in its work environment, such as the PAP 1 division, there are 4 units/sections of paper production, including Paper Machine 1 which has 64 employees, Paper Machine 5 has 56 employees, Paper Machine 7 has 73 employees. people, and Paper Machine 8 which has 51 employees working in the field. In each unit/section there is 1 Administration employee and 1 Work Planner employee who takes care of all office administration, sometimes there are employees who are not the same workload so that one employee is unemployed, and the other employee is busy doing piling up work. This makes researchers want to know-how with the workload owned by each employee in this case Administration and Work Planner and changes the workload hours to the number of people needed to complete the work with the FTE (Full Time Equivalent) method. This method can provide information about how heavy the workload of someone who can be categorized into normal, overload, or underload of work from the Administration and work planner and can calculate the number of employees to complete the work based on their FTE value.

Robotic Process Automation (RPA) is the rule-based automation of business process tasks by software robots mimicking human interactions. RPA projects often fail or do not achieve the expected benefits due to a missing support of the humans developing the robots. In practice, such software robots are often developed and configured by knowledge workers without any IT background. These non-IT experts require appropriate development and configuration support. The aim of this paper is to provide a checklist-based support of knowledge workers in conducting RPA projects. After an initial design, which is based on interviews with knowledge workers, an exploratory RPA case study in industry, and surveys among bot users, the checklist is improved in three iterations with comprehensive user feedback. The finally obtained checklist is evaluated in six RPA projects in industrial practice showing satisfying results. In particular, no project has failed and the expected full time equivalents savings, reduction of errors, and improvement of process speed have been achieved. Altogether, the checklist enables smooth process support of knowledge workers in RPA projects.

Intense competition in today's industrial world requires companies to keep abreast of developments. The more years, higher the need for labor costs. To reduce high production costs, one step is to cut existing labor. By cutting the number of workers, the workload that will be borne by workers will also increase. PT. SPINDO, is a manufacturing company engaged in the production of the steel pipe industry. To expand market reach, a breakthrough was made to open a new depot located in the city of Samarinda. At the beginning of the opening along with the Covid-19 outbreak, market demand was minimal. The impact on the work load in the depot is also low. The Full Time Equivalent method is a calculation process that uses working time as a reference in determining workload. In this research, the workload value most of the employees at PT. SPINDO Depo Samarinda is included in the underload category. So that man power planning is needed by cutting the number of existing employees to balance work load and the number of manpower. After the manpower planning was carried out, the work load that was previously unbalanced was balanced because the workload had been distributed to the employees.

Background: On a per capita basis, rural communities are underserviced by health professionals when compared to metropolitan areas of Australia. However, most studies evaluating health workforce focus on discrete professional groups rather than the collective contribution of the range of health, care and welfare workers within communities. The objective of this study was therefore to illustrate a novel approach for evaluating the broader composition of the health, welfare and care (HWC) workforce in Tasmania, Australia, and its potential to inform the delivery of healthcare services within rural communities. Methods: Census data (2011 and 2016) were obtained for all workers involved in health, welfare and care service provision in Tasmania and in each statistical level 4 area (SA4) of the state. Workers were grouped into seven categories: medicine, nursing, allied health, dentistry and oral health, health-other, welfare and carers. Data were aggregated for each category to obtain total headcount, total full time equivalent (FTE) positions and total annual hours of service per capita, with changes observed over the five-year period. Results: All categories of the Tasmanian HWC workforce except welfare grew between 2011 and 2016. While this growth occurred in all SA4 regions across the state, the HWC workforce remained maldistributed, with more annual hours of service per capita provided in the Hobart area. Although the HWC workforce remained highly feminised, a move toward gender balance was observed in some categories, including medicine, dentistry and oral health, and carers. The HWC workforce also saw an increase in part-time workers across all categories. Conclusions: Adopting a broad approach to health workforce planning can better reflect the reality of healthcare service delivery. For underserviced rural communities, recognising the diverse range of workers who can contribute to the provision of health, welfare and care services offers the opportunity to realise existing workforce capacity and explore how ‘total care’ may be delivered by different combinations of health, welfare and care workers.

Background Medical schools with distributed or regional programs encourage people to live, work, and learn in communities that may be economically challenged. Local spending by the program, staff, teachers, and students has a local economic impact. Although the economic impact of DME has been estimated for nations and sub-national regions, the community-specific impact is often unknown. Communities that contribute to the success of DME have an interest in knowing the local economic impact of this participation. To provide this information, we estimated the economic impact of the Northern Ontario School of Medicine (NOSM) on selected communities in the historically medically underserviced and economically disadvantaged Northern Ontario region. Methods Economic impact was estimated by a cash-flow local economic model. Detailed data on program and learner spending were obtained for Northern Ontario communities. We included spending on NOSM’s distributed education and research programs, medical residents’ salary program, the clinical teachers’ reimbursement program, and spending by learners. Economic impact was estimated from total spending in the community adjusted by an economic multiplier based on community population size, industry diversity, and propensity to spend locally. Community employment impact was also estimated. Results In 2019, direct program and learner spending in Northern Ontario totalled $64.6 M (million) Canadian Dollars. Approximately 76% ($49.1 M) was spent in the two largest population centres of 122,000 and 165,000 people, with 1–5% ($0.7 M – $3.1 M) spent in communities of 5000–78,000 people. In 2019, total economic impact in Northern Ontario was estimated to be $107 M, with an impact of $38 M and $36 M in the two largest population centres. The remaining $34 M (32%) of the economic impact occurred in smaller communities or within the region. Expressed alternatively as employment impact, the 404 full time equivalent (FTE) positions supported an additional 298 FTE positions in Northern Ontario. NOSM-trained physicians practising in the region added an economic impact of $88 M. Conclusions By establishing programs and bringing people to Northern Ontario communities, NOSM added local spending and knowledge-based economic activity to a predominantly resource-based economy. In an economically deprived region, distributed medical education enabled distributed economic impact.

The crisis of high labor cost leads companies to evaluate the number of employees in the head office. This study aims to determine the workload and needs of employees in the Directorate of Operations PT Perkebunan Nusantara VIII Head Office. The method used in this research is the analysis of the workload with the calculation of Full Time Equivalent (FTE) and work sampling using purposive sampling techniques. The ideal number of employees at the Directorate of Operations is 40 employees consisting of 21 employees of the Plant Department and 19 employees of the Engineering and Processing Department. Based on teh observation, employee working time in Directorate of Operations shows that the average of employee working time is 87,8 4percent fairly productive because it meets the standard that is above 85 percent.Keywords: workload analysis, job description, work sampling.ABSTRAKKrisis biaya tenaga kerja yang tinggi membuat perusahaan perlu mengevaluasi jumlah karyawan yang ada di kantor pusat. Penelitian ini bertujuan untuk mengetahui beban kerja dan kebutuhan karyawan pada Direktorat Operasional PT Perkebunan Nusantara VIII. Metode yang digunakan dalam penelitian ini adalah analisis beban kerja dengan perhitungan Full Time Equivalent (FTE) dan work sampling dengan penarikan sampel yang menggunakan teknik purposive sampling. Hasil penelitian menunjukkan bahwa jumlah karyawan ideal pada Direktorat Operasional sebanyak 40 karyawan yang terdiri dari 21 karyawan Bagian Tanaman dan 19 karyawan Bagian Teknik dan Pengolahan. Berdasarkan pengamatan penggunaan waktu kerja karyawan pada Direktorat Operasional menunjukkan bahwa rataan persentase waktu produktif karyawan sebesar 87,84 persen. Hal ini menunjukkan bahwa penggunaan waktu kerja karyawan sudah optimal karena sudah memenuhi standar yaitu di atas 85 persen.Kata kunci: analisis beban kerja, uraian pekerjaan, work sampling.

Objectives: The purpose of this study is to analyze the work area of the public health center and to establish a standard work classification system. Methods: We analyzed the general workforce status and Full Time Equivalent using public health information system. At first phase we classified the work of public health center considering Regional public health act and public health functions. Finally, we considered the establishment of sub-organizations in the public health center and classified them into essential tasks and transferable tasks. Results: The work of public health center was classified into policy development, evaluation and research, creating healthy environment and ensuring essential health services. Conclusions: This study suggest a new standard work classification system of public health center in response to change in healthcare environment.

Implementation of antimicrobial stewardship programs (ASPs) with multidisciplinary antimicrobial stewardship teams (ASTs) is critical for appropriate antimicrobial use at healthcare facilities. Although the Japanese medical reimbursement system was revised to allow fees for ASP implementation, several concerns remain, including understaffing and enforcement of the recommendations on ASTs and ASPs in practice. Furthermore, there are no recommendations on full-time equivalents (FTEs) of the core members in ASTs in Japan. This committee report presents our recommendations on ASTs based on an analysis of the nationwide survey on implemented ASPs and staff FTEs at 1358 healthcare facilities conducted by the Japanese Society of Chemotherapy. Our report provides a directive for structural and financial support of ASTs and should aid in planning for the enhancement of AST practices and the organization of new ASTs.

Most economic research on university athletics programs examines National Collegiate Athletic Association Division I universities with some consideration of universities in Division II. Division III universities are very different than Division I, consequently that which holds for athletics might be different. In this paper the relationship between athletics and the number of applications received per existing student is examined using a balanced panel of private Division-III universities from 2003 to 2014. Controlling for numerous common recruiting variables, the results indicate that a larger share of athletes on campus is positively associated with more applications per existing full time equivalent undergraduate students. The presence of football, a large, almost exclusively male set of athletes, is neutral in its relationship with total applications, though positive for male and negative for female applicants. Among Division-III universities with football programs, winning football programs have a neutral effecton applications.

BACKGROUND: Academic faculty who devote most of their time to clinical work often struggle to engage in meaningful scholarly work. They may be disadvantaged by limited research training and limited time. Simply providing senior mentors and biostatistical support has limited effectiveness. OBJECTIVE: We aimed to increase productivity in scholarly work of hospitalists and internal medicine physicians by integrating an Academic Research Coach into a robust faculty development program. DESIGN: This was a pre-post quality improvement evaluation. SETTING: This was conducted at the University of Washington in faculty across three academic-affiliated hospitals and 10 academic-affiliated clinics. PARTICIPANTS: Participants were hospitalists and internists on faculty in the Division of General Internal Medicine at the University of Washington. INTERVENTION: The coach was a 0.50 full time equivalent health services researcher with strong research methods, project implementation, and interpersonal skills. The coach consulted on research, quality improvement, and other scholarship. MEASUREMENTS: We assessed the number of faculty supported, types of services provided, and numbers of grants, papers, and abstracts submitted and accepted. RESULTS: The coach consulted with 49 general internal medicine faculty including 30 hospitalists who conducted 63 projects. The coach supported 13 publications, 11 abstracts, four grant submissions, and seven manuscript reviews. Forty-eight faculty in other departments benefited as co-authors. CONCLUSION: Employing a dedicated health services researcher as part of a faculty development program is an effective way to engage clinically oriented faculty in meaningful scholarship. Key aspects of the program included an accessible and knowledgeable coach and an ongoing marketing strategy.

Purpose The purpose of this study is to describe the efforts undertaken to convert the large university campus of Jordan University of Science and Technology (JUST) into a green, resource-efficient and low-carbon campus by following an action-oriented strategy. Sustainability features of the campus were discussed and benchmarked. Challenges were identified and remedial actions were proposed. Design/methodology/approach Taking 2015 as the baseline year, data on energy, water consumption and solid waste generation for the university campus were collected. Energy consumption for cooling, heating and transportation, besides electric power consumption, were reported, and the associated carbon dioxide (CO2) emissions were estimated. By calculating the full time equivalent of students and employees, carbon emission and water consumption per capita were calculated. A comparison with other universities worldwide was conducted. Findings Although located in a semiarid region with scarce water resources, JUST has set an example by greening its campus through an action-oriented approach. It was found that the per capita carbon emission for JUST campus was 1.33 ton of CO2 equivalent, which is less than the emissions from campuses of other universities worldwide. As for water, this study revealed that the daily per capita water consumption was about 56 L, which is approximately one-third of that for students in institutions in the USA. Furthermore, the findings of this study indicated that the average solid waste generation rate was 0.37 kg per student per day compared to 0.31 kg per capita per day when considering the university community (students and employees) collectively. These figures were less and thus compare favorably to the corresponding data for other universities in both developing and developed countries. Originality/value This research addresses the issue of greening JUST campus, which is one of the largest university campuses in the world. JUST campus is located in a semiarid, water-scarce country, which on its own poses a serious challenge. The originality and value of this study mainly stem from the facts that on the one hand, this is one of the unique and pioneering comprehensive studies of its type and, on the other hand, other universities with similar conditions can benefit from the findings of this research to meet the sustainability objectives on their campus operations.

Benchmarking and comparing group productivity is an essential activity of data-driven management. For clinical anesthesiology, accomplishing this task is a daunting effort if meaningful conclusions are to be made. For anesthesiology groups, productivity must be done at the facility level in order to reduce some of the confounding factors. When industry or external comparisons are done, then the use of total ASA units per anesthetizing sites allows for overall productivity comparisons. Additional productivity components (total ASA units/h, h/case, h/operating room/d) allow for leaders to develop productivity dashboards. With the emergence of large groups that provide care in multiple facilities, these large groups can choose to invest more effort in collecting data and comparing facility productivity internally with group-defined measurements including total ASA units per full time equivalent.

The object of research is the small and medium size enterprises (SMEs) of Taiwan. The implementation of the program Europe 2020 – construction of the innovation economy of the European Union (EU) countries is a priority of the EU. In Latvia, both on average and in the EU, 99.8% of enterprises are SMEs. The search for indicators that influence the creation of an innovative economy and the inclusion of small and medium-sized businesses in the innovation environment is a problem not only for Latvia and the Baltic countries, but for the whole EU.Taiwan is one of the «Asian tigers», which made a huge economic jump-start from an agrarian country to an industrial one. The release in 2016 of a number of high-tech products, such as: Motherboards – 89.7% of the world market, Cable CPE– 84.5% and Notebook PCs– 83.5% of the global market place. The country in a number of countries with innovative economies.Therefore analysis of Taiwan’s experience in building an innovative economy deserves further study and implementation in other countries. For the research, the author used the following methods: content analysis – Information source form and content of a systematic, numerical processing evaluation and interpretation,and statistical analysis – Pearson, Spearman and Tau-Kendall correlation method. Using these methods indicators affecting the number of SMEs were selected. During the theoretical analysis, the author has formulated the advantages of small and medium businesses, conducted a search for indicators affecting small and medium enterprises and their involvement in the innovative environment of Taiwan. The establishment of a linear relationship and the use of the correlation analysis of Pearson, Spearman and Tau Kendall, using SPSS program allowed the author to find the relationship between the indicators: Number of Researchers (full time equivalent); Annual Papers in Science Citation Index (SCI); Annual Papers in Engineering Index (EI); Number of SMEs; Total Employment SMEs; Number ofregistered patents. The use of interrelated indicators solves an important economic task – improving the standard of living of the population based on innovation. Evaluation of these perfomences in the EU countries using econometric methods will allow to implement the innovation policy of states.

Background and importance The introduction of the pharmacy based central intravenous additive service (CIVAS) enabled the batches production of ready-to-administer, non-hazardous intravenous drugs by using the robotic system APOTECAunit. The clinical benefits in terms of a higher quality aseptic process, reduced medication errors and increased quality control testing have been demonstrated. Aim and objectives The aim of the study was to evaluate the impact of the fully automatised CIVAS on the working efficiency of the wards by measuring the time saved in daily nursing practice. Material and methods The study was conducted over 3 months with data collected before and after introducing the CIVAS. Overall, three wards were analysed: inpatient haematology (IH), cardiac surgical (CS) and infectious diseases (ID). The nursing staff was observed daily for 4 weeks. Different tasks associated with the following intravenous drugs supplied by the CIVAS were recorded: ondansetron, palonosetron, cefazoline, piperacillin–tazobactam, ceftriaxone and dexamethasone. The average working time spent on managing intravenous drugs was calculated per full time equivalent (FTE), including direct activities (intravenous drug preparation) and indirect activities (procurement of drugs and medical devices, drugs inventory management, drug ordering). 1.0 FTE was equivalent to a nurse working 8.0 hours per day, 5 days per week. Results The overall time spent on managing intravenous drugs decreased from 1.6 to 0.7 hours/day/FTE in the IH ward, from 0.75 to 0.15 hours/day/FTE in the CS ward and from 2.1 to 0.43 hours/day/FTE in the ID ward. Before implementing the CIVAS, on average 1.0 FTE spent 0.5 hours/day on preparing intravenous drugs, whereas the intravenous drug preparation time was reduced to zero afterwards in each of the three wards. The time spent on procurement decreased by 80% in the IH ward, by 60% in the CS ward and by 75% in the ID ward. The nursing staff shortened the time required for drug inventory management by 33% in the CS ward and by 50% in the IH and ID wards. In all wards, ordering of drugs was reduced by at least 50%. Conclusion and relevance The study showed that the centralised, automated preparation of intravenous drugs optimised the working efficiency of the wards, thereby allowing the nursing staff to dedicate more time to perform tasks directly involved with patient care. References and/or acknowledgements Conflict of interest No conflict of interest

Background and importance In recent years, the incidence of medicine shortages (MS) has rapidly increased at the international level. These supply problems can affect the quality of patient care, due to potential interruption of treatment and, therefore, constitute an important issue for hospital pharmacists. Aim and objectives This study aimed to analyse MS and quantify their economic impact. Material and methods A retrospective observational study was conducted in a 1015 bed teaching hospital, from April 2018 to September 2020. It was based on a spreadsheet that was updated manually on a weekly basis for MS. Quantitative indicators were: (a) number of MS and the drugs involved; (b) duration of MS; (c) classification of the pharmaceutical interventions to manage MS; (d) economic impact of MS; and (e) time devoted to MS weekly analysis. Results Analysis of the collected data showed that: 706 MS were reported and concerned 459 drugs. Average time to restore availability was 60 days. Median duration was 33 days. The pharmaceutical strategies to solve MS were displayed as: No action was needed due to sufficient stock available at the pharmacy for 55.2% of MS. Replacement by the same drug (same active ingredient, same dosage, same pharmaceutical form, different packaging and/or different pharmaceutical company) for 16.8% of MS. Replacement by a similar drug (same active ingredient, different dosage and/or pharmaceutical form) for 14.0% of MS. Replacement by an alternative drug (different active ingredient) for 6.6% of MS. Foreign medicine importation for 6.9% of MS. Restricted use in a limited number of wards for 0.3% of MS. The hypothetical cost was 984 533€ (based on the prices with the regular suppliers), if no MS had occurred. The estimated cost due to MS was 1 633 340€ (based on the prices of the pharmaceutical strategies used). Management of MS required two full time equivalents: one pharmacist and one pharmaceutical technical assistant (cumulative annual remuneration of 128 000€). Conclusion and relevance These results suggested that MS generated an annual cost of 395 761€ for our hospital. Strategies to minimise the effects of MS should be implemented. References and/or acknowledgements Acknowledgements to Manuela Azzolini and Sarah Fadhil, pharmaceutical technical assistants, for their participation in the data collection, and to Guillaume de Marchin, IT specialist, for the extraction of the drug prices presented in this work. Conflict of interest No conflict of interest

Universidad de las Americas Puebla (UDLAP) was founded in 1940 and is one of the most prestigious higher education institutions in Mexico. UDLAP has 9,700 full time equivalent students enrolled at UDLAP and 317 full time equivalent faculty staff are employed. This chapter presents the results from 73 survey respondents. The main focus of the university is on cross-cutting themes, followed by social issues, environmental issues, and economic ones. The contribution is high and the strength is medium. The ranking of the competences shows that Inter-disciplinary work is the highest, followed by Critical thinking and analysis. The ranking of the pedagogical approaches resulted in Case studies and Project- or Problem-based learning were the highest, followed by Lecturing. The correlation analysis showed that Eco-justice and community developed the most competences, followed by Inter-disciplinary team teaching, Place-based environmental education, and Participatory Action Research. The competences most developed were Personal involvement, Anticipatory thinking, Assessment and evaluation, and Interpersonal relations and collaboration. The analyses can help UDLAP on its next sustainability efforts, such as at facilitating its educators to create or update their courses to provide a more complete, holistic, and systemic sustainability education to help students in becoming future leaders, decision makers, educators, and change agents.

The University of Gavle is located in the city of Gavle, Sweden. It has 16,000 students (about 6,500 full time equivalent) and 700 employees. The University of Gavle has been working with sustainability for the last 25 years. The university has extensive experience in working with an environmental management system, certified according to ISO 14001 since 2004. It published its first sustainability report in 2017. This chapter presents the results from the 66 survey respondents. The main focus of the university is on cross-cutting themes. The economic, environmental, and social dimensions have fairly similar percentages. The contribution to sustainability is high and the strength is high. The ranking of the competences shows that Critical thinking and analysis is the highest, followed by Justice, responsibility, and ethics. The ranking of the pedagogical approaches resulted in Project- or Problem-based learning and Case studies were the highest, followed by Inter-disciplinary team teaching. The correlation analysis showed that Project- or Problem-based learning developed the most competences followed by Case studies and then Place-based environmental education. The competences most developed were Systems thinking, Anticipatory thinking, Strategic action, Personal involvement, and Justice, responsibility and ethics. The results highlight a holistic understanding and teaching of sustainability at the University of Gavle. The results provide a necessary mapping of the competences being developed by the educators and the university and the pedagogical approaches being used. Identifying sustainability trends and patterns in teaching at the University of Gavle can help to better integrate sustainability into all educational programmes, so that students can better contribute to making societies more sustainability.

The Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A.) is a private and autonomous university, which since 1983 has offered higher education programmes in the areas of basic, environmental, agricultural, social, administrative, legal, health, education and engineering sciences. It has several campuses and sites in the cities of Bogota and Cartagena (Colombia), with 175 staff (full time equivalent) and 5,057 undergraduate and graduate students. U.D.C.A. is highly committed to social and environmental responsibility “at the service of sustainable human development”. U.D.C.A. has a strong commitment with environmental sustainability in the five main areas of university action: Governance, Training, Research, Outreach, and Management. This chapter presents the results from 21 survey respondents. The main focus of the university is on cross-cutting themes, followed by environmental issues, social issues, and economic ones. The ranking of the competences shows that Critical thinking and analysis is the highest, followed by Inter-disciplinary work. The ranking of the pedagogical approaches resulted in Project- or Problem-based learning and Case studies were the highest, followed by Lecturing. The correlation analysis showed that that Inter-disciplinary team teaching, Traditional ecological knowledge, Eco-justice and community, Community service learning, and Participatory Action Research developed the most competences. The competences most developed were Assessment and evaluation, Strategic action, Empathy and change of perspective and Personal involvement. The results allow U.D.C.A. to identify its strengths and weaknesses in significant aspects of the undergraduate and graduate training it provides to its students.

Because tobacco use remains one of the leading causes of disease, disability, and mortality, tobacco treatment programs should be integrated into medical systems such as hospitals and outpatient centers. Medical providers have a unique, high-impact opportunity to initiate smoking cessation treatment with patients. However, there are several barriers that may hinder the development and implementation of these programs. The purpose of this review was to address such barriers by illustrating several examples of successful tobacco treatment programs in US health-care systems that were contributed by the authors. This includes describing treatment models, billing procedures, and implementation considerations. Using an illustrative review of vignettes from existing programs, various models are outlined, emphasizing commonalities and unique features, strengths and limitations, resources necessary, and other relevant considerations. In addition, clinical research and dissemination trials from each program are described to provide evidence of feasibility and efficacy from these programs. This overview of example treatment models designed for hospitals and outpatient centers provides guidelines for any emerging tobacco cessation services within these contexts. For existing treatment programs, this review provides additional insight and ideas about improving these programs within their respective medical systems.