Knowledge jobs--how to manage without burnout?
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The working world is progressing from the industrial era to the era of knowledge. The critical factor of success in work is shifting from machines to the human mind. All work that essentially uses and produces knowledge during and as a result of the work process can be defined as knowledge work. Knowledge jobs involve many health-promoting features, but stress and burnout may be caused by the rapid increase in the knowledge-intensity of work, new job demands, and emerging new professional subcultures emphasizing excessive commitment to work. Very little empirical evidence is available on these developments. Much more research is needed to understand the essential features of knowledge work, the change in organizational cultures, and the values guiding this process from the point of view of human resources. Research is also needed to develop organizational strategies for the prevention of stress and burnout in knowledge jobs. (+info)
Medical informatics in healthcare organizations: a survey of healthcare information managers.
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OBJECTIVE: To assess the medical informatics needs of healthcare organizations and the work roles for informaticists in those organizations. METHODS: A 128-item survey was developed and administered as a structured interview to thirty-two information managers in eighteen organizations. The survey included items about medical informatics training, prior work experience, skills for informaticists, and programming proficiency. RESULTS: There was a strong preference for informaticists with prior clinical work experience and an understanding of healthcare. Project management and data warehousing were highly rated skills. Informaticists were expected to know about healthcare processes, clinical guidelines, and outcome management. They were not expected to be expert programmers. CONCLUSION: There is a role in healthcare organizations for interdisciplinary workers who understand clinical medicine, healthcare management, information technology, and who can communicate and work effectively across these organizational boundaries. (+info)
Barriers to employment-related healthy public policy in Canada.
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The Ottawa Charter for Health Promotion calls for building healthy public policy, that is for '[putting] health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health'. The objective of this study was to assess the past and potential future influence of information about the health consequences of unemployment and job insecurity on policy making and to identify the barriers to the use of such information in policy making. We conducted telephone interviews with 38 policy makers in the health and employment sectors of all three levels of Canadian government, as well as the executive directors of 10 Canadian non-governmental organizations that are active on employment issues. The interviews included both numerical ratings of the influence of this information and semi-structured questions about how this information could be used in policy making. Using an interpretive approach grounded in the political science literature, we identified barriers to using this information in their responses to these questions. Respondents rated the potential future influence of this information (mean 4.2 and median 5 on a seven-point Likert scale) higher than its past influence (mean 3.5 and median 3 on a seven-point Likert scale). Barriers related to the information itself or more commonly to the values of those who could respond to the information (i.e. idea-related barriers) were cited more frequently than either barriers related to how decisions are made (i.e. institution-related barriers) or barriers related to who would win and who would lose if the information were acted upon (i.e. interest-related barriers). We concluded that to build employment-related healthy public policy, these barriers would have to be overcome. Policy makers in health departments could, for example, frame information about health consequences in language that fits more easily with the values of other departments and advocate for institutional innovations that establish cross-departmental or cross-governmental accountability for health. (+info)
Ethical and research dilemmas arising from a questionnaire study of psychological morbidity among general practice managers.
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A questionnaire-based research project enquiring into the psychological health of general practice managers found that 5% of managers admitted to suicidal ideas. This paper explores the moral issues raised when research conducted at a distance uncovers information about participants which indicates that they may be at increased risk of harm. It examines whether the authors of such studies have responsibilities towards their research participants beyond those of analysing and properly interpreting the data supplied to them. The paper is an exercise in self-reflection and self-criticism; not all the questions posed and explored by it can be answered definitively. Implications for planning studies of this kind are discussed. (+info)
Perceived outcomes of public health privatization: a national survey of local health department directors.
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Almost three quarters of the nation's local health departments (LHDs) have privatized some services. About half of LHD directors who privatized services reported cost savings and half reported that privatization had facilitated their performance of the core public health functions. Expanded access to services was the most commonly reported positive outcome. Of those privatizing, over two-fifths of LHDs reported a resulting increase in time devoted to management. Yet, one-third of directors reported difficulty monitoring and controlling services that have been contracted out. Communicable disease services was cited most often as a service that should not be privatized. There is a pervasive concern that by contracting out services, health departments can lose the capacity to respond to disease outbreaks and other crises. (+info)
Privatization and the scope of public health: a national survey of local health department directors.
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OBJECTIVES: This study sought to obtain and analyze nationally representative data on (1) privatization of local health department services, (2) local health department directors' beliefs and perspectives on the desirable role and focus of health departments, and (3) the influence of these views on privatization practices. METHODS: A stratified representative national sample of 380 local health department directors was drawn, and 347 directors were interviewed by telephone. Logistic regression established the independent effects of various factors on decisions to privatize. RESULTS: Almost three quarters (73%) of the local health departments privatized public health services of some type. The 12% of the directors who believed that local health departments should be restricted to the core public health functions and move entirely out of direct provision of personal health care were more likely to privatize services. The 77% of the directors who believed that local health departments should be involved in an increasing array of social problems were more likely to privatize. CONCLUSIONS: Privatization has quietly and quickly become commonplace in public health, and privatization practices are intimately related to divergent conceptions of public health and the role of local health departments. (+info)
The first year of Health Improvement Programmes; views from Directors of Public Health.
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BACKGROUND: The White Paper The new NHS, modern, dependable gave the strategic lead at the local level in the new National Health Service to Health Authorities (Boards in Scotland and Northern Ireland). They are expected to lead the development of strategies that will identify the health needs of local people and what has to be done to meet them. These Health Improvement Programmes (HImPs) will be the local strategy for improving health and health care and the means to achieve national targets for each Health Authority or Board area. METHOD: To assess the strengths and weaknesses of HImP production for 1999, a questionnaire survey was carried out of Health Authorities or Boards throughout the United Kingdom. Participants were all district Directors of Public Health (DsPH) or Chief Administrative Medical Officers (CAMOs). The main outcome measures were the opinions of DsPH or CAMOs on the successes and failures of their local HlmP process. RESULTS: Ninety-three (83.8 per cent) DsPH responded. In just over half of all Health Authorities or Boards (56 per cent) the DsPH had taken the lead in producing the HlmP. Many aspects of the HlmP process went well, including multiagency 'stakeholder' involvement and partnership working, good project management, and agreeing a limited set of priorities for action. Key problems included: the short timescale and late Departments of Health guidance; difficulty in obtaining commitment from some local 'stakeholders'; linking HlmP aspirations with service and financial planning and securing funding for HlmP priority developments. Action plans to improve health and health care services were well developed in 40.5 per cent of HlmPs. This was less so for social services (8.3 per cent). It was too soon to assess the impact of HlmPs on the public's health. CONCLUSIONS: DsPH or CAMOs and local 'stakeholders' have been on a learning curve for HlmP production during 1999. Lessons learnt will translate into better HlmPs for next year. DsPH urged the Departments of Health to fully support HlmPs through resources and management processes so that HlmPs can realize their potential benefits for local populations. (+info)
Mortality of men versus women in comparable high-level jobs: 15-year experience in the Federal Women's Study.
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The authors investigated exposure to high-level occupations in relation to the well-known survival advantage of women compared with men of the same age. Women in the federal workforce in positions of General Schedule 14 and above in 1979--1993 (n = 4,727) were each matched with three men (n = 14,181) by age, General Schedule level, and supervisory role. Fifteen-year mortality rates were compared between men and women and against expected 15-year mortality from the US general population. Despite similar job demands, women experienced markedly lower 15-year mortality than did men. However, men in these positions had nearly 50% lower mortality compared with age-matched men in the general population; the comparable reduction for women was 38%. The simultaneous substantial, but unequal by gender, improvement in mortality resulted in a reduced male/female mortality ratio, from 1.67 in the general population to 1.40. The reduced male/female mortality ratio was especially prominent for cancer and was not evident for heart disease mortality. Survival was nominally higher in non-White than in White participants. In summary, high-level employment is associated with substantially reduced mortality in both men and women. The relative improvement in survival is greater in men despite a comparable reduction in risk of heart disease mortality by gender. (+info)