Health workforce governance: Processes, tools and actors towards a competent workforce for integrated health services delivery

Barbazza, Erica; Langins, Margrieta; Kluge, Hans; Tello, Juan

doi:10.1016/j.healthpol.2015.09.009

Cited by 50 publications

(38 citation statements)

References 46 publications

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“…At the same time, in recent years there has been a continuous reorganization of the health system and health workforce, aiming to reduce hospitals and to increase alternative services, especially in primary care, with the purpose of offering better follow-up, continuity of care for outpatients with chronic degenerative diseases and integrated care structures for the diagnosis and treatment of different pathologies (Barbazza, Langins, Kluge, & Tello, 2015;WHO, 2016). The delivery of these new health services, which are more functional for the needs of the population and the rationalization of health expenditures, would also seem to suggest a change in nurses' work in terms of greater autonomy and role specialization, strengthening its jurisdictional boundary in the workplace arena (Abbott, 1988;Salhani & Coulter, 2009).…”

Section: Professional Paths and Institutional Constraintsmentioning

confidence: 99%

Professionalization without Autonomy: The Italian Case of Building the Nursing Profession

Sena

2017

P&P

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Abstract:The nursing professionalization is still a work in progress, especially because forms of medical dominance and conflicts with other health professions often undermine its professional autonomy. This article contributes to the understanding of the relationship between professionalization and autonomy building in the health professions by presenting the case of Italian nursing, where medical dominance, supported by the legal system, is the main factor preventing nursing from achieving professional autonomy. The work aims particularly to understand how professionalization and professional autonomy can follow two parallel and sometimes opposite paths toward building the nursing profession, and the role of academic knowledge and specialized roles to legitimize and strengthen professional autonomy. The analysis draws on the literature addressing professionalization, professional autonomy, and medical dominance, as well as various sources on Italian nursing. They include national legislation, research literature, and national sociological surveys on Italian nurses.

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Section: Professional Paths and Institutional Constraintsmentioning

confidence: 99%

Professionalization without Autonomy: The Italian Case of Building the Nursing Profession

Sena

2017

P&P

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“…Research has shown that elements from the health system or health policy levels influence the implementation and success of integrated care activities. In short, policy is necessary but not sufficient [33], strengthening health workforce is imperative [34], interacting barriers and facilitators to implementation exist [18,[35][36][37][38] and finally, individual leadership [39,40] as well as attitude towards change and innovation [41] play important roles. The Swiss health system ranks very well internationally regarding quality of care, access, efficiency, equity and healthy lives [42].…”

Section: Introductionmentioning

confidence: 99%

Integrated care in Switzerland: Results from the first nationwide survey

Filliettaz

Berchtold²,

Kohler

et al. 2018

Health Policy

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“…It is increasingly becoming clear that better health workforce governance can make a difference to health system performance and policy implementation [1–5] and this brings monitoring into sight as a backbone of informed policy-making. Over recent years, data on health human resources have significantly improved in the European Union (EU) member states and internationally [6–11].…”

Section: Introductionmentioning

confidence: 99%

“…A recent policy analysis recalls that ‘the need to pay attention to components of systemic and intersectoral governance is becoming increasingly clear’ ([19], p. 130). So there is no shortage of problem diagnoses, and ‘therapeutic advice’ and measurements have also significantly improved [1, 26, 52–56]. Yet little is known on how to make better health workforce governance happen.…”

Section: Introductionmentioning

confidence: 99%

Regional health workforce monitoring as governance innovation: a German model to coordinate sectoral demand, skill mix and mobility

2016

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BackgroundAs health workforce policy is gaining momentum, data sources and monitoring systems have significantly improved in the European Union and internationally. Yet data remain poorly connected to policy-making and implementation and often do not adequately support integrated approaches. This brings the importance of governance and the need for innovation into play.CaseThe present case study introduces a regional health workforce monitor in the German Federal State of Rhineland-Palatinate and seeks to explore the capacity of monitoring to innovate health workforce governance. The monitor applies an approach from the European Network on Regional Labour Market Monitoring to the health workforce. The novel aspect of this model is an integrated, procedural approach that promotes a ‘learning system’ of governance based on three interconnected pillars: mixed methods and bottom-up data collection, strong stakeholder involvement with complex communication tools and shared decision- and policy-making. Selected empirical examples illustrate the approach and the tools focusing on two aspects: the connection between sectoral, occupational and mobility data to analyse skill/qualification mixes and the supply–demand matches and the connection between monitoring and stakeholder-driven policy.ConclusionRegional health workforce monitoring can promote effective governance in high-income countries like Germany with overall high density of health workers but maldistribution of staff and skills. The regional stakeholder networks are cost-effective and easily accessible and might therefore be appealing also to low- and middle-income countries.

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Health workforce governance: Processes, tools and actors towards a competent workforce for integrated health services delivery

Cited by 50 publications

References 46 publications

Professionalization without Autonomy: The Italian Case of Building the Nursing Profession

Professionalization without Autonomy: The Italian Case of Building the Nursing Profession

Integrated care in Switzerland: Results from the first nationwide survey

Regional health workforce monitoring as governance innovation: a German model to coordinate sectoral demand, skill mix and mobility

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