New Article: Kerzman et al, Attitudes toward Expanding Nurses’ Authority

Kerzman, Hana, Dina Van Dijk, Limor Eizenberg, Rut Khaikin, Shoshi Phridman, Maya Siman-Tov, and Shoshi Goldberg. “Attitudes toward Expanding Nurses’ Authority.” Israel Journal of Health Policy Research (early view; online first).

 

URL: http://dx.doi.org/110.1186/s13584-015-0005-z

 

Abstract

Background
In recent years, an increasing number of care procedures previously under the physician’s authority have been placed in the hands of registered nurses. The purpose of this study was to examine the attitudes of nurses towards expanding nurses’ authority and the relationships between these attitudes and job satisfaction facets, professional characteristics, and demographics.

Methods
A cross-sectional study was conducted between 2010 and 2011 in three major medical centers in Israel. Participants included 833 nurses working in 89 departments. Attitudes toward the expansion of nurses’ authority were assessed by self-report questionnaire, as well as job satisfaction facets including perception of professional autonomy, nurse-physician working relations, workload and burnout, perceptions of quality of care, and nursing staff satisfaction at work.

Results
Nurses reported positive attitudes toward the expansion of nurses’ authority and moderate attitudes for interpretation of diagnostic tests in selected situations. The results of multivariate regression analyses demonstrate that the nurses’ satisfaction from professional autonomy and work relations were the most influential factors in explaining their attitudes toward the expansion of nurses’ authority. In addition, professionally young nurses tend to be more positive regarding changes in nurses’ authority.

Conclusion
In the Israeli reality of a nurse’s shortage, we are witnessing professional transitions toward expansion of the scope of nurses’ accountability and decision–making authority. The current research contributes to our understanding of attitudes toward the expansion of nurses’ authority among the nursing staffs. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.

 

 

New Article: Lewis and Grant, Expanding the Anesthesiology Workforce in Israel

Lewis, Michael C., and Gilbert J. Grant. “Marketing or Strategy? Defining the Best Approach to Expand the Anesthesiology Workforce in Israel.” Israel Journal of Health Policy Research (early view; online first).

 

URL: http://dx.doi.org/110.1186/s13584-015-0041-8

 

Abstract

There is a chronic shortage of anesthesiologists in Israel. The study by Cohen et al. suggests that a marketing campaign may be one method of addressing this shortage. This commentary argues for a more comprehensive strategy based on the US experience. This would not only involve marketing as suggested by Cohen et al. but would also involve a fundamental change in the Israel anesthesia care model, as well as providing substantial financial incentives to young physicians. We believe that a combination of these approaches will help to alleviate the shortage of anesthesia providers in Israel. Creating a new class of physician extenders, namely, anesthesiologist assistants, would also provide an employment pathway for the skilled medical technicians trained by the Israel Defense Forces, and other non-physicians with an interest in anesthesiology.

 

 

New Article: Schoenbaum et al, Policy Issues Related to Educating the Future Israeli Medical Workforce

Schoenbaum, Stephen C., Peter Crome, Raymond H. Curry, Elliot S. Gershon, Shimon M. Glick, David R. Katz, Ora Paltiel, and Jo Shapiro. “Policy Issues Related to Educating the Future Israeli Medical Workforce: An International Perspective.” Israel Journal of Health Policy Research (early view; online first).

 

URL: http://dx.doi.org/110.1186/s13584-015-0030-y

 

Abstract

A 2014 external review of medical schools in Israel identified several issues of importance to the nation’s health. This paper focuses on three inter-related policy-relevant topics: planning the physician and healthcare workforce to meet the needs of Israel’s population in the 21st century; enhancing the coordination and efficiency of medical education across the continuum of education and training; and the financing of medical education. All three involve both education and health care delivery.

The physician workforce is aging and will need to be replenished. Several physician specialties have been in short supply, and some are being addressed through incentive programs. Israel’s needs for primary care clinicians are increasing due to growth and aging of the population and to the increasing prevalence of chronic conditions at all ages. Attention to the structure and content of both undergraduate and graduate medical education and to aligning incentives will be required to address current and projected workforce shortage areas. Effective workforce planning depends upon data that can inform the development of appropriate policies and on recognition of the time lag between developing such policies and seeing the results of their implementation.

The preclinical and clinical phases of Israeli undergraduate medical education (medical school), the mandatory rotating internship (stáge), and graduate medical education (residency) are conducted as separate “silos” and not well coordinated. The content of basic science education should be relevant to clinical medicine and research. It should stimulate inquiry, scholarship, and lifelong learning. Clinical exposures should begin early and be as hands-on as possible. Medical students and residents should acquire specific competencies. With an increasing shift of medical care from hospitals to ambulatory settings, development of ambulatory teachers and learning environments is increasingly important. Objectives such as these will require development of new policies.

Undergraduate medical education (UME) in Israel is financed primarily through universities, and they receive funds through VATAT, an education-related entity. The integration of basic science and clinical education, development of earlier, more hands-on clinical experiences, and increased ambulatory and community-based medical education will demand new funding and operating partnerships between the universities and the health care delivery system. Additional financing policies will be needed to ensure the appropriate infrastructure and support for both educators and learners.

If Israel develops collaborations between various government agencies such as the Ministries of Education, Health, and Finance, the universities, hospitals, and the sick funds (HMOs), it should be able to address successfully the challenges of the 21st century for the health professions and meet its population’s needs.