Browsing by Person "Dussault, G."

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Nurses in advanced roles: A review of acceptability in Portugal [Enfermeiros em funes avanadas: Uma anlise da aceitao em Portugal]
(2013-02) Buchan, James; Temido, M.; Fronteira, Ins; Lapo, L.; Dussault, G.
Objective: This paper focuses on the policy context for the deployment of nurses in advanced roles, with particular reference to Portugal. The health sector in Portugal, as in all countries, is labour intensive, and the scope to utilise nurses in more advanced roles is currently being debated. Methods: Mixed methods were used: an analysis of international data on the nursing workforce; an analysis of documents and media articles; interviews with key-informants; an online survey of managers, and a technical workshop with key-informants. Conclusions: The limited evidence base on nurses in advanced roles in Portugal is a constraint on progress, but it is not an excuse for inaction. Further research in Portugal on health professionals in innovative roles would assist in informing policy direction. There is the need to move forward with a fully informed policy dialogue, taking account of the current political, economic and health service realities of Portugal.
Nursing Workforce Policy and the Economic Crisis: A Global Overview
(2013-09-08) Buchan, James; O'May, Fiona; Dussault, G.
Purpose To assess the impact of the global financial crisis on the nursing workforce and identify appropriate policy responses. Organizing Construct and Methods This article draws from international data sources (Organisation for Economic Co-operation and Development [OECD] and World Health Organization), from national data sources (nursing regulatory authorities), and the literature to provide a context in which to examine trends in labor market and health spending indicators, nurse employment, and nurse migration patterns. Findings A variable impact of the crisis at the country level was shown by different changes in unemployment rates and funding of the health sector. Some evidence was obtained of reductions in nurse staffing in a small number of countries. A significant and variable change in the patterns of nurse migration also was observed. Conclusions The crisis has had a variable impact; nursing shortages are likely to reappear in some OECD countries. Policy responses will have to take account of the changed economic reality in many countries. Clinical Relevance This article highlights key trends and issues for the global nursing workforce; it then identifies policy interventions appropriate to the new economic realities in many OECD countries.
Policies to sustain the nursing workforce: an international perspective
(2015-01) Buchan, James; Twigg, D.; Dussault, G.; Duffield, Christine M.; Stone, P.W.
Aim: Examine metrics and policies regarding nurse workforce across four countries. Background: International comparisons informs health policy makers. Methods: Data from the OECD were used to compare expenditure, workforce and health in: Australia, Portugal, the United Kingdom (UK) and the United States (US). Workforce policy context was explored. Results: Public spending varied from less than 50% of gross domestic product in the US to over 80% in the UK. Australia had the highest life expectancy. Portugal has fewer nurses and more physicians. The Australian national health workforce planning agency has increased the scope for co-ordinated policy intervention. Portugal risks losing nurses through migration. In the UK, the economic crisis resulted in frozen pay, reduced employment, and reduced student nurses. In the US, there has been limited scope to develop a significant national nursing workforce policy approach, with a continuation of State based regulation adding to the complexity of the policy landscape. The US is the most developed in the use of nurses in advanced practice roles. Ageing of the workforce is likely to drive projected shortages in all countries. Limitations: There are differences as well as variation in the overall impact of the global financial crisis in these countries. Conclusion: Future supply of nurses in all four countries is vulnerable. Implications for nursing and health policy: Work force planning is absent or restricted in three of the countries. Scope for improved productivity through use of advanced nurse roles exists in all countries
Scaling-up the medical workforce in Timor-Leste: Challenges of a great leap forward
(Elsevier, 2013-07) Cabral, J.; Dussault, G.; Buchan, James; Ferrinho, P.
The health services system of Timor-Leste (T-L) will, by 2015, add 800 physicians, most of them trained in Cuba, to the 233 employed by the national health system in 2010-2011. The need for more physicians is not in discussion: poor health indicators, low coverage and utilization of services, and poor quality of services are well documented in T-L. However, the choice of this scaling-up, with a relatively narrow focus on the medical workforce, needs to be assessed for its relevance to the health profile of the country, for its comprehensiveness in terms of other complementary measures needed to make it effective. This article discusses the potential effects of the rapid scaling-up of the medical workforce, and the organizational capacity needed to monitor the process and eventually mitigate any deleterious consequences. The analysis is based on a review of documentation collected on site (T-L) and on interviews with key-informants conducted in 2011. We stress that any workforce scaling-up is not simply a matter of increasing numbers of professionals, but should combine improved training, distribution, working conditions, management and motivation, as a means towards better performing health services' systems. This is a major challenge in a context of limited organizational and managerial capacity, underdeveloped information systems, limited training and research capacity, and dependency on foreign aid and technical assistance. Potential risks are associated with funding the additional costs of recruiting more personnel, associated expenditures on infrastructure, equipment and consumables, the impact on current staff mix, and the expected increased demand for services. We conclude that failing to manage effectively the forthcoming great leap forward will have long term effects: formal policies and plans for the balanced development of the health workforce, as well as strengthened institutions are urgently needed. 2013 Elsevier Ltd. All rights reserved.