Objectives: This presentation compares the health care restructuring actions and utilization patterns contributing to hospital workforce downsizing in several developed nations, and the impact of these activities on the nations' workforce and patient outcomes. It discusses international health care leaders and researchers' identification of the issues in hospital health care delivery arising from these changes. Lastly, it describes recommendations based on a synthesis of the findings.
Methods: An international survey of literature from 1990 to the present addressing hospital workforce downsizing provides the context for a cross-country comparison, integration and synthesis of issues and a discussion regarding possible future directions. The survey will be conducted through an exhaustive search of international nursing, medical, health services, and economic publications.
Expected Findings: The presentation will be based on the review. Anticipated findings include the following: Restructuring actions contributing to hospital workforce downsizing are similar across developed nations despite differences in health care systems. Financial and utilization pressures are expected to be significant indicators of hospital workforce downsizing. International patterns of workforce utilization, particularly nurse staffing, show diversity as well as similarities regarding labor force reductions and nursing staff skill-mix changes. Research in several countries indicates a link between inadequate nurse staffing or skill-mix changes and poorer quality of patient care.
Implications for Policy and Practice: The various international experiences and suggestions are the context for a discussion of proposals to manage restructuring pressures in a manner which maximizes workforce utilization and ensures positive patient outcomes.
Learning Objectives: Participants will: 1. Describe the utilization patterns and restructuring actions contributing to hospital workforce downsizing internationally. 2. Compare and integrate the reported impact of hospital downsizing on the employment, health, and performance of the hospital workforce internationally. 3. Compare and integrate the perceived and researched impact of hospital downsizing on patient outcomes internationally. 4. Summarize and synthesize the issues identified by international leaders and researchers and their recommendations regarding hospital downsizing. 5. Summarize and synthesize research needs.
Keywords: Health Care Restructuring, Health Care Delivery
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.