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PubMed2004

The influence of quality-of-life, academic, and workplace factors on residency program selection.

PURPOSE: To examine the influence of quality-of-life, academic, and workplace factors on residency program selection and determine whether factors are valued differently by applicants choosing surgical (SP) versus nonsurgical (NSP) programs. METHOD: All 16,183 graduates of U.S. allopathic medical schools registered with the Electronic Residency Application Service were surveyed during the 2003 residency match. A total of 7,183 (44%) applicants responded. Selection prevalence from among 20 possible influential factors and the relative importance assigned to those chosen factors were analyzed. RESULTS: The most common factors influencing residency program selection were how much the residency program seemed to care about its trainees (98%), how satisfied the current residents are with their program (98%), how well the applicant thought he or she would fit into the program (97%), the geographic location of the residency (95%), and how well the current residents seem to work with each other (94%). Applicants to NSP were more likely to consider geographic location (p <.001), emphasis on interacting with medical students (p =.019), amount of clinical support services (p <.001), frequency of on-call duty (p =.047), types of benefits (p <.001), salary (p =.023), and supplemental income (moonlighting) opportunities (p <.001) than were applicants to SP. SP applicants were more likely to consider emphasis on research in the residency curriculum (p <.001) and how well the current residents worked together (p <.001) than were NSP applicants. CONCLUSIONS: Of factors that influence residency program selection, those related to the characteristics of the workplace environment and geography are the most important. Minimal differences exist between applicants selecting surgical and nonsurgical specialties regarding academic and quality-of-life issues.

Adult↗
PubMed2000

Protect your staff from workplace violence.

Your staff faces the possibility of workplace violence every day. Information and safety policies can give them a fighting chance. Answer the questions about workplace violence below, then check your answers at http:¿www.nursingmanagement.com.

Humans↗
PubMed1997

The effects of smoking outside workplaces on non-regular smokers.

The introduction of workplace smoking bans has resulted in smokers smoking outside their workplaces (exiled smoking). Social identity theory postulates that this may cause antagonism between smokers and non-smokers, or where non-smokers were friends with smokers, pressure on non-smokers to smoke. This study examines perceptions and beliefs about exiled smoking in 166 non-smoking workers. They saw smokers as having a work benefit not available to them, but otherwise they were generally not drawn to the activity. Half had joined smokers outside for breaks, but of these only one-third had ever smoked. Those would smoked reported that they did not have a regular pattern of joining the same group of smokers. Although it may provide a conduit for susceptible non-smokers to take up smoking, exiled smoking does not appear to influence those who are not otherwise vulnerable.

Adult↗
PubMed1999

Workplace-violence investigations by the California Division of Occupational Safety and Health, 1993-1996.

In response to the growing recognition of violence in the workplace, government agencies who oversee workplace safety are beginning to incorporate security issues into comprehensive safety plans. The California Division of Occupational Safety and Health began conducting inspections for violent events in 1993, and information from these security inspections was collected from January 1993 through January 1997. The inspections were examined by initiating source, industry, type of event, and citations issued and compared with distributions of known victimizations. The factors predicting whether a citation was issued were determined through logistic models. Over 200 inspections were conducted in 11 industries, with retail and health care establishments inspected most frequently. Employee complaints initiated 50.6% of events and accident reports initiated 40.1%. One third of inspections were initiated because of a fatal event, and 27.4% were initiated in response to a physical assault. Citations for security hazards were issued to 23.6% of businesses. Inspections initiated by employee complaints, in response to customer-related security issues, and involving non-fatal assaults were the most frequently cited reasons for inspection. The California Division of Occupational Safety and Health conducted security inspections in a large range of industries and for diverse issues, even though no specific security codes exist.

Accidents, Occupational↗
PubMed2001

Impact of illness and its treatment on workplace costs: regulatory and measurement issues.

In an attempt to document a broader spectrum of the benefits of their pharmaceutical products, drug companies increasingly seek to include productivity claims in their promotional campaigns. We describe the existing regulatory framework of the Food and Drug Administration (FDA) for considering productivity claims, distinguishing between the traditional "substantial evidence" standard and the "competent and reliable scientific evidence" standard. But the notion of competent and reliable scientific evidence may itself be problematic, even when it is the appropriate regulatory standard, because there exists no consistent measurement approach across diseases, workplaces, jobs, and worker capabilities that is widely accepted in this emerging area of health outcomes research. We examine the various measurement approaches that have been used to quantify the impact of illness and its treatment on workplace productivity, and we describe some of the shortcomings associated with each alternative. This discussion highlights the possible difficulties faced by the FDA in reviewing productivity-based promotional claims. Finally, we suggest possible strategies for furthering this field of investigation.

Absenteeism↗
PubMed2001

Effect of state workplace safety laws on occupational injury rates.

The purpose of this study was to evaluate the effect of four common types of mandatory state-level workplace safety regulations on injury severity rates during the period 1992 to 1997 for the manufacturing sector. The full Poisson regression model showed safety committee regulations to have a highly significant reducing effect on injury rates, chi 2 (1, n = 3286) = 10.1774, P = 0.0014. Safety program regulations were significant at the alpha = 0.10 level, chi 2 (1, n = 3286) = 3.5676, P = 0.0589. The effect of insurance carrier loss control regulations in the full model was nonsignificant. However, insurance carrier loss control regulations were highly significant (alpha = 0.01) in the final reduced model. Targeting initiatives were nonsignificant in both the full and reduced models (alpha = 0.05). The study results are important to state and federal agencies considering adopting workplace safety regulations that are similar to the four types evaluated in this study.

Accidents, Occupational↗
PubMed2002

HIV and AIDS in the workplace.

Since the onset of the HIV epidemic, AIDS and HIV infection have presented tremendous challenges to infected individuals seeking to remain productive in the workplace, to employers coping with the special needs of such individuals, and to physicians who treat and counsel exposed or infected personnel. OEM physicians should strive to ensure that employers are familiar with legislation and guidelines protecting the rights of infected employees, and they should support rational workplace policies applying to employees with HIV infection or AIDS. When the potential for occupational HIV exposure exists, OEM physicians should ensure that adequate training around exposure prevention, triage, and treatment is provided. OEM physicians who treat individuals with occupational HIV exposures should involve themselves in institutional efforts to prevent exposures through the use of safer devices and procedures, and they should ensure that immediate and adequate clinical evaluation of exposures is available at all times.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Exposure to secondhand smoke in the workplace: serum cotinine by occupation.

To examine workplace exposure to secondhand smoke by occupation, we analyzed data from The Third National Health and Nutrition Examination Survey (NHANES III) (1988 to 1994), a nationally representative sample of the noninstitutionalized population. The analysis was restricted to 4952 employed nonsmoking adults who reported no home exposure to cigarette smoke. Occupations were assigned to 40 groups and 7 categories. Among the categories, geometric mean serum cotinine (ng/mL) ranged from 0.09 for farming/forestry/fishing occupations to 0.22 for operators/fabricators/laborers (median, 0.16). The lowest values were observed among farmers and nursery workers (0.06) and the highest among waiters (0.47). Between 1988 to 1991 and 1991 to 1994, the overall geometric mean cotinine and the proportion reporting that they could smell smoke at work decreased significantly. In conclusion, workplace exposure to secondhand smoke varied by occupation, and decreases in exposure occurred between 1988 to 1991 and 1991 to 1994.

Adolescent↗
PubMed1995

Fostering a drug-free workplace.

Drug abuse costs American industry and the public an estimated $100 billion a year. As a result, workplace drug testing programs have become a serious option for many companies. Federal guidelines regarding testing and laboratories are in place. An overview of the current components necessary in designing a corporate drug testing program that complies with these guidelines is presented. Essential features of a corporate workplace drug testing program, that is, the policy, the testing process, and the laboratory contracted to test employees, are detailed from designs suggested in the current literature and in compliance with federal guidelines. Developing a cost-effective corporate program that meets federal guidelines, stands up to court scrutiny, and is universally accepted by employees is the objective of a drug testing program. The challenge can be met by building consensus, spelling out policy, maintaining high testing standards, and above all making rehabilitation of employees who test positive the ultimate goal of a drug-free workforce/workplace.

Cost-Benefit Analysis↗
PubMedDate not supplied

Sexuality, sexual harassment, and sexual humor: guidelines for the workplace in health care.

Sexual humor is common in the health care workplace. However, it may be used inappropriately and present a challenge to the manager. Managers must set appropriate standards for workplace humor. When sexual humor is not effectively handled, legal action may result, which wastes time and money for all involved and damages interpersonal relationships.

Administrative Personnel↗
PubMedDate not supplied

Attitudes toward incorporating fun into the health care workplace.

This study examined the extent to which health care workers' attitudes toward fun influenced their level of experienced fun and job satisfaction. We also examined their perceptions of whether 40 workplace activities were fun or not fun. Our results showed that, in general, our sample expressed positive attitudes regarding the appropriateness, salience, and consequences of having fun at work. In addition, those who reported experiencing greater levels of workplace fun had significantly higher job satisfaction. Implications for health care institutions are discussed.

Attitude of Health Personnel↗
PubMed2006

Improving outcomes: focus on workplace issues.

PURPOSE OF REVIEW: Staff satisfaction has not traditionally been included as an intensive care unit quality indicator. The process of providing intensive care may profoundly affect clinicians. Dysfunctional encounters with coworkers and ethical burdens may extract a considerable personal toll and affect work attitudes and performance. RECENT FINDINGS: Mounting evidence indicates that psychosocial tensions, burnout and ethical stress are common and serious problems in the intensive care unit. These experiences impact negatively on job satisfaction, turnover, workplace disruption and patient care. Addressing workplace issues will help improve quality of care. SUMMARY: Two common sources of staff dissatisfaction are examined. Improving staff satisfaction can improve unit performance, and serve to attract and retain quality clinicians.

Burnout, Professional↗
PubMed2003

Health-related workplace productivity measurement: general and migraine-specific recommendations from the ACOEM Expert Panel.

An establishment of health-related productivity measurements and critical evaluation of health-related productivity tools is needed. An expert panel was created. A literature search was conducted to identify health-related productivity measurement tools. Each instrument was reviewed for: 1) supporting scientific evidence (e.g., reliability and validity); 2) applicability to various types of occupations, diseases, and level of severity of disease; 3) ability to translate data into a monetary unit; and 4) practicality. A modified Delphi technique was used to build consensus. The expert panel recommended absenteeism, presenteeism, and employee turnover/replacement costs as key elements of workplace health-related productivity measurement. The panel also recommended that productivity instruments should: 1) have supporting scientific evidence, 2) be applicable to the particular work setting, 3) be supportive of effective business decision-making, and 4) be practical. Six productivity measurement tools were reviewed. The panel recommended necessary elements of workplace health-related productivity measurement, key characteristics for evaluating instruments, and tools for measuring work loss. Continued research, validation, and on-going evaluation of health-related productivity instruments are needed.

Absenteeism↗
PubMed2004

Disparities in smoke-free workplace policies among food service workers.

Information is lacking on which groups of workers are protected from job-related environmental tobacco smoke. Data from the Census Bureau's Current Population Survey are analyzed for trends in smoke-free workplace policies among 38 major occupations. Data are also analyzed to determine the degree of compliance with such policies. Although over three fourths of white collar workers are covered by smoke-free policies, including 90% of teachers, just 43% of the country's 6.6 million food preparation and service occupations workers benefit from this level of protection. Compliance with workplace restrictions is not a significant human resources issue because only 3.8% of workers reported that someone violated a smoke-free policy in 1999, down from 4.9% in 1996. Protection for workers is increasing, but those in food preparation and service occupations are significantly less protected than others.

Female↗
PubMed2006

Modeling the impact of enhanced depression treatment on workplace functioning and costs: a cost-benefit approach.

BACKGROUND: The impact of depression on the workplace has been widely observed in studies examining absenteeism and reduced productivity during days at work. However, there is little scientific evidence about whether depression interventions are cost-beneficial to employers. OBJECTIVE: We construct a cost-benefit analysis of depression treatment under different workplace assumptions better reflecting the nature of employment. RESEARCH DESIGN: Data from a randomized controlled trial in which employed primary care patients with depression were treated in practices randomly assigned to an enhanced treatment intervention or usual care were used to construct a cost-benefit model from an employer perspective under different assumptions regarding employment. SUBJECTS: A national sample of 198 workers employed in a range of positions by companies was studied. MEASURES: Benefits included self-reported productivity and absenteeism; costs included intervention and treatment costs. Net benefit was calculated under different scenarios and return on investment (ROI) is derived. RESULTS: Enhanced depression treatment resulted in an average net benefit to the employer of Dollars 30 per participating worker in Year 1 of the intervention and Dollars 257 per participating worker in Year 2, for an estimated ROI during the 2-year period of 302%. ROI increased in firms that rely on team production, hire more costly substitute labor, or realize penalties for output shortfalls. ROI decreased in firms that have a large fraction of employees with dependent coverage and experience high turnover rates. Results also are sensitive to how subjectively reported productivity is valued. CONCLUSION: Many employers will receive a potentially significant ROI from depression treatment models that improve absenteeism and productivity at work.

Absenteeism↗
PubMed2004

Quality of life: a case report of bullying in the workplace.

The literature on bullying in the workplace describes the mental and physical ill health suffered by the victims and their families as the consequences of the bullying. The literature also discusses methods of bullying such as overt and covert physical and psychological abuse. The implications are that the consequences of abuse go far beyond the intended target; from impact on the working environment to individuals' health to economic and financial loss. The literature suggests various recommendations to employers and managers to combat bullying at work. However, the common assumption within the literature has been that the bullying is done by a colleague, a line manager, or middle manager. Furthermore, it is often assumed that the executive/vice-chancellor, human resources, the trustees, or the governing board are unaware of bullying in their workplace. In this article, it is argued that cases of bullying (whether due to isolated individuals, competition, rivalry, power, or pure meanness as is reported in the literature) can only thrive in a bullying management culture. Therefore, debate and policy formulation must be directed at government level in the first instance. The case report is intended to raise some relevant issues to stimulate a debate and more research in this area.

Humans↗
PubMed2004

Reaction to epilepsy in the workplace.

PURPOSE: The purpose of this study was to determine the characteristics of epilepsy that produce avoidant behavior in the workplace and therefore contribute to the actual stigma that persons with epilepsy are subjected to on the job. METHODS: We developed a survey consisting three vignettes briefly describing a coworker with either depression, multiple sclerosis, or epilepsy. Each vignette was followed by eight identical questions addressing the level of comfort during interactions with the vignette subject. The epilepsy vignette did not describe a seizure. The surveys were hand-distributed in two companies in New York City and returned anonymously by mail. The results of the responses to each illness were compared by chi2, and the responses were correlated with demographic information by using Pearson's correlation. RESULTS: Seventy-four of 200 distributed questionnaires were returned. Respondents reported more anxiety at the thought of interacting with a coworker with epilepsy than with depression or multiple sclerosis, but this difference did not reach significance. Worry about sudden, unpredictable behavior for the coworker with epilepsy was significantly greater than that with multiple sclerosis (p = 0.014). The level of comfort regarding providing first aid for the coworker with epilepsy was significantly less (p = 0.018) than that for depression and multiple sclerosis. Lower job level and lower income level correlated with more social discomfort for all three illnesses. CONCLUSIONS: The idea of a having a coworker with epilepsy may produce some social avoidance. However, the worry about a sudden, unpredictable event and the discomfort regarding providing first aid for a coworker with epilepsy is significant when compared with that with depression or multiple sclerosis. These findings suggest that education about first aid for epilepsy will reduce the worry and discomfort surrounding persons with epilepsy in the workplace.

Adult↗
PubMedDate not supplied

Workplace variables and their relationship to quality client outcomes in home health.

The purpose of the study was to investigate the relationship of workplace variables and client outcomes, and to propose a model of the fit between the workplace variable dimensions of nursing technology (NT) and organizational structure (OS) to predict client outcomes in home health. The researchers used a correlational, predictive, descriptive design to measure NT, OS, nurses' role clarity, client outcomes, and client satisfaction. A convenience sample consisted of 43 home health sites with 205 nurses and 325 clients completing surveys. Nurses perceived that clients had better outcomes when the three dimensions of NT fit the three dimensions of OS: (1) when clients' conditions were unstable, nurses interacted with peers; (2) when care was complex, nurses consulted with supervisors; and (3) when clients' needs varied, nurses used rules to guide clinical decisions. Findings suggested that nurses' understanding of their roles correlated to OS. Nurse managers in home health care settings can use the model constructed as a result of the research to adjust the dimensions of OS to improve client outcomes.

Adolescent↗