United States

Imported Care: Recruiting Foreign Nurses to U.S. Health Care Facilities

Foreign nurses are increasingly being sought, creating a lucrative business for new recruiting agencies both at home and abroad. This paper examines past and current foreign nurse use as a response to nurse shortages and its implications for domestic and global nurse workforce policies. [from abstract]

Health Worker Shortages and Inequalities: the Reform of United States Policy

This paper advocates multiple strategies for the United States to further assist with solving the global health workforce crisis.

Doctor Displacement: a Political Agenda or Health Care Imperative?

In the face of medical workforce shortages, governments are looking to displace doctors with alternative health care providers like nurse practitioners, physician assistants, and other health professionals such as psychologists and pharmacists to relieve bottlenecks in health care delivery. Displacing doctors in this way, or role or task substitution as it is also termed, has been actively pursued in the United Kingdom and United States. How should the medical profession react to these developments? [from author]

Pay for Performance in Primary Care in England and California: Comparison of Unintended Consequences

This study undertook an in-depth exploration of the unintended consequences of pay-for-performance programs In England and California. The authors interviewed primary care physicians in California and England and compared unintended consequences in each setting. [adapted from abstract]

US Physician Workforce: Where do we Stand?

This review surveys trends in physician supply in the United States from 1980 to the present. It discusses the composition of the physician workforce; changes in the inflows and outflows of the physician workforce; and how international migration, retirement, part-time practice and alternative employment have impacted the physician workforce. Finally, the paper considers implications of physician shortages and the recruitment of physicians from abroad. [adapted from summary]

Nurse Workforce Challenges in the United States: Implications for Policy

The United States has the largest professional nurse workforce in the world but does not produce enough nurses to meet its growing demand. The U.S. is now the world’s major importer of nurses, but the shortage is too large to be solved by recruitment abroad without depleting world nursing resources. The national shortage could be largely addressed by investments in expanding nursing school capacity. [adapted from summary]

Sitting in Different Chairs: Roles of the Community Health Workers in the Poder es Salud/Power for Health Project

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs’ perspective. This article presents the CHWs’ points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. [introduction]

Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Nurses to the United States

The Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Nurses to the United States reflects the mutual recognition of stakeholder interests relevant to the recruitment of foreign educated nurses. It is based on an acknowledgement of the rights of individuals to migrate, as well as an understanding that the legitimate interests and responsibilities of nurses, source countries, and employers in the destination country may conflict.

US Based International Nurse Recruitment: Structure and Practices of a Burgeoning Industry

This report summarizes the results of the first year of the two-year project entitled International Recruitment of Nurses to the United States: Toward a Consensus on Ethical Standards of Practice. It examines the structure and basic practices of the U.S. based international nurse recruitment industry. The purpose of the project is to facilitate consensus among stakeholders on how to reduce the harm and increase the benefits of international nurse recruitment for source countries and for migrant nurses themselves. [from author]

Nurse Wages and Their Context: Database Summary (North America, Western Europe and Japan)

These yearly summary reports provide information on nurse wages and the comparitive buying power of these wages in select countries in North America, Western Europe and Japan. The data are results from a survey of 10 National Nurses’ Associations. [from introduction]

Hospital Nurse Staffing and Quality of Care

This report summarizes the findings of AHRQ-funded and other research on the relationship of nurse staffing levels to adverse patient outcomes. This valuable information can be used by decisionmakers to make more informed choices in terms of adjusting nurse staffing levels and increasing nurse recruitment while optimizing quality of care and improving nurse satisfaction. [author’s description]

U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency

This article reviews estimates of U.S. nurse supply and demand, documents trends in nurse immigration to the United States and their impact on nursing shortage, and considers strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. [from abstract]

Crossing Borders: International Nurses in the US Workforce

The story of the international nurse in the U.S. workforce is generally one of perserverance - not only in obtaining a visa and a state license, but in adjusting to living and working in the United States. [author’s description]

United States Physician Workforce and International Medical Graduates: Trends and Characteristics

International medical graduates (IMGs) have been a valuable resource for the United States physician workforce, and their contribution to the United States workforce is likely to increase. This article describes the historical trends and compare the characteristics of IMGs to United States medical graduates in the United States. It also recommends that policymakers consider the consequences for both the United States and source countries. [adapted from abstract]

Graduates of Lebanese Medical Schools in the United States: an Observational Study of the International Migration of Physicians

As healthcare systems around the world are facing increasing physician shortages, more physicians are migrating from low to high income countries. As an illustrative case of international migration of physicians, we evaluated the current number and historical trends of Lebanese medical graduates in the US, and compared their characteristics to those of US medical graduates and other international medical graduates. [abstract]

Nursing Workforce Profile

This yearly profile is a summary of statistics about the nursing workforce in Canada, Denmark, Germany, Iceland, Ireland, Japan, New Zealand, Norway, Sweden, UK and USA.

Guidelines on Workplace Violence in the Health Sector: Comparison of Major Known National Guidelines and Strategies: United Kingdom, Australia, Sweden, USA (OSHA and California)

The present study reviews and analyses major known national guidelines and strategies for prevention and management of workplace violence. The purpose is to get a detailed picture of strategies recommended, a better knowledge on existing guidance for employers and employees. Another objective is to obtain information on the implementation processes and the impact of the reviewed guidelines. Identification of good practices as well as gaps shall serve as a basis for lessons learnt for the development of future guidance materials.

Training Community Health Workers: Using Technology and Distance Education

This paper provides a brief overview of some programs and issues related to the use of technology and distance education to train community health workers in frontier areas. Issues include the use of consistent definitions, the appropriate technology format for the learner and access to that technology, cultural competency /proficiency of faculty, support for faculty and students, and the assurance of quality. [from executive summary]

Management Training of Physician Executives, Their Leadership Styles and Care Management Performance: an Empirical Study

The objective of this study was to examine associations between management training of physician executives and their leadership styles, as well as effectiveness in achieving disease management goals. [author’s description]

Recruitment and Retention of a High-Quality Healthcare Workforce

Functioning health services are key to making the community of New Orleans livable again. Conversely, a livable community is key to attracting a stable healthcare workforce to New Orleans. Hurricane Katrina forced the entire healthcare workforce to evacuate the City of New Orleans and a large majority of these workers have since found jobs elsewhere, such as in neighboring parishes and Texas. This brief summarizes policy options to create and maintain a healthcare workforce, as well as options to bridge the transition from the current situation to the point at which the interventions will show an effect.

Factors that Influence Students in Choosing Rural Nursing Practice: A Pilot Study

This pilot study focused on self-identified factors of nursing students who expressed an interest in rural practice post-graduation. The sample included students from the USA and Canada, who were enrolled in graduate and undergraduate programs of nursing, and were attending an international rural nursing conference. [From abstract]

Migration of Physicians from Sub-Saharan Africa to the United States of America: Measures of the African Brain Drain

The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa.

Migration of Nurses: Trends and Policies

This paper examines the policy context of the rise in the international mobility and migration of nurses. It describes the profile of the migration of nurses and the policy context governing the international recruitment of nurses to five countries: Australia, Ireland, Norway, the United Kingdom, and the United States.

Skill-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles.

This report was commissioned by OECD to examine the evidence on role change and delegation from physicians to advanced practice nurses (APN), nurse practitioners and nurses in other advanced roles in the hospital setting and primary care. The report has three components: a literature review, an assessment of country responses to an OECD questionnaire, and two more detailed country case studies, on England and the US. [author’s description]