Leadership progression in schools of allied health.

The purpose of this study was to determine the number of future vacancies in the lead administrator positions (i.e., dean or director) in schools and units of allied health academic programs and the potential pool of candidates for the positions. The survey was mailed to the deans or directors of the 100 institutional members of the Association of Schools of Allied Health Professions (ASAHP). The response rate was 80%. Of the respondents, 58% reported intentions to vacate their positions in the next decade; another 28% reported being unsure of their plans. Retirement was listed as the primary reason (76%). The respondents listed 239 qualified candidates for their positions, or 5.2 candidates per vacancy. The ASAHP's initiatives in leadership development appear to have prepared allied health education for leader succession.

Strategic planning in a school of health related professions: organizational transformation for the future.

The School of Health Related Professions (SHRP) at The University of Alabama at Birmingham (UAB) has been in existence for over a quarter of a century. During this time, it expanded and grew to offering 34 individual programs at the time of its silver anniversary. A concerted strategic planning process over two years has resulted in the School pursuing major organizational transformations to better align itself with the rest of the University's academic health center, to maximize its resources, and to refine its niche in academia. The strategic planning process used and major outcomes are described for the potential benefit of other schools of health related professions desiring to pursue introspection for future survival.

The development of a state-level health manpower database using an employer-based survey: a pilot project.

State health care reform may provide a better approach to meeting the health care needs of rural communities than does federal reform because the planning is closer to the needs of local communities. However, state health reform requires a health manpower database (along with other data) that includes all health occupations and such databases are often nonexistent. This study reports on one element of such a database--a survey of a wide range of rural health care employers covering the full range of health occupations in Alabama. Information on current and future employment of the most significant health occupations is reported here. It was found that the greatest numbers of new health personnel employees needed in the future were, in descending order, nursing assistants, registered nurses, licensed practical nurses, radiological technicians, specialist physicians, nurse practitioners, physical therapists, primary care physicians, and respiratory care therapists. While an employer survey has limitations and should be supplemented by data on community needs and health status indicators, it does provide useful information for planning educational programs to prepare health personnel.

Multiskilled health practitioners: a viable strategy for health-care delivery.

Multiskilled health practitioners offer a viable strategy for addressing the personnel shortages and cost-containment pressures that most departments within hospitals and other health-care organizations are experiencing. With sufficient attention to state licensure and practice act constraints, management issues, and employee job satisfaction through job enrichment and appropriate employee selection, multiskilled health practitioners can benefit both employers and employees. The results of a national documentation project relative to multiskilled workers in health care are provided with applications and guidance for managers who wish to implement the concept.

Differences in innovation-related characteristics between singleskilled and multiskilled health practitioner educational programs.

A survey of educational programs preparing single- and multiskilled health practitioners was conducted to determine the predictive power of organizational formalization and centralization and individual program director cosmopolitanism (ie, orientation to their larger profession as opposed to local environment) upon readiness to innovate for the educational units. Questionnaires were sent to 45 directors of programs preparing multiskilled health practitioners and 49 directors of programs preparing singleskilled health practitioners. Results indicated no significant differences between program directors of single- and multiskilled programs in their perceptions of the readiness to innovate for their educational units. Regression analysis indicated that a decentralized organization was a predictor of an educational unit's readiness to innovate. This finding held for both single- and multiskilled programs. Although cosmopolitanism was not a significant predictor of readiness to innovate, program directors at four-year institutions had a significantly higher level of that characteristic than directors at two-year institutions. The results of this study, although limited by individual and not multiple responses from each institution, do not indicate any differences in the ability of organizational formalization and centralization to predict the innovative characteristics of single- and multiskilled allied health programs. Additionally, the cosmopolitanism of program directors also does not predict these same characteristics.

The impact of multiskilled practice on the job satisfaction of medical laboratory personnel.

This study examined practice patterns of medical laboratory personnel and investigated relationships of job-related variables and job satisfaction for single- and multiskilled practitioners. Data were collected from a random sample of American Society of Clinical Pathologist-registered practitioners in a five-state region. Twenty-five percent of the sample was categorized as multiskilled. Regression analysis revealed that work performed had a significant positive contribution to overall job satisfaction for medical laboratory technicians (MLTs) and medical technologists. The strength of the relationship was weakest for multiskilled MLTs. Results support the contention that when jobs are redesigned, enriching them by adding tasks of increased complexity and challenge is possibly more effective than simply enlarging the jobs with lower- or parallel-level tasks.

Utilization and management of multiskilled health practitioners in U.S. hospitals.

This article examines the utilization and management of multiskilled health practitioners by U.S. hospitals. Results indicate such utilization is greatest for small hospitals as well as for other not-for-profit and government nonfederal hospitals. Flexibility, efficiency, and cost containment are the major reasons for utilizing such personnel. Secondary skills added to most multiskilled workers were of a parallel or lower level. Managerial issues and implications in utilizing multiskilled workers including training, compensation, evaluation, supervision, and competency assessment are also discussed.

Effects of a surgical case review handbook on chart documentation.

The study results demonstrated statistically significant improvement in chart documentation after handbook distribution for the residents (t = 5.67, p.05). Improvement was made in the attending group after distribution of the handbook relative to documentation, but it was not statistically significant. The attending physicians showed a reduction of 1.2 percent in the mean percentage of documentation errors per month after use of the handbook, whereas the residents showed a reduction of 5.0 percent. The new residents (first-year) reached levels of chart documentation comparable to the more senior residents (second- and third-year) within three months after handbook distribution. During the study period, no interventions or efforts were made other than distribution of the handbook. Therefore, it can be concluded that the handbook produced an improvement in chart documentation compliance for all physicians, with a statistically significant effect for the resident physicians. The results indicate a high potential benefit for the first-year residents in particular.

Multiskilled health practitioners. Applications to group practice.

Multiskilled health practitioners (MSHPs) may be used to reduce costs and increase the availability of services for group practices. There are a variety of possible competency combinations for MSHPs, many of which are unique to the needs of specific health care facilities. Examples of MSHPs as well as employer and employee perceptions of multiskilled needs relevant to health care delivery and applications to the group practice setting are presented.

The effect of risk assessment in conjunction with health promotion education on compliance with preventive behaviors.

In this study, 55 subjects were given prevention-oriented recommendations from general, detailed nutritional, and Type A personality risk assessments in conjunction with health promotion education. Changes in compliance with health behaviors were measured 13 months after the first assessment, using the same three risk assessment instruments. Based on self-report, a statistically significant number of persons changed from noncompliance to compliance on three nutritional behaviors, three behaviors related to health-promoting exercise and recreation, and one medical screening behavior. A statistically significant reduction in mean from the first to second year was observed for daily sodium intake and percent of calories from fat, and a significant increase in mean percent of time using seatbelts. Though limited by study design, the results provide encouraging evidence in support of the proposition that risk assessment in conjunction with health promotion education can effect positive change in preventive behaviors.

The multiskilled health practitioner movement: where are we and how did we get here?

Multiskilled practitioners have been in health care settings for a long time. The form multiskilled practitioners have taken has varied with the cultural, socioeconomic, and technological constructs of the times. Some multiskilled practitioners have come and gone while others, such as the medical assistant and physician assistant, have remained. The complexity and sophistication of skills being combined have increased over time as have the degree level and opportunities for dual certification. Skills have been combined both across and within disciplines. There is currently a greater number and variety of formal programs to prepare multiskilled health practitioners in educational institutions and health care facilities, and more informal on-the-job training efforts than ever before--and they are increasing. Employment of multiskilled personnel has become a survival strategy for health care institutions in this current era of cost containment. Multiskilled allied health practitioners with basic nursing skills (ie, LPN level) may also provide one step toward a solution to the nursing personnel shortage being experienced by some health care facilities. The catchword for multiskilled has become not "whether," but "how."15 It is to everyone's benefit to learn from the efforts of those with experience in implementing the multiskilled health practitioner concept for both national and international application. The National Multiskilled Health Practitioner Clearinghouse intends, through its publications, services, and resource files, to serve as the cornerstone upon which the information from those with experience can be reposited and disseminated.

A health professions faculty workload plan for a liberal arts setting.

This case study describes an approach to planning the workload and expenditure of allied health faculty effort. The plan is based upon a review of the literature, a survey of other schools in similar settings, and faculty negotiation. It meets the need for faculty accountability, congruence between faculty workloads and institutional goals, faculty staffing determinations, and a means to compare nursing and allied health faculty workloads with those of more traditional liberal arts faculty. The plan may serve as a model for other health professions academic units.

Multicompetent allied health professionals: current approaches and suggestions for baccalaureate level programs.

A study of the need for multicompetency was conducted by the University of Florida College of Health Related Professions among the graduates of its baccalaureate programs in dietetics, medical technology, occupational therapy, and physical therapy. Most responding dietitians, physical therapists, and occupational therapists said they had felt a need during their professional practice to be competent in areas outside their profession, while most responding medical technologists did not feel such a need. The respondents listed those areas outside their profession in which they had felt a need for competency. This article also describes current approaches to the education of multicompetent allied health professionals and suggests new strategies for educating these personnel at the baccalaureate level.

Implications for the use of field mode assessment of students in allied health programs.

This paper describes the results of a study which revealed that the majority of students in the allied health disciplines of nursing and medical technology are perceptually field dependent according to Witkin's model of field mode, while the majority of practitioners in these disciplines are field independent. Also described are the results of a second study to determine the validity of the hypothesis that debilitation of student test performance caused by stress produced from complex multiple choice formats accounts for the observed difference in field mode between students and practitioners of allied health. Further possible explanations for such a field mode difference, with implications for the use of field mode assessment of allied health students as an aid in the evaluation of student learning and in employment counseling, are described.

Educating clinical laboratory scientists in the 1980s: some suggestions.

Projected changes in health care needs and delivery systems carry implications for clinical laboratory science education. Suggestions on how medical technology programs may produce graduates who will function better in future health care delivery systems are described.