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Table 3 Characteristics of the review included for well performing and motivated workforce

From: Evidence from facility level inputs to improve quality of care for maternal and newborn health: interventions and findings

Reviews (n=12) Description of included interventions Type of Studies included (no) Targeted health care providers Outcome reported Pooled data (Y/N) Results
     Other outcomes MNCH specific outcomes   
Baker 2010[36] Strategies to improve professional practice that are planned taking account of prospectively identified barriers to change. 26 trials (12 meta-analyzed) Healthcare professionals responsible for patient care in HIC Desired professional practice   Yes 1.52 (1.27- 1.82)
Blanca-Gutierrez 2012[35] Implementation of any intervention to reduce absenteeism among hospital nursing staff. RCT: 11
observational trials: 4
Nursing staff Nurses working full-time versus other working time   No 3.2 days on average absenteeism in nurses full-time versus 2.5 working in time partial
     Cognitive behavioral therapy    The intervention group had an average of 2.29 absences hours against 14 hours in the group control
     Flexibility of shifts (From 4 hour shifts duration up to 12 hours    41% reduction absenteeism
     Rewards    Decreased 24.97% of total days of absenteeism
Flint 2011[39] Any form of exit interview undertaken at the voluntary cessation of employment or at a prescribed time following departure from the organization was eligible. These could be a face to face exit interview, a telephone exit interview, a self-completed exit interview survey, electronic exit interview survey and mailed exit interview survey. No trials included Healthcare professionals Turnover rate   No No studies identified for inclusion
Flodgren 2012[58] An organizational infrastructure was defined as the underlying foundation or basic framework through which clinical care is delivered and supported. ITS: 01 Healthcare organizations comprising nurses, midwives and health visitors in hospital and community settings in HIC Risk of developing healthcare-acquired pressure ulcers (HAPUs).   No 0.7% (1.7-3.3)
Kiwanuka 2011[40] Dual practice was defined as the holding of more than one job by a health professional. Approaches identified and considered to manage dual practice were complete prohibition. Restrictions on private sector earnings, Providing incentives for exclusive public service, Raising health worker salaries, allowing private practice in public facilities, self-regulation, regulation of private sector. None included All health professionals in LMIC Increased working hours, reduced waiting hours, absenteeism, reduced sick leaves   No No studies identified for inclusion
Parmelli 2011[15] Strategy intended to change organizational culture in order to improve healthcare performance None included Any type of healthcare organization Professional performance, patient outcomes   No No studies identified for inclusion
Pearson 2007[59] Types of interventions included any strategy that had a cultural competence component, which influenced the work environment, and/or patient and nursing staff in the environment. Descriptive:02
Discursive: 13
Staff, patients, and systems or policies that were involved or affected by concepts of cultural competence in the nursing workforce in a healthcare environment Nursing staff outcomes, patient outcomes, organizational outcomes and systems level outcomes.   No Appropriate and competent linguistic services, and intercultural staff training and education would contribute to the development of a culturally competent workforce.
Peñaloza 2011[60] The complex combination of factors that drives the migration flow of health professionals contributes to the complexity of the strategies to manage this flow. ITS: 01 Any group of health professionals who are nationals of a LMIC and whose graduate training was in a LMIC. Yearly number of Philippine nurses migrating to the USA   No +807.6 nurses, (95% CI 480.9 to 1134.3)
Rowe 2005 (Overview)[61] An essential first step towards improving performance understands the factors that influence it. Such factors fall into two categories: interventions (e.g., training) and non-intervention determinants (e.g., patient’s age). Overview All health workers in LMIC    No Simple dissemination of written guidelines is often ineffective. Supervision and audit with feedback is effective. Multifaceted interventions might be more effective than single interventions
Socha 2011[62] Review of the literature on the consequences of dual practice for the physician labor supply; the quality of the public health care; the costs of the public health care provision. Section 5 discusses regulatory responses Overview     No Narrative
Tanj -Dijkstra 2011[38] Physical environmental stimuli are part of the (shared) healthcare environment and can be classified as ambient, architectural or interior design features that influence healthcare personnel through mediation by psychological processes. CBA: 01 Both medical and paramedical personnel whoare directly involved in treatment and care of patients in healthcare settings. Change in mood    Intervention group: 4.3 lower
     Satisfaction with physical environment    Not estimable
     Change in unscheduled absenteeism    Intervention group: 3.2 lower
Van Wyk 2010[34] We included any intervention intended to improve health workers’ ability to cope or manage job stress. These include:
(a) formal and informal staff-support groups;
(b) training or education in coping skills (or stress management) and communication;
(c) management interventions, e.g. multidisciplinary meetings, feedback sessions, etc.
RCT’s: 10 Professional health workers and health teams working in primary, secondary, tertiary, community, residential and referral care settings. Job stress:   Yes Job stress:
     Assertiveness training vs. in-service training    -6.10 (-8.39- - 3.81)
     Stress management vs. no intervention    -0.06 (-0.44 – 0.32)
     Mindfulness training vs. no intervention    3.44 (-4.10- 10.98)
     Management intervention vs. no intervention    0.66 (-1.24 – 2.44)
     Burnout (emotional exhaustion)    Burnout (emotional exhaustion)
     Stress management vs. no intervention    -6.00 (-8.16- -3.84)
     Job satisfaction:    Job satisfaction:
     Mindfulness training vs. no intervention    1.48 (-4.81 – 7.77)
     Stress management vs. no intervention    -0.13 (-0.53 – 0.27)
     Management intervention vs. no intervention    -0.63 (-1.23- -0.03)
     Absence:    Absence:
     Management intervention vs. no intervention    20.35 (-10.65- 51.35)