A systems life cycle approach to managing the radiology profession: an Australian perspective

Slack Is Needed to Solve the Shortage of Nurses

Healthcare systems are facing a shortage of nurses. This article identifies some of the major causes of this and the issues that need to be solved. We take a perspective derived from queuing theory: the patient-nurse relationship is characterized by a scarcity of time and resources, requiring comprehensive coordination at all levels. For coordination, we take an information-theoretic perspective. Using both perspectives, we analyze the nature of healthcare services and show that ensuring slack, meaning a less than exhaustive use of human resources, is a sine qua non to having a good, functioning healthcare system. We analyze what coordination efforts are needed to manage relatively simple office hours, wards, and home care. Next, we address the level of care where providers cannot themselves prevent the complexity of organization that possibly damages care tasks and job quality. A lack of job quality may result in nurses leaving the profession. Job quality, in this context, depends on the ability of nurses to coordinate their activities. This requires slack resources. The availability of slack that is efficient depends on a stable inflow and retention rate of nurses. The healthcare system as a whole should ensure that the required nurse workforce will be able to coordinate and execute their tasks. Above that, workforce policies need more stability.

The need for a complex systems approach in rural health research

On a global scale, many major rural health issues have persisted for decades despite the introduction of new health interventions and public health policies. Although research efforts have generated valuable new knowledge about the aetiology of health, disease and health inequities in rural communities, rural health systems remain to be some of the most deprived and challenged in both the developing and developed world. While the reasons for this are many, a significant factor contributing to the current state of play is the pressing need for methodological innovation and relevant scientific approaches that have the capacity to support the translation of novel solutions into 'real world' rural contexts. Fortunately, complex systems approaches, which have seen an increase in popularity in the wider public health literature, could provide answers to some of the most resilient rural health problems in recent times. The purpose of this article is to promote the value and utility of a complex systems approach in rural health research. We explain the benefits of a complex systems approach and provide a background to the complexity sciences, including the main characteristics of complex systems. Two popular computational methods are described. The next step for rural health research involves exploring how a complex systems approach can help with the identification and evaluation of new and existing solutions to policy-resistant rural health issues. This includes generating awareness around the analytical trade-offs that occur between the use of traditional scientific methods and complex systems approaches.

The health workforce demand: a systematic literature review

Understanding imbalances between the supply and demand of the human resour- ces for health (HRH) is essential for enhancing health outcomes. Addressing the HRH demand is particularly challenging, especially given the deficit of accurate data and surplus of unresolved methodological flaws. This study presents a systematic review of the literature surrounding HRH demand and answers the following key questions: How has HRH demand been addressed? What are the harms and barriers that accompany HRH demand modeling? This systematic review was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement. Relevant keywords were used in a thorough search of the PubMed/MEDLINE, SCOPUS, and Web of Science databases. A total of 2,599 papers were retrieved and evaluated according to their title and abstract. Of these, the full-text of 400 papers was analyzed, 53 of which successfully met the inclusion criteria in our study. While the topic's relevance is widespread, it still lacks a validated approach to model HRH demand adequately. The main characteristics of the applied methods are presented, such as their application complexity by health policymakers. Opportunities and orientations for further research are also highlighted.

A System Dynamics Simulation Applied to Healthcare: A Systematic Review

In recent years, there has been significant interest in developing system dynamics simulation models to analyze complex healthcare problems. However, there is a lack of studies seeking to summarize the available papers in healthcare and present evidence on the effectiveness of system dynamics simulation in this area. The present paper draws on a systematic selection of published literature from 2000 to 2019, in order to form a comprehensive view of current applications of system dynamics methodology that address complex healthcare issues. The results indicate that the application of system dynamics has attracted significant attention from healthcare researchers since 2013. To date, articles on system dynamics have focused on a variety of healthcare topics. The most popular research areas among the reviewed papers included the topics of patient flow, obesity, workforce demand, and HIV/AIDS. Finally, the quality of the included papers was assessed based on a proposed ranking system, and ways to improve the system dynamics models' quality were discussed.

Interventional radiology training: a comparison of 5 English-speaking countries

OBJECTIVE

To compare key characteristics of interventional radiology (IR) training in the UK with four other English-speaking countries (USA, Canada, Australia and New Zealand) and summarise requirements for training.

METHODS

Main features examined were career pathway and requirements, examinations required, specific competition for IR and the process of applying for training as an international medical graduate. Data were collected from official governing body publications, literature and personal experience.

RESULTS

Several differences were highlighted, including length of training (ranging from 6 to 9 years after medical school), length of IR-specific training (ranging from 1 to 3 years) and examinations required (USA and Canada have additional IR-specific examinations). The level of competition is generally high, in all countries.

CONCLUSIONS

With the demand for IR services set to increase over the next few years, it is crucial that more IR specialists are trained to meet this demand. Awareness of training structures in other countries can highlight opportunity and pitfalls, and help ensure the number of highly trained interventional radiologists in the UK continues to grow.

Social networks and expertise development for Australian breast radiologists

Background

In this study, we explore the nexus between social networks and expertise development of Australian breast radiologists. Background literature has shown that a lack of appropriate social networks and interaction among certain professional group(s) may be an obstacle for knowledge acquisition, information flow and expertise sharing. To date there have not been any systematic studies investigating how social networks and expertise development are interconnected and whether this leads to improved performance for breast radiologists.

Methods

This study explores the value of social networks in building expertise alongside with other constructs of performance for the Australian radiology workforce using semi-structured in-depth interviews with 17 breast radiologists.

Results

The findings from this study emphasise the influences of knowledge transfer and learning through social networks and interactions as well as knowledge acquisition and development through experience and feedback. The results also show that accessibility to learning resources and a variety of timely feedback on performance through the information and communication technologies (ICT) is likely to facilitate improved performance and build social support.

Conclusions

We argue that radiologists’ and, in particular, breast radiologists’ work performance, needs to be explored not only through individual numerical characteristics but also by analysing the social context and peer support networks in which they operate and we identify multidisciplinary care as a core entity of social learning.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-016-1938-9) contains supplementary material, which is available to authorized users.