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Recent brief: NC nurse employment in hospitals similar to national trends

A recent analysis of North Carolina licensure data by Esita Patel, PhD, RN showed the percentage of NC nurses in hospital settings—inpatient, outpatient and ED—are similar to estimates in the National Sample Survey of Registered Nurses (NSSRN). While the nursing profession needs a national inventory, such as the Physician Masterfile used for physicians, these analyses suggest that the NSSRN can be used to estimate state-level nurse employment. Read the full brief here.

Teams: past, present, future

Erin Fraher, PhD, MPP recently wrote a commentary in the Journal of American Board of Family Medicine (JABFM) on teams in primary care. The article tackled the changing skill mix of primary care teams and evolving roles of RNs, social workers, LPNs, and medical assistants.

Read the full article here.

Fraher featured in NEJM podcast on Ensuring and Sustaining a Pandemic Workforce

Complementing a recent New England Journal of Medicine (NEJM) article, Ensuring and Sustaining a Pandemic Workforce, Erin Fraher, PhD, MPP was interviewed by Stephen Morrissey, Executive Managing Editor of the Journal, on opportunities for expanding health workforce capacity during the COVID-19 pandemic. Listen to the podcast here.

Will Community Health Centers Survive COVID‐19?

Throughout their 55-year history, community health centers have survived social, political and economic challenges—but will they survive the pandemic? A recent paper in the Journal of Rural Health led by Brad Wright, PhD, Associate Professor in the Department of Family Medicine at the UNC School of Medicine, and co-authored by Erin Fraher, PhD, MPP with colleagues from Piedmont Health, highlights the importance of Federally Qualified Community Health Centers (FQHCs), the financial impact the pandemic may have on them, and the need for renewed investment in primary care. To read the full article, select here.

Fraher delivered the national keynote on nursing workforce

This past June, Erin Fraher, PhD, MPP, Director of Program on Health Workforce Research and Policy, delivered the keynote presentation at the National Forum of State Nursing Workforce Centers. Her presentation explored the power of data to illuminate challenges and opportunities facing the nursing workforce. She highlighted trends in LPN employment in North Carolina, the need to modernize LPN scope of practice, the pandemic’s impact on nursing workforce, burnout, and the possibilities for telehealth. Check out the presentation here.

Meet our new team members

Meriel McCollum, RN, PhD
Meriel McCollum, RN, PhD is a postdoctoral researcher at the Health Workforce Research Center. She earned her PhD in nursing from UNC-Chapel Hill, where she studied healthcare system responses to disasters. Her research interests lie at the intersection of healthcare policy and the healthcare workforce, and disasters such as hurricanes and pandemics. Her research couldn't be more timely.

Julia Long
Julia Long is a Graduate Research Assistant with the Program for Health Workforce Research and Policy. She is a senior in the BSPH program in the Department of Health Policy and Management at UNC-Chapel Hill's Gillings School of Global Public Health. Her research focuses on integrating spatial analyses into health workforce research and policy, and understanding the health workforce challenges facing rural and underserved communities.

Workforce dogs at work

With the workforce team working remote, our pets are now our colleagues. Rest assured, they are hard at work as well! Meet Dugie, a Wheaten Terrier and one of our finest canine coworkers. In between dour moods, he is happy to meet new people, though he does get bored with them if they do not have a pork chop to hand over. His life is complicated by dog sister Maisy, a hyperactive Doberman Pincer.

We updated our health professional data viz!

We recently updated our Sheps Health Workforce NC site. In addition to an updated look, we added new features and functionality.

New layers. Our supply visualization allows users to view 21 different health professionals by county, AHEC region or Medicaid region. Now you can also view geographic layers: major interstates, squares indicating rural counties, and lines around urbanized areas.
More options for data downloads. We understand that sometimes you just need the data. Our new data download page makes it easy to download numbers of professionals by geographic region or health profession.
More interactive visualizations. We have added several new interactive visualizations: age distribution by health profession, growth of health professions over time, and the population structure (age and gender) by health profession.

If you have any questions or need further information, email us at nchealthworkforce@unc.edu.

Distribution of NC’s Critical Care Physician Workforce

As North Carolina navigates the pandemic, the Program on Health Workforce Research and Policy is providing data on the availability of needed health professionals. Our latest blog tackles the supply and distribution of Critical Care physicians. Critical Care physicians, or Intensivists, are board-certified physicians who care for complex and critically ill patients in the ICU, often coordinating a team of nurses, physical therapists, respiratory therapists, and pharmacists. Like many more specialized health professionals, Critical Care physicians are most often concentrated in areas with large healthcare systems. Read the full blog here.

What EHRs Tell Us about How We Deploy Health Professionals to Address the Social Determinants of Health

In a recent CHWRC brief, researchers Erica Richman, PhD, MSW, Brianna Lombardi, PhD, MSW and Lisa de Saxe Zerden, PhD, MSW used Electronic Health Record (EHR) data from a large health care system located in the southeastern United States to describe the mix of professionals identifying and addressing patient Social Determinants of Health SDOH, such as food and housing insecurity. They found that multiple health professionals address patient SDOH—including dietitians, physicians, RNs, chaplains, community health workers, care manager assistants, care managers, physician assistant, counselor, medical assistants, and care coordinators— but social workers carry the majority of this workload. Read the full brief online here.

New CHWRC projects funded

The Center was recently funded for four new projects:

Professional Structures and Physician Burnout. - Investigator: Tania Jenkins, PhD
Strategies to Support and Prevent Burnout among Low-Wage Front Line Workers during the COVID-19 Pandemic - Investigators: Brianna Lombardi, PhD, MSW, Lisa de Saxe Zerden, PhD, MSW, Erica Richman, PhD, MSW with UCSF investigators Laura Wagner, PhD, RN, GNP, FAAN, Susan Chapman, RN, PhD, FAAN, and Joanne Spetz, PhD
Understanding the influence of COVID19 on the primary care workforce - Investigator: Valerie Lewis, PhD
Responses of safety net practices to the COVID-19 pandemic as experienced by and affecting frontline clinicians in 22 states - Investigators: Donald Pathman, MD MPH and Jeffrey Sonis, MD, MPH

CHWRC funded for two COVID-19 rapid response projects

This spring, the National Center for Health Workforce Analysis (NCHWA) in the Health Resources and Services Administration (HRSA) funded the CHWRC for two projects addressing workforce issues critical in the pandemic: retraining/retooling health professionals and workforce burnout.

Resources for Quickly Retraining/Retooling the Workforce
In this project, researchers will create a comprehensive database containing publicly available resources and training materials that describe how to rapidly train staff to provide coronavirus-related care in the ICU. This work will create a valuable resource for hospitals, health system leaders and practices as they seek to surge and “flex” the workforce to respond to rapidly increasing demand.

Strategies to Address Workforce Burnout During a Public Health Emergency
Researchers will conduct a literature review on burnout of healthcare workers in other countries during the coronavirus pandemic and during previous pandemics and public health emergencies. They will identify proven strategies for reducing burnout and increasing mental health and well-being of health care providers.

Rapid response explores adequacy of preventive medicine physician workforce

CHWRC researchers, Tom Ricketts, PhD, MPH, Erin Fraher, PhD, MPP, and Deborah Porterfield, MD, MPH, responded to a “Rapid Response” request from HRSA that explored the status of the Preventive Medicine (PM) specialty and workforce in the United States. The increasing emphasis on population health, value-based care, and improving the social determinants of health has created a growing need for PM physicians. The COVID-19 pandemic, as well as the ongoing epidemic of overdoses and drug misuse, has highlighted gaps in the public health infrastructure that can be aided by PM physicians.

The research team examined multi-year physician supply data and found that:

The number of PM physicians being trained will not maintain the current supply relative to population in the near future.
The PM workforce needs to be more representative of the geography and demography of the nation, especially in rural and underserved areas.
The “place” and “role” for preventive medicine physicians has not been well delineated.

These findings suggest that the number of PM physicians trained be expanded, particularly those from rural and underserved areas The report is available on request.

Recent Scholarship and Media

Publications

Fraher EP. Primary Care Teams: Past, Present and Future. The Journal of the American Board of Family Medicine July 2020, 33 (4) 495-498. doi.org/10.3122/jabfm.2020.04.200260.
Wright B, Fraher EP, Gwyther Holder M, Akiyama J, Toomey T. Will Community Health Centers Survive Covid-19? The Journal of Rural Health. May 2020. doi.org/10.1111/jrh.12473.
Fraher EP, Balu R, Buerhaus P, George J, Murillo C, Washington AE. Developing a Workforce for Health in North Carolina: Planning for the Future. North Carolina Medical Journal. 2020 May-Jun;81(3):185-190. doi: 10.18043/ncm.81.3.185.
Fraher EP, Pittman P, Frogner BK, Spetz J, Moore J, Beck AJ, Armstrong D, Buerhaus PI. Ensuring and Sustaining a Pandemic Workforce. N Engl J Med. 2020 April 8 2020. Epub DOI: 10.1056/NEJMp2006376.

Presentations

Fraher E. The Power of Data to Illuminate the Challenges and Opportunities Facing the Nursing Workforce. Keynote presentation delivered at the National Forum of State Nursing Workforce Centers. June 11, 2020.
Ricketts TC, Porterfield D, Fraher E. Preventive Medicine Physician Supply and Distribution. HRSA/BHW/DMD, Preventive Medicine Residency Program Grantee Meeting. May 13, 2020.

Research briefs

Erica Richman, PhD, MSW, Brianna Lombardi, PhD, MSW, Lisa de Saxe Zerden, PhD, MSW. What EHRs Tell Us about How We Deploy Health Professionals to Address the Social Determinants of Health. Carolina Health Workforce Research Center. June 2020.
Esita Patel, PhD. Comparing Hospital Nurse Settings from the 2018 NSSRN vs. 2008-2013 North Carolina Licensure Data. Sheps Health Workforce NC. June 2020.

Media

Interview with Erin Fraher, PhD, MPP on opportunities for expanding health workforce capacity during the Covid-19 pandemic. New England Journal of Medicine podcast. June 2020.
Fraher on the “A ‘new norm’ after the coronavirus pandemic.” NC Health News, April 12, 2020.
Fraher contributed to Match Day on the Trade Offs Podcast, March 20, 2020.
The Rural Residency Planning and Development – Technical Assistance Center (RRPD—TAC), for which Fraher is PI, mentioned in “The Doctor Gap: A Training Program for Country-Doc Wannabes.” US News and World Report, March 17, 2020.