C 3 | Orals | SPHC 2024

Room

Rez-de-chaussée E040


Theme

All about healthcare professionals

Chair

Natalie Messerli




Title
Healthcare Professionals’ Intent to Stay in their Profession and its Determinants

Name
Jubin Jonathan

Affiliation
La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland


Abstract

Background and aims:
In the context of high turnover and personnel shortages, the Swiss Cohort of Healthcare professionals and informal caregivers (SCOHPICA) aims to gather data about healthcare professionals’ (HP) working conditions, well-being, and trajectories, to better understand which factors weight most in their decision to stay in their profession or leave it.

Design and population:
SCOHPICA is a prospective open cohort that was initiated in 2022. All healthcare professionals working in contact with patients in Switzerland, irrespective of their employment status and work setting, were eligible to participate by completing an online questionnaire.

Measures:
Outcome variables were intent to stay in the profession and well-being. As determinants, we considered different type of factors: organizational (e.g., leadership, workload), psychosocial (e.g., sense of belonging, recognition, burnout, resilience) which were complemented by sociodemographic and socio-professional variables.

Results:
In 2022, 1707 HPs responded to the baseline-survey (78.1% women, mean age: 42.4±11.6). The most represented professions were registered nurses (32.4%), physicians (12.4%), and physiotherapists (9.1%). Data revealed that work-life balance, opportunities for development, and meaning of work were the determinants most strongly associated with one’s intent to stay in their profession, regardless of the profession. Moreover, it showed disparities between professions with lower scores on many determinants for nurses, pharmacists, and physicians. The 2023 data collection is to bring more than 4500 additional participants that will allow more detailed and powerful analyses.

Conclusion:
SCOHPICA will allow to collect data about healthcare professionals from all professions and work settings across Switzerland. It will continue collecting this information from new and already enrolled participants through yearly data collections and interviews that will make possible to follow and analyse the trajectories of healthcare professionals. By helping understand healthcare professionals’ trajectories and sharing its data, SCOHPICA will be of use both to national and international healthcare stakeholders, and researchers to guide the development of policies and interventions. Thus, SCOHPICA will contribute to elaborate concrete solutions to the challenges the healthcare system faces and will lead to higher quality of care.


to the slides



Title
Building capacity for evidence-based health promotion: How to prepare future health professionals? 

Name
Jennifer Wegrzyk Masset 

Affiliation
Haute Ecole Santé Vaud (HESAV)


Abstract

Health promotion and preventive healthcare are integral components of public health strategies. However, future health professionals often lack experiential learning opportunities beyond clinical settings. On the example of physical activity (PA) promotion, we present a competency-based educational program which integrates community-based learning (CBL) to empower future health professionals as advocates for a healthy lifestyle.

Guided by behaviour change theories, the program aims to equip students with evidence-based knowledge, skills, and a professional identity to promote PA behaviour in local communities. Developed and implemented in the HESAV Bachelor curricula for Midwifery (since 2018) and Physiotherapy (since 2022) based on the Intervention Mapping approach, the ongoing program includes 12-28 hours of lectures, workshops, and community interactions. In a sequential explanatory mixed-methods approach, Gerard's evaluation including open-ended questions, and unstructured group conversation were employed to assess the program’s pedagogical impact. Content analysis was applied to qualitative data to identify inductive behavioral determinants linked to the COM-B model.

Students (n=44) emphasized the relevance of the pedagogical objectives and satisfaction with their acquired competences. Optimism about transferring these competencies into professional practice varied between study courses. CBL enhanced 1) reflective Motivation (strengthened beliefs about capabilities), 2) psychological Capability (increased knowledge and skills) and 3) physical Opportunity (social environment and networking). The partnership between educational institutions and communities was perceived as meaningful. The integration of a lifelong learning support and increased on-campus PA opportunities were highlighted as potential improvements. In a broader context, the program could facilitate the implementation of targeted behaviour change interventions in the community.


Title
Assessing earnings of health professionals in Europe: A comparative analysis, 2011-2020

Name
David Weisstanner

Affiliation
University of Lucerne


Abstract

Demands for adequate funding and better working conditions of health professionals have recently been voiced in many countries. However, attempts to slow down growing health costs may lead to the opposite effect, putting pressure on the resources available to the health workforce. Although recent empirical studies found that health-related occupations earn slightly above-average incomes in Europe (Lehwess-Litzmann 2022), a comprehensive account of the earnings situation of the health workforce with harmonized, high-quality income data over a long time period is still lacking.
This paper uses representative EU-SILC survey microdata from 1.9 million individuals in 30 European countries between 2011 and 2020 to compare the full-time equivalent gross (pre-tax) earnings of upper-grade health professionals and lower-grade health workers relative to those of the general population.
In a first part, descriptive results indicate that, when adjusted for age and gender, upper-grade health professionals are located at the 71st percentile of the earnings distribution, outperforming other managerial/professional occupations. Lower-grade health associates are located at the 54th percentile, again outperforming other non-routine intermediate occupations. Trends over time between 2011 and 2020 were relatively stable. However, these findings mask substantial cross-country variation in both the relative earnings position levels and trends over time. Using multilevel analysis, the second part of the analysis then proceeds to analyse whether this variation can be explained by four groups of factors: (1) institutional characteristics (health system and welfare state indicators), (2) socio-economic conditions, (3) political factors (strength of unions and left-wing political parties), and (4) policy adjustments (austerity and liberalization reforms).
Overall, this paper illustrates how the allocation of health resources towards different occupations depend on the broader policy context.



Title 
What influences health professionals’ innovativeness? A cross-sectional study

Name
Sophie Karoline Brandt 

Affiliation
Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland; University of Lucerne, Faculty of Health Sciences and Medicine, Lucerne, Switzerland;


Abstract

Introduction: 

In discussions about optimising healthcare, the spotlight has often been on the role of physicians as gatekeepers and main contributors to political debates. In view of the challenges in primary care, knowledge about the health professionals’ individual innovativeness is essential. It helps to utilise the innovative capacity of healthcare professionals and to adapt change processes accordingly. There is limited scientific evidence on the relationship between the professional-related characteristics of health professionals and their individual innovativeness. Therefore, this study aims to 1) compare the individual innovativeness between members of the five main health professions in primary care in Switzerland, and 2) investigate associations between profession-related characteristics and the individual innovativeness.

Methods:
A cross-sectional survey was addressed to pharmacists, physicians, medical practice assistants, nurses, and physiotherapists working in primary care in Switzerland. The short version of the individual innovativeness scale was used to measure individual innovativeness. Differences between groups were tested and multivariable linear regression analyses were used to evaluate associations.

Results:
Overall, 3032 health professionals participated. Non-physician health professionals showed on average a higher individual innovativeness compared to physicians. This was particularly true among nurses (40.24), physiotherapists (39.28) and pharmacists (39.06). Profession-related characteristics and the individual innovativeness are strongly associated. Professionals with advanced professional education (β = 1.24 CI [0.83, 1.66], p<.001) and more professional experience tend to have higher levels of individual innovativeness compared to professionals with basic professional education and few professional experience, respectively. Employed individuals with leadership responsibility, tend to have higher levels of innovativeness compared to individuals without leadership responsibility or self-employed individuals.

Conclusion:
To stimulate and implement innovations in primary care provision, professional education, career development and leadership responsibility should be promoted, particularly among non-physician health professionals. The innovative potential of these non-physician health professionals is insufficiently utilised if, as in the past, it is solely physicians who are mandated to innovative primary care.



Title 
Lessons Learned from the Swiss Learning Health System: Bridging Research and Health System Improvement

Name
Natalie Messerli

Affiliation
University of Lucerne


Abstract

Background: 

Since 2017, the Swiss Learning Health System (SLHS) has facilitated the movement of research to practice and policy   . Originally established as a response to national calls to strengthen health services research in Switzerland and strategically enhance the capacity of doctoral researchers, the SLHS has aimed to create continuous learning cycles through knowledge translation (KT) approaches and learning health system (LHS) science. While previous studies have explored LHS implementation  within health systems and specialty/disease-focused LHSs, there is currently no information available on the perceptions and experiences of a national-level LHS, such as the SLHS. The purpose of this study is to contribute to an understanding of how LHSs can serve as conceptual frameworks to support the development of KT platforms. By exploring lessons learned within the SLHS, the study aims to identify successes, barriers, and enabling conditions that can inform institutionalizing KT for evidence-informed health policy and decision-making as well as capacity-building strategies in similar environments.

Methods:
We employed a mixed-methods approach conducted from September to December 2023, using the SLHS program aims and the Knowledge-to-Action framework to inform the study’s conceptualization. The study involved two workshops with more than 40 SLHS network members, a survey completed by 39 network members, and subsequent in-depth interviews with 12 key informants. Analysis was conducted using descriptive and thematic methods.

Results: 
Capacity-building efforts prompting a cultural shift by training scientists to adopt a science-policy-practice mindset was the most common success captured. The LHS and KT approaches aided in breaking down silos and encouraged community building through participatory methods. An important lesson learned by the network is the value of co-creation, meaningfully involving stakeholders in research processes from the initial stages to dissemination approaches and products, to ensure relevance, health system prioritization, and evidence utilization. However, the program faces barriers, with continuity of learning cycles being identified as a challenge. The program’s structure and funding mechanism expose difficulties in transferring knowledge between doctoral cohorts  and maintaining continuous improvement learning cycles for each research topic.