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Previous research has not confirmed public and practitioner perceptions of a decline in hospital nurse staffing. One reason for this discrepancy is that aggregate or mean values may not be an accurate description of the situation in a sizable percentage of hospitals. This article calculates the mean percentage change in various measures of nursing staff in Pennsylvania hospitals, 1991-1997, and the percentage of hospitals that experienced various degrees of this change. Major findings are that the means of changes in nursing staff understate the declines. When adjusted for patient severity and outpatient care, 50 percent of the hospitals experienced large decreases in RNs per patient days of care, 70 percent had large decreases in LPNs per patient days of care, and 56 percent had large declines in licensed nurses per patient days of care. Overall, the findings support perceptions of a decline in licensed nurse staffing. Policy implications are discussed.

Purpose
Public safety personnel (law enforcement, firefighters, emergency medical services and dispatchers) face work environments which are high stress. These can lead to burnout, secondary traumatic stress and a reduction of compassion satisfaction. However, very little is known about what individual and work factors influence these negative coping mechanisms in public safety personnel. It is also unknown how perceived organizational and coworker support, debriefing methods, or individual characteristics are associated with the aforementioned coping mechanisms. The differences between these fields are also unknown. The paper aims to discuss these issues.


Design/methodology/approach
A cross-sectional administration of surveys to Florida public safety personnel was done. A total of 1,360 public safety individuals completed the survey. Three regression analyses were carried out, utilizing the three Professional Quality of Life Version 5 subscales as the dependent variables. The Perceived Coworker Support Survey, Survey of Perceived Organizational Support, the Brief Resilience Survey and questions regarding debriefing practices were included.


Findings
Public safety personnel cannot be treated as a singular population for many things. An exception of this was that perceived organizational support and psychological resilience were associated with positive outcomes, albeit, to varying degrees in all fields. The other individual and organizational factors had very distinct impacts on the varying fields.


Research limitations/implications
There are limitations due to the nature of cross-sectional survey design and due to the sample size.


Originality/value
This study displays statistical relationships between factors which public safety agencies could use to increase employee job satisfaction and potentially reduce turnover. It was the only study the authors could find which include dispatchers when comparing these four public safety fields.

Volunteer programs are expected to positively impact the organizations in which they exist. This article reviews the literature on volunteerism, including what volunteers do, how their contributions can be measured, and the financial- and quality-related outcomes of volunteer programs. The focus is on volunteerism in health care settings, particularly hospitals. The article summarizes the existing theoretical and empirical literature concerning the roles of volunteers, the economic value of volunteers, cost–benefit analysis of volunteer labor, and the impact of volunteers on quality and patient satisfaction. The review indicates that the use of volunteers offers significant cost savings to hospitals and may positively impact profit margins. Volunteers are also likely to enhance quality indicators such as patient satisfaction and safety. Implications of these findings for management and future research are discussed.

Frontmatter -- CONTENTS -- PREFACE -- ACKNOWLEDGEMENTS -- LIST OF ABBREVIATIONS -- LIST OF TABLES, FIGURES AND BOXES -- ABSTRACT -- EXECUTIVE SUMMARY -- AUTHORS' NOTE -- 1. Introduction -- 2. Organization and governance -- 3. Financing -- 4. Physical and human resources -- 5. Provision of services -- 6. Principal health reforms -- 7. Assessment of the health system -- 8. Conclusions -- 9. Appendices -- INDEX

Intro -- Brief Contents -- Detailed Contents -- Preface -- Acknowledgments -- Part I Introduction -- Chapter 1 Why Should the Economics of Health Be Reconsidered? -- Chapter 2 The Traditional Competitive Model -- Chapter 3 Assumptions Underlying the Competitive Model and Implications for Markets and Government -- Part II Demand -- Chapter 4 Demand for Health, Insurance, and Services -- Chapter 5 Special Topics in Demand: Externalities of Consumption and the Formation of Preferences -- Part III Supply -- Chapter 6 How Competitive Is the Supply of Healthcare? -- Chapter 7 The Profit Motive in Healthcare -- Chapter 8 The Healthcare Workforce -- Part IV The Role of Government -- Chapter 9 Equity and Justice -- Chapter 10 Healthcare Expenditures -- Chapter 11 Economic Evaluation in Healthcare -- Chapter 12 Healthcare Systems in Developed Countries: Organization, Outcomes, and Lessons -- Chapter 13 Conclusion -- References -- Index -- About the Authors.

Purpose
Personnel who work in emergency medical services (EMS) face work environments which are high stress. These can lead to burnout, secondary traumatic stress (STS), and a reduction of compassion satisfaction (CS). However, very little is known about what individual and work factors influence these negative coping mechanisms in EMS personnel. It is also unknown how perceived organizational and coworker support, debriefing methods, or individual characteristics are associated with the aforementioned coping mechanisms in EMS personnel. The paper aims to discuss these issues.


Design/methodology/approach
A cross-sectional administration of surveys to Florida EMS personnel was done. A total of 351 individuals who regularly performed EMS tasks completed the survey. Three regression analyses were carried out, utilizing the three ProQOL 5 subscales as the dependent variables. The Perceived Coworker Support survey, Survey of Perceived Organizational Support, the Brief Resilience Survey and questions regarding debriefing practices were included.


Findings
Both organizational support and psychological resilience were found to be related to higher CS as well as lower burnout and STS. Coworker support was associated with higher CS. Informal debriefing was associated with higher CS and lower burnout. Several individual factors were also statistically significant, specifically education with CS, being a volunteer and race with burnout, and working part time or volunteering with STS.


Research limitations/implications
There are limitations due to the nature of cross-sectional survey design and due to the sample size. The varying circumstances which EMS personnel work also hinders generalizability.


Originality/value
This study displays statistical relationships between factors which EMS agencies could use to increase employee job satisfaction and potentially reduce turnover.

Purpose
The purpose of this paper is to determine a baseline level of the Professional Quality of Life (ProQOL 5) in emergency dispatchers in the state of Florida, as well as to examine the how it is associated with psychological resilience, perceived coworker support, different types of debriefing, and perceived organizational support.


Design/methodology/approach
This was done through a cross-sectional administration of surveys to emergency telecommunicators and dispatchers in the state of Florida.


Findings
In total, 186 surveys were completed by active emergency dispatch personnel across the state of Florida. The study found that psychological resilience, education, and perceived organizational support were statistically related to professional quality of life in Florida Dispatchers.


Research limitations/implications
There are limitations due to the nature of cross-sectional survey design and due to the sample size. There are also possible issues with the accuracy of self-reported survey answers. The lack of participation from all agencies also hinders generalizability.


Practical implications
This study serves as a reference point for a very under studied emergency service population. There are also implications that psychological resilience development in dispatch personnel would assist in multiple aspects of their professional quality of life.


Originality/value
This is the first study to use the ProQOL 5 on dispatch personnel in Florida. It also displays statistical relationships between factors which dispatch agencies could use to increase employee job satisfaction and potentially reduce turnover.

"The fifth edition of The Economics of Health Reconsidered continues to challenge the reliance on market forces to address health policy issues, and it argues instead for the value of government intervention. By critically examining economic theory as applied to the healthcare sector, the authors encourage readers to question the assumptions on which the perceived success of the competitive-healthcare-market model is based."

This study investigated the impact of state nursing home staffing standards on nurse staffing levels for the year 2011. Specifically, the study attempted to measure state staffing standards at facility level (i.e., nurse staffing levels that each individual nursing home must retain by its state staffing standards) and analyzed the policy impact. The study findings indicated that state staffing standards for the categories of registered nurse, licensed nurse, or total nurse are positively related to registered nurse, licensed nurse, or total nurse staffing levels, respectively. Nursing homes more actively responded to licensed staffing requirements than total staffing requirements. However, nursing homes did not increase their staffing levels as much as those required by state staffing standards. It is possibly because the quality-oriented inspection allows flexibility in nursing homes' control of nurse staffing levels.