Healthcare

  • At a time of widespread budget constraints, many healthcare-providing institutions--including public schools--are cutting back on the number of nurses and other healthcare professionals they employ. Although a large body of research has established that inadequate staffing levels result in negative patient outcomes, the link between workplace conditions and the quality of care has yet to make it into many policy discussions.

    Far more work is needed in this area, especially in regard to the impact on children's health and wellbeing. The Institute sponsors model pilot projects, discussions and research aimed at improving the quality of patient care in hospital settings and exploring the critical role of school nurses in student outcomes. Thus far, the Institute has conducted two programs in this area, one a pilot project on the impact that improved nurse-management collaboration can have on improved patient care, and the other a study to explore the feasibility of conducting broader studies on the impact of school nurses on students’ health and academic success.

     

     

     

     

     

     

     

     

     

  • Feasibility of School Nurse Data Collection

    In 2015, the Institute published a pilot study which focused on the feasibiity of measuring school nurse impacts on student health and achievement.  The underlying assumption of this study is that, to benefit from education and instruction in school, children must be healthy and ready to learn.  School nurse positions are often cut as schools struggle with decreased state funding and the lower property tax revenues that resulted from the 2008 recession. Although there are studies that demonstrate the effectiveness of school nursing on a wide range of child health and education outcomes, significantly more research and statistical data supporting school nurse practice outcomes is needed.

  • Patient Care Collaboration Project

    In 2011, with support from the Albert Shanker Institute and the Foundation for St. Francis and Franklin, the Wisconsin Federation of Nurses and Health Professionals (WFNHP) and the management of St. Francis Hospital in Milwaukee, Wisconsin, collaborated on a joint project designed to improve patient care and patient satisfaction, focusing on the Emergency Department.

  • In Memoriam: Eugenia Kemble

    It is with great sorrow that we report the death of Eugenia Kemble, the founding executive director of the Albert Shanker Institute, after a long battle with fallopian tube cancer. “Genie” Kemble helped to conceive of and launch the institute in 1998, with the support of the late Sandy Feldman, then president of the American Federation of Teachers (AFT). Endowed by the AFT and named in honor of the AFT’s iconic former president, the Albert Shanker Institute was established as a nonprofit organization dedicated to funding research reports and fostering candid exchanges on policy options related to the issues of public education, labor, and democracy.

    A graduate of Mount Holyoke College and the University of Manila, Genie entered the teacher union movement as part of a cohort of young Socialist Party activists who were close to Bayard Rustin, the organizer of the 1963 March on Washington, and deeply involved in the civil rights struggle. She began her career in 1967 as a reporter for the newspaper of the United Federation of Teachers (UFT), the AFT’s New York City local, and became a top aide to then UFT president Albert Shanker. She was a first-hand witness to the turbulent era during which Shanker served as UFT president, including the UFT strike for More Effective Schools in 1967, the harrowing Ocean Hill Brownsville strike over teachers’ due process rights in 1968, the remarkable UFT election victory to represent paraprofessionals in 1969, and the masterful bailout of a faltering New York City government through the loan of teacher pension funds in the mid-1970s.

  • Is The Motherhood Penalty Real? The Evidence From Poland

    It has long been assumed that the residual gap in earnings between men and women (after controlling for productivity characteristics, occupation and industry segregation, and union membership status) is due to gender discrimination. A growing body of evidence, however, suggests that it may also reflect the effect of having children.

    According to this research, employed mothers now account for most of the gender gap in wages (Glass 2004). In the U.S., controlling for work experience, hourly wages of mothers are approximately four percent lower for each child they have, compared to the wages of non-mothers (Budig and England, 2001). The magnitude of these family effects differs across countries, but, in general, men accrue modest earnings premiums for fatherhood, whereas women incur significant earnings penalties for motherhood (Waldfogel, 1998; Harkness and Waldfogel, 2003; Sigle-Rushton and Waldfogel, 2007; Budig and Hodges, 2010; Hodges and Budig, 2010; Smith Koslowski, 2011).

    The size of the penalty seems also to vary by whether women and men are toward the top or bottom of the employment hierarchies of skills and wages, and it also varies across countries (England et al. 2014; Cooke 2014). The findings in this area are sometimes inconsistent, however, and suggest that there is a need to include a combination of skills and wages (England et al. 2014) and to choose carefully measures of job interruptions (Staff and Mortimer, 2012).

  • To Seek Common Ground On Life's Big Questions, We Need Science Literacy

    Our guest author today is Jonathan Garlick, Director of the Division of Cancer Biology and Tissue Engineering at the School of Dental Medicine at Tufts University. This article was originally published on The Conversation.

    Science isn’t important only to scientists or those who profess an interest in it. Whether you find fascinating every new discovery reported or you stopped taking science in school as soon as you could, a base level understanding is crucial for modern citizens to ground their engagement in the national conversation about science-related issues.

    We need to look no further than the Ebola crisis to appreciate the importance of science literacy. A recently elected senator has linked sealing the US-Mexican border with keeping Ebola out of the US, even though the disease is nonexistent in Mexico. Four out of 10 Americans believe there will be a large scale Ebola epidemic here, even though there have been just four cases in the US and only one fatality. Flu, on the other hand, which killed over 100 children here last winter, barely registers in the public consciousness.

    Increasingly we must grapple with highly-charged and politicized science-based issues ranging from infectious diseases and human cloning to reproductive choices and climate change. Yet many – perhaps even the majority – of Americans aren’t sufficiently scientifically literate to make sense of these complicated issues. For instance, on one recent survey of public attitudes and understanding of science and technology, Americans barely got a passing grade, answering only 5.8 out of 9 factual knowledge questions correctly.

  • Performance Measurement In Healthcare And Education

    A recent story in the New York Times reports that, according to an Obama Administration-commissioned panel, the measures being used to evaluate the performance of healthcare providers are unfairly penalizing those that serve larger proportions of disadvantaged patients (thanks to Mike Petrilli for sending me the article). For example, if you’re grading hospitals based on simple, unadjusted re-admittance rates, it might appear as if hospitals serving high poverty populations are doing worse -- even if the quality of their service is excellent -- since readmissions are more likely for patients who can’t afford medication, or aren’t able to take off from work, or don’t have home support systems.

    The panel recommended adjusting the performance measures, which, for instance, are used for Medicare reimbursement, using variables such as patient income and education, as this would provide a more fair accountability system – one that does not penalize healthcare institutions and their personnel for factors that are out of their control.

    There are of course very strong, very obvious parallels here to education accountability policy, in which schools are judged in part based on raw proficiency rates that make no attempt to account for differences in the populations of students in different schools. The comparison also reveals an important feature of formal accountability systems in other policy fields.

  • How Many Schools Don't Have Nurses?

    In 2006, the National Association of School Nurses (NASN) commissioned the largest and, to my knowledge, most recent national survey on the availability of nursing services in U.S. public schools. It was administered to a sample of over 1,000 schools in all 50 states and D.C.

    The primary purpose was to gather basic information on the health staff in these schools, as well as a few core characteristics, such as school size and student demographics.

    I must confess that I was a little surprised by the results. Here is the distribution of schools by nursing availability, summarized very briefly (these proportions vary by school size, type and other characteristics):

  • Bahraini Repression Against Teachers And Health Care Workers

    The Kingdom of Bahrain, a small island nation in the Persian Gulf, is a perfect political stew, situated as it is at the confluence of political, religious, economic and international tensions simmering in the Persian Gulf.  A majority Shi’a Muslim country ruled for hundreds of years by Sunni tribal chieftains with family ties to Saudi Arabia, Bahrain is a dictatorship whose people have regularly demanded political reform and seen their aspirations crushed.

    Today, with strong support from the oil-rich Saudis, the Kingdom’s hard-line Al-Khalifa regime enjoys absolute powers, although the day-to-day political reality is often complex.

    Bahrain is also the home of the U.S. Navy’s Fifth Fleet, which patrols those volatile waters, largely to keep an eye on Iran. The U.S. considers the port a critical element of its military posture in the Gulf. This consideration drives U.S. policy toward Bahrain. The centuries-old Bahraini-Saudi connection has, predictably, deterred the U.S. and other democratic countries from applying significant pressure to the kingdoms’ rulers. Stability is the byword.

  • The Data Are In: Experiments In Policy Are Worth It

    Our guest author today is David Dunning, professor of psychology at Cornell University, and a fellow of both the American Psychological Society and the American Psychological Association. 

    When I was a younger academic, I often taught a class on research methods in the behavioral sciences. On the first day of that class, I took as my mission to teach students only one thing—that conducting research in the behavioral sciences ages a person. I meant that in two ways. First, conducting research is humbling and frustrating. I cannot count the number of pet ideas I have had through the years, all of them beloved, that have gone to die in the laboratory at the hands of data unwilling to verify them.

    But, second, there is another, more positive way in which research ages a person. At times, data come back and verify a cherished idea, or even reveal a more provocative or valuable one that no one has never expected. It is a heady experience in those moments for the researcher to know something that perhaps no one else knows, to be wiser—more aged if you will—in a small corner of the human experience that he or she cares about deeply.

  • An Uncertain Time For One In Five Female Workers

    It’s well-known that patterns of occupational sex segregation in the labor market – the degree to which men and women are concentrated in certain occupations – have changed quite a bit over the past few decades, along with the rise of female labor force participation.

    Nevertheless, this phenomenon is still a persistent feature of the U.S. labor market (and those in other nations as well). There are many reasons for this, institutional, cultural and historical. But it’s interesting to take a quick look at a few specific groups, as there are implications in our current policy environment.

    The simple graph below presents the proportion of all working men and women that fall into three different occupational groups. The data are from the Bureau of Labor Statistics, and they apply to 2011.

  • The False Conflict Between Unionism and Professionalism

    Some people have the unfortunate idea that unionism is somehow antithetical to or incompatible with being a professional. This notion is particularly salient within education circles, where phrases like “treat teachers like professionals” are often used as implicit arguments against policies associated with unions, such as salary schedules and tenure (examples here, here, here and here).

    Let’s take a quick look at this "conflict," first by examining union membership rates among professionals versus workers in other types of occupations. As shown in the graph below, if union membership and professionalism don’t mix, we have a little problem: Almost one in five professionals is a union member. Actually, union membership is higher among professionals than among any other major occupational category except construction workers.

  • An Update From The Independent Labor Movement In Egypt

    Our guest author today is Heba F. El-Shazli.  She has 25 years of experience in the promotion of democracy, independent trade unions, political and economic development. She has worked with institutions and leaders throughout the Middle East and North Africa (MENA) to challenge authoritarian regimes. Currently she is a visiting professor of international studies and modern languages at the Virginia Military Institute. The views expressed here are her own.

    The revolution in Egypt has unleashed a torrent of pent up frustration and protest from Egyptian workers in all walks of life. For weeks, beginning the day after former President Hosni Mubarak resigned, workers have taken to the streets to demand respect for basic worker rights and democratic principles. Their grievances are fundamental and share much in common with their U.S. counterparts now protesting in Wisconsin and elsewhere: the right to bargain collectively with employers over wages, hours, benefits and working conditions. Egyptian workers have been protesting at many worksites all over the country:

    • More than 6,000 teachers protested in front of the Education Administration building in the governorate (state) of Qena in Upper Egypt.  A majority of teachers are now working under temporary contracts without benefits. Teachers are calling for the end of these temporary contracts that cheapen their profession and cause much professional insecurity. 
    • Hundreds of workers from the iron and steel factory who were hired as “temporary contractual” workers demanded payment of three months’ worth of overtime and other benefits, and an end to their “temporary” status.

    The never-ending “temporary contract” is a tactic to weaken workers’ rights, which  has been widely used in both the Egyptian public and private sectors. In response to teacher protests, the new Education Minister did announce on Feb. 28 that the teachers who had been working under temporary contracts for more than three years will be made permanent as long as they are able to pass the teacher proficiency tests, which the Ministry will administer on March 25.