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Evaluation of Better Jobs Better Care: Clinical Manager Survey, 2004-2007 [Iowa, North Carolina, Oregon, Pennsylvania, and Vermont] (ICPSR 29063)

Released/updated on: 2024-02-14
Geographic coverage: North Carolina, Oregon, Vermont, Iowa, United States, Pennsylvania
Time period: 2004-01-01--2007-01-01

Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, Better Jobs Better Care (BJBC) was a demonstration program that sought to bring about changes in public policy and management practice that would lead to improved recruitment and retention of high-quality paraprofessional direct care workers (DCW) in nursing homes as well as in home- and community-based settings. This was to be accomplished by implementing both policy and management practice goals. Policy goals included developing initiatives related to wages and benefits, incentives for job redesign, curriculum and credentialing, professional associations, and promotion of public awareness and policies. Practice goals involved interventions related to caregiving skill development, peer mentoring, team building, top management training, supervisor training, and provider-specific interventions. The program established demonstration projects in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont which enrolled long-term care establishments across the spectrum of long-term care settings: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers.

Conducted as part of the BJBC evaluation, which used a before-after design to assess the implementation of the interventions and their impact, this survey of the top clinical manager at each participating long-term care provider explored the establishments' organizational characteristics and management practices. One version of the survey was administered at the beginning of the demonstration (Time1), and a second version, toward the end of the demonstration (Time 2). Organizational characteristics covered by the survey include nonprofit/for-profit status, whether the establishment was free standing or part of a chain, number of competing establishments, whether the DCWs were unionized, and the type and amount of services provided. Management practices investigated by the survey include participation in care planning, communication about tasks, feedback, DCW training, management communication, organizational readiness for change, professional development, and work design practices. The survey also collected information about the racial and Hispanic origin composition of DCWs and patients/residents/clients.

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Evaluation of Better Jobs Better Care: Direct Care Worker Survey, 2004-2007 [Iowa, North Carolina, Oregon, Pennsylvania, Vermont] (ICPSR 29064)

Released/updated on: 2024-02-14
Geographic coverage: North Carolina, Oregon, Vermont, Iowa, United States, Pennsylvania
Time period: 2004-01-01--2007-01-01

Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, Better Jobs Better Care (BJBC) was a demonstration program that sought to bring about changes in public policy and management practice that would lead to improved recruitment and retention of high-quality paraprofessional direct care workers (DCW) in nursing homes as well as in home- and community-based settings. This was to be accomplished by implementing both policy and management practice goals. Policy goals included developing initiatives related to wages and benefits, incentives for job redesign, curriculum and credentialing, professional associations, and promotion of public awareness and policies. Practice goals involved interventions related to caregiving skill development, peer mentoring, team building, top management training, supervisor training, and provider-specific interventions. The program established demonstration projects in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont which enrolled long-term care establishments across the spectrum of long-term care settings: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers.

Conducted as part of the BJBC evaluation, this survey interviewed DCWs at two points during the demonstration. The Time 1 interview was fielded as soon as establishments enrolled in the demonstration and provided a list of their DCWs (July 2004 to December 2006), and the Time 2 interviews were completed 12 to 28 months after the Time 1 interviews (April 2006 to June 2007). Both rounds of the survey used the same self-administered questionnaire which included questions about length of employment, job satisfaction, job rewards and problems, supervision, perceptions of quality of care, job confidence, training, intent to quit, and demographic characteristics. The survey also elicited recommendations for improving DCWs' jobs by asking the open-ended question "What is the single most important thing your employer could do to improve your job as a direct care worker?"

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Evaluation of Better Jobs, Better Care: Frontline Supervisor Survey, 2005-2007 [Iowa, North Carolina, Oregon, Pennsylvania, Vermont] (ICPSR 23000)

Released/updated on: 2008-09-26
Geographic coverage: North Carolina, Oregon, Vermont, Iowa, United States, Pennsylvania
Time period: 2005-01-01--2007-01-01

In long-term care, frontline supervisors play a central role in direct care workers' (DCW) job quality and turnover and are critical to the implementation of management changes. To better understand supervisors' perceptions of management practices, the quality of supervision, and the effect on DCW turnover and job quality, the Office of the Assistant Secretary for Planning and Evaluation in the United States Department of Health and Human Services contracted with Pennsylvania State University to conduct this survey of supervisors participating in the Better Jobs, Better Care (BJBC) demonstration. Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, the BJBC demonstration -- which took place in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont -- tested innovative policy and practice models designed to improve the quality of DCW jobs in an effort to improve recruitment and retention of these workers and strengthen capacity to meet future demand for long-term care.

Frontline supervisors were interviewed from the four types of facilities and agencies that participated in the demonstration: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers. The survey explored the supervisors' job responsibilities, formal training, job satisfaction, and thoughts about quitting. It investigated the culture of the organizations in which the supervisors worked, probed for problems with the supervisors' jobs, assessed how rewarding the supervisors felt their jobs were, inquired as to whether the supervisors felt respected by their clients, DCWs, and managers, gauged the supervisors' assessments of the overall competency level of the DCWs in their organizations, and explored the supervisors' beliefs about managerial support for the BJBC project, how well the BJBC programs were executed, and whether the overall impact of the project was positive.

In addition, the respondents were queried about management practices (e.g., rotation of assignments to different services or units, mechanisms to handle employee concerns, and approaches used to handle poor performance or negative behaviors among employees). They were also asked about DCW training, mentoring, and career ladder programs, DCW participation in patient/resident/client care plans, and communication among DCWs and between DCWs and their supervisors. Respondents were also asked what was the most important thing that their employer could do both to improve the jobs of DCWs and to improve their own ability to do their jobs as supervisors of DCWs. Additional information collected by the survey includes the supervisors' age, sex, race, Hispanic origin, educational attainment, nursing degree or license (LPN, RN, Diploma RN, BSN, MSN, or Advanced Practice Nurse), wages, and health insurance coverage.

This collection comprises three data files: (1) Supervisor Identification Instrument Data, (2) Supervisor Survey Data, and (3) Clinical Managers Who Are Also Supervisors Data. The first file contains information collected by the Supervisor Identification Instrument that was submitted to the clinical manager at each BJBC provider organization. This instrument instructed clinical managers to name all of the supervisors in their organization and to indicate which supervisory responsibilities each one performed. The second data file contains the responses to the Supervisor Survey questionnaire.The third data file contains the responses of clinical managers who also functioned as supervisors in their organization. These clinical managers responded to the same questions in the Supervisor Survey questionnaire, except for ten questions that were worded somewhat differently.

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Massachusetts Nursing Profession Entrants Survey, 1988 (ICPSR 9520)

Released/updated on: 2024-02-14
Geographic coverage: United States
The purpose of this survey was to gather information to assist educators, administrators, and policymakers in the development of strategies for the recruitment and retention of registered nurses. To that end, nurses taking the Massachusetts licensure exam were queried about their reasons for going into nursing, their nursing career goals, their attitudes toward the nursing profession, their preferences for various branches of the nursing profession, and the importance they placed on various aspects of work in general, e.g., job security, high income, and good opportunities for advancement. Respondents were also questioned about their job searches and their current or impending jobs: how the job was found, number of applications filled out and offers received, number of hours usually worked, earnings, type of medical facility, shift usually worked and preferred, commuting distances, public transportation and child care needs, whether student clinical experience was obtained with the employer, planned length of stay at the job, and the importance of various factors that attracted them to the position, such as the attractiveness of the town or city where the job was located, salary and benefit levels, availability of parking and child care, and job flexibility. In addition, the survey asked respondents how and when they decided to become nurses, how they found out about educational options in nursing, how much basic nursing education they received and how it was financed, which factors attracted them to the schools from which they graduated, and how much of their basic nursing education was devoted to clinical experience. Background information on respondents includes age, sex, citizenship, race, ethnic group, marital status, education, education goals, family income, number and ages of related persons living in the household, usage of child care and elderly care services, parents' education and occupations, and mother's employment status at various stages of the respondent's childhood and adolescence.
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Practice Patterns of Young Physicians, 1991: [United States] (ICPSR 6145)

Released/updated on: 2009-09-15
Geographic coverage: United States

The purpose of this survey was to obtain information on the characteristics and practice patterns of early career physicians in order to analyze trends in physicians' activities and the supply of physicians. To that end, the survey interviewed early career physicians and re-interviewed physicians who participated in the previous survey of early career physicians PRACTICE PATTERNS OF YOUNG PHYSICIANS, 1987 (ICPSR 9277). With separate samples drawn for allopathic and osteopathic physicians, the respondents were interviewed about their medical training, medical education financing, career choices and satisfaction, practice arrangements and compensation, and patient care activities. They were also questioned about medical care management in their practice(s), perceptions of their freedom to deliver care, medical malpractice claims, and the composition of their patients, such as the percent who were poor, black, Hispanic, uninsured, covered by Medicaid or Medicare, or had severe physical disabilities, chronic mental illness, or problems with substance abuse. Demographic characteristics covered by the survey include race, Hispanic origin, year of birth, marital status, number and ages of children, and parents' education.

In addition to the variables collected by survey, the allopath sample data also comprise variables obtained from the American Medical Association (AMA) and the Student and Applicant Information Management System (SAIMS) of the Association of American Medical Colleges (AAMC). The AMA variables include gender, name of medical school, board certification status, physician's specialty, and AMA membership, while the SAIMS variables include dates of application to medical school, graduation dates, Medical College Admission Test (MCAT) scores, undergraduate grade-point averages, religious preference, career preference, preferred practice setting, educational debt, scholarship information, and participation in courses/clerkships in different subject areas.

The study comprises five data files. Dataset 1 contains the public-use version of the data for the allopath sample and Dataset 2 the public-use version of the data data for the osteopath sample. Both of these files were generated by ICPSR from the original restricted-use allopath and osteopath data files provided by the principal investigator, which are stored as Datasets 3 and 4 respectively. As noted in the ICPSR Processing Note in the codebook, Dataset 5 contains 26 restricted variables which the principal investigator omitted from the original allopath data (Dataset 3) for reasons of confidentiality. ICPSR received the omitted variables in 2009, 14 years after its initial release of the data.

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Practice Patterns of Young Physicians, 1997: [75 Largest Metropolitan Statistical Areas in the United States] (ICPSR 2829)

Released/updated on: 2024-02-14
Geographic coverage: United States
This survey reinterviewed a subsample of physicians who responded to the survey PRACTICE PATTERNS OF YOUNG PHYSICIANS, 1991: [UNITED STATES] (ICPSR 6145). Respondents answered questions about their practice arrangements, such as the number of different medical practices that they worked in during the past month, the number of hours spent providing patient care, and the number of patients seen in the past week. They also described the characteristics of their main practice in terms of type of practice setting, practice ownership, number of physicians, percentage of revenues from patients covered by Medicaid and Medicare, share of Medicaid and Medicare revenues from managed care organizations, percentage of patients with no health insurance coverage, and percentage of Black and Hispanic patients. Other information covered whether the practice had a formal mechanism for reviewing clinical practice decisions, whether it had contracted to provide care through a Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), or Independent Practice Arrangement (IPA), whether it was joined with one or more physician practices or was purchased by an insurance company in the past two years, percentage of revenues from PPO, HMO, and IPA arrangements, and whether there were personal financial incentives that favored reducing or expanding services to patients. Additionally, respondents were asked whether contracts or other communications received from insurance plans implied that continued participation in the plans depended upon costs associated with their clinical decisions, or implied that they should not tell patients about restrictions on coverage for medically accepted testing, treatment, or referral options. Other questions probed respondents' career satisfaction, ethical beliefs regarding the practice of medicine, and freedom to practice medicine as they saw fit. The survey also gathered information on determinants of physician compensation, medical specialty, income, marital status, spouse's occupation, and the number of children living with the respondent.