Allied Health Services Avoiding Crises (1989) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-14
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Department of Health and Human Services, this study by the Institute of Medicine was intended to answer the following questions: First, what roles do allied health workers perform and how will these roles fit into a changing health care delivery system over the next 15 years? Second, what will be the future demand for allied health personnel and how can public and private poli
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Fourth, what sorts of actions should educators take to prepare allied health practitioners for the workplace of the future? The committee's recommendations are based on what existing evidence tells about vital characteristics of the allied health labor market: · the composition of the labor force—namely, the predominance of technically competent women with a service orientation; · highly regulated professions and work environments; · education programs that are unable to compete effectively with other academic programs for limited resources and sufficient numbers of students; and · employers whose organizations are undergoing sweeping changes in their financial incentives and who must make hiring, compensation, and work force allocation decisions in the absence of good information.
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Given its limited funds and time the committee concluded that its greatest contribution would be to try to clarify the future outlook for allied health personnel- which is crucial to strategic planning and policy rather than to systematically assess the current situat~on. Data Limitations The committee's ability to fulfill its charge was severely hampered by a lack of data, the result of a relatively low interest and small investments of public resources in learning about the allied health work force.
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This task force should work toward increasing the amount and improving the quality of data needed to inform public policy decision makers, health care managers, unions, prospective students, and academic institutions about the allied health occupations. To help implement this recommendation and others that require federal action, the committee recommends that the Department of Health and Human Services maintain an organizational focal point on allied health personnel to implement the grant programs recommended in this report, to coordinate the recommended work of the interagency data task force, and to facilitate communication among state legislative committees and the federal government.
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THE FUTURE EMPLOYMENT SITUATION Barring major economic or health care financing contractions, the growth in the number of jobs for allied health workers will substantially exceed the nation's average rate of growth for all jobs. Unless some existing trends are moderated, the flow of practitioners into the work force through graduation from education programs will be, at best, stable.
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Our conclusions about the future outlook for allied health personnel refer to the long term and are national in scope. For all fields, there are likely to be periods of greater and lesser imbalance between now and the year 2000, as well as local variations in demand and supply.
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Faced with increased competition for students, educational institutions must become creative in their approaches to recruitment. Alliances must be forged with organizations that are also interested in recruiting allied health personnel.
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The committee endorses the objectives of the Health Careers Opportunity Program and believes that funding levels must be maintained at least at current levels. Allied health programs are vulnerable to closure because they appear to lag behind other programs in contributing to the academic standing and financial health of the institution in which they are located.
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HEALTH CARE INSTITUTIONS Health care employers directly generate demand for allied health workers and indirectly affect supply by the conditions of employment they offer. The committee reviewed the available literature to determine the sorts of activities that employers could undertake to enhance the supply of allied health workers by making a career in an allied health field more attractive to people choosing an occupation and by increasing retention rates.
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Chief executive officers, human resource directors, and other health care administrators must develop methods for the effective utilization of the existing supply of allied health personnel. Such methods must grow cut of experimentation with new ways of organizing work efficiently and the distribution of labor among skill levels, always ensuring that the quality of care is not compromised.
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To facilitate this interaction, the committee recommends that state legislatures establish special bodies whose primary purpose would be to address state and local issues in the education and employment of allied health personnel. LICENSURE, CERTIFICATION, AND ACCREDITATION the committee took a broad view of the charge from Congress and examined the full spectrum of allied health personnel regulation, including state licensure of individuals and health facilities, certification of individuals by private organizations, the imposition of standards by third-party payers, and voluntary accreditation of education programs.
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The Bureau of Health Professions (or other future focal points for allied health personnel in the Department of Health and Human Services) should sponsor a body with members drawn from allied health and other health professions and from the health and social science research communities to assess objectively the evidence bearing on "turf" issues.
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More generally, allied health workers in all long-term care settings need special preparation to care for patients with chronic illness, to understand the psychological aspects of aging, and to confront disability, death, and dying. Therefore, the committee recommends that all allied health education and training programs include substantive content and practical clinical experience in the care of the chronically ill and aged.
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Ultimately, collaborative action will be required. None of the committee's recommendations is self-implementing.
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