Background
The ultimate goal of health human resource (HHR) planning is to provide a crucial evidence-base for policymakers to develop and deploy a fit-for-purpose workforce with the right mix of providers for a given population. Health care reform priorities have focused on system changes to support the quintuple aim. Integrated models of care, such as the Ontario Health Teams (OHTs), support the needs of their local population by bringing health care providers and sectors together as a team to deliver seamless care across the full continuum. There are five primary approaches to HHR planning:
- Supply-based approaches – Include health-counts and focuses on current or targeted provider-population ratios.
- Demand-based approaches – Population service use is examined and focuses on utilization rates which are converted to productivity estimates using estimates of future population size.
- Needs-based approaches – Demand for service based on population needs, expected future needs and provider requirements based on best practices.
- Competency-based approaches - Knowledge, skills, and judgement explicitly taken into consideration based on health needs of population.
- Scenario-based approaches - Description of different plausible situations as a means of prediction.
Regardless of the approach, HHR planning is invariably done in silos, focusing on one profession, one sector or population, often in isolation of larger policy issues and removed from regional population health needs. In order to meet the needs of local populations, regional health human resource planning is critical. When HHR planning is aligned with health system objectives and policy, it is more likely to be sustainable. However, there is sparse evidence and policies to support local health workforce planning.
Setting
Frontenac, Lennox and Addington Ontario Health Team (FLA-OHT)
Case under study: Frontenac, Lennox & Addington Ontario Health Team (FLA-OHT)
The OHT for this study received official designation in November 2020. They are a mid-sized OHT with responsibility for approximately 150 000 patients who live in both urban and rural locations. There is one urban academic hospital, a primary care network that represents all primary care providers, and a strong Community Council that is comprised of community members with patient, client, family member, caregiver and citizen representation. The FLA-OHT has established processes to ensure community voices are a part of all organizational structures; these processes and structures(e.g., monthly Partnership Council meetings) will be used to ensure the evidence gathering phase includes the input of the OHT community. Team members have been actively engaged with the FLA-OHT: supporting evaluation, leading and participating in community engagement, and working on projects with Ontario Health to measure patient experience within the OHT. The FLA-OHT’s five-year strategic plan includes the development of a collaborative regional health human resources plan, which this work will directly support.
Research Approach
Objective 1: PHASE 1 - Generate Evidence
Understand the contextual factors that influence regional planning and apply an HHR planning framework driven by population health needs in one Ontario Health Team.
Objective 2: PHASE 2 - Knowledge mobilization (KM) and contextualization
Contextualize how policy makers and knowledge users can implement the proposed policy options related to regional HHR planning.
Objective 3: PHASE 3 - Iterative re-formulation and dissemination of evidence and policy
Co-develop policy options to inform integrated care models for regional HHR planning.