The importance of division of work and clinical focus in health human resources planning: a dynamic, multi-professional, needs-based simulation model

MacKenzie, Adrian (2019) The importance of division of work and clinical focus in health human resources planning: a dynamic, multi-professional, needs-based simulation model. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Background: Comprehensive health human resources (HHR) planning is essential for addressing population health needs and meeting other common health care system objectives. For reasons that remain unclear, conceptually invalid approaches to HHR planning remain commonplace in Canada and other countries. The overarching aim of this study is to assess the feasibility of using a dynamic, multi-professional, needs-based simulation model to inform HHR planning in Nova Scotia. Objectives: 1) Estimate the supply of and requirements for physicians, nurses, social workers, and psychologists to address anxiety and depression among school-aged children in Nova Scotia through 2032; and 2) Identify technical and political factors affecting the choice of HHR planning models in Nova Scotia. Methods: A dynamic, multi-professional, needs-based simulation model was used to achieve the first objective. A series of key informant interviews with HHR planners from different Nova Scotia stakeholder groups was conducted to address the second objective. Results: Simulation modeling suggests Nova Scotia currently lacks the number and mix of HHR required to address anxiety and depression among its school-aged children, and that this problem will worsen without intervention. Examples of policy interventions with the potential to address simulated HHR gaps are provided. The most important factor identified as affecting the choice of HHR planning model in Nova Scotia was the buy-in of key stakeholder groups. Other factors identified as particularly important in determining this choice were the model’s balance between comprehensiveness and complexity, the political and technical capacity of individuals and organizations responsible for HHR planning, and concerns regarding the availability of appropriate planning data to populate the model. Conclusion: Use of this model to inform HHR planning in Nova Scotia is feasible with appropriate engagement of key stakeholders. The structure and presentation of the model are viewed by HHR planners in the province as being suited to facilitating such engagement. Coordinated investments are needed to ensure adequate planning capacity among the individuals and organizations responsible for HHR planning in Nova Scotia, and the availability of adequate data to inform HHR and health system planning.

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