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 Healthcare Quarterly, 11(4) 2008: 30-36

Abstract For three days in September 2007, chief executive officers (CEOs) from health systems and organizations across Canada gathered in Banff, Alberta, for the inaugural Healthcare CEO Leadership Summit. We came together to consider and debate two of the most pressing issues facing the transformation of our country's healthcare environment: health human resources (HHR) and public-private partnerships (P3s). (This gathering, from September 14 to 16, was made possible by an unrestricted educational grant from Hoffmann-La Roche Limited. HHR and P3s were selected as topics based on an extensive needs assessment carried out among participants prior to the meeting.)Frank McKenna, the former premier of New Brunswick and former ambassador to the United States, gave the plenary address at the summit. Tom Closson, the past president and CEO of Toronto's University Health Network, delivered a keynote lecture on HHR, while the president and CEO of Hoffman-La Roche Limited, Ronnie Miller, shared his insights on P3s. By listening to presentations from these experts, brainstorming in breakout sessions and openly discussing the topics as a group, summit participants arrived at several conclusions regarding the main challenges and opportunities associated with HHR and P3s. Fundamentally, we all agreed that successfully managing HHR and P3s is critical for healthcare organizations that are focused on serving patients better. In this article, I first set out some of the main elements that characterize Canada's transforming healthcare environment and that largely form the raison d'être for new approaches to HHR and for the emergence of P3s. I then present core findings that emerged from our meeting in Banff and add my views based on my own experience as president and CEO of Kingston General Hospital. Where appropriate, I also briefly present recent innovations that might serve as examples of possible routes forward.

The Government of Canada is committed to improving Canadians’ access to sustainable, publicly funded health care services for all Canadians. The move toward a dynamic Health Human Resource Strategy (HHRS) builds upon the important work of Commissioner Roy Romanow and the Senate Committee chaired by Michael Kirby, which reviewed Canada's current health-care system and made recommendations for its improvement. Building on the First Ministers’ 2003 and 2004 Accord commitments to health human resources, the Pan-Canadian HHRS was launched in 2004/05 to support effective co-ordination and collaborative health human resources planning across the country.

Abstract The World Health Report launched the Health Workforce Decade (2006-2015), with high priority given for countries to develop effective workforce strategies including healthy workplaces for health workers. Evidence shows that healthy workplaces improve recruitment and retention, workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes. Over the past few years, healthy workplace issues in Canada have been on the agenda of many governments and employers. The purpose of this paper is to provide a progress update, using different data-collection approaches, on knowledge transfer and uptake of research evidence in policy and practice, including the next steps for the healthy workplace agenda in Canada. The objectives of this paper are (1) to summarize the current healthy workplace initiatives that are currently under way in Canada; (2) to synthesize what has been done in reality to determine how far the healthy workplace agenda has progressed from the perspectives of research, policy and practice; and (3) to outline the next steps for moving forward with the healthy workplace agenda to achieve its ultimate objectives. Some of the key questions discussed in this paper are as follows: Has the existing evidence on the benefits of healthy workplaces resulted in policy change? If so, how and to what extent? Have the existing policy initiatives resulted in healthier workplaces for healthcare workers? Are there indications that healthcare workers, particularly at the front line, are experiencing better working conditions? While there has been significant progress in bringing policy changes as a result of research evidence, our synthesis suggests that more work is needed to ensure that existing policy initiatives bring effective changes to the workplace. In this paper, we outline the next steps for research, policy and practice that are required to help the healthy workplace agenda achieve its ultimate objectives. The early decades of the 21st century belong to health human resources (HHR). The World Health Report (World Health Organization [WHO] 2006) launched the Health Workforce Decade (2006-2015), with high priority given for countries to develop effective workforce strategies that include three core elements: improving recruitment, helping the existing workforce to perform better and slowing the rate at which workers leave the health workforce. In this recent report, retaining high-quality healthcare workers is discussed as a major strategic issue for healthcare systems and employers, and improving workplaces as a key strategy for achieving this goal. The workplace can act as either a push or pull factor for HHR. Heavy workloads, excessive overtime, inflexible scheduling, safety hazards, poor management and few opportunities for leadership and professional development are among the push factors that result in poor recruitment and retention of HHR. Evidence shows that healthy workplaces improve recruitment and retention, workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes. What are healthy workplaces? Based on existing definitions, there is not yet a standardized and comprehensive definition of healthy workplaces. In this paper, we define healthy workplaces as mechanisms, programs, policies, initiatives, actions and practices that are in place to provide the health workforce with physical, mental, psychosocial and organizational conditions that, in return, contribute to improved workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes (Griffin et al. 2006). Over the past few years, healthy workplace issues in Canada have been on the agenda of many governments and stakeholder organizations. Nationally and internationally, robust evidence has been accumulated on the impact of healthy workplaces on workers' health and well-being, quality of care, patient safety, organizational performance and societal outcomes. This evidence has provided guidance for governments and employers in terms of what should be done to make the workplace healthier for healthcare workers. Across Canada, many initiatives to improve the working conditions for HHR are currently under way, but the continuing concerns suggest that barriers remain. An assessment of the progress to date is necessary in order to inform the next steps for research, policy and practice.

our theme today is health and human resources

Dr. Andrew Padmos, Chief Executive Officer, Royal College of Physicians and Surgeons of Canada

The first is to continue and augment investments in patient-centred medical education and training programs that support lifelong learning.

Current and impending shortages and imbalances in the supply of health care providers have been well documented both within Canada and internationally. As health care delivery in Canada has undergone changes in structure and organization, many jurisdictions have reassessed their methods of deployment of health human resources (HHR) with a view to exploring different and innovative means of responding to these shortages and imbalances in number and mix of health care providers, in geographic maldistribution, and to developing new organizational models of delivery.

September 7, 2016 at 02:00 PM

Live Webinar by Gabriela Prada

Physician assistants (PAs) are academically prepared and highly skilled health care professionals who provide a broad range of medical services in different clinical settings. Under the supervision of a physician, PA’s provide needed support and care when other medical staff could be stretched to their limit. However, despite their invaluable role, there is a lack of data on the impact of PAs from a productivity and cost-effectiveness perspective.

a working group on health care innovation to examine three critical issues related to the health workforce. These issues include examining the scopes of practice of health care providers to better meet patient needs, better coordinated management of health human resources, and accelerated adoption of clinical practice guidelines (CPGs).

Typically, the public dialogue around the health workforce is narrowly focused on addressing shortages and other supply-related crises, real or imagined, so it is refreshing to see attention paid at this level to broader health workforce issues.

we are not so much suffering from a lack of health care professionals as from their inappropriate deployment

Raising entry-to-practice credentials (ETPC) in health disciplines is the new pandemic.

Employers never demand increased ETPC; on occasion they explicitly oppose it. No one has ever produced evidence that those practicing with the about-to-be-abandoned credential were harming the public. Governments never instigate the changes.

increasing the credential does not necessarily mean more training

And second, a lid must be placed on APP program payments. Funding for benefit and incentive programs should be folded into the negotiation of fee schedules, recognizing that they are, like fees, simply part of the average prices physicians receive for their services.

the coming increases in numbers have, once again, foreclosed for decades the possibilities for exploiting the full competence of complementary and substitute health personnel, expanding interprofessional team practice and in general, shifting the mix

Including rapid growth in net immigration, the annual "crop" has nearly doubled.

A co-ordinated approach to better manage cost and wage escalation while ensuring the right mix and number of health providers are being trained and deployed in Canada.

The needs of the patient, sustainability, and best practice and not ideology must guide the future of health care. Public funding will always be at the foundation of ensuring Canadians have access to health care. Expanding on the successes with private delivery in Saskatchewan's surgical initiative, further expansion of private sector involvement in the health system will occur.

In 2004, federal, provincial and territorial governments, in their "Ten-Year Plan to Strengthen Health Care," renewed their commitment under the 2003 Health Accord, and agreed to increase the supply of health professionals in Canada and to make their action plans public. The plans, including targets for the training, recruitment and retention of professionals, are to be released by December 31, 2005. Regarding this commitment, the Federal Health Care Partnership, which includes Health Canada, Correctional Service Canada, the Department of National Defence, Veterans Affairs Canada, the Royal Canadian Mounted Police and Citizenship and Immigration Canada, will report on the role of the federal government and its collective activities in this area.

Health workforce planning is the latest plank in health system reform being pursued by countries around the world. A main objective of health workforce planning is to have the right number and mix of health practitioners with appropriate skills in the right places at the right time, to provide quality services to those who need them. Historically, however, workforce planning has more often referred to less-than-perfect approaches to planning for physician 'manpower,' based on maintaining existing physician-population ratios. Less focus was placed on planning for nurses and other health providers.

Studies included in the ROI series: are authored by both Canadian and international researchers reflect a variety of clinical settings involve registered nurses as well as other members of the health-care team include health promotion, interprofessional care and the use of technology address cost savings, increased system capacity and improved quality of care

This report presents a synthesis of the last four years of public opinion polling data (2002 – 2006) on the Canadian health care system. These data are used to understand how Canadian perceptions have changed since the Romanow Commission – including whether Canadians see the system as improving or deteriorating, and how they view governments’ performance on health care issues. In addition, the report examines the state of Canadian opinion on issues such as government spending, private health care, problems with the current system, and priorities for future policy developments, including home care and pharmacare. This overview – Canadian Perceptions of the Health Care System by Professor Stuart Soroka – was released as a companion document to the Council’s report, Health Care Renewal in Canada: Measuring Up?

Canada is facing a growing aging population, which will demand health care practitioners – including doctors, nurses and social workers – who can provide the specialized care older adults need. However, Canada faces a shortage of professionals who can provide that care and thus many older adults receive care from practitioners who do not have specific training in care for older adults. In response to this situation, this project aimed to undertake activities to improve the health human resources available that can provide the specialized care Canada’s aging population requires now, and in the future. This project targeted two key audiences: post-secondary students and curriculum development stakeholders. Resources created through this project include:

We thank the Standing Committee on Health for the opportunity to share our views. We are here to submit to you five recommendations that address the issue of Health Human Resources. These recommendations are not “magic bullets”, but they will help to put Canada on the road to self-sustainability. The labour shortages and resulting wait times seen across the continuum of care can be history.

  Healthcare Quarterly, 11(2) 2008: 80-84 Futurethink Healthcare Systems and Organizations: Implications for Health Human Resources* Michael B. Decter

Abstract What will the healthcare system and healthcare organizations look like in the year 2020? What requirements will they have for health human resources? These two questions require both a careful consideration of the general direction of change in health systems and a consideration of the pace of change over the next 15 years. The geographical focus of this article is Ontario, although broader international and Canadian trends are also considered in arriving at answers.This article is organized in five brief sections, beginning with looking backward to look forward and proceeding through key trends, organizational evolution by sector and future health organizations and concluding with 10 implications for health human resources.