Abstract
Background: Canada is currently experiencing a health workforce crisis, reflective of the global workforce challenges. Integrated models of care such as Ontario Health Team (OHTs), in Ontario, Canada are important examples of large-scale reform focusing on local populations and a regional health workforce. To ensure a workforce that meets the needs of their population, a regional approach to workforce planning is required. While significant work has been published on health workforce planning, there are few examples of how regional integrated care systems can apply workforce planning models to address population needs. The overall aim of this project is to inform policy to support regional workforce planning for integrated care strategies.
Approach: An exploratory mixed methods single case study design was used. The study was conducted in partnership with one Ontario Health Team that served as the case. Lived experience patient partners were core members of the research team, providing input throughout the project. The Health Workforce Planning Model was identified in a scoping review and applied to the OHT. A mixed methods approach included multiple regional, provincial, and federal data sources to describe the population, health needs, and service providers. Interviews were conducted with the OHT leaders and community members to obtain insights into workforce planning from the regional context. A document analysis of publicly available workforce planning documents across all OHTs was completed. A deliberative dialogue was held to obtain input from the OHT, provincial and federal decision makers to inform policy recommendations. Discrete analysis was conducted for each data set and the quantitative and qualitative data was merged through a process of pattern matching.
Results: Using the Health Workforce Planning Model, we attempted to capture data related to service requirements (population data demographics, health status, health services utilization) and service capacity (health workforce) to examine fit and identify gaps. Data were gathered by a complex web at federal, provincial, and regional levels. Six federal/provincial data sets were used to describe the population. Nineteen of 93 regional organizations completed surveys to obtain workforce data. A review of 54 OHT websites found only 12 OHTs had documents mentioning health workforce planning, including strategic plans (66.7%) and other reports (e.g. year-end). Fourteen interviews were completed with regional OHT leaders and community partners, providing insights into contextual factors including current status of health workforce planning, driving forces, capacity for change and solutions. Key recommendations focused on the need for: 1) health workforce planning governance structures and accountability provincially and within OHTs, 2) standardized and comprehensive data and reporting across all sectors and 3) infrastructure at the provincial level and within regions to support health workforce planning.
Implications: Despite the crisis in the health workforce there remains significant challenges in obtaining data to inform workforce planning and little infrastructure within integrated care systems such as Ontario Heath Teams to support regional planning. Ongoing efforts need to focus on consistency and standardization of workforce data and building in targeted resources and infrastructure to support regions to proactively plan for population needs.