Optimizing nursing human resource planning in British Columbia

Workforce Planning for Community-Based Palliative Care Specialist Teams Using Operations Research

CONTEXT

Many countries have aging populations. Thus, the need for palliative care will increase. However, the methods to estimate optimal staffing for specialist palliative care teams are rudimentary as yet.

OBJECTIVES

To develop a population-need workforce planning model for community-based palliative care specialist teams and to apply the model to forecast the staff needed to care for all patients with terminal illness, organ failure, and frailty during the next 20 years, with and without the expansion of primary palliative care.

METHODS

We used operations research (linear programming) to model the problem. We used the framework of the Canadian Society of Palliative Care Physicians and the Nova Scotia palliative care strategy to apply the model.

RESULTS

To meet the palliative care needs for persons dying across Nova Scotia in 2019, the model generated an estimate of 70.8 nurses, 23.6 physicians, and 11.9 social workers, a total of 106.3 staff. Thereby, the model indicated that a 64% increase in specialist palliative care staff was needed immediately, and a further 13.1% increase would be needed during the next 20 years. Trained primary palliative care providers currently meet 3.7% of need, and with their expansion are expected to meet 20.3% by 2038.

CONCLUSION

Historical, current, and projected data can be used with operations research to forecast staffing levels for specialist palliative care teams under various scenarios. The forecast can be updated as new data emerge, applied to other populations, and used to test alternative delivery models.

A scoping review of nursing workforce planning and forecasting research

AIM

This study will critically evaluate forecasting models and their content in workforce planning policies for nursing professionals and to highlight the strengths and the weaknesses of existing approaches.

BACKGROUND

Although macro-level nursing workforce issues may not be the first thing that many nurse managers consider in daily operations, the current and impending nursing shortage in many countries makes nursing specific models for workforce forecasting important.

METHOD

A scoping review was conducted using a directed and summative content analysis approach to capture supply and demand analytic methods of nurse workforce planning and forecasting. The literature on nurse workforce forecasting studies published in peer-reviewed journals as well as in grey literature was included in the scoping review.

RESULTS

Thirty six studies met the inclusion criteria, with the majority coming from the USA. Forecasting methods were biased towards service utilization analyses and were not consistent across studies.

CONCLUSION

Current methods for nurse workforce forecasting are inconsistent and have not accounted sufficiently for socioeconomic and political factors that can influence workforce projections. Additional studies examining past trends are needed to improve future modelling.

IMPLICATIONS FOR NURSING MANAGEMENT

Accurate nursing workforce forecasting can help nurse managers, administrators and policy makers to understand the supply and demand of the workforce to prepare and maintain an adequate and competent current and future workforce.

Strategic modeling of the pediatric nurse practitioner workforce

OBJECTIVE

To assess the current pediatric nurse practitioner (PNP) workforce and to investigate the impact of potential policy changes to address forecasted shortages.

METHODS

We modeled the admission of students into nursing bachelor's programs and followed them through advanced clinical programs. Prediction models were combined with optimal decision-making to determine best-case scenario admission levels. We computed 2 measures: (1) the absolute shortage and (2) the expected number of years until the PNP workforce will be able to fully satisfy PNP demand (ie, self-sufficiency).

RESULTS

There is a forecasted shortage of PNPs in the workforce over the next 13 years. Under the best-case scenario, it would take at least 13 years for the workforce to fully satisfy demand. Our analysis of potential policy changes revealed that increasing the specialization rate for PNPs by 4% would decrease the number of years required until there are enough PNPs from 13 years to 5 years. Increasing the certification examination passing rate to 96% from the current average of 86.9% would lead to self-sufficiency in 11 years. In addition, increasing the annual growth rate of master's programs to 36% from the current maximum of 10.7% would result in self-sufficiency in 5 years.

CONCLUSIONS

Current forecasts of demand for PNPs indicate that the current workforce will be incapable of satisfying the growing demand. Policy changes can result in a reduction in the expected shortage and potentially improve access to care for pediatric patients.

Pilot-testing an applied competency-based approach to health human resources planning

A competency-based approach to health human resources (HHR) planning is one that explicitly considers the spectrum of knowledge, skills and judgement (competencies) required for the health workforce based on the health needs of the relevant population in some specific circumstances. Such an approach is of particular benefit to planners challenged to make optimal use of limited HHR as it allows them to move beyond simply estimating numbers of certain professionals required and plan instead according to the unique mix of competencies available from the existing health workforce. This kind of flexibility is particularly valuable in contexts where healthcare providers are in short supply generally (e.g. in many developing countries) or temporarily due to a surge in need (e.g. a pandemic or other disease outbreak). A pilot application of this approach using the context of an influenza pandemic in one health district of Nova Scotia, Canada, is described, and key competency gaps identified. The approach is also being applied using other conditions in other Canadian jurisdictions and in Zambia.

Development of an interactive model for planning the care workforce for Alberta: case study

INTRODUCTION

In common with other jurisdictions, Alberta faces challenges in ensuring a balance in health worker supply and demand. As the provider organization with province-wide responsibility, Alberta Health Services needed to develop a forecasting tool to inform its position on key workforce parameters, in the first instance focused on modeling the situation for Registered Nurses, Licensed Practical Nurses and health care aides. This case study describes the development of the model, highlighting the choices involved in model development.

CASE DESCRIPTION

A workforce planning model was developed to test the effect of different assumptions (for instance about vacancy rates or retirement) and different policy choices (for example about the size of intakes into universities and colleges, different composition of the workforce). This case study describes the choices involved in designing the model. The workforce planning model was used as part of a consultation process and to develop six scenarios (based on different policy choices).

DISCUSSION AND EVALUATION

The model outputs highlighted the problems with continuation of current workforce strategies and the impact of key policy choices on workforce parameters.

CONCLUSIONS

Models which allow for transparency of the underlying assumptions, and the ability to assess the sensitivity of assumptions and the impact of policy choices are required for effective workforce planning.