A dynamic, multi-professional, needs-based simulation model to inform human resources for health planning

Abstract

Background: As population health needs become more complex, addressing those needs increasingly requires the knowledge, skills, and judgment of multiple types of human resources for health (HRH) working interdependently. A growing emphasis on team-delivered health care is evident in several jurisdictions, including those in Canada. However, the most commonly used HRH planning models across Canada and other countries lack the capacity to plan for more than one type of HRH in an integrated manner. The purpose of this paper is to present a dynamic, multi-professional, needs-based simulation model to inform HRH planning and demonstrate the importance of two of its parameters-division of work and clinical focus-which have received comparatively little attention in HRH research to date.

Methods: The model estimates HRH requirements by combining features of two previously published needs-based approaches to HRH planning-a dynamic approach designed to plan for a single type of HRH at a time and a multi-professional approach designed to compare HRH supply with requirements at a single point in time. The supplies of different types of HRH are estimated using a stock-and-flow approach.

Results: The model makes explicit two planning parameters-the division of work across different types of HRH, and the degree of clinical focus among individual types of HRH-which have previously received little attention in the HRH literature. Examples of the impacts of these parameters on HRH planning scenarios are provided to illustrate how failure to account for them may over- or under-estimate the size of any gaps between the supply of and requirements for HRH.

Conclusion: This paper presents a dynamic, multi-professional, needs-based simulation model which can be used to inform HRH planning in different contexts. To facilitate its application by readers, this includes the definition of each parameter and specification of the mathematical relationships between them.

Keywords: HHR; HRH; Health human resources; Health services; Health workforce; Human resources for health; Multi-professional; Planning.

Fig. 1

Visual representation of the model structure

Fig. 2

Simulated Nova Scotia HHR gap for addressing anxiety and depression among school-aged children: All parameters remain constant except population

Fig. 3

Simulated Nova Scotia HHR gap for addressing anxiety and depression among school-aged children: Shift work to less scarce professions

Fig. 4

Simulated Nova Scotia HHR gap for addressing anxiety and depression among school-aged children: No psychotherapy performed by family physicians

Fig. 5

Simulated Nova Scotia HHR gap for addressing anxiety and depression among school-aged children: Increased clinical focus for all but social workers

Fig. 6

Simulated Nova Scotia HHR gap for addressing anxiety and depression among school-aged children: Reduced clinical focus for social workers