More Effective Use of Skills

Having the right mix and distribution of qualified and skilled health care providers is critical to delivering safe and effective health services to Canadians.

Recruitment and Retention

As the Pan-Canadian Health Human Resource Strategy evolved during its first five years, supporting and promoting the effective use of skills of current and future health care providers became a major focus. Health human resource planning must take into account the design of each jurisdiction's health care system and its chosen service delivery models within the context of the following considerations:

• Canadians' changing health needs, given the demographics of our aging population, including the aging health workforce itself;
• increased investment in health promotion and chronic disease management and the resulting need for different skills and deployment as compared to acute (hospital-based) care;
• advances in treatment and technology that may change the type and amount of treatment patients need;
• new service delivery models (e.g., use of interprofessional teams);
• expanded scopes of practice (e.g., prescribing pharmacists) and emerging health provider roles (e.g., nurse practitioners, patient navigators);
• the distribution of the workforce across the country and within each jurisdiction, in particular, rural and remote areas; and
• other factors such as generational and gender differences in work patterns.

Interprofessional Collaboration

Significant potential exists to improve the utilization of health human resources by clarifying professional roles and responsibilities and implementing more collaborative models of care.  Interprofessional collaboration has been linked with greater provider satisfaction, leading to enhanced recruitment and retention, and improved patient safety and outcomes.

Interprofessional collaboration in both education and health care delivery settings can be defined as working together with one or more members of the health care team who each make a unique, professional competency-based, contribution to achieving a common goal. Through interprofessional collaboration, each individual contributes from within the limits of their scope of practice.  It is a process for communication and decision making that enables the separate and shared knowledge and skills of different care providers to synergistically influence the care provided through changed attitudes and behaviours, all the while emphasizing patient-centred goals and values.  Interprofessional collaboration allows efficient use of health human resources while enhancing performance and the benefit for patients by focusing on the right skills for the right task. 

As jurisdictions design their systems to meet population health needs, the types of providers required, their skills and the way they are deployed may change.

Strategic Directions

The Strategy supports provinces and territories in increasing the supply of health care providers and in developing a health workforce which uses its skills efficiently by:

• modernizing the health education programs and clinical practice models in order to prepare the health workforce to respond to the changing health needs of the Canadian population; 
• developing health system leaders who have the skills to manage change, respond to emerging challenges and develop/implement intelligent health systems;
• improving workforce utilization, so that all providers, regulated and unregulated, can practice to their full scope and competencies;
• improving recruitment and retention of skilled health care providers in areas of high need, including rural and remote settings;
• increasing the accountability and performance monitoring for interprofessional collaboration and quality of worklife through the development of national indicators and standards, benchmarking and reporting;
• building capacity and supporting the uptake of interprofessional collaboration and healthy work environments; and
• strengthening the evidence of the economic and quality of care impacts of interprofessional collaboration and healthy work environments.

Accomplishments within the First Five Years of the Strategy

Achievements from the first five years of the Strategy include:

• improved pan-Canadian health human resources data for key health professions, more cohesive collaborative approaches to HHR planning across jurisdictions;
• improved planning among Aboriginal and official language minority communities;
• alignment of education curricula with health system need and promotion of patient-based care and to make the health workforce more effective;
• supported the education sector in training health care professionals to work more collaboratively, including the development of a comprehensive model of Interprofessional Education for Collaborative Patient Centred Practice;
• fostered the capacity of health professionals to work in an interprofessional approach;
• identified interprofessional competencies, created teaching materials and developed faculty supports;
• established an electronic clearing house and library; and
• supported the creation of the  Canadian Interprofessional Health Collaborative (CIHC), an organization of champions who continue to build the evidence base, communicate results and work on the ongoing sustainability of interprofessional education and interprofessional collaborative practice.

Links and Resources:

Released in April 2009,  Teams in Action: Primary Health Care Teams for Canadians profiles team-based care and highlights benefits for patients with different health needs and for health professionals from different disciplines working collaboratively and complementarily.

Released in November 2005,  Modernizing the Management of Health Human Resources in Canada: Identifying Areas for Accelerated Change makes a range of recommendations including on the organization of the health care workforce to best use its skills.

•  Canadian Interprofessional Health Collaborative (CIHC)
•  College of Health Disciplines, University of British Columbia (Vancouver, British Columbia, Canada)
•  The Centre for Collaborative Health Professional Education, Memorial University of Newfoundland (St. John's Newfoundland, Canada)
•  The Office of Interprofessional Education, University of Toronto (Toronto, Ontario, Canada)
•  National Health Sciences Students' Association

Publications influencing current HHR policy development include:

Advisory Committee on Health Delivery and Human Resources

•  (2009) How many are enough? Redefining Self-Sufficiency for the Health Workforce
•  (2005, revised 2007) A Framework for Collaborative Pan-Canadian Health Human Resources Planning

Health Canada

• (2004) Literature Review and Environmental Scan of Preferred Practices for Deployment of Health Human Resources and Decision Support Tools: Final Report

Recent statistics on health providers in Canada:

The  Canadian Institute for Health Information (CIHI) produces data at the national and provincial/territorial levels on different professions making up Canada's health care workforce.  Featured  reports include information on the supply, distribution and migration of professions such as physicians, nurses, pharmacists, physiotherapists, occupational therapists, medical laboratory technologists, and medical radiation technologists.

Recent statistics on accessing health providers in Canada (Statistics Canada):

Released in July 2009,  Experiences with Primary Health Care in Canada (2008) was jointly funded by the Canadian Institute for Health Information and the Health Council of Canada and is based on the responses of more than 11,000 people aged 18 and older.

Released in June 2009,  Population with a regular medical doctor, by sex, provinces and territories and  Population with a regular medical doctor, by age group and sex (national data from Statistics Canada) provides statistics on Canadians aged 12 and over who reported having a regular medical doctor in 2003, 2005, 2007 and 2008.

Released in July 2006,  Access to Health Care Services in Canada (2001, 2003, 2005) provides updated results of the experiences of patients waiting for care and is based on 12 months of data for  2005. The Health Council of Canada also partnered with Statistics Canada in 2007 to produce the  Canadian Survey of Experiences with Primary Health Care in 2007.