Pan-Canadian Health Human Resource Strategy

Report 4

Background

People are the health care system's greatest asset. Canada's ability to provide access to "high quality, effective, patient-centred and safe" health services depends on the right mix of health care providers with the right skills in the right place at the right time. The sustainability of Canada's Health Human Resources (HHR) is an issue which has received significant attention in recent years. Canada's HHR are facing a constantly evolving health care landscape in which factors such as an aging population and workforce, new technologies, and health care reforms are all contributing to the need for change.

Through recent health care accords, First Ministers have repeatedly stressed the need for appropriate planning and management of HHR in order to ensure that Canadians have access to the health care providers they need. Through the 2003 Budget $20M was provided, annually, on an ongoing basis. These funds have formed the foundation for Health Canada's Pan-Canadian Health Human Resource Strategy. Additionally, the First Ministers Agreement of 2004 provided further support through a commitment to accelerate and expand the assessment and integration of internationally educated health care professionals. Budget 2005 provided $75M over five years to support integration of internationally educated health care professionals.

Over the past year, Health Canada has worked collaboratively with other federal departments, provincial/territorial (P/T) governments, professional associations and a range of stakeholders across sectors to advance HHR issues.

Strategy

Health Canada and its stakeholders have begun work to address the many challenges our country faces with respect to HHR within three broad components:

• Pan-Canadian HHR Planning;
• Interprofessional Education for Collaborative Patient-Centred Practice; and
• Recruitment and Retention of Health Care Providers

Health Canada is also playing a lead role to deliver programs to facilitate the integration of internationally educated health care professionals with a focus on the following priority groups:

• International medical graduates;
• Internationally educated nurses; and
• Internationally educated pharmacists, physiotherapists, occupational therapists, medical radiation technologists, and medical laboratory technologists.

Current Situation

Pan-Canadian HHR Planning:

In recent years, it became clear that there was a need to change the traditional method of HHR planning in Canada, which had limited collaboration between federal/provincial/territorial (F/P/T) governments with respect to addressing the supply and demand issues of Canada's health care workforce as well as improve data sources, forecasting models and research.

The Pan-Canadian HHR Planning Initiative seeks to address the above issues by achieving the following objectives:

• enhance and strengthen the evidence base and capacity for coordinated HHR planning to better support F/P/T, jurisdictional and nation wide activities; and
• create a culture in which key HHR issues of jurisdictional, inter-jurisdictional and pan-Canadian concern can be identified and addressed.

One of the key successes over the past year is the agreement by the federal, provincial and territorial Ministries of Health on a Framework for Collaborative Pan-Canadian Health Human Resources Planning.

Interprofessional Education for Collaborative Patient-Centred Practice:

Recent trends towards interprofessional team based care suggest that the roles and responsibilities of various health care providers are evolving. Changing the way we educate health care providers is key to achieving system change and to ensuring that health care providers have the necessary knowledge and skill to work effectively in interprofessional teams within the evolving health care system.

The IECPCP initiative seeks to enhance interprofessional patient-centred practice by accomplishing the following objectives:

• promote and demonstrate the benefits of interprofessional education for collaborative patient-centred practice;
• increase the number of educators prepared to teach from an interprofessional collaborative patient-centred perspective;
• increase the number of health professionals trained for patient-centred collaborative practice before, and after, entry-to-practice;
• stimulate networking and sharing of best educational approaches for collaborative patient-centred practice; and
• facilitate interprofessional collaborative care in both the education and practice settings.

Through the Interprofessionally Educated Patient-Centred Practice Intitiative Health Canada has funded 11 projects for a total of $13M and has developed a framework for interprofessionally educated patient-centred practice.

Recruitment and Retention:

There are current and impending imbalances in the supply of health care providers across a wide variety of disciplines. As the health workforce continues to age, demand for services increases, and the workplace becomes increasingly global, the need to appropriately recruit and retain HHR becomes progressively more essential. This need is often emphasized in more remote geographical areas of Canada where undersupply of providers is a significant challenge. This imbalance threatens the system's capacity to deliver health services to Canadians. The Recruitment and Retention Initiative seeks to address these issues by accomplishing the following objectives:

• increase interest in health careers, both generally and in specific areas of shortage;
• increase diversity of health care providers to reflect the Canadian mosaic;
• increase the supply of health care providers to ensure availability, when and where needed;
• reduce barriers for internationally educated health care providers;
• improve utilization and distribution of existing health care providers; and
• make current workplace environments healthier for health care workers and in doing so, support the provision of high-quality care.

Health Canada has funded a national "Healthy Health Care Provider Advocacy Campaign" in collaboration with the Canadian Medical Association, Canadian Nurses Association, and the Canadian Medical Foundation to highlight the contributions made by health care providers in improving the lives of Canadians.

Health Canada's Healthy Workplace Initiative was created to support actions by local initiatives that precipitate improvements in the short-term in one or more of the following areas: work environments; health and well-being of health care workers; and job satisfaction and quality of work life.

This is based on the fact that healthy work environments contribute to positive outcomes for workers and to improved health service quality, cost-effectiveness, and workforce renewal. Progress depends on addressing symptoms of unhealthy workplaces; focusing on how front-line patient care or related health services are provided.

Through the Healthy Workplace Initiative, Health Canada has funded 11 projects to address the work environment in health care organizations across the country.

Internationally Educated Health Care Professionals (IEHPs):

Recent trends towards interprofessional collaborative care suggest that the roles and responsibilities of various health care providers are being clarified. Changing the way we educate health care providers is key to achieving system change and to ensuring that health care providers have the necessary knowledge and training to work effectively in interprofessional teams within the evolving health care system. There is growing consensus that interprofessional collaborative patient-centered practice - across all health sectors and along the continuum of care - will contribute to the following:

• improved population health / patient care;
• improved access to health care;
• improved recruitment and retention of health care providers;
• improved patient safety and communication among health care providers;
• more efficient and effective employment of health human resources; and
• improved satisfaction among patients and health care providers.

The Interprofessional Education for Collaborative Patient Centred Practice (IECPCP) initiative has the following objectives:

• promote and demonstrate the benefits of interprofessional education for collaborative patient-centred practice;
• increase the number of educators prepared to teach from an interprofessional collaborative patient-centred perspective;
• increase the number of health professionals trained for patient-centred collaborative practice before, and after, entry-to-practice;
• stimulate networking and sharing of best educational approaches for collaborative patient-centred practice; and
• facilitate interprofessional collaborative care in both the education and practice settings.

Through the IECPCP initiative, Health Canada has funded a variety of initiatives in all jurisdictions, including complimentary projects.

Aboriginal Health Human Resources:

Health Canada has a unique relationship with First Nations and Inuit communities in working closely with them to enhance their health services and improve their health. This is an ongoing commitment of the federal government, resulting from a series of reports and commissions on Aboriginal health.

Health Canada's First Nations and Inuit Health Branch (FNIHB) works to ensure that First Nations and Inuit health care needs are addressed and, where possible, integrated into larger pan-Canadian strategies. FNIHB is directly responsible for implementing the HHR Strategy from a First Nations and Inuit perspective and seeks to accomplish the following goals:

• ensure that the current and future supply, mix and distribution of First Nations and Inuit HHR are optimized and respond to the needs of First Nations and Inuit through a coordinated approach to HHR planning;
• achieve and maintain an adequate supply of qualified health care providers who are appropriately educated, distributed, deployed and supported, to ensure culturally appropriate and safe health care services are available to First Nations and Inuit;
• increase the number of First Nations and Inuit entering into health careers, and the number of health care providers working in First Nations and Inuit communities;
• ensure that First Nations and Inuit HHR data collection is ongoing, coordinated and systematic, and that the process involves First Nations and Inuit organizations; and
• promote interprofessional education for health care workers and collaborative patient-centred practice that addresses the holistic health care needs of First Nations and Inuit.

Challenges

There are a number of challenges facing Health Canada's Pan-Canadian Health human Resource Strategies. The success of the strategy relies on the commitment of federal, provincial and territorial governments as well as stakeholders to work together collaboratively to ensure that Canadians have the right mix of health care providers with the right skills in the right place at the right time.

Some of the critical challenges that lay ahead include:

• strong leadership and adequate resources in order to ensure effective change;
• clear understanding of roles and responsibilities;
• a focus on cross-jurisdictional issues;
• facilitating a change in system/organizational culture;
• ensuring the flexibility required to be responsive to individual jurisdictional needs; and
• acting on the current health human resource needs while monitoring new and emerging issues.

While these challenges are diverse and complex, Health Canada is confident that it can work collaboratively with other federal departments, provincial and territorial governments and the many health care stakeholders to ensure the success of the strategy.