Pan-Canadian Health Human Resource Strategy: 2005-2006 Annual Report

The Initiatives of the Pan-Canadian HHR Strategy

Pan-Canadian HHR Planning

In 2003, the First Ministers requested that collaborative strategies be undertaken to strengthen the evidence base for pan-Canadian HHR planning. In recent years, it has become clear that there is a lack of appropriate data, forecasting models, and research on HHR. In the case of existing data, there are gaps and a lack of consistency concerning how and what data is currently collected. In addition, the traditional methods of HHR planning in Canada 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.

The Pan-Canadian HHR Planning Initiative seeks to address collaborative planning 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 nation­wide activities; and
• create a culture in which key HHR issues
  of jurisdictional, inter-jurisdictional and
  pan-Canadian concern can be identified
  and addressed.
  

Projects funded under this initiative of the Strategy are outlined on pages 17 to 19. These projects rep­resent a critical step towards accomplishing the objectives of this planning initiative, such as colla­borating with the Canadian Institute for Health Information on the development of a pan-Canadian supply-based minimum dataset and initiating the creation of five national HHR databases.

Interprofessional Education for Collaborative Patient-Centred Practice (IECPCP)

Recent trends towards interprofessional team-based care suggest that the roles and responsibilities of various health care providers are changing.

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 skills to work effectively in interprofessional teams within the evolving health care system. In the 2002 report, Building on Values: The Future of Health Care in Canada , Roy Romanow recommend­ed a review of "current education and training pro­grams for health care providers to focus more on integrated provider education approaches for preparing health care teams."

Furthermore, in the 2003 Accord, First Ministers agreed that among other HHR activities, collaborative strategies are to be undertaken to promote interpro­fessional provider education.

The objective of the IECPCP initiative of the Pan-Canadian HHR Strategy is to facilitate the adoption of these approaches across all health care sectors.

The goals are to increase patient and provider satis­faction, and ultimately improve patient care. The IECPCP Initiative began in 2003 and is embarking on a 5-year plan, with 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.

Year One (2003/2004) focused on building the foun­dation for IECPCP through the creation of a National Expert Committee, and the examination and assessment of issues related to IECPCP. Best practices for interprofessional education were identi­fied through a literature review and environmental scan. In May 2005, Health Canada funded the publi­cation of a series of discussion and synthesis papers which were commissioned to examine key issues in interprofessional education and collabora­tive patient-centred practice. These issues included: attitudes, perceptions, structural and regulatory bar­riers to interprofessional education, principles and methods of IECPCP and faculty development.

A two-cycle Call for Proposal funding program was implemented in November 2005 for projects lasting up to June 2008.

Descriptions of contribution agreements funded dur­ing the 2005/06 fiscal year related to IECPCP can be found on pages 21 to 42.

Recruitment and Retention (R&R)

As the health workforce continues to age, the popu­lation becomes increasingly diverse, demand for health care increases, and the need to appropriately recruit and retain health care providers 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 sys-tem's capacity to deliver health services to Canadians.

The R&R 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.

There are many factors that contribute to recruit­ment and retention including scope of practice, job satisfaction, and other issues related to the work­place.

Scope of practice for health professionals plays out at three levels: the legislated scope of practice, set by the provinces and territories (which is what providers are legally allowed and educated to do); the expectations of employers; and role enact­ment that which actually occurs in the clinical setting.

Resolution of issues related to scope of practice is important, yet complicated work. It requires consul­tation and collaboration with several stakeholder groups. Some funding under the Strategy is set aside to conduct further developmental work in this area.

Several studies have also identified that continuing education for health care providers has a significant impact on the quality of health care services provided.

Health Canada produced a literature review and environmental scan, which were the basis of a report on continuing education of health care providers in Canada. This report identified the barri­ers to accessing continuing education and the best practices for improving access and delivery of con­tinuing education to health care providers in rural, remote, northern, Aboriginal, and inner city commu­nities in Canada.

During 2005/06 Health Canada funded a variety of projects and activities. Highlights include:

• Enhancement of Physician Health Human Resources in Rural Canada ($153 thousand to the Society of Rural Physicians of Canada)
• Enhancement of the image of Family Medicine and the role of Family Medicine in undergraduate medical curriculum and support for family physicians in primary care ($1.4 million to College of Family Physicians of Canada)
• A national conference on innovative HHRdeployment strategies ($228 thousand toDalhousie University)
• Development and implementation of a national multimedia campaign on health care providers to raise awareness of health careers ($2 million to the Canadian Medical Association and Canadian Nurses Association)

Recruitment and Retention complementary projects which Health Canada led or collaborated on can be found on page 107.

Another factor that contributes to positive outcomes for health care workers is the creation and mainte­nance of healthy work environments that improve health service quality, are cost-effective, and enhance workforce renewal.

Healthy Workplace Initiative (HWI)

The Healthy Workplace Initiative, under the policy framework of Recruitment and Retention, focuses on front-line methods of identifying innovative ways to foster healthy workplace practices and positive change within the health care workplace. One of the key activities of HWI is to provide direct funding to support local-level healthy workplace initiatives.

Pages 43 to 64 describe Recruitment and Retention contribution agreements continued or implemented in 2005/06.

Provincial/Territorial/Regional Projects

In order to work collaboratively with our jurisdictional partners, and to ensure that the Strategy objectives are accomplished on a pan-Canadian basis, Health Canada invited jurisdictions to submit P/T and regional project proposals. From a $4 million total, each P/T was allocated a base lump sum plus addi­tional funds on a per-capita basis to be utilized between 2004/05 and 2005/06. In some cases, P/Ts chose to pool their allocated resources to collabo­rate regionally, such as the Western & Northern Health Human Resources Planning Forum. A num­ber of these projects, which collectively address the priorities of all three Strategy initiatives, were imple­mented in 2005/06. Pages 65 to 74 outline these projects.