Assigning People as Number One Priority

Notions of the “expert patient,” user choices about where care is provided and by whom, and enhanced understanding between patients and healthcare workers for continuity of care all have implications for workforce planning and human resources. Modern health systems and care require a range of patient and community inputs if they are to be relevant for their users. However, partnering with disadvantaged communities for such purposes is not an easy undertaking. Such partnership efforts need to be premised on a participatory approach and face multiple challenges. Given the range of the stakeholders involved, the sharing of turf, risks, and resources that are usually part of such efforts requires careful consideration of all the partners. Further, there is always the possible exhaustion of the communities from being repeatedly over-researched, as well as the frequently encountered initial lack of trust between partners-to-be who have not previously collaborated. In such circumstances, the sharing of assets and a focus on enhancing the mutual capacities for a common purpose needs to be spelled out clearly from the start. Notwithstanding these and other challenges, over the past decade partnerships have become a frequent requirement for government and funding agency assistance. Research partnerships that incorporate community assets and values are among the defining approaches to social problem solving, where partnering has become the fundamental and strategic component of efforts aimed at promoting community health.

Tailor-Made Distance Education as a Retention Strategy

In rural areas of Thailand, health center personnel are responsible for primary health care. The opportunity for continuing education is imperative in the attraction and retention of these workers at their primary locations. The provision of continuing education also increases the quality and spectrum of health care available for the local people leading to better health outcomes for the Thai population. Distance education is one promising form of continuing education involving the use of advanced communication technologies to allow health center staff to continue to work and study off-campus. This chapter describes a tailor-made “Learning at the Workplace” distance education program provided to Thai rural health center personnel through the College of Public Health Sciences at Chulalongkorn University. Focus group discussions and selected quantitative research methods are recommended to evaluate the effectiveness of this learning model and determine the educational needs of health workers. Learning at the Workplace is expected to make a new contribution to the local needs of continuing education among the health care workforce in Thailand. This chapter emphasizes the potential that distance education offers to attract and retain health care personnel as well as the importance of providing a tailor-made curriculum in response to different regional and epidemiological factors.

Recruitment and Retention of Healthcare Professionals for the Changing Demographics, Culture, and Access in Canada

The Canadian healthcare system strives to serve a population altered by ever-changing demographics, cultural shifts, and diverse societal populations, and to serve those in rural communities with remote access to health care. The following chapter examines Canada’s current healthcare system and the effects on demand for services and the supply of healthcare providers created by the need to service rural populations, by limited access to medical schools, and by the introduction of foreign medical/health professionals. More specifically, the chapter reviews the symptoms of a strained medical system plagued by “brain waste” due to the non-use of qualified immigrant healthcare professionals, long wait times as a result of inadequate staffing and resources, and a school system that hinders the development of aspiring medical care professionals from rural and international areas. If Canada is to face these challenges with efficacy and vigour, effective human resources management techniques and competent human resources professionals are a necessary prologue. Medical knowledge and skill must be valued; healthcare professionals should be utilized more efficiently to improve healthcare access and minimize brain waste.

Managing and Motivating

It is now more than a decade since the acknowledgement of the health human resources crisis that exists in many low-income countries. During that decade much attention has focused on addressing the “pull” factors (e.g. developing voluntary international recruitment guidelines and bilateral agreements between recruiting and source countries) and on scaling up the supply of health professionals. Drawing on research conducted in two sub-Saharan African countries, we argue that a critical element in the human resources crisis is the poor working environments in these countries that not only continue to act as a strong “push” factor, but also impact on the motivation and performance of those who remain in their home countries. Unless attention is focused on improving work environments, the human resources crisis will continue in a vicious cycle leading to further decline in the health systems of low-income countries.

The Impact of Telehealth on the Healthcare Workforce

The pressures on the health workforce have a profound impact on the quality of care. The solution to health workforce issues is a global concern and governments and health systems around the world are seeking solutions to the problems of worker shortages and access to health services. Education and training of more doctors, nurses, and other health professionals require long-term policy changes, funding, and infrastructure development. Telehealth has been identified as an alternative solution to address some of these critical issues and this chapter outlines the potential of telehealth to address some challenges facing the health workforce. The discussion will provide evidence for feasible and effective adoption of telehealth solutions.

Expanding the Boundaries of Healthcare Human Resources Planning

Human resources are central to healthcare services, yet leveraging these resources to meet strategic operations and operational outcomes can present challenges to leaders and human resources professionals because of the complex and dynamic nature of healthcare delivery. Although the traditional roles of human resources management are necessary in supporting an organization in meeting its goals, economic, strategic, and cultural considerations are becoming increasingly important to human resources management and workforce planning in healthcare settings. This chapter presents several features of these different lenses to assist human resources managers in developing a holistic view of human resources planning in health care.

Hu Resources Replaces Human Resources in Health Care

Intelligent technologies are exponentially approaching the stage where healthcare professionals must begin to plan for the management of “hu” (human, software, and robotic) resources, replacing management of human resources alone in isolation from other intelligences. The healthcare industry in multiple levels and ways must begin to plan for human resources in health care to extend existing and to develop new conceptual and behavioral skills in order for humans, intelligent software, and robots to optimally partner with each other. The interaction among hu resources will be active and carried out in multiple modes and intellectual and emotional intensities. Healthcare professionals, who shape the social and cultural institutions around intelligence and active knowledge, can optimize the impact and performance of this intelligence partnership.

Interprofessional Care and Health Care Complexity

Health care systems are complex and often approach a deterministic chaos in the number and types of interactions that occur among health care providers and patients, as well as among the providers themselves. Such complexity may be an important barrier as North American health care systems are evolving into care-giving settings in which providers work to improve patient outcomes though interprofessional collaborative patient-centred care. The research on evidence-based learning and how to build new models of professional development opportunities for health information management (HIM) professionals is explored. Additionally, creating new and more effective undergraduate training programs in HIM is examined. From the perspective of interprofessional care, the authors provide a core set of interprofessional competencies and discuss how these competencies may be sensibly integrated into, and evaluated within, undergraduate curricular structures as well as professional development programs. A special emphasis of the chapter is an analysis of two case studies that highlight the barriers inherent within complex health care systems. Such barriers inhibit evidence-based education and professional development designed to improve interprofessional care.

The Health Informatics Professional

Health informatics (HI) is an increasingly important discipline to healthcare. HI is the scientific field concerned with improving how information in healthcare is captured, used, and managed. Developments in HI have streamlined and improved the efficacy of health service delivery, ranging from administration to bedside care to telehealth. Anecdotally, one observes that the paradigm of health domain experts working with information technology (IT) domain experts still produces health information systems that fail or do not work adequately; thus, there is a need for individuals knowledgeable in both information methods/tools and health. HI is a very broad discipline, but demonstrates features of a profession that set it apart from conventional IT or computer science; one notes different aspects of knowledge and skill and an ethos that is more aligned with that of health. This chapter provides an overview of HI, introducing the concepts of HI, its history, and how it relates to the skills, knowledge and attitudes of the emerging HI professional. HI is changing how healthcare is delivered and HI professionals are a part of that process. There are a range of roles these individuals fill, with some overlap with more established positions, such as health information managers. Despite the emergence of the HI profession, there are hurdles to overcome in terms of consistent education and registration or accreditation/credentialing.

Assessing Risk in Healthcare Collaborative Settings

This chapter describes a case study addressing risk assessment in a hospital unit. The objective of the case study was to analyse the impact on collaborative work and work flow after the unit changed its design and installations, and the consequences for risk management. The Software-Hardware-Environment-Liveware-Liveware (SHELL) model, a conceptual framework for understanding the interaction between human factors (liveware), computers (software and hardware) and the environment, was used in this study. The outcomes show that the SHELL model is adequate for analyzing the complex issues raised in healthcare collaborative settings. The SHELL analysis highlighted how the relationships among doctors, nurses and assistants – expressed according to the software, hardware, environment and liveware elements – evolved in the new work setting, characterized by new working rooms, glass walls and automatic doors. This analysis shows that even small changes, such as changing the way that computers are used in the work environment, may have a significant impact in a collaborative work setting.