The Use of Simulation Technology in Needs-Based Health Human Resource Planning: A Canadian Nursing Experience

Tuesday, 8 July 2008: 10:50 AM
Gail Tomblin Murphy, RN, PhD , School of Nursing, Dalhousie University, Halifax, NS, Canada
Robert Alder, MMedSc, PhD , Health Services Consulting, Med-Emerg Inc, London, ON, Canada
Cindy Pelletier, MSc , Health Services Consulting, Med-Emerg Inc, Mississauga, ON, Canada
Adrian MacKenzie, BSc(H) , Population Health Research Unit, Dalhousie University, Halifax, NS, Canada

Learning Objective 1: The learner will be able to understand the influence of population health care needs and provider productivity in health human resource planning.

Learning Objective 2: Will also be able to understand the use of technology to incorporate the influence of various factors in HHR planning and their impact on policy.

Policy related to Health Human Resources (HHR) planning usually proceeds in the absence of evidence on the relative effectiveness of the policy options. In this study, based on a needs-based HHR planning framework, the authors employed system dynamic simulation technology to evaluate the relative effectiveness of policy options and provide a graphic display of the most effective combination of options.

The requirements for Registered Nurses (RN) in Nova Scotia, Canada, were estimated based on projections in population size, health status (as a measure of health care need), estimated levels of service, and provider productivity. The supply of RNs in Nova Scotia was estimated based on the current stock and inputs to it from education programs and in-migration as well as outputs from it due to retirements, deaths, and out-migration. The difference between the two, supply and requirement, was the gap, where a negative reflects a shortage and positive reflects a surplus of RNs.

It was found that at baseline, without any policy intervention and assuming that the trend in health status of the past 10 years continues, the gap over the next 15 years went from a shortage of 164 activity-adjusted RNs (similar to full-time equivalents) to and shortage of 1994. Addressing the downward trend in health status to improve it to match the Canadian national levels had a marked effect on the shortage, reducing it from a shortage of 1994 to a shortage of 854. An important finding is that a combination of policies directed at retention, productivity and activity levels for RNs were most effective compared to policies focused on training seat increases, student attrition and graduate out-migration. Hence, needs-based simulation models can provide a graphic presentation of relative effectiveness such that the most effective portfolio of options can be readily identified and discussed.