Paper
Friday, July 23, 2004
This presentation is part of : Nurses and Staffing Patterns
A Needs-Based Approach to Human Resource Planning: A Multistakeholder Perspective
Jean Hughes, RN, PhD, School of Nursing, Dalhousie University, Halifax, NS, Canada and Judith Ritchie, RN, PhD, Nursing, McGill University Health Centre, Montreal, QC, Canada.
Learning Objective #1: Gain an enhanced understanding of needs-based health human resource planning
Learning Objective #2: Gain an enhanced awareness of the necessity for identifying the perspectives of all stakeholders when considering patient need
Background/Objectives: Policy makers routinely conduct health human resource planning (HRP) using supply and demand models that result in cycles of shortage and surplus that rarely match the ‘needs’. This paper reports on a study that explored the concept of needs-based HRP planning among people living with end-stage renal disease (ESRD) in Atlantic Canada.

Phase I Methods: We explored the needs of people with ESRD. We held 34 focus groups (n = 197 people) to determine the separate perspectives of patients, family members, clinicians, clinical decision makers and administrators, and policy makers about what needs should be considered in planning nursing resources for people with ESRD.

Findings: The thematic analysis described a wide range of health-related and health system-related needs but the relative importance accorded each need varied from none to a lot according to stakeholder group.

Phase II Methods: We explored the extent to which the needs exist in the population of interest, and whether they are met or unmet. Based on the needs emerging from the focus groups, we assessed patients (n = 134) across all four provinces, using an instrument derived from standardized instruments, to determine the profile of need. We concurrently interviewed information system (IS) experts to determine what information they maintain regarding those needs.

Findings: The patient assessment revealed high levels of disability but relatively few absolute unmet needs. The main predictors of health status (SF –12) and of illness burden (subscales of the instrument) were scores on subscales – ‘symptoms’, ‘the effects of ESRD and its treatment on daily living’ and ‘co-morbidities’. Very little information about patient determined needs or about the nursing staff involved in addressing patients’ needs is collected, and/or computerized, and/or linked to enable needs-based HRP.

Conclusions: These results raise many questions in terms of future needs-based HRP work.

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Sigma Theta Tau International
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