Healthcare Workforce Planning
Workforce planning is the assessment of needs for human resources. This process can be very formal and complex or depend on “back-of-the-employee” estimates and can be applied to small organization or practices as well as to national and international healthcare delivery systems. Workforce planning fits in with overall health systems planning and human resources development and management. Workforce planning is used to support decision making and policy development for a wide range of concerns. For healthcare organizations to meet their clinical and operating goals and objectives, they must effectively deploy and support workers of all kinds. Doing so requires that the numbers and types of workers match the needs of the patients, regulators, and payers who make up the functional environment of the healthcare organization.
The Rationale for Healthcare Workforce Planning
The drivers of HRH planning have expanded to include the workforce’s adaptation to technology as well as the match of needs to supply. The following figure describes an analytical framework for HRH planning that considers the emerging concerns over global markets; migration; and changes in technology, institutions, and populations.
Healthcare Workforce Planning Methodologies
Five basic strategies are used in workforce planning, each approach has its strengths and weaknesses, depending on the goal of the planning exercise and the context in which it will be applied. These methods may be used separately or in combination, depending on the system at which the planning is targeted as well as the specific policy questions posed during planning.
Population-Based Estimating
This method rests on presumed appropriate or normative ratios of personnel and professionals to a population. These ratios are not always epidemiological analysis or careful study of productivity and utilization, but they often come from rules of thumb or from a current state of balance of practitioner to the population. Nevertheless, analysts and planners persist in using ratios as standard indicators of desired staffing or as guides to their studies of professional supply.
Benchmarking
The benchmarking method takes into consideration existing ratios but adds a test of efficiency to the analysis. Advocates of benchmarking view these ratios as achievable, optimal ratios and accept the implication that these ratios describe the most efficient supply of practitioners.
Needs-Based Assessment
Perhaps the most obvious method of determining how many healthcare professionals should be supported in a system or an organization is to match the consensus healthcare needs of a population or client base with their biological need for care. The consensus process for needs-based assessment is iterative, where lists of indicators, signs, and conditions are presented in various combinations and where expert clinicians are asked to determine if these combinations are high, medium, or low-level reasons for hospitalization, for conducting specific procedures, for course therapy, or for prescribing a specific medication.
Demand-Based Assessment
This method is explicitly economic in nature and is based largely on past patterns of service utilization. Demand is considered to be somewhat independent of the need for care in that some individual may seek care when they are not ill because they either misread their symptoms or desire to be treated regardless of medical need. In practice, need and demand are considered very closely tied. In an economic sense, demand is equal to utilization- what is consumed is what is demanded; that is, there is a balance in supply and demand in the market that is regulated by the price of the goods and services that are consumed.
Training-Output Estimating
This method is perhaps the most common method for anticipating supply of practitioners. Essentially, it draws on data from training programs, such as the number of enrollees, the number of anticipated graduates, and the trends in applications. This approach has been used to anticipate trends in the general supply for physicians, general surgeons, internists, pediatricians, and allied health professionals.
