Planning for a modern workforce
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Alexandre Lourenço's keynote on "Planning for a modern workforce", at the WHO High-level Regional Meeting on Health and Care Workforce in Europe: 22-23 March 2023, Bucharest, Romania.
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Planning for a modern workforce
- 1. High-level Regional Meeting on Health and Care Workforce in Europe: TIME TO ACT March 22-23, 2023 BUCHAREST
- 2. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT Planning for a modern workforce 2 A systems perspective
- 3. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT 3 © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 5. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT Healthcare workforce supply inflows and outflows 6 Current Workforce Projected Future Workforce 1. Increasing demand for health services Needed Workforce © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 8. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT Healthcare workforce supply inflows and outflows 9 Current Workforce Retirements Attrition Projected Future Workforce 2. Changing workforce expectations © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 12. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT Healthcare workforce supply inflows and outflows 13 Current Workforce Training pipeline Retirements Attrition Projected Future Workforce © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 14. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT “Capable” doctors 15 14 -61 -76 -10,000% -7,500% -5,000% -2,500% 0% 2,500% Productivity Signs of Burnout Planning leave current employer (1)the decision-making latitude they need to provide high-quality care and (2)the necessary tools and resources. Schlesinger and Josh Gray 2017 Harvard Business Review © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 15. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT “Our practice values teamwork more than individual performance” 16 3X more “capable” 5X more willing to go above and beyond in their jobs -75% less likely to say they experience significant signs of burnout 5X recommend and stay with their organizations Schlesinger and Josh Gray 2017 Harvard Business Review © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 16. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT 17 Adapted from Walshe et al (2016) Leadership Supervisor's support Team working Job design Work pressure Having a challenging role Feeling valued by colleagues Overall engagement Advocacy Intrinsic engagement Involvement/ proactivity Employee reactions Health and well-being Stress Organizational performance Quality of services Financial performance Absenteeism Patient mortality rate Patient satisfaction The link between HR strategies, staff engagement and patient safety © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 17. Building better organizations will support better healthcare workforce © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 18. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT Healthcare workforce supply inflows and outflows 19 Current Workforce Projected Future Workforce 3. New and changing models of care Model of Care © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 22. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT 23 Redistribution Handing off existing tasks to other workers, such as nurse practitioners and general practitioners with specialist interests Creation Creating new jobs for work previously not done by anyone, such as genetic counsellors and lay providers to support self- care Capacity expansion Increasing the numbers of nurses, doctors, and other health professionals Retraining Expanding the job descriptions of existing workers, such as community matrons, to include work previously not done by anyone New ( alternative ) worker Old worker Old work New work Adapted from Walshe et al (2016) © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 23. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT Healthcare workforce supply inflows and outflows 24 Current Workforce Training pipeline Retirements Attrition Model of Care Projected Future Workforce Migration © 2023 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 26. HIGH-LEVEL REGIONAL MEETING ON HEALTH AND CARE WORKFORCE IN EUROPE: TIME TO ACT Thank you. 27 www.alexandrelourenco.pt
Notas do Editor
- Good morning. It is a pleasure to be here at this landmark event in HRH.
- Health workforce planning aims to achieve a proper balance between the supply and demand of health professionals in both the short and longer term. We know that even the countries using planning models failed to account for current imbalances in the healthcare workforce. - health expenditure ultimately determines the size of the healthcare workforce, and different expenditure projections significantly impact future workforce demand. - Some models have focused on healthcare needs rather than utilization, which requires normative judgments and is highly uncertain. Many models are uni-professional and miss the opportunities for a degree of ‘horizontal’ or ‘vertical’ substitution. Most models make arbitrary assumptions about changes in productivity, with little evidence to base this on. A review of twenty six workforce planning models across the OECD (Ono et al., 2013) identified the following issues in the current approaches (see Table 17.1).
- While most workforce attrition comes from retirement, workers also drop out of the workforce for other reasons, including abandonment, time taken off to raise children, to care for elderly family members, or to pursue additional training. Sometimes this break becomes permanent, but many return to the workforce. Like retirement decisions, workforce retention rates are often cyclical with the economy. Nurse workforce retention rates have also been shown to be sensitive to wage changes. As wages increase, workforce participation rates increase (Buerhau: Auerbach, and Staiger 2007). Modeling attrition from the workforce due to economic factors is difficult because economic conditions cannot be anticipated. To overcome this difficulty, analysts often assume an average attrition rate that evens out boom and bust cycles over the projection period. Hire new workers • Increase the amount of time that workers provide patient care • Retain workers who would have otherwise retired or left the organization • Develop skills of workers within organization
- While most workforce attrition comes from retirement, workers als Irop out of the workforce for other reasons, including death and time take off to raise children, to care for elderly family members, or to pursue add tonal training. Sometimes this break becomes permanent, but many return to the workforce. Like retirement decisions, workforce retention rates ar often cyclical with the economy. For example, nurses tend to stay in the workforce during economic downturns, presumably to offset a decline i earnings by their spouses (Stager, Auerbach, and Buerhaus 2012). Nurse workforce retention rates have also been shown to be sensitive to changes in wages. As wages increase, workforce participation rates increase (Buerhau: Auerbach, and Staiger 2007). Modeling attrition from the workforce due t economic factors is difficult because economic conditions cannot be antic pated. To overcome this difficulty, analysts often assume an average attritio rate that evens out boom and bust cycles over the projection period. Hire new workers • Increase the amount of time that workers provide patient care • Retain workers who would have otherwise retired or left the organization • Develop skills of workers within organization
- Increased demand for health services as a result of: an aging population, increase in chronic diseases, service backlogs due to the COVID-19 pandemic and increasing legitimate expectations from patients.
- Not only increased demand but also demanding more convenience.
- While most workforce attrition comes from retirement, workers als Irop out of the workforce for other reasons, including death and time take off to raise children, to care for elderly family members, or to pursue add tonal training. Sometimes this break becomes permanent, but many return to the workforce. Like retirement decisions, workforce retention rates ar often cyclical with the economy. For example, nurses tend to stay in the workforce during economic downturns, presumably to offset a decline i earnings by their spouses (Stager, Auerbach, and Buerhaus 2012). Nurse workforce retention rates have also been shown to be sensitive to changes in wages. As wages increase, workforce participation rates increase (Buerhau: Auerbach, and Staiger 2007). Modeling attrition from the workforce due t economic factors is difficult because economic conditions cannot be antic pated. To overcome this difficulty, analysts often assume an average attritio rate that evens out boom and bust cycles over the projection period. Hire new workers • Increase the amount of time that workers provide patient care • Retain workers who would have otherwise retired or left the organization • Develop skills of workers within organization
- While most workforce attrition comes from retirement, workers als Irop out of the workforce for other reasons, including death and time take off to raise children, to care for elderly family members, or to pursue add tonal training. Sometimes this break becomes permanent, but many return to the workforce. Like retirement decisions, workforce retention rates ar often cyclical with the economy. For example, nurses tend to stay in the workforce during economic downturns, presumably to offset a decline i earnings by their spouses (Stager, Auerbach, and Buerhaus 2012). Nurse workforce retention rates have also been shown to be sensitive to changes in wages. As wages increase, workforce participation rates increase (Buerhau: Auerbach, and Staiger 2007). Modeling attrition from the workforce due t economic factors is difficult because economic conditions cannot be antic pated. To overcome this difficulty, analysts often assume an average attritio rate that evens out boom and bust cycles over the projection period. Hire new workers • Increase the amount of time that workers provide patient care • Retain workers who would have otherwise retired or left the organization • Develop skills of workers within organization
- While most workforce attrition comes from retirement, workers als Irop out of the workforce for other reasons, including death and time take off to raise children, to care for elderly family members, or to pursue add tonal training. Sometimes this break becomes permanent, but many return to the workforce. Like retirement decisions, workforce retention rates ar often cyclical with the economy. For example, nurses tend to stay in the workforce during economic downturns, presumably to offset a decline i earnings by their spouses (Stager, Auerbach, and Buerhaus 2012). Nurse workforce retention rates have also been shown to be sensitive to changes in wages. As wages increase, workforce participation rates increase (Buerhau: Auerbach, and Staiger 2007). Modeling attrition from the workforce due t economic factors is difficult because economic conditions cannot be antic pated. To overcome this difficulty, analysts often assume an average attritio rate that evens out boom and bust cycles over the projection period. Hire new workers • Increase the amount of time that workers provide patient care • Retain workers who would have otherwise retired or left the organization • Develop skills of workers within organization
- While most workforce attrition comes from retirement, workers als Irop out of the workforce for other reasons, including death and time take off to raise children, to care for elderly family members, or to pursue add tonal training. Sometimes this break becomes permanent, but many return to the workforce. Like retirement decisions, workforce retention rates ar often cyclical with the economy. For example, nurses tend to stay in the workforce during economic downturns, presumably to offset a decline i earnings by their spouses (Stager, Auerbach, and Buerhaus 2012). Nurse workforce retention rates have also been shown to be sensitive to changes in wages. As wages increase, workforce participation rates increase (Buerhau: Auerbach, and Staiger 2007). Modeling attrition from the workforce due t economic factors is difficult because economic conditions cannot be antic pated. To overcome this difficulty, analysts often assume an average attritio rate that evens out boom and bust cycles over the projection period. Hire new workers • Increase the amount of time that workers provide patient care • Retain workers who would have otherwise retired or left the organization • Develop skills of workers within organization
- Health service utilization (or healthcare needs in approaches that use a broader approach to measuring demand) – for example, taking account of different utilization rates by different population groups. 4Different health service delivery models (which may influence workforce requirements in primary care, hospitals and long-term care). Walshe, Kieran; Walshe, Kieran; Smith, Judith; Smith, Judith. EBOOK: Healthcare Management (UK Higher Education Humanities & Social Sciences Health & Social Welfare) (p. 310). McGraw-Hill Education. Kindle Edition.
- The health system is typically dominated by: healthcare traditional providers: hospitals, primary care centers, clinics, etc pharma and medical devices industry These two have been evolving in developing precision medicine and risk-sharing contracts. Hospitals also understand that they need to break their walls and increase proximity to patients and communities. Namely to solve problems in provider-patient transitions. A third party is emerging. Primarily as technological partners of legacy providers, pharma, and medical devices industry. New technological players are primarily influencing the previous two. We see its influence on Bigdata, remote monitoring, decision-support tools, etc. If primarily they rely on conventional providers, they now venture themselves to solo initiatives: remote physical therapy, teleconsultations, etc., disrupting the way care is being provided. In my opinion, the most significant disruption will come from an alternative player. The individual health providers. The primary technology companies are investing in health prevention. They have the capacity and resources to influence healthcare, as we didn’t see it yet. The ability to detect prediabetes, fever, arrhythmia, and provide meaningful advice. if care providers can access these decision-support tools, what stops the patients they serve from also accessing them? And if my patients can access these same tools, what do they need me for? a new world is around the corner
- While most workforce attrition comes from retirement, workers als Irop out of the workforce for other reasons, including death and time take off to raise children, to care for elderly family members, or to pursue add tonal training. Sometimes this break becomes permanent, but many return to the workforce. Like retirement decisions, workforce retention rates ar often cyclical with the economy. For example, nurses tend to stay in the workforce during economic downturns, presumably to offset a decline i earnings by their spouses (Stager, Auerbach, and Buerhaus 2012). Nurse workforce retention rates have also been shown to be sensitive to changes in wages. As wages increase, workforce participation rates increase (Buerhau: Auerbach, and Staiger 2007). Modeling attrition from the workforce due t economic factors is difficult because economic conditions cannot be antic pated. To overcome this difficulty, analysts often assume an average attritio rate that evens out boom and bust cycles over the projection period. Hire new workers • Increase the amount of time that workers provide patient care • Retain workers who would have otherwise retired or left the organization • Develop skills of workers within organization
- Good morning. It is a pleasure to be here at this landmark event in HRH.