Post on 09-Jul-2020
Royal College – National Specialty Societies 2018 Human Resources for Health Dialogue
Author: Lisa Little
January 08, 2019
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1 Overview
On December 11, 2018, the Royal College held its eight annual National Specialty Societies
(NSS) Human Resources for Health (HRH) Dialogue. This year’s dialogue focused on aligning
quality health workforce data, research and analysis to decision making.
Objectives:
Learning and establishing actions about:
1. advancing effective workforce research methodologies and metrics
2. identifying and addressing the health needs of populations
3. identifying and integrating system factors into workforce planning
The event was attended by 70 participants representing 47 member organizations
comprised of:
29 NSSs
7 medical organizations/groups
6 data holder organizations
2 research groups
2 government organizations
1 learner organization
A list of participants can be found in Appendix A.
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Bridging the Divide Between Data and Decision
Making Keynote Presentation
Dr. Jennifer Zelmer, President and CEO of the Canadian Foundation for Healthcare
Improvement launched the day by providing her
perspective as someone who has experience in a
number of health workforce aspects spanning data,
research and planning. She noted that healthcare
decisions are informed by a myriad of people and
organizations. Canada is fortunate to have a wide
range of data sources available to it. However,
information deluge is both an opportunity and a
challenge. How do we manage all this data? Dr. Zelmer noted that if attendees read 1
hr/day, 15 mins/article, they would have read only 0.3% of articles produced in that year.
Most important are the threads and connections between the data sets.
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Promoting evidence-informed decision-making is a key lever for healthcare improvement
and is impacted by a number of considerations which she highlighted. Data collection and
decision making in healthcare is also impacted by a changing landscape which includes
interprofessional collaborative practice, e-patients and big data analytics. Dr. Zelmer
challenged participants to ask themselves how ready they were for this change.
This presentation generated discussion among the participants on:
physicians as chief information officers
how to move from crisis oriented data needs on urgent issues to creating long term
data infrastructure through capacity building when opportunities arise and building
relationships to develop coalition for change
the importance of visualization of data for decision makers
the importance of patient privacy with the goal of improved patient care.
3 Health Needs: Connecting the Dots Panel Discussion to explore how specialists can better address health needs of the population
Ms Carolyn Canfield, Founding member, Patient Advisors Network (Patient Perspective) and
first patient safety champion and Adjunct Professor at University of British Columbia Faculty
of Medicine
Ms Canfield spoke of the need to bridge the gap between data and the patient experience.
Patients now have access to data and understanding how they use this data is key - whether
online or in person with a healthcare provider. She noted that Canadians are hungry for
information about their healthcare system - what will it look like when they need it. There is
a growing appetite by citizens to not only understand data but also generate data in the
form of patient expectations and health literacy levels. Ms Canfield noted that it is difficult
cfhi-fcass.ca | @cfhi_fcass.ca 7
Decision Considerations: Examples
1 2 3 4 5 6
Knowledge
about data/
analysis
varies
greatly
Speed
Is key when
decision
timescales
are short
Cost
of access
and analysis,
in $ or time
Use
depends on
context,
relationship,
culture,
timing
Quality
of data
including
perceived
relevance
New models
of care affect
data needs &
interpretation
Source: CFHI 2018
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for the public to learn about the health system. There are numerous barriers including
limited access to conferences, cost of health journals, etc. She suggested there are
numerous roles for patients. She shared her experiences in the Strategy for Patient-
Oriented Research (SPOR) to ensure projects are patient focused/sensitive, in planning by
sitting on various committees, and in teaching in undergraduate medical education. She
encouraged participants to consider how to involve citizens in what matters to them.
Dr. Cory Neudorf, Chief Medical Health Officer, Saskatoon Population & Public Health
Services, also associate professor at University of Saskatchewan
Dr. Neudorf shared his experience in examining data at a smaller geographical area. He
noted that the way we are analyzing and reporting data can lead to short comings in
accurately identifying health needs and subsequently providing appropriate healthcare
services. Enhanced data, such as educational levels and Indigenous status, is needed to
describe unique patient experiences. Huge variation in health outcomes is seen based on
Canadians’ socioeconomic status; it is the root of all other patient outcomes and is driving
changes in patient behaviour and how patients access the healthcare system. Dr. Neudorf
suggested that we continue to improve care for those who access healthcare, but what
about those who never access healthcare? Prevention programming is not getting to those
that need the highest level of care. There is a need to involve citizens in designing health
care that is meaningful and culturally relevant. He encouraged participants to consider how
we work differently together with the patient and examine the cultural context to provide
culturally appropriate care. He suggested there is a greater need to examine the social
determinants of health, and that examining the enablers of health may lead to a different
health team composition.
This panel presentation generated discussion among the participants on:
trust between providers and patients is key
listening is a first step in patient led care and that is not something we do well
when you listen to patients, you understand social inequities and the interplay with
health and social policy/care
how do we structure and build the system to be meaningful and relevant to
patients/citizens?
an appropriate level of detail on patient context and demographics needs to be
collected, especially in EMR, to enable a systems approach
too often we try to control, rather than focus, on the factors that are driving health
status
need to enhance patient data - averages mask important differences
what would you do to reduce the need for each specialty; what are things in the
health system that create demand?
maps are visualizations that move people and enable granularity
infographics are now an important way of conveying information quickly
patient stories are powerful data
specialties still siloed and don’t communicate with other specialties to enhance the
patient journey; use patients to structure connections across those specialties.
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4 The Current State World Café
In preparation for the afternoon breakout sessions, featured researchers and subject matter
experts rotated though groups of participants to start identifying actions and solutions
relating to the following four topics. Background documents and discussion questions for
each group topic were distributed in advance to all participants.
Group 1 Data collection and standards
Mr. Geoff Ballinger, Manager, Physicians Information, Canadian Institute for Health Information
(CIHI)
Group 2 Full-time equivalent (FTE) methodologies Dr. Evert Tuyp, President, BC Section of Dermatology and Clinical Assistant Professor, University of
British Columbia
Group 3 Expanding and building on needs based planning Mrs. Danielle Fréchette, Executive Director, Office of Health Systems Innovation and External
Relations, Royal College
Group 4 Exploring solutions related to employment of newly certified specialists
Dr. Allison Fox-Robichaud, President of the Canadian Critical Care Society
Dr. Paola Fata, President of the Canadian Association of General Surgeons
5 Tackling the Current State Concurrent Sessions
Participants contributed to one of the four groups to discuss and advance the actions and solutions
identified during the previous World Café session. Each group was asked to identify key takeaways,
actions and key stakeholders. The following are the results presented by each group.
In their words: Group 1 Data collection and standards
Key
Tak
eaw
ays Designing data for use
for future policy change.
Most information is on supply side, need to start looking at population health needs side (e.g. CIHI;s Population Health Grouper).
Integrate models of care into workforce planning, include qualitative data.
Data should be accessible and scalable in a timely and transparent fashion.
Act
ion
s Build capacity to educate stakeholders about current data sources/tools and how to work with that data including gaps.
Review and modify minimum data set to provide to regulatory bodies (e.g. equity indicators, FTE, retirement).
Press upon regulatory bodies the importance of data.
Key
Sta
keh
old
ers
Regulatory bodies
Patient advisors
Researchers
Data holders
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In their words: Group 2 Full-time equivalent (FTE) methodologies
In their words: Group 3 Expanding and building on needs based planning
Key
Tak
eaw
ays Current CIHI definition is
irrelevant to some specialties, regions and facilities ( payment information gaps and various professional roles).
Step back and ask “How do we define an FTE. What info do we need to get out of FTE?”.
-What FTE requirement is needed to deliver services to a population/community?
-What does an average or reasonable FTE look like for a particular specialty group (e.g., X ER visits per day, X slides read per week, X hours of work per week, etc)?
The specialty specific approach could result in a loss of comparability. We still need an FTE measure that can be used to talk with policy makers.
Act
ion
s Conduct an environmental scan to build on the working paper that was started for this meeting, leading to a repository/drop box of existing resources, studies, etc (InfoCentral, Research Gate).
NSS need to develop a definition of FTE for their specialty, looking at other NSS approaches for best practices.
Review current FTE metrics to see which specialties they reflect well and what new methods exist or might be created to improve measurement for other specialties for which they don’t work.
Key
Sta
keh
old
ers
NSS
Governments (P/T)
CIHI and data holders
Universities
Patients
Health economists
ImagineCanada
Key
Tak
eaw
ays
Don't boil the ocean: planning is complex, jurisdiction owned so make actions meaningful/have impact.
Pick 1-2 things that will have a real impact.
Pick what and who you’re trying to influence/inform.
Act
ion
s Inform students upstream about employability by specialty, geography (current & what should be).
- Geospatial mapping, partnerships with geographers to provide information to faculties of medicine
Common voice that health resource planning is socially accountable.
- Engagement with citizen patients to reflect those voices in planning
Specialty Workforce Collaborative (SWC) as a resource to government with informed opinions & facts about planning.
Key
Sta
keh
old
ers
Citizen patients
Policy/decision makers
Medical Schools
Future Physicians/ Learners
Specialty Workforce Collaborative
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In their words: Group 4 Exploring solutions related to employment of newly certified specialists
6 Priority Actions Next Steps
Participants undertook a prioritization exercise using Poll Everywhere to identify the top 5
actions from the list of actions generated from the four groups. The following actions were
the highest rated:
1. Increase robust data predicting health workforce needs (work with NSS to extract
data).
2. NSS need to develop a definition of FTE for their specialty, looking at other NSS
approaches or best practices.
3. Emphasize the importance or data to regulatory bodies and others.
4. Inform students upstream about employability by specialty and geography (current
and what should be).
5. Strive for national licensing for trainees (more complicated for certified specialists).
7 Closing Remarks
Mrs. Fréchette concluded the day by stating the Royal College will support the Coordinating
Group of the Specialty Workforce Collaborative to define next steps. She also emphasized
that active participation of NSS and others will be critical to moving these actions forward.
She thanked theme leads, speakers, the Coordinating Group, and everyone present for their
contribution to moving from problems to action.
Key
Tak
eaw
ays What is the minimal
data set that we need to move forward to identify gaps in your specialty HRH planning?
How do we make it easier for trainees to move between regulatory colleges?
Facilitating transitioning into and out of practice (*in areas of need) via a mentoring program system.
Act
ion
s Increase robust data predicting health workforce needs (work with NSS to extract data).
Strategy around governance of a region.
Central repository of jobs.
National licensing for trainees (more complicated for certified specialists).
Royal College to define a community rotation.
Key
Sta
keh
old
ers Regulatory bodies
Medical school (i.e. undergraduate program directors, deans)
Governments (P/T) NSS
Physician Resources Planning Advisory Committee (specific governmental group based on actual data)
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Appendix A Participant List
FIRST NAME
Peter
LAST NAME
Anderson*
ORGANIZATION
Canadian Urological Association
Inika Anderson Canadian Society of Endocrinology and Metabolism
Henry Annan Canadian Federation of Medical Students
Geoff Ballinger Canadian Institute for Health Information
Geoff Barnum Canadian Post-M.D. Education Registry (CAPER)
Rob Beanlands University of Ottawa Heart Institute
Ivy Bourgeault University of Ottawa
Jennifer Brunet-
Colvey*
Canadian Ophthalmological Society
Carolyn Canfield University of British Columbia
Caroline Chamberland University of Ottawa
Tara S. Chauhan Canadian Medical Association
Lindsay Cherpak Canadian Association of Radiologists
Essandoh Dankwa Labrador - Grenfell Health
Jana Davidson BC Children's Hospital
Isabelle De Bie Centre universitaire de santé McGill
Shanna DiMillo Royal College of Physicians and Surgeons of Canada
Heather Dow Events & Management Plus Inc.
Mary Jean Duncan Canadian Society of Plastic Surgeons
Bryce Durafourt Resident Doctors of Canada
Paola Fata* McGill University Health Centre
Pamela Forsythe* Canadian Psychiatric Association
Alison Fox-
Robichaud*
Canadian Critical Care Society
Danielle Fréchette Royal College of Physicians and Surgeons of Canada
Colleen Galasso HealthCareCAN
John Gallinger Canadian Resident Matching Service
Irving Gold Resident Doctors of Canada
B.J. Hancock University of Manitoba/ Canadian Association of
Paediatric Surgeons
Desiree Hao Tom Baker Cancer Centre
Katie Hardy* Canadian Psychiatric Association
Douglas Hedden Royal College of Physicians and Surgeons of Canada
David Henderson Canadian Society of Palliative Care Physicians
Caroline Herzberg Canadian Dermatology Association
Tanya Horsley Royal College of Physicians and Surgeons of Canada
Casey Hurrell Canadian Association of Radiologists
Carole Jacob Royal College of Physicians and Surgeons of Canada
Suzanne Joyal Canadian Dermatology Association
Karen Kieley Royal College of Physicians and Surgeons of Canada
Greg Killough Royal College of Physicians and Surgeons of Canada
Jon Kimball Association of Faculties of Medicine of Canada
Chad Leaver Canada Health Infoway | Inforoute Santé du Canada
Robert Lee Canadian Resident Matching Service
Francine Lemire College of Family Physicians of Canada
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Myuri Manogaran Royal College of Physicians and Surgeons of Canada
Raymond Maung Royal Inland Hospital
Colin McCartney The Ottawa Hospital/University of Ottawa
Jill McEwen* Canadian Association of Emergency Physicians
Dolores McKeen Dalhousie University
Frank Molnar* The Ottawa Hospital
Cordell Oren Neudorf University of Saskatchewan
Julia Niles The Canadian Association of Radiologists
Barry Pakes University of Toronto
Bojan Paunovic Winnipeg Regional Health Authority/
University of Manitoba
Jasmine Pawa University of Toronto
Carolyn Pullen Canadian Cardiovascular Society
Cheryl Ripley Canadian Ophthalmological Society
Artem Safarov College of Family Physicians of Canada
Leah Salvage Public Health Physicians of Canada
Sarah Simkin University of Ottawa
Steve Slade Royal College of Physicians and Surgeons of Canada
Christine Smith Royal College of Physicians and Surgeons of Canada
Caroline St. Denis Royal College of Physicians and Surgeons of Canada
Debra Thomson Canadian Anesthesiologists' Society
Paul Tomascik Royal College of Physicians and Surgeons of Canada
Evert Tuyp* Canadian Dermatology Association
Elizabeth Waite Canadian Academy of Child and Adolescent Psychiatry
Joel Campbell Watts Royal Ottawa Mental Health Centre
Jessica Widdifield Canadian Rheumatology Association
Dawn Wilson* Canadian Association of General Surgeons
Homer Yang London Health Sciences Centre /
Schulich School of Medicine & Dentistry
Jennifer Zelmer Canadian Foundation for Healthcare Improvement
*members of the Coordinating Group of the Specialty Workforce Collaborative.
Additional Group members not in attendance at the 2019 Dialogue include:
Shanna Scarrow, Canadian Association of Emergency Physicians
Jasmin Lidington, Canadian Association of General Surgeons
Geneviève Moineau, Physician Resources Planning Advisory Committee
Sandra Allison, Public Health Physicians of Canada
Yvonne Buys, Canadian Ophthalmologic Society