Saskatchewan's Health Human Resources Plan

IntroductionHealth care in the 21st century is a highly complex undertaking. Rapidlyshifting economics and demographics lead to ever-evolving demands on thehealth system. New and expensive technologies are continually appearingwhile research and new discoveries lead to continual re-evaluation of clinicaland medical practices. Individual practitioners are challenged to keep up withthe newest developments in their field, and the system as a whole is oftenpressed to meet the needs and expectations of a changing populace.In a sector subject to such dynamic change, planning must be guided by aclear vision of the kind of health system we want. This vision must be basedon principles that will apply as well in 2021 as they do today. The resultingplan must be flexible and general enough to guide us through the inevitablechanges of the coming years, yet directive and specific enough to lead ustoward an adequate supply and mix of health care providers for years tocome.In his 2009 report to the Minister of Health, Patient First Review commissionerTony Dagnone recommended that the Ministry of Health “assume more of astrategist-integrator-steward role for the health system” and “concentrate onsetting strategy, priorities, and standards of performance” (Patient First ReviewCommissioner’s Report, p. 52).In keeping with this approach, Saskatchewan’s Health Human ResourcesPlan is not a service delivery plan for the health system. It does not prescribespecific approaches and details as to how health regions, the SaskatchewanCancer Agency, educational institutes, and other health organizations willdevelop and maintain an optimum supply and mix of care providers. Thisdocument can, however, assist these organizations in planning and developingfuture service delivery options. It provides a common vision and broad policyguidelines that will inform their health human resources strategies, policies,programs and priorities.This plan complements and enhances current government initiatives andcommitments regarding Saskatchewan’s health system and human resources.More specifically, the plan attempts to align with the recommendationsarising out of the Patient First Review. It also incorporates the health humanresources recommendations developed under the recent Memorandum ofUnderstanding on First Nations Health and Well-Being. The plan considersthe province’s physician recruitment strategy and builds upon the partnershipagreement signed by the government and the Saskatchewan Union of Nurses.Saskatchewan’s Health Human Resources Plan is comprised of four sectionsdescribing the desired future state for Saskatchewan’s health workforce.Following a section of concluding thoughts, the document’s first appendixidentifies a number of actions and observations as to how we can move toour desired future state.The plan’s appendices provide more detailed current-state analysis andforecast our workforce based on a number of assumptions and variables.As this plan is implemented, these assumptions and projections will requireregular review, adjustment and updating.9

10I. The Heart of Our HealthSystem: Patient- andFamily-Centred CareThe Government of Saskatchewan has made a commitment to a publiclyfunded, publicly administered health system that is centred aroundthe interests and needs of patients and families. From the planning andadministration to the delivery and evaluation of health services, patients andtheir families are to be the first priority.In keeping with this foundational principle, Saskatchewan’s Health HumanResources Plan is based upon a clear expectation that Saskatchewan’s healthcare professionals will function in a patient- and family-centred manner.

I. The Heart of Our Health System:Patient- and Family-Centred CareThe Vision:1. By 2021, all health care providers in Saskatchewan understand patientand family-centred care (PFCC) and apply it consistently in theirpractices and professions.According to the Institute for Patient- and Family-Centred Care, PFCC isguided by four principles:Dignity and Respect. Health care practitioners listen to and honourpatient and family perspectives and choices. Patient and familyknowledge, values, beliefs and cultural backgrounds are incorporated intothe planning and delivery of care.Information Sharing. Health care practitioners communicate and sharecomplete and unbiased information with patients and families in ways thatare affirming and useful. Patients and families receive timely, completeand accurate information in order to effectively participate in care anddecision-making.Participation. Patients and families are encouraged and supported inparticipating in care and decision-making at the level they choose.Collaboration. Patients, families, health care practitioners, and hospitalleaders collaborate in policy and program development, implementationand evaluation, in health care facility design, in professional education,and in the delivery of care.2. By 2021, Saskatchewan has made significant progress in training healthprofessionals to provide care for First Nations and Métis peoples, and isrecognized nationally as a leader in this regard.During the Patient First Review, First Nations and Métis individuals andcommunities expressed a desire for more culturally appropriate care.The commissioner’s report noted that First Nations and Métis patientsconsistently ranked their quality of care lower in such categories asoverall care, overall doctor care, trust in nurses and overall pain control.The report recommended that the health system, in collaboration withFirst Nations and Métis elders and patient and family advisors, developa safe and competent health system that better serves First Nations andMétis citizens. It is also noted from other reports that efforts to build arepresentative workforce should lead to more culturally appropriate care.By 2021, we should see an increase in the number of First Nations andMétis health professionals in Saskatchewan, approaching a ratio that isrepresentative of their overall population. This will contribute to culturallyappropriate, patient- and family-centred care.To increase workforce representation, First Nations and Métis peopleswill be active participants in developing and implementing healthhuman resources and mental health strategies. Their communities will beengaged and have a role in guiding and directing health services. Elders,traditional teachers and healers will be a part of the patient’s journeywithin all health care systems.11

I. The Heart of Our Health System:Patient- and Family-Centred Care3. By 2021, Saskatchewan’s health workforce is better prepared to providecare in rural, remote and northern communities.We envision a health system in which every Saskatchewan resident hasequitable access to patient- and family-centred health services, no matterwho they are or where they live. While medical and communicationstechnologies help to overcome the barriers of geography, a diverse andwell-trained health workforce understands the challenges of working withrural and remote populations.4. By 2021, Saskatchewan’s health workforce supports self-managementand aging in place.We favour initiatives that support keeping patients at home and withintheir communities, and give patients and their families a greater role intheir own care.Greater emphasis will be placed on supporting self-management,continued enhancements to telehealth, and a more flexible approach tospecialist outreach. This will require a cultural shift among health careproviders and patients and their families. There will also need to be a shiftin the training and continuing professional development of health careproviders and the resources made available to patients and their familiesto support self-management (education, self-monitoring tools, and peersupport groups).12A Current Example of the Vision in Practice:All Nations Health Centre, Fort Qu’AppelleWithin the All Nations Healing Hospital in Fort Qu’Appelle is theWomen’s Health Centre, a holistic, culturally responsive collaborativeof primary health care providers.Led by nurse practitioners, a midwife in collaboration withcommunity physicians, and administrative support, the Women’sHealth Centre is accessed by women and children of all ages andintegrates Western maternal and child health care with traditional FirstNations healing approaches.Since opening its doors in August 2007, the Women’s Health Centrehas focused on promotion of health and prevention of disease,helping clients to manage or avoid chronic conditions, reducing theneed for more costly interventions and therapies later.To learn more, visit http://www.fortquappelle.com/anhh prg.html.

II. Working nterprofessional collaboration is the process of developing and maintainingeffective working relationships with other practitioners, patients/clients/families, learners, and communities, to enable optimal health outcomes.Collaboration means respect, trust, shared decisions, and partnerships.The Vision:1. By 2021, all health care providers are enabled and encouraged to workwithin an optimal and appropriate scope of practice – to bring to theirwork the full range of competencies and skills that are a part of theirprofession.Pharmacists, nurses, and other professionals have seen their rolesexpanded appropriately and within their scopes of practice. Advancedpractice roles are more common within Saskatchewan care models.Infrastructure will be in place to support interprofessional collaborativecare models.13

II. Working Together:Collaborative, Interprofessional PracticesThis not only makes Saskatchewan a more attractive and fulfilling placein which to build a health care career; it also means the health system isgetting full value for its investment in a provider and has more options forensuring that communities have access to the services they need. Mostimportantly, patients benefit greatly when providers are working to theirfull scope of practice. They will often enjoy greater continuity of care,with fewer “handoffs” between providers.2. By 2021

Saskatchewan’s Health Human Resources Plan Key Enablers and Actions A number of key enablers and actions can help Saskatchewan accomplish its health human resources goals. Listed below are some options that were raised during the development of the plan and from various reports and research concerning planning for health human resources.