School of Health and Human Sciences, Southern Cross University, Military Road, East Lismore, NSW 2480, Australia.
Hum Resour Health. 2013 Dec 11;11:66. doi: 10.1186/1478-4491-11-66.
Increasingly, health workforces are undergoing high-level 're-engineering' to help them better meet the needs of the population, workforce and service delivery. Queensland Health implemented a large scale 5-year workforce redesign program across more than 13 health-care disciplines. This study synthesized the findings from this program to identify and codify mechanisms associated with successful workforce redesign to help inform other large workforce projects.
This study used Inductive Logic Reasoning (ILR), a process that uses logic models as the primary functional tool to develop theories of change, which are subsequently validated through proposition testing. Initial theories of change were developed from a systematic review of the literature and synthesized using a logic model. These theories of change were then developed into propositions and subsequently tested empirically against documentary, interview, and survey data from 55 projects in the workforce redesign program.
Three overarching principles were identified that optimized successful workforce redesign: (1) drivers for change need to be close to practice; (2) contexts need to be supportive both at the local levels and legislatively; and (3) mechanisms should include appropriate engagement, resources to facilitate change management, governance, and support structures. Attendance to these factors was uniformly associated with success of individual projects.
ILR is a transparent and reproducible method for developing and testing theories of workforce change. Despite the heterogeneity of projects, professions, and approaches used, a consistent set of overarching principles underpinned success of workforce change interventions. These concepts have been operationalized into a workforce change checklist.
越来越多的卫生工作者正在进行高水平的“再造”，以帮助他们更好地满足人口、劳动力和服务提供的需求。昆士兰州卫生部门在超过 13 个医疗保健学科实施了一项大规模的 5 年劳动力重新设计计划。本研究综合了该计划的研究结果，以确定和编纂与成功的劳动力重新设计相关的机制，为其他大型劳动力项目提供信息。
本研究使用了归纳逻辑推理（ILR），这是一种使用逻辑模型作为主要功能工具来制定变革理论的过程，随后通过命题测试对这些理论进行验证。最初的变革理论是从对文献的系统回顾中得出的，并使用逻辑模型进行综合。这些变革理论随后被发展成命题，并随后根据劳动力重新设计计划中的 55 个项目的文件、访谈和调查数据进行实证检验。
确定了三个总体原则，这些原则优化了成功的劳动力重新设计：（1）变革的驱动力需要接近实践；（2）在地方层面和立法层面，环境都需要得到支持；（3）机制应包括适当的参与、促进变革管理的资源、治理和支持结构。这些因素的关注与个别项目的成功是一致的。
ILR 是一种开发和检验劳动力变革理论的透明和可重复的方法。尽管项目、专业和所使用的方法存在异质性，但一系列总体原则始终支持劳动力变革干预措施的成功。这些概念已被转化为劳动力变革清单。
