Flinders University, Adelaide, Australia.
University of Adelaide, Adelaide, Australia.
BMC Health Serv Res. 2021 Jul 10;21(1):680. doi: 10.1186/s12913-021-06711-x.
Internationally, health and social services are undergoing creative and extensive redesign to meet population demands with rationed budgets. This has critical implications for the health workforces that serve such populations. Within the workforce literature, few approaches are described that enable workforce development for health professions in the service contexts that emerge from large scale service redesign in times of industry shift. We contribute an innovative and robust methodology for workforce development that was co-designed by stakeholders in allied health during the personalisation of disability funding in Australia (the introduction of the National Disability Insurance Scheme).
In the context of a broad action research project, we used program logic modelling to identify and enact opportunities for sustainable allied health education and workforce integration amidst the changed service provision context. We engaged with 49 industry stakeholders across 92 research engagements that included interviews (n = 43), a workshop explicitly for model development (n = 8) and a Project Advisory Group (n = 15). Data from these activities were inductively coded, analysed, and triangulated against each other. During the program logic modelling workshop, we worked with involved stakeholders to develop a conceptual model which could be used to guide trial and evaluation of allied health education which was fit-for-purpose to emerging workforce requirements.
Stakeholder interviews showed that drivers of workforce design during industry shift were that (1) service provision was happening in turbulent times; (2) new concerns around skills and professional engagement were unfolding for AHP in the NDIS; and (3) impacts to AHP education were being experienced. The conceptual model we co-designed directly accounted for these contextual features by highlighting five underpinning principles that should inform methodologies for workforce development and AHP education in the transforming landscape: being (1) pedagogically sound; (2) person- or family-centred; (3) NDIS compliant; (4) informed by evidence and (5) having quality for all. We use a case study to illustrate how the co-designed conceptual model stimulated agility and flexibility in workforce and service redesign.
Proactive and situated education of the emerging workforce during policy shift is essential to realise future health workforces that can appropriately and effectively service populations under a variety of changing service and funding structures - as well as their transitions. We argue that collaborative program logic modelling in partnership with key stakeholders including existing workforce can be useful for broad purposes of workforce (re)design in diverse contexts.
在国际上,医疗保健和社会服务部门正在进行创造性和广泛的重新设计,以在有限预算的情况下满足人口需求。这对为这些人群服务的卫生劳动力队伍产生了重大影响。在劳动力队伍文献中,很少有描述能够使卫生专业人员在行业转型时期大规模服务重新设计所产生的服务环境中发展劳动力的方法。我们为劳动力发展贡献了一种创新且强大的方法,该方法是在澳大利亚残疾人资金个性化期间(国家残疾人保险计划的引入)由相关医疗保健利益相关者共同设计的。
在广泛的行动研究项目的背景下,我们使用计划逻辑模型来识别和利用在不断变化的服务提供背景下可持续的相关医疗保健教育和劳动力整合机会。我们与 92 次研究活动中的 49 个行业利益相关者进行了接触,其中包括访谈(n=43)、专门用于模型开发的研讨会(n=8)和项目咨询小组(n=15)。这些活动的数据经过归纳编码、分析和相互验证。在计划逻辑模型研讨会期间,我们与参与的利益相关者合作开发了一个概念模型,该模型可用于指导适合新兴劳动力需求的相关医疗保健教育的试验和评估。
利益相关者访谈表明,行业转型期间劳动力设计的驱动因素是:(1)服务提供是在动荡时期进行的;(2)新的技能和专业参与问题正在为国家残疾人保险计划中的 AHP 展开;(3)正在经历对 AHP 教育的影响。我们共同设计的概念模型直接考虑了这些背景特征,突出了应该为转型中的劳动力发展和相关医疗保健教育提供信息的五项基本原则:(1)具有教学意义;(2)以个人或家庭为中心;(3)符合 NDIS 要求;(4)基于证据;(5)为所有人提供质量。我们使用一个案例研究来说明共同设计的概念模型如何在劳动力和服务重新设计中激发灵活性和敏捷性。
在政策转型期间,对新兴劳动力进行积极主动和具体的教育对于实现未来的卫生劳动力至关重要,这些劳动力能够在各种不断变化的服务和资金结构以及他们的过渡时期,为各种人群提供适当和有效的服务。我们认为,与包括现有劳动力在内的关键利益相关者合作进行协作计划逻辑建模对于在不同背景下进行广泛的劳动力(重新)设计具有有用性。