Workforce planning for community-based palliative care specialist teams using operations research
Authors: Majid Taghavi, Grace Johnston, Robin Urquhart, David Henderson, Cheryl Tschupruk, and Beth Tupala
Context Many countries have aging populations. Thus, the need for palliative care will increase. However, the methods to estimate optimal staffing for specialist palliative care teams are rudimentary as yet. Objectives To develop a population-need workforce planning model for community-based palliative care specialist teams and to apply the model to forecast the staff needed to care for all patients with terminal illness, organ failure, and frailty during the next 20 years, with and without the expansion of primary palliative care. Methods We used operations research (linear programming) to model the problem. We used the framework of the Canadian Society of Palliative Care Physicians and the Nova Scotia palliative care strategy to apply the model. Results To meet the palliative care needs for persons dying across Nova Scotia in 2019, the model generated an estimate of 70.8 nurses, 23.6 physicians, and 11.9 social workers, a total of 106.3 staff. Thereby, the model indicated that a 64% increase in specialist palliative care staff was needed immediately, and a further 13.1% increase would be needed during the next 20 years. Trained primary palliative care providers currently meet 3.7% of need, and with their expansion are expected to meet 20.3% by 2038. Conclusion Historical, current, and projected data can be used with operations research to forecast staffing levels for specialist palliative care teams under various scenarios. The forecast can be updated as new data emerge, applied to other populations, and used to test alternative delivery models. Key Message This article uses operations research to forecast community-based palliative care specialists staffing by geographic area for the first time. It uses projected deaths, a Canadian Expert Consensus White Paper, and models primary care substitution. Our innovative approach is population based, multifaceted, adaptable, and prompted hiring more palliative care social workers.
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