Literature review on workforce innovation, workforce
productivity, planning and modelling in the health sector.
Preliminary findings
Background
Aims of the review
Methods of the review
Increasing workforce productivity and efficiency becomes more and
more important in the context of changing demographics,
technological advances and rising costs.
New and amended roles, new ways of working, clinical pathway
redesign, multi-professional team working, collaborative working
and advances in technology can help to achieve this.
But what is the evidence?
A literature review is currently being undertaken in collaboration
with the NHS Workforce Review Team on behalf of the NHS West
Midlands.
Review of published and grey literature which provides empirical
evidence on:
a) the outcomes of measures designed to increase the
productivity of the health care workforce (including factors
which facilitate successful change management);
(a) is the focus of this poster
b) innovations in workforce development and assistive
technologies which have led to improvements in the
quality of patient care;
c) how these improvements have been incorporated into
workforce planning and modelling;
(d) best / good practice examples in relation to (a), (b) and (c)
Factors which facilitate or hamper successful change
management
Facilitators
Barriers
• Leadership and champions
• Taking on board existing
good practice guidelines
• lack of role clarity and
governance issues
• lack of career development
opportunities which may affect
attrition
• lack of data on costeffectiveness
• lack of consideration on how
the new role beds into the
organisation
Relatively few robust studies on workforce
productivity merit calls for more research
Possible reasons as to why evidence is not abundant:
•
Role implementation lag: studies on some staff groups
indicate that local role implementation can lag behind
national policy
•
Evidence lag: robust evidence on will typically emerge
some time after new roles have been implemented
•
Challenges in measuring and evaluating workforce
productivity: definition of assessment criteria at the outset;
choosing a suitable research design; complexity of the
environment (other factors may also be relevant)
•
Resources required (time and money)
•
•
•
Database search (literature published since 2000):
Medline, Pubmed, CINHAL, Psychinfo and Cochrane,
deploying a range of key words
Web-based searches included
(b1) UK: including key stakeholders, academic institutions
(b2) international (Australia, Canada, USA and Europe):
relevant government organisations and other entities
focusing on workforce issues in the health sector
Contacted named individuals (HR Directors and the
Clinical Pathway Leads in the West Midlands and a range
of other stakeholders) (limited success)
Evidence of improvement in health workforce
productivity, efficiency and cost-effectiveness
•
•
•
•
Has your organisation …
•
implemented new ways of working or new or extended
roles or
engaged in collaborations across sectors (e.g. health,
social care, voluntary, third sector) which have led or are
expected to lead to improvements in workforce
productivity and efficiency or
•
looked at how improvements in workforce productivity or
efficiency feed through to workforce planning and
workforce modelling?
If yes to any of these questions, we would like to hear from you,
particularly if you are willing to share supportive evidence with the
researchers.
•
Contact details
Beate Baldauf, Research Fellow,
Warwick Institute for Employment Research (IER),
B.Baldauf@warwick.ac.uk
Lack of robust evidence across the sector
Some results are encouraging in the sense that changes
in skill mix result in reduced costs, reduced length of stay
or increased patient and staff satisfaction
Other studies indicate longer consultation times for the
professional taking on an extended or new role (e.g.
nurses and physician assistants) but increased patient
satisfaction
And yet other studies indicate a tension between
improving access to care and cost-effectiveness (e.g. a
study on GPs with special interests)
What does efficiency, cost effectiveness and
workforce productivity mean?
Efficiency
Output produced at minimum cost (or reduction of input
without decreasing output)
Cost effectiveness
Optimal cost of producing a given outcome (e.g. quality of
life or change in mobility)
Labour or workforce productivity
Level of output per unit of labour input using quality adjusted
measures or treating quality as a component of input or output
Professor Rob Wilson, Deputy Director of the IER,
r.a.wilson@warwick.ac.uk
Debbie Hilder, NHS Workforce Review Team
Debbie.Hilder@wrtnhs.org