1. Overview of Health Human Resource Planning: A Canadian Perspective 2006 Trilateral Conference Vancouver, British Columbia, Canada Dr. Nick Busing President and CEO Association of Faculties of Medicine of Canada

2. Thoughts on HHR Planning Presentation Outline A View of HHR in Canada

3. The term “HHR” encompasses all those involved in the delivery of health care, such as physicians, nurses, technologists, therapists, and the wide spectrum of other health care providers. - Health Canada, Pan-Canadian Health Human Resource Strategy, 2004-2005 Annual Report.

4. A View of HHR in Canada Based on the Health Personnel Database (HPDB) HPDB is maintained by the Canadian Institute for Health Information Data is gathered primarily from professional membership and regulatory organizations HPDB provides basic summary information for 23 health profession groups HPDB describes the following for each health care provider group: –Brief definition of each provider group, including main responsibilities, activities and typical practice settings –Time spent training –When regulation was introduced, if at all –The number of providers exiting training –The total number of providers –Age and sex demographics –Key research and reports related to the profession

5. Number of Health Care Providers, Canada, 2004 Plus 246,575 Registered Nurses Source: HPDB, CIHI

6. Percent Change in Number of Health Care Providers, Canada, 1995 vs 2004

7. Number of Graduates in 2004 and Percent Change in Number of Graduates 1995 vs 2004, Canada Source: HPDB, CIHI * For midwives, the percent change compares graduating class numbers for 1996 and 2004

8. Females as a Percentage of Health Care Provider Groups, Canada, 2004 Source: HPDB, CIHI *Based on 2001Statistics Canada Census

9. Source: Statistics Canada, 2001 Census Percentage of Health Care Provider Groups Aged 45+, Canada, 2000

10. Source: Statistics Canada, 2001 Census Percentage of Health Care Provider Groups Who Worked Full-Time for the Full Year, Canada, 2000

11. 2004 National Physician Survey This survey provides insights on the extent to which various health care providers work together (from a physician perspective) Separate surveys were mailed to all licensed physicians and all physicians in postgraduate training Licensed physicians were asked about sharing patient care with other providers Residents were asked who they plan to share care with

12. 2004 NPS: Percent of Second Year Residents Who Plan to Share Care with Various Health Care Providers, Canada, 2004 Source: 2004 National Physician Survey, CMA, CFPC, RCPSC.

13. 2004 NPS: Percent of Second Year Family Medicine Residents Who Plan to Share Care with Various Health Care Providers and the Percent of Licensed Family Physicians Who Share Care With Various Health Care Providers, Canada, 2004 Source: 2004 National Physician Survey, CMA, CFPC, RCPSC.

14. 2004 NPS: Percent of Licensed Physicians Who Share Care with Various Health Care Providers, Canada, 2004 Source: 2004 National Physician Survey, CMA, CFPC, RCPSC.

15. Interprofessional Education for Collaborative Patient-Centred Practice (IECPCP) The IECPCP initiative is part of Health Canada’s Pan-Canadian HHR Strategy Some of the project goals are to… –foster interprofessional education for collaborative patient-centred practice; –promote teaching from an interprofessional collaborative patient-centred perspective; –increase the number of health professionals trained for collaborative patient-centred practice, and –facilitate interprofessional collaborative care in both the education and practice settings.

16. Interprofessional Education for Collaborative Patient-Centred Practice (IECPCP) The project has gathered information on IE in Canada using survey and key informant methodologies In its first cycle the project has funded 11 IE projects, including: –Creating an Interprofessional Learning Environment through Communities of Practice: An Alternative to Traditional Preceptorship –Structuring Communication Relationship for Interprofessional Teamwork (SCRIPT) –Interprofessional Education for Geriatric Care –The McGill Educational Initiative on Interprofessional Collaboration: Partnerships for Patient-Family Centred Practice –Seamless Care: An Interprofessional Education Project for Innovative Team Based Transition Care Visit http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/strateg/interprof/index_e.html for more information http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/strateg/interprof/index_e.html

17. Thoughts on HHR Planning

18. Thoughts on HHR Planning HHR Planning Often Focuses on Headcounts Source: AFMC, Canadian Medical Education Statistics, 2006.

19. Thoughts on HHR Planning Even Basic Adjustments Can Change The Headcount Picture Source: Canadian Institute for Health Information * Adjusted for age-sex of patients and age-sex of physicians Adjusted* Physician Supply: # MDs per 1,000 Population

20. Thoughts on HHR Planning International Indicators Highlight Physician Resource Challenges in Canada USA UK CAN

21. Thoughts on HHR Planning Comparison of Medical School Opportunity Source: Personal communication with CMA. Note: UK data based on acceptances into pre-clinical medicine; US data based on medical school and osteopathic acceptances.

22. Thoughts on HHR Planning International Medical Graduates Play an Important Role in Canada’s Physician Supply Source: CMA Masterfile, January 2006, Canadian Medical Association

23. Thoughts on HHR Planning IMG Trends Vary Within the Physician Workforce Source: Supply, Distribution and Migration of Canadian Physicians, CIHI.

24. Source: Supply, Distribution and Migration of Canadian Physicians, CIHI Thoughts on HHR Planning The Number of Physicians Leaving Canada Has Declined

25. Thoughts on HHR Planning There is Still Much to Learn About the Things Health Care Providers Do

26. Thoughts on HHR Planning Many Individuals and Organizations Have a Hand in HHR Planning Individual Patients & Practitioners Health Care Facilities (clinics, hospitals, nursing homes, etc) Training Institutions (colleges, universities, etc) Regional Health Authorities Regulatory Authorities Professional Associations (membership, certifying & accrediting agencies, etc) Health Care Research, Information & Service Agencies (CIHI, CHSRF, CHEPA, CHSPR, MCHP, CaRMS, OPHRDC and many more) Health Quality Councils Provincial/Territorial Governments Federal Government HHR Planning The establishment of goals, policies, and procedures to direct all those involved in the delivery of health care. An orderly arrangement of the wide spectrum of health care providers. Having in mind an orderly arrangement of all health care providers. Teaching Hospitals

27. Thoughts on HHR Planning Example of Possible HHR Planning Roles AgencyHHR Planning Role Local health care facilityCoordinate care of individual patients in multidisciplinary environment Regional Health AuthorityEvaluate patient needs within region; Work with local health care facilities to ensure delivery of service; Implement recruitment/retention strategies Provincial/Territorial GovernmentEstablish RHAs to carry out regional health care delivery; Establish HHR regulatory frameworks; Establish and manage health care programs and systems; Work with colleges & universities to set quotas for health care provider training Provincial/Territorial Regulatory AuthoritiesAssess credentials; Issue licenses National Government and Professional AgenciesSet standards for certification; Accredit training institutions; Compile national level data and information for planning purposes

28. Overview of Health Human Resource Planning: A Canadian Perspective 2006 Trilateral Conference Vancouver, British Columbia, Canada Dr. Nick Busing President and CEO Association of Faculties of Medicine of Canada THANK YOU