Sophia Myles

Background. High-quality data on the health workforce are critically needed across Canadian jurisdictions for effective health workforce analysis and planning in support of care delivery and strengthened health systems. This is particularly in the context of mobility across a uniquely decentralized health system. Objective. To describe the pan-Canadian data sources and identify key challenges and opportunities for optimizing data use for health workforce analysis and planning. Methods. We undertook an environmental scan of the literature and publicly available information on pan-Canadian data pathways to identify data sources, coverage, and alignment. We identify challenges associated with using these data for health workforce research and planning and provide insight into promising opportunities for improvement. Results. Two data custodians collate pan-Canadian health workforce data from administrative health sources (Canadian Institute for Health Information) and population survey sources with questions on labour activities (Statistics Canada). Both custodians maintain multiple datasets, each with notable strengths and limitations reflecting the breadth and depth of health workforce information. No sources were identified as having been designed primarily to inform health workforce planning, resulting in data silos, varying coverage, and often inadequate metadata standards. Despite the policy priority of enhancing interprofessional collaborations, when data have been used for health workforce analysis it often remains focused on a single sector or profession. Conclusions. Targeted investments into data standardization and interoperability, with more common data elements are among the key areas of improvement for enhancing cross-occupational and cross-jurisdictional health workforce analysis and planning.

Introduction: Primary care nurses (PCNs) are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PCNs (ie, nurse practitioners, registered nurses, licensed/registered practical nurses) to leverage one another’s expertise to work to optimal scope; the extent to which this happens depends on multiple context-dependent factors. We will conduct an umbrella review to synthesise and compare international knowledge syntheses focused on scope of practice enactment (ie., roles and activities) of PCNs in primary care. Methods and analysis: We will conduct the umbrella review according to the Joanna Briggs Institute methodology, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines, and using the Nursing Care Organization Framework as guidance. We will search a wide range of scientific electronic databases and grey literature sources, and consider articles published in English and French by the Organization for Economic Cooperation and Development and designated key partner countries for inclusion, with no publication date limits. Two independent reviewers will screen titles, abstracts and full-text articles, and any disagreements will be resolved through discussion or by a third reviewer. We will use the Risk of Bias Assessment Tool for Systematic Reviews to assess the quality and risk of bias in the included systematic and scoping reviews. Ethics and dissemination: Results will be presented in a PRISMA Scoping Review flow diagram. We will synthesise data from included studies in a detailed literature review table and develop visual aids to communicate the shared and unique roles and activities of PCN scope of practice. We will disseminate the results of the review through peer-reviewed publications and conferences related to this field. Ethics approval is not required.

Social accountability has become a key driver of change within health professional education programs worldwide. Over the last two decades, there has been a growing number of frameworks, tools, and standards to help measure social accountability. This paper shares the experiencesand lessons learned from one of the institutions that participated in piloting the Institutional Self-Assessment Social Accountability Tool (ISAT). We argue that tools for measuring social accountability are valuable not only because they provide data but, more importantly, because they can embed a dialogic and critical reflective culture within institutions. We describe how the tool expanded our thinking about social accountability to advance it, including what constitutes socially accountable research and who and what fields contribute to this work. We argue that the tool encouraged collaborative critical reflexive practice and offered a process that was incorporated into institutional processes and activities, and simultaneously fostered intra-institutional cooperation. Finally, we contend that the application of quality and equity lenses offers sources of sustainability to advance social accountability in medical education as they encourage the prioritization of social accountability processes to achieve desired outcomes.

Canada needs a systematically developed, fit-for-purpose Mental Health and Substance Use Health (MHSUH) workforce strategy to improve and coordinate planning across jurisdictions, provider types, and the public and private sectors. Guided by a pan-Canadian advisory committee, our project synthesized evidence and refined key priorities through a virtual policy dialogue. This article describes the insights generated at this dialogue and highlights the coordinated priority actions for a MHSUH workforce strategy for Canada. Specific actions are recommended under the following five priorities: (1) collect data for planning; (2) support the workforce; (3) target recruitment; (4) optimize and diversify roles; and (5) close policy gaps. This proposed strategy can inform effective workforce planning, foster the well-being of the MHSUH workforce, and facilitate retention and recruitment. Engagement from MHSUH system partners, including leaders from government, provider, and lived experience organizations, is essential to advancing this workforce strategy.

Strategies to promote workplace mental health can target system, organization, team, and individual levels exclusively or in concert with each other. Creating toolkits that include these different levels is an emerging innovative strategy to support employees working in various sectors. Our paper describes the development, implementation, and refinement of two different online toolkits: the Healthy Professional Worker Toolkit for Education Workers and the Health Worker Burnout Toolkit. The Knowledge to Action Framework guided the team during the development and early interventions phases of toolkit development. Stakeholder engagement regarding the intended use of the toolkit of promising practices for workplace interventions was integrated throughout with different forms of feedback in a research capacity between 2022 and 2024. Reflecting on the different phases of the KTA Framework, we describe first the engagement involved in building the toolkits and then on their utilization. Our toolkits were built to include different resources aimed at empowering workers, teams, and employers offering innovative ideas to address the mental health-leaves of absence and return to work cycle in one case and the different forms and consequences of burnout in the other. Criteria for inclusion were informed by ongoing research with a range of stakeholders and other intended toolkit users including managers, supervisors, executives, human resource specialists, staff, and others in healthcare and educational organizations and settings. In the implementation phase, the volume of resources available in each toolkit considered a strength by some was overwhelming for some partners and individual workers to navigate. Capacity, engagement, time, and readiness for change, are themes that heavily influenced if and when organizations interacted with each toolkit, and how much time they spent exploring the resources provided. It is critical to ground toolkits in the experiential evidence of workplace mental health as is linking these to evidence-informed interventions that correspond to workplace concerns. Organizational readiness to adopt and adapt resources and implement changes is a key consideration. Ultimately, user engagement is what brought these toolkits to life.

Technology is transforming service delivery and practice in many regulated professions, altering required skills, scopes of practice, and the organization of professional work. Professional regulators face considerable pressure to facilitate technology-enabled work while adapting to digital changes in their practices and procedures. However, our understanding of how regulators are responding to technology-driven risks and the impact of technology on regulatory policy is limited. To examine the impact of technology and digitalization on regulation, we conducted an exploratory case study of the regulatory bodies for nursing, law, and social work in Ontario, Canada. Data were collected over two phases. First, we collected documents from the regulators’ websites and regulatory consortiums. Second, we conducted key informant interviews with two representatives from each regulator. Data were thematically analyzed to explore the impact of technological change on regulatory activities and policies and to compare how regulatory structure and field shape this impact. Five themes were identified in our analysis: balancing efficiency potential with risks of certain technological advances; the potential for improving regulation through data analytics; considering how to regulate a technologically competent workforce; recalibrating pandemic emergency measures involving technology; and contemplating the future of technology on regulatory policy and practice. Regulators face ongoing challenges with providing equity-based approaches to regulating virtual practice, ensuring practitioners are technologically competent, and leveraging regulatory data to inform decision-making. Policymakers and regulators across Canada and internationally should prioritize risk-balanced policies, guidelines, and practice standards to support professional practice in the digital era.