Workforce Planning for Community-Based Palliative Care Specialist Teams Using Operations Research

Abstract

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.

Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

“…Formalising palliative care needs screening in an end-of-life conversation in acute care settings may reduce distress for patients and their informal care givers [ 48 ] and the SPICT™ is a relevant proforma for such a conversation. Furthermore with the increase in the numbers of people living with chronic illness globally [ 49 ] arguably the formal adoption of palliative care needs screening in all health care settings may not only reduce patient distress but may assist health care managers and policy makers to more appropriately plan services [ 50 ]. Identifying needs early in the illness trajectory may allow appropriate personalised care and services to be provided in a timely and cost effective manner thus avoiding health crises at the end of life [ 51 ].…”

Use of the Supportive and Palliative Care Indicators Tool (Spict™) for End-of-life Discussions: a Scoping Review

“…Formalising palliative care needs screening in an end-of-life conversation in acute care settings may reduce distress for patients and their informal care givers 42 and the SPICT™ is a relevant proforma for such a conversation. Furthermore with the increase in the numbers of people living with chronic illness globally 43 arguably the formal adoption of palliative care needs screening in all health care settings may not only reduce patient distress but may assist health care managers and policy makers to more appropriately plan services 44 . Identifying needs early in the illness trajectory may allow appropriate personalised care and services to be provided in a timely and cost effective manner thus avoiding health crises at the end of life 45 .…”

Palliative care need in the Eastern Mediterranean Region and human resource requirements for effective response

“…To our knowledge, our estimates of human resource needs to make basic palliative care universally accessible within each country in a region, including LMICs, are the first such estimates. Existing literature describes only palliative care specialist needs, or needs in special circumstances, in a few high-income countries [27][28][29].…”