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What is innovation?

This article looks at Innovative and evidence-based (EB) approaches that can be used by health leaders to solve health workforce challenges.

What does innovation mean?

Innovation, according to the Collins Dictionary, is ‘the introduction of new ideas, methods, or things’.

Innovation can take many forms, including:

  • Service or service delivery innovation – the introduction of new services or ways of delivering services and interacting with users
  • Administrative and organisational innovation – improved organisational principles for the production and delivery of services
  • Policy innovation – changes in policies or new programs or reform
  • Systemic innovations – improved ways of interacting with other organisations and knowledge bases (Bloch & Bugge, 2013).

The father of the study of innovation

Schumpter, who is sometimes known as the father of the study of innovation, conveyed that most innovations are combinations of elements that already exist.

This might involve the development of new technologies, processes, or ways of organising (Salter & Alexy, 2013).

When innovative services and ways of working are introduced then this impacts upon the health workforce and how services are delivered, the type and mix of skills required and technologies utilised.

Innovative and evidence-based approaches can be used by health leaders to solve health workforce challenges.

So let’s now look at some of the innovations in health workforce planning and management.

Change of paradigm in planning approach

This change involves a shift towards thinking backwards from the outcomes that are desired of the health system to the health workforce that is needed and then using this to develop the plans (Rees et al 2018).

Often our planning processes are based on the known health workforce requirements and not the ideal way that our health services should or could be delivered. Envisioning the future health system, defining the population and desired health outcomes can be the starting point for workforce planning.

Retaining skilled and talented clinicians

Turnover of clinical staff is costly. It is important that once we recruit clinicians to the health workforce that they remain in the system.

Innovative approaches to optimise the current workforce and develop the appropriate future workforce are essential. An Australian study of nurses working in hospitals found key factors influential in nurses deciding to remain in the profession.

The influential factors identified in this study were:

  • the limited career opportunities for nurses
  • poor staff support
  • recognition and attitudes of co-workers

Ward nurses reported specific factors such as:

  • reduced physical resources
  • increased patient and family expectations
  • inadequate skill-mix to care for patients
  • poor staff relationships
  • low nurse-to-patient ratios
  • constant change
  • issues related to leaving and shifts
  • a lack of involvement in decision making (Dawson et al 2014).

To retain nurses – involve them in designing, evaluating and implementing solutions and cultural change including empowering nurses to steer their careers (Dawson et al 2014).

Qualitative data and horizon scanning

We have learned that planning requires quantitative data such as headcounts by professions, projections of future service requirements and a number of services.

New workforce planning approaches will also incorporate qualitative data. Work conducted in Europe suggests that a future-focused approach to workforce planning uses qualitative techniques such as horizon scanning.

According to the Joint Action on Health Workforce and Planning ‘horizon scanning is used to describe the factors and forces, and their inter-relationships, driving future changes in workforce systems.’ (Joint Action Health Workforce Planning and Forecasting). You can read on this website more about horizon scanning

Examples of other qualitative data that can be used in a future-oriented planning approach are surveys, focus groups, interviews with stakeholders and literature reviews.

Workforce planning is not a static process

Continued refinement is needed. Future-focused workforce planning will use a staged approach and look at short, medium and longer-term horizons (Rees et al 2018).

Innovations presented in the research to strengthen health workforce planning are:

  1. Improved simulation models and the data that is used for forecasting. Strengthening and implementing necessary workforce policy responses
  2. Use of more systematic approaches to workforce planning and modelling. Inclusion of robust workforce variables and demographics
  3. Casting backwards from a desired vision or future state of the health system and understanding how to achieve the desired outcomes for the health system (Rees et al 2018).

The diagram below shows the steps in workforce planning.

Large circle with text: workforce planning and 4 outer circles: Data: analysis of current workforce and future needs. Strategy: an overarching workforce planning approach. Planning: An approach to create pipelines to fill future workforce needs. Evaluation: the ability to monitor the effectiveness of the plan.

(Adapted from Chartered Institute of Personnel and Development 2018).


Dawson et al.(2014). Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies, BMC Nursing, 13(11). Retrieved from:

Rees et al.(2018). The promise of complementarity: Using the methods of foresight for health workforce planning Research Article. Retrieved from:

Somerville, L et al.(2014). Building allied health workforce capacity: a strategic approach to workforce innovation, Australian Health Review, 39(3), 264-270: Retrieved from:

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