The determination of staffing needs in healthcare is not just
calculating the optimal number of professionals but is defining
how the professional contingent accompanies the development
of the healthcare organisation and of the population’s care
needs. This research investigates the existence of a gold
standard for determining health personnel requirements. We
perform a systematic literature review to explore several
approaches worldwide, examining a wide range of contextual
variables, useful for the definition of an omni-comprehensive
approach. A total of 557 articles was initially detected, then
reduced to 57 after excluding everything not related to
healthcare context and staff planning models. Results do not
reveal a recognized standard for determining staffing needs.
Approaches to the definition of staffing standards are mainly
ex-ante (31%), based on the characteristics of specific models
and organisational needs, or ex-post (62%), based on
production analysis and historical trends. Most of these refer
to the medical and nursing category (68.4%), while the
minority proposes a multi-professional approach (17.5%).
This review highlights innovative approaches based on
algorithms which, starting from historical data, are adjusted
by moderating key variables such as contextual factors,
healthcare organisation models and professional attributes.
The review suggests:
1. Develop and share a unique tool for defining standards
based on several variables that identify the characteristics of the
context
2. Use up-to-date information flows and quality data
3. Consider a multi-professional approach
4. Adopt a long-term vision and continuous dialogue with the
training process
It is clear the need to develop a tool for the definition of
personnel requirements in line with internal and external
changes in the health system. Therefore, such models need to
account for an adequate number of variables, useful to identify
the characteristics of the overall context.
Key messages:
The development of staffing needs estimates must necessarily rely on a certain level of standardisation, but at the same
time must take into account the variability characterising
different contexts.
In order to respond to recent demographic and epidemiological trends, it is crucial to include in the model skill mix
and task shifting strategies involving health professionals as a
whole