Modelling Home Care Services
to Identify Service Shortfalls
Carmen Hust, R.N. Comcare Health Services
311 O’Connor, Ottawa ON. K2P 2G9 613-733-5671
chust@ monisys.ca
Eric Milligan, Delsys Research Group
Suite 400 - 45 Rideau St. Ottawa, ON. K1N 5W8 Canada 613-562-4077
milligan@ delsysresearch.com
Gordon Kubanek, Brookfield High School
824 Brookfield Ottawa ON. K1V 6J3 613 733 0610
gordon kubanek@ ocdsb.edu.on.ca
Project Goal
¢ A model was built to help understand and
communicate with other players in the Health sector
the reasons why Home Care Employers are having
difficulty hiring and retaining workers.
¢ The model may also serve for future planning that
could prevent a severe shortfall in services as the
population ages and hospitals discharge patients
whose conditions are more complex.
Problem Statement
¢ The ageing population and shorter hospital stays
require more Home Care Services.
¢ As more home care services are required the ability
of service providers to meet service needs by hiring
and retaining more workers becomes increasingly
difficult.
¢ The more training workers receive the more able
they are to seek better paying employment
opportunities.
Key Variables
¢ Number of available Home Care providers for hire
¢ Number of Home Care clients requiring services
¢ Gap in Services delivered
* wage gap between home care and other jobs
* recruitment & retention rate
¢ job satisfaction & stress
¢ complexity of services required
¢ relative attractiveness of home care
Behavior Over Time Graphs
¢* Number of available ¢ Number of Home Care
Home Care providers clients requiring
for hire services
eel
months months
Behavior Over Time Graphs
* job stress * complexity of services
required
months 12 months
Behavior Over Time Graphs
* wage gap between ¢ relative attractiveness
home care and other of home care
jobs
— |
months 2 months 2
Causal Loops: Feedback
stress“; bo -_
care delivery gap service hours pe
+ client +
J
+
/ Na
home care i
i entitlement
un + complexity of
+ services required
Productivity of Home Global Home Care
Care Agency Budget
wage gap
+
+ t+) ability to increase
wages
+
: skill level of
Sltemstive eanyorment wagesats + employee
opportunities
PP corresponding to te required
skill level investment i nb
~\_sul level of training
employee.
ability of home care worker to
move into other higher paying+
health care jobs
HomeCare Service Provider
Policy Structure Diagram
3 stress
Care Delivery Gap
Reduces Assessed
more workers HomeCare Entitlement
available Effect of Worker
Stress on Worker
availability of productivity providing demanding
alternate services eonices
employment
Adjusted Service
Hours per Client
job
satisfaction
workers find
other jobs Hiring Delay
iw Complexity of
Required Home Care
Services
x quitting
Effect of Wage leaving
Effect of Wage Gap on. homecare AN
Gap on Hiring Quitting A
A
demand for Long
Term Care Workers Wage Gap
=
wages paid by other
health care sectors
clients from
Hospitals
demand for
Hospital workers
Fraction of Population
requiring Health Care poe
<Time> Services
direct
referrals
Leverage points Identified
¢ The following stresses were identified as requiring
attention by Home Health Care providers:
- wage gap between Home Care workers & others
- productivity of Home Care workers
- skill level of Home Care workers
- competition between Home Care Providers & Long Term
Care Facilities for the same workers
- demographic shifts will continue to increase the fraction
of the population requiring Home Care services
- global Home Care budget
Recommended Interventions
- wages need to correspond to skill level
- do not reduce the time per visit to a point where the
worker s
clients
- coordina
pends much of her/his time travelling between
te hiring and training requirement with Long
Term Care facilities & Hospitals
- increased efficiencies using new technologies &
management methods are needed to allow fewer
workers
to meet the needs of more clients
- the Home Care Budget needs to reflect the
demogra
phic population shifts
Conclusion
¢ The use of Systems Thinking
tools will improve
communication between the
e 9 Health Care sectors
¢ Itis hoped this investigation
of the interrelationships and
feedback processes will allow
ocal Health Care Policy
makers deal with stresses on
the System
