Health Human Resources Productivity: What It Is, How It’s Measured, Why (how You Measure) It Matters, and Who’s Thinking about It

through an agreement with the Government of Canada, CHSRF is an independent, not-for-profit corporation with a mandate to promote the use of evidence to strengthen the delivery of services that improve the health of Canadians. The views expressed herein are those of the authors and do not necessarily represent the views of CHSRF or the Government of Canada. Acknowledgements We are grateful to Devon Greyson for undertaking the literature search, Colleen Cunningham for her assistance with the e-mail survey, Steve Morgan for collaboration in the early, design and information assembly stages of this project, and to Charlyn Black for assistance in interpretation of some of the evidence on the effectiveness of care. We readily absolve them of any responsibility for what appears on these pages. The leads provided by those who responded to our 'snowball' survey proved invaluable. We are grateful to all of those who gave so willingly of their time, expecting nothing in return (and getting precisely that), to help make this a more complete report. Improvements in productivity are the fundamental source of most increases in the material well-being of human populations. Although a relatively simple concept, productivity can be difficult to define, and changes difficult to measure in practice. In principle, health human resources productivity (HHRP) should be defined in terms of the relationship between health outcomes achieved (health status protection or improvement for individuals or populations) and the health human resource inputs (time, effort, skills and knowledge) required. The vast majority of current HHRP literature does not consider health outcomes, often using inappropriate and misleading measures of output. For example, more MRIs or more radiologists may contribute to increased procedural output but do not necessarily result in better health outcomes or improved productivity. Opportunities for increasing HHRP may be realized: – by examining unexplained variations in clinical practice evident in current comparative studies; and – through new ways of deploying health human resources that take advantage of full scopes of practice and roles, particularly within collaborative practice models. Many examples of HHRP-related successful innovation may not make their way into published literature because " getting published " is not a priority of those involved with HHRP-related innovation at the " coalface. " Key points from this scoping review included: – Virtually all health services research is related in some way to HHR productivity, and yet few studies are explicit about their relevance to productivity. It …