Julia is an embedded researcher in a regional health authority whose team has been asked to support retention efforts for facilities and care organizations in the region. 

Their project focuses on retention through considering the health and well-being of care providers starting with the wellness of registered nurses (RNs) in their region and looking across comparators, including the impact on patient outcomes. They plan to conduct targeted interviews of RNs and their employers in the health region to understand current drivers of retention and the policies in play, as well analyze clinical data and outcome indicators at those facilities. First, they need to gather concrete data on the current state of RN wellness and workload to help guide development of their interview questions.  

Five ways the dashboards can help Julia 

1. From the Employment module, she views the pan-Canadian picture by selecting all provinces and selects hospital nursing inpatient units to get an overview of overtime hours worked and paid sick leave hours reported. With RNs being one of the primary providers in hospital inpatient units, these metrics can offer her a window into workload metrics related to burnout and wellbeing.
2. On the Provider Wellness module, Julia examines how nurses responded to survey questions on key aspects of working conditions (including physical, psychological and work-life balance factors). She also gets a snapshot of the factors impacting the physical well-being of RNs from the section on lost time claims.
3. From the Recruitment and Retention module, she reviews the ratio of inflow to outflow for RNs in each jurisdiction over the years. She exports the results for each jurisdiction so she can compare and group them by region for additional analysis later.
4. She also notes that her province had announced several retention policies over the past two years. She moves to the Policy Tracker to obtain more details on these policies and if they were applicable to RNs. Using the data she exported, she can track whether there is any indication these policies may have had an impact on the trends she observes in the data.
5. Julia wishes to conduct a deeper analysis and moves to the Data Catalogue to check how she can access record-level data on health and wellbeing for RNs by applying filters for data theme and occupation. 

Five things Julia learned 

1. For nursing inpatient services units in Canada’s hospitals, paid sick leave hours increased sharply between 2020 – 2022. This was accompanied by an increase in the proportion of overtime hours as a share of total hours worked, suggesting that RNs working in this area may be experiencing burnout and a lack of work-life balance.
2. Although around half of nurses surveyed responded that they were satisfied or very satisfied with their job, favorable responses related to burnout were lower. Only about a third of nurses felt burned out from work once a month or less frequently.
3. Some jurisdictions experienced a decrease in the ratio of RNs entering and exiting the profession over the past five years. It even dipped below one in some jurisdictions, indicating that more providers left than entered. Julia suspects that these jurisdictions are not able to retain enough RNs to ensure a balanced workforce.
4. Although there were several retention policies announced in 2023, these policies were targeted more towards other professions such as nurse practitioners and family physicians.
5. In the data catalogue module, she notes that the Statistics Canada has several data holdings on the health and wellness of RNs. She downloads the complete data catalogue and navigates to the ‘How to Access’ tab to find out how she can access more detailed data to add to her body of research. 

What Julia and her team will do with this information 

• Extract key data points and findings on wellness and workload that can be used in tandem with the results of her team’s analysis on patient outcomes to demonstrate a possible relationship between the two. 

• Develop focused questions for the interview phase of the study, which will help uncover some of the drivers of what they have observed in the data and inform quality improvement initiatives.  

• Julia feels that data on patient outcomes could augment the dashboards as they provide further insight to the potential downstream effects of provider health and wellness. She uses the dashboard feedback form to suggest that Health Workforce Canada may consider this in their next dashboard iteration.