Canada’s health workforce continues to face significant challenges that pose potential threats to quality of care, worker wellbeing, and access for patients. We’re seeing familiar challenges like retention, staff shortages, regional disparities, and joint health workforce planning with the education sector take on new features as other complex systems outside of healthcare leave their mark.
Those who work to solve Canada’s health workforce challenges understand that focusing on one-size-fits-all solutions won’t work. Real progress requires dynamic, inclusive, incremental and creative responses. Working together is the key to tackling these challenges and developing new, resilient, and adaptive solutions to the health workforce issues we all face.
This is precisely why we chose Tackling System Complexity as the theme for our second Health Workforce Canada Connects symposium.
In October, we brought together more than 300 participants from across Canada and around the world to share their expertise, dive deeper into these critical issues, and develop practical approaches and solutions.
“Independent initiatives alone are not enough,” said Interim Health Workforce Canada CEO Deb Gordon. “Whether it’s expediting credential recognition, enhancing the integration of health workforce and education planning, finding context-specific solutions for rural and remote health workforces across Canada, or scaling up team-based primary care, success depends on understanding our individual roles, how we all contribute and how all the pieces fit together.”
With a core focus on shifting the way we view health workforce challenges from a siloed lens to one that embraces system complexity, symposium participants left with a refreshed commitment to strong health workforce planning and a renewed understanding of the roles we each must play to collectively work towards developing new, resilient and adaptive solutions.
Our symposium opened in a good way with an Indigenous welcome and prayer from Dr. & Elder Roberta Price. Photo credit: Threshold Studios
International Innovation in Health Workforce Planning
The opening keynote address brought together international expertise and insights from speakers Cris Scotter (WHO, Denmark), Åsa Olsson (National Board of Health and Welfare, Sweden), and Dr. Benjamin Puertas (PAHO/WHO, Washington, D.C.). Together, they explored the theme of embracing complexity in health workforce planning around the world, highlighting respective international lessons in leadership, decision-making, data, innovation, and building strong networks to support system transformation for the future, while working within ever-changing political and economic environments.
Cris Scotter emphasized the importance of recognizing complexity through strategic planning and proper governance. He said that while workforce challenges are complex, they aren’t necessarily complicated. Adopting a systems-thinking approach helps identify emergent risks and solutions across the whole system and the way they interact together.
Cris introduced the need to talk to people to truly understand health workforce data and said we need to reframe and move past the symptoms to understand the problem. He also emphasized the importance of questioning assumptions and taking time to do this before implementation.
Six keys to addressing complexity
- Adopt a complex solutions framework
- Structure analysis around three core dimensions: patterns, mechanisms, dynamics
- Use multiple methodologies to create meaningful system change
- Integrate and expand workforce data
- Strengthen interdisciplinary collaboration
- Reorient evidence and decision making
According to Cris, “It’s not about doing the wrong things ‘righter,’ it’s about taking a hard look at what you really want to accomplish and collectively working towards that desired future state.” He reminded all of us that the WHO has some great resources on promising practices and brilliant failures and encouraged participants to check them out.
Through her work transforming health workforce planning in Sweden, Åsa brought forward back-casting as a key approach to success. Similar to Canada, Sweden has 21 autonomous regional health systems as well as many professional associations, employers, unions, and other stakeholder interests.
Åsa’s team created a transformational shift in health workforce planning by first determining the desired future state of health care and working back from there to determine the practical, tangible steps they needed to create this vision. They brought together existing national data and developed more robust, specific data sets that showed team complexities and how they worked together. Åsa shared some critical areas of focus to achieve success: through a system complexity lens:
- Emphasize work on innovation more than efficiency
- Focus on the ecosystem more than single institutions
- Take a long term approach, over a short term one
- Consider ways to improve human augmentation, rather than simple automation
- Remember that management is an art more than a science
- Stay grounded in reality and pragmatism, rather than ideology
- Apply a self-renewal lens, rather than a revolution.
With 39 countries and territories under its purview, each with differing levels of health data collection and indicators, the Pan American Health Organization (PAHO) has undertaken extensive work to strengthen health workforce planning, promote system transformation, and foster collaboration.
A critical piece of their work is the development of the first report on health human resources in Latin America. This involved bringing countries together to establish standardized data collection sets, regulations, and strategic frameworks, while recognizing their autonomy in respect to models of care and cultural mechanisms.
With multi-country health workforce data now available, PAHO has also created the Human Resources for Health Core Indicators Dashboard, providing a new tool to assist Latin American countries with analysis and decision making.
At Health Workforce Canada Connects 2025, each of the keynote addresses centered around the critical importance of embracing complexity and provided real-world examples of how this can be achieved. An integrated health system touches all of us in some way, every single day. We owe it to those working so hard to deliver and support great care—and to everyone who depends on provincial and territorial healthcare systems—to do all we can to strengthen and support them. That means working together, using the best data and knowledge, creating smart, human-centered policies and practices, and most of all, taking real and meaningful action.