Abstract
BackgroundThe article describes a healthcare staffing exercise that took place in a Cancer Hospital IV, Brazil’s first public palliative care unit. There are numerous gaps in the literature on specialized cancer staffing. Palliative care is a therapy modality that should begin with the diagnosis of a chronic disease, at which point the personnel must be technically and numerically adequate, as well as well-distributed, to provide coverage of the population that requires this type of care.MethodsThe WISN tool was chosen after a systematic review of the use of workload studies in palliative care, because it fulfills this objective. The WISN method is based on a health worker's workload, was developed in the late 1990s in the health sector and has been field-tested and implemented in several countries. Direct observation was used as the fieldwork approach, which was carried out by 18 research assistants with the assistance of two supervisors. They monitored 60 professionals in seven categories for 2 weeks on weekdays in the morning and afternoon periods: nursing, pharmacy, physical therapy, medical, nutrition, psychology, and social services.ResultsExcept for the medical staff, which at the time included additional physicians on loan from a partner institution to address a shortage in this professional group, all categories exhibited overload with WISN ratios ranging from 0.53 to 0.97. The analysis of time spent on individual activities indicated flaws with the services' informal organizations. The authors also noticed a strong emphasis on support activities and a lack of a clear schedule for training and research. The study's findings included a definition of standard activities for each professional group, an analysis and comparison of activities by categories, departments, and work shifts, a standard workload for training and research, and recommendations to include human resources planning as a fundamental part of a national policy for palliative care.ConclusionsThe WISN tool can be used to plan human resources in cancer centers that provide palliative care, and it provides for a variety of analyses that can be combined with other approaches in the literature.
Highlights
The article describes a healthcare staffing exercise that took place in a Cancer Hospital IV, Brazil’s first public palliative care unit
Despite the contribution by the above-mentioned themes to improvement of the supply of palliative care, there is a gap in the literature on the estimation and numerical adequacy of staffing to serve the population [5]
Planning that neglects to estimate the number of staff needed will present a level of incompleteness and could have a negative effect on health outcomes
Summary
The article describes a healthcare staffing exercise that took place in a Cancer Hospital IV, Brazil’s first public palliative care unit. There are numerous gaps in the literature on specialized cancer staffing. The literature offers extensive knowledge on important issues in the field of palliative care, such as adequate structure of services, the healthcare staff ’s role, multidisciplinary work, inclusion of family members in the treatment plan and management of emotional issues, staff stress and illness, and training and retention of specialists [1,2,3,4]. Despite the contribution by the above-mentioned themes to improvement of the supply of palliative care, there is a gap in the literature on the estimation and numerical adequacy of staffing to serve the population [5]. The challenge is to guarantee sufficient human resources for health systems to offer these services [6]. Evidence shows that investment in healthcare staff impacts areas, such as education, allowing employment opportunities, facilitating decent work in the formal sector, and fueling economic growth [7, 8]
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