Abstract
People living in rural places face unique challenges due to their geographic isolation and often experience poorer health outcomes compared to people living in major cities. The struggle to attract and retain an adequately-sized and skilled health workforce is a major contributing factor to these health inequities. Health professionals’ decisions to stay or leave a rural position are multifaceted involving personal, organisational, social and spatial aspects. While current rural health workforce frameworks/models recognise the multidimensional and interrelated influences on retention, they are often highly complex and do not easily support the development of strategic actions. An accessible evidence-informed framework that addresses the complexity but presents the evidence in a manner that is straightforward and supports the development of targeted evidence- and place-informed retention strategies is required. The ‘Whole-of-Person Retention Improvement Framework’ (WoP-RIF) has three domains: Workplace/Organisational, Role/Career and Community/Place. The necessary pre-conditions for improving retention through strengthening job and personal satisfaction levels are set out under each domain. The WoP-RIF offers a person-centred, holistic structure that encourages whole-of-community responses that address individual and workforce level needs. It is a significant response to, and resource for, addressing avoidable rural health workforce turnover that rural health services and communities can harness in-place.
Highlights
Compared to people who live in major cities, people living in rural and remote places face unique challenges and often experience poorer health outcomes due to their geographic isolation [1,2]
The individual is placed at the centre of the Whole-of-Person Retention Improvement Framework’ (WoP-RIF), signifying that each person’s experience and needs are highly individual and when developing recruitment and retention strategies, line managers, organisations and/or communities need to understand and address this diversity
The authors argued that, given the small size of allied health workforces in rural and remote health services, there are likely to be limited opportunities for career advancement [5]. Given both the limited opportunities for career advancement and high turnover of nursing and allied health professionals in small rural and remote settings, investing in grow-your-own workforce policies is recommended for building a sustainable workforce [40,41]
Summary
Compared to people who live in major cities, people living in rural and remote places face unique challenges and often experience poorer health outcomes due to their geographic isolation [1,2]. High staff turnover and long-term unfilled positions limit the health services that can be provided. This simultaneously results in heavy workloads for existing staff, which negatively impacts upon their job satisfaction, leading to further staff turnover [3,4]. Given their large land masses and small, broadly-dispersed populations with high proportions of Indigenous peoples, high income countries like Australia and Canada face additional challenges meeting their rural populations’ health needs.
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