Florizone stresses the importance of comprehensive approaches as solutions, concrete targets
Earlier this volume, the Carillon spoke to Dan Florizone, Executive-in-Residence and Professional Affiliate at Johnson Shoyama Graduate School of Public Policy and former President and CEO of the Saskatoon Health Region. The Carillon spoke with Florizone about the recent and frequent disruptions in health care and emergency services in the province. Florizone offered valuable insights into the possible causes for disruptions, as well as strategies that can be adopted to prevent future incidents.
A report published by Saskatchewan Population Health and Evaluation Research Unit (SPHERU) in Apr 2024 explained that health facilities in CUPE local 5430 regions encountered 533 service delays between Aug 2019 and July 2023, totaling 2,932 days or eight years of disruptions across all facilities, according to the publicly available study.
These interruptions lasted an average of 5.5 days and happened once every three days. Additionally, the number of disruptive episodes increase each year.
Florizone believes that it is as critical for health care services to retain their workers as it is to attract newcomers. “It takes a while to train up providers, so you’ll have to rely on some immigration. You’ll rely on some return to work; you’ll rely on making sure we can stop the bleeding of health professionals in the short term. We want to create a magnet or attractive environment for them to work.”
Florizone also spoke about current chaos, explaining that it is proving to be more expensive in terms of funding. Hiring more staff could reduce the burden of extra money that needs to be paid to the staff working overtime. “Across Canada there is use of agency nurses. Those agency nurses are being paid twice, sometimes three times or more, than what our own staff cost us. We’re paying it in overtime […] there will always be a growth in the health sector but right now the status quo going forward, if you project it out, is much, much more expensive than if we stopped, anticipated our staffing, and normalized the workplace. Recruitment is very expensive. Retention is a far less expensive strategy,” he said.
Florizone also recognized that creating an environment that can retain its current employees and attract new employees is long term work and takes collective team effort. With consistent long term team efforts, he believes that change can happen. “We could start to see hope in the next six months,” Florizone claimed.
Florizone thinks that while some jurisdictions are very effective in human health resource planning, some of their plans are focused a little too much on the short-term goals and not enough on the mid-to-long-term goals.
He believes that it is not only the Ministry of Health but also the Ministry of Advanced Education that plays a huge role in designing and managing long term strategies. “It’s not only the Ministry of Health, but you’ve got the Ministries of Advanced Education as the ones that decide on the number of training seats that are out there,” he said.
Florizone also explained how the CARMS matching process means that “there’s a real draw for specialist selection for physicians to choose the specialties that are higher paid. Family physicians are not the highest paid,” and that the solution to this is to align incentives to be consistent with needs.
Another strategy suggested by Florizone was to train nurse practitioners, which takes less time, and allows for existing registered nurses to become nurse practitioners. He believes it is imperative to “work the plan and get the people trained up.”
Florizone believes issues surrounding recruitment need a more comprehensive approach. “We’re having trouble with some basic recruitment and in particular in rural areas, but also in urban parts in just filling the maintenance and housekeeping and dietary staff positions. Part of what we need to do is get to grade nine students,” he said.
Florizone continuned, “Grade nine you’re making your decisions about what the future might look like. If you’re going to go into the health professions, you have to really start selecting the sciences in high school and those decisions in grade nine that that kids are making is really telling the tale of what might happen later […] we need to actually go into grade nine classrooms and invite grade nine students into the health sector to see how promising and exciting a career in health can be.”
“So, when I say a comprehensive approach, I’m saying start young. I’m saying create the capacity, get students excited and involved in the sciences […] there’s a huge potential here in First Nations and Métis students that are totally unrepresented, both in the economy and in the health sector. We’ve got the youngest population in Canada and they’re sitting right here in Saskatchewan. We have huge potential to unleash that talent pool into the healthcare sector,” he concluded.
Florizone recognizes that, for long-term approaches, a number of things will need to change. He believes that change is going to have to be comprehensive and there is an imminent need to incorporate positivity in the system.
“I can tell you every campaign or marketing approach that we take to track people into the health sector is not going to gain traction as long as their mothers and brothers and sisters and uncles and grandparents are disillusioned because they worked in that system. We need to start treating the health professionals with the respect they deserve. We need to be paying them appropriately. We need to be […] treating them in a far better way,” he said.
With all the approaches, he also believes that measuring progress with the help of targets and timeframes is essential. “What we lack in the health human resource planning across the country is that there’s great intentions but there aren’t concrete targets,” he concluded.
