Future Training and Competency Needs in Hospital-at-Home Care: A Mixed-Methods Study From the Perspective of...

The growing complexity of hospital-at-home care highlights the pressing need for continuous professional development to enhance specialized skills.

This study aimed to describe the future training and competency needs in hospital-at-home care from the perspective of healthcare administrators and managers.

A mixed-method convergent design was used to integrate quantitative and qualitative data on similar topics simultaneously, providing a more comprehensive understanding of system-level competency requirements than either method alone.

The data were collected through a nationwide survey (n = 25) and interviews (n = 46), covering all wellbeing services counties in Finland in 2023. Descriptive statistics were used for quantitative data and inductive content analysis for qualitative data.

Quantitative results indicate needs for additional training in RAI assessment (68%), mental health care (60%), substance abuse expertise (48%), and managing disruptive behaviors (44%). Qualitative findings highlight broader future competence needs, including digital health; cultural and linguistic competence; interprofessional collaboration; managerial competence; home-environment quality and safety; clinical competence; and autonomy in evidence-based practice. Overall, the mixed-method findings differ yet complement one another: quantitative data identify concrete skill gaps, while qualitative insights emphasize wider, system-level competencies to meet the evolving demands of home-based care.

Taken together, these complementary findings indicate that advancing the workforce will require a dual approach: addressing concrete skill deficits while simultaneously developing the broader competencies needed to meet the evolving demands of home-based care.

This study informs the creation of structured competency frameworks, enabling nursing leaders to meet the evolving demands of home-based care.