A mixed methods approach for the identification and assessment of workforce innovations in home health care

The effective and efficient deployment of staff in home-based health care is fundamental to the sustainability of health and social care systems, particularly in the context of ageing populations and an increasing number of patients with complex needs.

We combined Soft Systems Methodology, mathematical optimisation and sociotechnical systems analysis of a local health economy in London, UK, to identify and assess the potential impact of different (combinations of) workforce innovations on multiple aspects of system performance, and the readiness of the local health economy to implement them.

Through stakeholder engagement, we identified 21 aspects of system performance and 38 potential innovations that could be considered to improve one or more of them. We quantitatively compared the potential impact on several aspects of system performance of a subset of the innovations chosen because they are seemingly in tension, promote similar goals but at different planning levels, or illustrate intrinsic trade-offs between different aspects of system performance. We additionally assessed the innovations according to the local health economy's readiness for them and the likely barriers to their successful implementation.

Our multifaceted approach synthesises an organisation's preferences and change capabilities, while providing some additional quantitative insights on the potential effects of different innovations under consideration together with a rich understanding of the aspects of system performance considered important by different stakeholders. Decision makers could use this novel approach to explore and assess different combinations of innovations for their organisation.