CapEs: designing and implementing a Capacity Estimator tool to support primary care workforce planners in Canada

Primary care is a cornerstone of high-quality healthcare systems and primary care workforce planning requires more robust tools than panel size targets, particularly as jurisdictions shift to team-based care. Few such tools exist in Canada. This paper describes the design of CapEs, a primary care CAPacity EStimator simulation software and its formative use, applied in facilitated workshops for primary care planners assessing primary care need and workforce capacity.

CapEs was developed through a partnership with the British Columbia (BC) Ministry of Health. This paper describes the intervention development study: requirements were gathered through stakeholder interviews and a co-design workshop. The simulation model was built in Stella Architect 3, informed by published literature and additional evidence from seven modified Delphi studies. CapEs was implemented by embedding it in facilitated workshops where the research team used the tool in real-time with workforce planners to explore community-level workforce plans and team configurations. Outputs were compared to current BC panel size targets.

Requirements led to the design of a simulation model that could be used with limited local data to predict the percentage of primary care needs met by clinically diverse primary care teams. CapEs was implemented as a complex intervention: the simulation model was embedded in workshops where the authors used CapEs with workforce planners to explore primary care plans, discussing implications of the model's predictions. Forty-five plans or communities have been reviewed with CapEs in three provinces in Canada. The facilitated workshop format allowed planners to explore scenarios in real-time while the research team provided clinical context and navigated data limitations. Benchmarking against BC policy panel targets showed broadly consistent results with some differences that suggest refinements to both the model and policy targets.

Tools like CapEs that estimate capacity match offer a more nuanced view of primary care workforce adequacy compared to panel targets. Embedding such tools in facilitated workshops made them accessible to planners with varying knowledge and data availability. Further validation and population-level data are needed to strengthen these models for primary care workforce planning in Canada.