Why we need multi-level health workforce governance: Case studies from nursing and medicine in Germany

Health Policy
Ellen Kuhlmann, Christa Larsen

Abstract

Health workforce needs have moved up on the reform agendas, but policymaking often remains 'piece-meal work' and does not respond to the complexity of health workforce challenges. This article argues for innovation in healthcare governance as a key to greater sustainability of health human resources. The aim is to develop a multi-level approach that helps to identify gaps in governance and improve policy interventions. Pilot research into nursing and medicine in Germany, carried out between 2013 and 2015 using a qualitative methodology, serves to illustrate systems-based governance weaknesses. Three explorative cases address major responses to health workforce shortages, comprising migration/mobility of nurses, reform of nursing education, and gender-sensitive work management of hospital doctors. The findings illustrate a lack of connections between transnational/EU and organizational governance, between national and local levels, occupational and sector governance, and organizations/hospital management and professional development. Consequently, innovations in the health workforce need a multi-level governance approach to get transformative potential and help closing the existing gaps in governance.

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Citations

Mar 9, 2019·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Peter Schröder-BäckMitch Blair
Aug 16, 2017·International Journal of Health Policy and Management·Madhan BalasubramanianDavid S Brennan
Jun 10, 2020·Human Resources for Health·Sophie WitterChristopher H Herbst

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