Staff perspectives on health practice in Greenland after the 2010 Health Reform

By Tine Aagaard and Lene Seibæk

Staff perspectives on health practice in Greenland after the 2010 Health Reform - an interview study

This study of staff's perspectives on health practice follows on from studies of management perspectives on the effects of the health care reform on the organization of health care after the reform and on citizens' perspectives on health care.

The aim of the study is to identify staff's perspectives on changes in practice because of the reform, and to provide input on how the reform's measures can be modified and improved so that the reform's intentions can be better achieved than at present. In the report, staff identify opportunities and barriers to achieving the reform's aims - including strengthening primary care services, improving people's equal access to healthcare through telemedicine and dialogue with citizens, promoting staff recruitment and retention, and improving intersectoral collaboration with municipalities.

Based on an analysis and discussion of the staff interviews, four general recommendations are made for improvements in health care practice in the focus areas of the health care reform:

1. As a prerequisite for increasing job satisfaction and retaining staff, it is recommended that the resources of permanent staff be recognized and further developed. In addition, given the changing patterns of illness in the population, short-term staff could take on an increasing number of tasks related to prevention, health promotion and rehabilitation. This requires a comprehensive approach to skills development for health professionals.
2. It is advisable to develop a comprehensive staffing policy for the whole health care system, with plans both for how to deal with the staffing situation in the short term and how to build up a stable staff of permanent, well-trained employees in the long term. This will include the staff development strategy referred to in point 1, as well as a management development strategy based on shared goals and values for the development of the health system.
3. It is recommended to promote a focus on intersectoral patient care through joint competence development of health care staff and municipalities. The aim is to upgrade the health care skills of municipal staff, to increase health care staff's awareness of opportunities for prevention, health promotion and rehabilitation, and to strengthen working relationships.
4. There is great potential for improving the efficiency and quality of health services and the job satisfaction of staff through better dialogue with the public. The increase in the number of chronically ill and elderly people calls more for conversations about health challenges and less for disease management. It is recommended to prioritize citizen involvement and dialogue with the population as health interventions. As part of this, it is recommended to activate telemedicine throughout the health system, and to accelerate the implementation of new telemedicine equipment.

In addition, a wide range of concrete tools to strengthen the focus areas of the health reform are described.