Workload Indicators of Staffing Need (WISN) Method for Health Workforce Planning at Health Facility: A scoping review

Abstract

Background In the presence of diverse workforce planning method, identifying advantages, challenges and limitations of each method is very important. Population to health workforce ratio method faced challenges of continuous population growth and variations of health care needs over time. Standard staffing schedule was used to solve challenges of population ratio method but itself faced another challenge on how to distribute health workforces between health facilities with in a country. A workload indicator of staffing need (WISN) method was designed to alleviate challenges of the above mentioned methods. Challenges and limitations of WISN method have not been systematically reviewed and that is why this scoping review was designed Methods We conducted a scoping review of literatures with the objective of identifying implications, challenges and limitations of WISN method workforce planning at health facilities. Arksey and O’Malley’s methodological steps were followed to develop the research questions, identify relevant studies, include/ exclude studies, extract data, and report the findings. To ensure methodological quality PRISMA guideline and PRISMA- ScR checklist was used. Results A total of 27 studies were eligible and more than 83% were published between 2019 and 2022. Majority of studies used retrospective quantitative data with cross sectional study design but four studies incorporated qualitative parts too. The major challenges identified were health service activity standard of workload component, data quality or availability and technical details of the WISN itself. This review reveled WISN method limitations on precision of WISN result as it depends on last year record, service interruptions, time differences in completing clinical activity based on patient status and professional variations and over time health care activities. Conclusion WISN model of human resources for health planning adjusts workload pressure among health care workers within and between health facilities. Health care administrators or authorities use it for task shifting indicator within a health facility and equitable distribution indicator between health facilities. Being a very useful human resource planning tool, WISN has challenges and limitations too.