Navigating Workforce Challenges in Long-Term Care: A Co-Design Approach to Solutions

Sheila A. Boamah (), Farzana Akter, Bahar Karimi and Farinaz Havaei
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Sheila A. Boamah: Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON L8S 4K1, Canada
Farzana Akter: Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON L8S 4K1, Canada
Bahar Karimi: Thrive Group Centre of Excellence in Healthcare Innovation, Hamilton, ON L9C 7N4, Canada
Farinaz Havaei: Faculty of Health, School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada

IJERPH, 2025, vol. 22, issue 4, 1-20

Abstract: (1) Background: The enduring impact of COVID-19 on the long-term care (LTC) sector remains uncertain, necessitating targeted efforts to address current and emerging challenges. This study aims to identify the key stressors faced by healthcare workers (HCWs) in LTC and to co-develop innovative, actionable strategies that mitigate these stressors, foster resilience, and promote workforce retention. (2) Methods: This study utilized a qualitative co-design methodology within a mixed-methods, multi-phase framework conducted between July 2023 and October 2024. This article focuses on Phase 1, which involved 11 semi-structured focus groups and steering group discussions with 24 HCWs, including personal support workers (PSWs), nurses, and LTC administrators across Ontario to explore workplace-related distress and foster a shared understanding of challenges in the LTC sector. Data were audio-recorded, transcribed verbatim, and analyzed using thematic analysis to derive key themes and actionable insights. (3) Results: Key themes emerging from co-design sessions included the need for (i) effective workload management tools, (ii) the prioritization of psychological safety and mental health services, (iii) reducing regulatory and bureaucratic burdens, (iv) strengthening management practices, and (v) fostering recognition and a positive sector image. Co-design sessions with HCWs and leaders facilitated the identification of priority issues and high-level solutions, including addressing workload issues, implementing mental health and support programs, enhancing work–life integration, improving management training, and promoting psychological safety in LTC settings. (4) Conclusions: This study deepens our understanding of workplace challenges in the LTC sector and the factors contributing to HCWs’ mental distress. Leveraging a co-design approach offers valuable insights into the lived experiences of HCWs and leaders. The findings provide actionable guidance for LTC leaders and policymakers to create effective, tailored interventions that actively engage HCWs in addressing workplace stressors and mitigating recurrent challenges.

Keywords: co-design; mental health; healthcare workers; long-term care; workforce well-being; retention (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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