Abstract
Drawing inspiration from business strategy, public health methodologies, and quality improvement frameworks, environmental scanning emerges as a pivotal tool for understanding and navigating the complexities of home care in Canada. This approach, increasingly recognized by healthcare organizations and policymakers, facilitates a comprehensive assessment of the home care landscape. Through diverse methods, environmental scans engage stakeholders to address critical research questions, analyze policy frameworks, evaluate existing literature, and gather both qualitative and quantitative data. The insights gleaned from this process are crucial for informing strategic planning, policy development, and decision-making aimed at enhancing the Canadian home care sector. This article outlines the application of environmental scanning to home care in Canada, highlighting its significance for practitioners, policymakers, and stakeholders dedicated to strengthening this vital component of the healthcare system.
Background
Environmental scanning, a strategic process widely utilized in business and organizational management, is equally valuable in the context of public health and healthcare. It involves systematically gathering, organizing, and analyzing information about both internal capabilities and external factors that can impact an organization or sector. In the realm of Canadian home care, environmental scanning serves as a crucial mechanism for decision-makers to understand the current landscape, identify emerging trends, and proactively address challenges and opportunities. By examining internal strengths and weaknesses alongside external opportunities and threats, stakeholders can make informed decisions that promote the sustainability and effectiveness of home care services.
In business, environmental scans leverage diverse methodologies such as literature reviews, online database analyses, social media monitoring, policy evaluations, competitor benchmarking, and stakeholder consultations. These techniques are equally applicable to the home care sector, allowing for a multifaceted understanding of the environment. The goal is to acquire relevant and reliable data that can inform evidence-based strategies for improvement and innovation.
The application of environmental scanning is increasingly recognized in healthcare for its ability to identify quality improvement opportunities, guide research priorities, inform interventions, and ultimately improve health outcomes. It has been successfully employed across various health domains, including chronic disease management, mental health services, and quality improvement initiatives. In home care, this methodology can be instrumental in addressing challenges related to service delivery, workforce capacity, technological integration, and policy gaps.
Environmental scanning in home care integrates multiple data collection strategies, mirroring its application in broader healthcare contexts. These methods include focus groups with caregivers and clients, in-depth interviews with providers and administrators, surveys, reviews of relevant literature and internal documents, and policy analyses. This comprehensive approach ensures a holistic understanding of the issues and perspectives within the home care sector.
While sharing similarities with traditional public health evaluation frameworks, environmental scanning distinguishes itself primarily in purpose. Similar to established evaluation frameworks, it emphasizes stakeholder engagement, data-driven insights, and the use of findings for improvement. However, the core objective of an environmental scan is to understand the context, gather comprehensive information, and identify resources, connections, and gaps, rather than to evaluate the merit or worth of a specific program or policy. In the context of home care, this means focusing on understanding the broader system, its dynamics, and the factors influencing its performance, to strategically inform planning and decision-making processes.
Despite its growing recognition as a valuable assessment tool, environmental scanning in home care lacks a universally standardized definition and process. It is sometimes used informally as a broad term for needs assessments, while in other cases, it is more closely aligned with strategic planning and quality improvement efforts. To enhance the effectiveness and methodological rigor of environmental scanning in home care, further application and critical analysis are essential. This article aims to contribute to this development by outlining a structured approach to environmental scanning in the Canadian home care context, providing a practical guide for stakeholders seeking to apply this methodology.
7 Steps for Conducting an Environmental Scan of Home Care in Canada
To effectively navigate the complexities of home care in Canada and drive meaningful improvements, a structured environmental scan is crucial. Drawing from established best practices and adapted for the specific needs of the Canadian home care landscape, a seven-step process can be implemented. This framework is designed to be adaptable and applicable across various contexts within the home care sector, from policy development to service delivery improvement.
This structured approach to environmental scanning can be adapted and applied to address various public health and healthcare issues relevant to the Canadian context, including access to care, chronic disease management in the community, and mental health support services. Lessons learned from these applications can further refine the methodology and enhance its effectiveness. As stakeholders engage in the process of development, implementation, evaluation, and dissemination (Figure), ongoing communication and collaboration are essential to ensure the scan is comprehensive, relevant, and actionable. Sharing the process and methodology with experts and stakeholders in home care and environmental scanning will help to refine the approach and ensure its practical applicability. The following outlines the seven steps for conducting an environmental scan of home care in Canada, detailing the actions within each step.
Figure. Adaptable Timeline for developing and implementing an environmental scan for Canadian home care initiatives, 2024-2025. Abbreviations: CAN, Canada; HC, Home Care; RFP, Request for Proposal. [A text version of this figure is also available.]
Step 1: Establish Leadership and Build Capacity for the Project
Successful environmental scanning requires dedicated leadership and a well-defined team. A coordinator or team leader must be appointed to champion the entire process, from initial planning to final dissemination of findings. While resource availability may vary, it is crucial to allocate sufficient resources and define clear roles and responsibilities for each team member. The scope and scale of the project should be realistically aligned with the organization’s capacity and available resources.
Example for Canadian Home Care: A provincial Ministry of Health could initiate an environmental scan of home care services. They would designate a project lead with expertise in health policy and home care, supported by a multidisciplinary team comprising researchers, policy analysts, and home care practitioners. This team would leverage existing expertise in policy analysis, stakeholder engagement, data collection, and health service delivery to effectively conduct the scan. The Ministry would allocate dedicated staff time and budget to support the coordinator and team throughout the project lifecycle.
Step 2: Define the Focal Area and Purpose of the Scan
Clearly defining the purpose and scope of the environmental scan is paramount. A well-articulated purpose serves as the anchor for the entire process, ensuring that efforts remain focused and resources are used efficiently. While flexibility is important, a firm purpose will maintain the scan’s direction and ensure its scope remains manageable and relevant to the intended outcomes.
Example for Canadian Home Care: The purpose of a home care environmental scan in Canada could be to comprehensively assess the current state of home care services across a specific province or territory. This would involve identifying existing programs, policies, and initiatives related to home care; understanding the needs of diverse populations requiring home care; assessing the strengths and weaknesses of the current system; identifying gaps in service delivery and policy; and exploring opportunities for innovation and improvement. A clear definition could be:
A comprehensive and systematic assessment process designed to explore the landscape of home care in Canada, identify key trends, challenges, and opportunities, and provide stakeholders with actionable insights for strategic planning and policy development to enhance the quality, accessibility, and sustainability of home care services.
Step 3: Develop a Timeline and Set Incremental Goals
Establishing a realistic timeline is essential for effective project management. Timelines may be dictated by funding bodies or organizational mandates. If the scan is self-initiated, it is crucial to develop a timeline at the outset. Planning scan activities in phases, with incremental goals, helps to optimize the process and maintain momentum. For instance, if surveys or qualitative interviews are included, allocate sufficient time for instrument development, pilot testing, ethics review board approvals, participant recruitment, data collection, analysis, and synthesis.
Example for Canadian Home Care: A timeline for a provincial home care environmental scan might be set over 18 months. This timeframe would allow for distinct phases: initial planning and stakeholder engagement (3 months); data collection, including surveys, interviews, and document reviews (6 months); data analysis and synthesis (4 months); report writing and dissemination planning (3 months); and dissemination and initial follow-up (2 months). Within the data collection phase, specific timelines would be allocated for each activity, such as survey development (2 months), ethics approval (1 month), pilot testing (1 month), survey fielding (2 months), and qualitative interview scheduling and completion (3 months).
Step 4: Determine the Information to be Collected
Brainstorm comprehensively to identify all relevant topics and information sources that could inform the environmental scan. While not all desired information may be readily available, it is beneficial to initially cast a wide net. Identifying information gaps early is preferable to overlooking potentially crucial data. Unlike Step 2, this step is inherently dynamic, evolving as stakeholder engagements unfold and new resources are discovered.
Example for Canadian Home Care: Initial areas of inquiry for a Canadian home care environmental scan might include: demographic trends and projections related to aging and chronic illness; current home care policies and regulations at federal, provincial, and territorial levels; the range of home care services available across different regions; funding models and resource allocation for home care; workforce demographics, training, and recruitment challenges; technological innovations in home care delivery; best practices and evidence-based models of care; and the perspectives of clients, caregivers, and providers. As the scan progresses, new topics may emerge, such as the impact of specific federal or provincial initiatives, emerging models of integrated care, or innovative approaches to caregiver support.
Step 5: Identify and Engage Key Stakeholders
Stakeholder engagement is critical to the success of an environmental scan. Develop a diverse and iterative list of individuals and organizations that possess relevant information pertaining to the topics identified in Step 4. Stakeholders can expand the initial list of topics by recommending additional contacts and connecting the project team to other relevant individuals or groups (snowball approach).
Prior to contacting stakeholders, clearly define what information or input is needed from them. Develop a plan for engagement, whether it involves structured interviews, surveys, focus groups, or information sharing. Be prepared to address stakeholder questions about the scan’s purpose, process, and intended outcomes. Document all suggestions and feedback, even if their immediate relevance is unclear, as they may prove valuable later in the project. Consider offering reciprocal value for stakeholder participation, such as access to the final scan results or opportunities to contribute to future initiatives.
Example for Canadian Home Care: Stakeholders for a Canadian home care environmental scan would include: home care clients and family caregivers; home care providers (nurses, personal support workers, therapists, etc.); home care agencies and organizations (public, private, non-profit); provincial and territorial ministries of health and long-term care; federal government agencies involved in health and social care; professional associations and regulatory bodies for healthcare professionals; advocacy groups for seniors and people with disabilities; researchers and academics in home care and related fields; and technology vendors in the home care sector. Engagement strategies could include advisory committees, key informant interviews, online surveys, and workshops. For example, client and caregiver perspectives could be gathered through focus groups and surveys, while policy insights could be obtained through interviews with government officials and policy analysts.
Step 6: Analyze and Synthesize Findings into a Concise Report
Analyze all collected data and triangulate information from various sources according to the environmental scan plan. Document quantitative and qualitative findings from surveys, interviews, policy reviews, literature assessments, and other sources. Synthesize these results into meaningful conclusions that directly address the scan’s focal area and purpose. Furthermore, identify evidence-based priorities for action, whether in research, policy, or service delivery. Use the synthesized results to inform strategic decision-making and develop an action plan that guides future initiatives and empowers stakeholders to move forward collaboratively.
Example for Canadian Home Care: Analysis of data from a Canadian home care scan would involve: statistical analysis of survey data to identify trends in service utilization and client satisfaction; thematic analysis of qualitative interview transcripts to identify recurring themes and perspectives on challenges and opportunities; content analysis of policy documents to understand the regulatory and funding landscape; and synthesis of findings from literature reviews and best practice scans to identify evidence-informed approaches. The synthesis would aim to identify key themes such as workforce shortages, funding gaps, unmet needs of specific populations (e.g., rural communities, Indigenous populations), opportunities for technology integration, and policy recommendations to strengthen the sector.
Step 7: Disseminate Results and Conclusions to Stakeholders
The final step involves sharing the findings of the environmental scan with relevant stakeholders in a clear and accessible format. The format of dissemination may vary depending on the audience and purpose. For instance, a funding agency might require a specific reporting template. If no template is specified, develop one at the outset or towards the conclusion of the project. The report should clearly articulate how the initial overarching questions and sub-topics were addressed and provide a comprehensive list of information sources. Ensure the scan results are accessible to the funding agency (if applicable), organizational leadership, participating stakeholders, and the broader home care community.
Example for Canadian Home Care: Dissemination strategies for a Canadian home care environmental scan could include: a comprehensive written report summarizing key findings, conclusions, and recommendations; presentations at relevant conferences, workshops, and stakeholder meetings; policy briefs targeted at government decision-makers; webinars for home care providers and organizations; and plain language summaries for clients and caregivers. The dissemination plan should prioritize reaching all relevant stakeholder groups and tailoring the format and content of the information to their needs and interests. For example, policy recommendations would be emphasized in briefs for government, while practical implications for service delivery would be highlighted in presentations for providers.
Discussion
Environmental scanning provides a robust methodology for assessing the external and internal environments of home care systems, programs, or initiatives. It is instrumental in identifying barriers and facilitators to addressing challenges and achieving goals within the context of a community, region, or national priority area like home care in Canada. The insights gained from environmental scans can effectively inform strategic planning, policy development, and decision-making for home care projects and interventions. It can guide the direction of new initiatives, raise awareness of disparities or inequities in access and quality, and serve as a catalyst for project development and funding opportunities. For example, in the context of Canada’s aging population and increasing prevalence of chronic conditions, understanding the evolving landscape of home care is crucial for ensuring the system can effectively meet future demands. An environmental scan can provide a strategic overview of the current situation and identify key areas for investment and innovation.
Before initiating an environmental scan, it is crucial to establish a clear working definition of environmental scanning tailored to the specific context of home care in Canada. This definition should outline detailed yet flexible steps to achieve the desired outcomes. The process must be adaptable to accommodate new information and insights gained from stakeholder engagement and emerging questions.
Perhaps the most critical aspect of environmental scanning is ensuring the results are effectively utilized. The final output, whether a report or presentation, should be proactively shared with all stakeholders, particularly those who contributed information to the scan. Ideally, the findings will generate actionable research priorities, highlight funding gaps, identify opportunities for effective interventions, and foster new partnerships and collaborations. A well-executed environmental scan in Canadian home care should lead to concrete actions, such as informing policy changes, guiding service delivery improvements, stimulating research initiatives, and strengthening collaboration among stakeholders to enhance the home care sector for the benefit of Canadians.
The described approach to environmental scanning has some limitations. Firstly, the absence of a standardized definition and universally applied methodology for environmental scanning in public health and healthcare, including home care, introduces a degree of ambiguity. This lack of standardization is an inherent limitation of the process, and the definition and methodology are likely to continue evolving as more organizations and practitioners adopt and adapt the tool. Secondly, the applicability of these steps may vary across different contexts within Canadian home care. Factors such as available resources, the specific focus of the scan, and the nature of stakeholder engagement can influence the implementation and effectiveness of each step. Despite these limitations, the outlined seven-step process, or adapted versions thereof, offers a valuable framework applicable to a wide range of questions and challenges in Canadian home care research, policy, and practice.
Acknowledgments
The development of this framework for environmental scanning in Canadian home care was informed by best practices in public health methodology and strategic planning.
Author Information
Corresponding Author: [Your Name/Organization], [Your Title/Affiliation], [Your Contact Information].
Author Affiliations: [Your Affiliations].
References
- Morrison JL. Environmental scanning. In: Whitely MA, Porter JD, Fenske RH, editors. A primer for new institutional researchers. Tallahassee (FL): The Association for Institutional Research; 1992. p. 86–99.
- Rowel R, Moore ND, Nowrojee S, Memiah P, Bronner Y. The utility of the environmental scan for public health practice: lessons from an urban program to increase cancer screening. J Natl Med Assoc 2005;97(4):527–34.
- Thinking Futures. Holtham Hill (Australia): Doing an environmental scanning: an overview guide; 2012. http://www.sswm.info/sites/default/files/reference_attachments/CONWAY%202012%20Doing%20Environmental%20Scanning.pdf. Accessed June 8, 2016.
- Society for Human Resource Management. Alexandria (VA): Society for Human Resource Management; 2016. https://www.shrm.org. Accessed April 2, 2016.
- Liddy C, Mill K. An environmental scan of policies in support of chronic disease self-management in Canada. Chronic Dis Inj Can 2014;34(1):55–63.
- Graham P, Evitts T, Thomas-MacLean R. Environmental scans: how useful are they for primary care research? Can Fam Physician 2008;54(7):1022–3.
- National Association of County and City Health Officials. Developing a local health department strategic plan: a how-to guide. http://www.naccho.org/uploads/downloadable-resources/Programs/Public-Health-Infrastructure/StrategicPlanningGuideFinal.pdf. Accessed June 20, 2016.
- Centers for Disease Control and Prevention. CDC evaluation framework. Atlanta (GA): Centers for Disease Control and Prevention; 2016. http://www.cdc.gov/eval/framework/. Accessed June 5, 2015.
- Public Health Foundation. The ABCs of plan-do-check-act (PDCA). Washington (DC): Public Health Foundation. http://www.phf.org/resourcestools/Pages/The_ABCs_of_PDCA.aspx. Accessed June 20, 2016.
- Guion LA. A 10-step process for environmental scanning. J Ext 2010;48(4) http://www.joe.org/joe/2010august/iw2.php.
