Grant: Health Sys. Impact Embedded ECR Award - Health Services, Health Systems & Policy

Home and community care is one of the fastest-growing sectors of the Canadian health system and is central to supporting aging in place, system sustainability, and patient-centred care. Despite its importance, the home care sector remains under-studied, with limited system-level evidence to guide nursing workforce planning, integration of internationally educated nurses (IENs), and long-term workforce stability. This embedded program of research is designed to address these gaps by generating policy-relevant, decision-ready evidence that strengthens workforce sustainability and advances home care science through a learning health system approach.This program of work includes four projects that aim to strengthen the home and community care workforce. Project 1 will create a clear picture of Ontario's home and community care workforce, with a focus on nurses and internationally educated nurses. This will help show how different parts of the system are connected and where gaps or pressures exist. Project 2 will compare how home care organizations and nursing workforces are structured across Canadian provinces, with attention to policies that support aging at home. Project 3 will use existing data from VHA, CIHI, and Statistics Canada to examine where home care nurses are working, how many there are, and how they are distributed across regions. Project 4 will explore nurses' experiences in home care, including why they stay, move between roles, or leave, through interviews with nurses, staff, and nurse leaders. All projects will be designed and interpreted together with VHA leaders, home care system partners, and policymakers. The findings will support VHA's role as a learning organization by helping leaders adjust policies and practices over time to better support a stable and sustainable workforce.