“Rookie factor”: why healthcare workforce policy needs to embrace experience

Abstract

What price experience? I have been working across several safety critical industries for years and in terms of the approaches that these industries take to workforce issues there are some stark differences between safety critical industries and healthcare. One of the most striking differences is the failure to value a risk facing, proficient workforce where safety and productivity are two sides of the same coin rather than competing.1 When we think of safety critical industries, there is often a focus on the retention of expertise and experienced workers as they improve the bottom line in terms of productivity and safety, whereas in healthcare the focus is fundamentally one of more hands for least money and a focus on activity rather than outcome.23 In their seminal work Dreyfus and Dreyfus describe the novice to expert continuum, through novice, advanced beginner, competency, proficiency, and expertise.4 While expertise is needed, it’s a proficient …