Frameworks to Guide Medical Staffing and Skill Mix Decisions in Hospital Settings: A Scoping Review of National and International Practices and Implementation Enablers and Barriers

Background In Ireland and internationally, healthcare systems are increasingly challenged by population ageing, multimorbidity, rising service demand, workforce shortages and evolving models of care. These pressures require consideration not only of how many doctors are needed, but of how available doctors should be deployed and configured within clinical services. To address an identified evidence gap, this paper presents a protocol to collate evidence on frameworks and structured approaches to support medical staffing and skill-mix decisions for hospital doctors, including how these have been developed, implemented and their feasibility in practice. Method This scoping review will follow JBI methodology and will be reported in accordance with the PRISMA Extension for Scoping Reviews. Searches will be conducted in Medline, Embase, Scopus and CINAHL, alongside relevant grey literature sources. Sources addressing frameworks for medical staffing and skill mix in hospital settings will be included. Two reviewers will independently screen sources and extract data, with disagreements resolved by a third reviewer. Findings will be summarized descriptively, with reported enablers and barriers mapped to the Capability, Opportunity, Motivation–Behaviour model. Conclusion This review will map frameworks which aim to guide medical staffing and skill mix decisions, including key components, implementation strategies, evaluation approaches and reported enablers and barriers. Post review completion, findings will be used to inform the co-design of a framework to guide medical staffing and skill mix decisions for hospital doctors in Ireland.