Abstract
BACKGROUND: The growing complexity of hospital-at-home care highlights the pressing need for continuous professional development to enhance specialized skills. AIM: This study aimed to describe the future training and competency needs in hospital-at-home care from the perspective of healthcare administrators and managers. DESIGN: A mixed-method convergent design was used to integrate quantitative and qualitative data on similar topics simultaneously, providing a more comprehensive understanding of system-level competency requirements than either method alone. METHODS: The data were collected through a nationwide survey (n = 25) and interviews (n = 46), covering all wellbeing services counties in Finland in 2023. Descriptive statistics were used for quantitative data and inductive content analysis for qualitative data. RESULTS: Quantitative results indicate needs for additional training in RAI assessment (68%), mental health care (60%), substance abuse expertise (48%), and managing disruptive behaviors (44%). Qualitative findings highlight broader future competence needs, including digital health; cultural and linguistic competence; interprofessional collaboration; managerial competence; home-environment quality and safety; clinical competence; and autonomy in evidence-based practice. Overall, the mixed-method findings differ yet complement one another: quantitative data identify concrete skill gaps, while qualitative insights emphasize wider, system-level competencies to meet the evolving demands of home-based care. CONCLUSION: Taken together, these complementary findings indicate that advancing the workforce will require a dual approach: addressing concrete skill deficits while simultaneously developing the broader competencies needed to meet the evolving demands of home-based care. IMPLICATIONS FOR NURSING MANAGEMENT: This study informs the creation of structured competency frameworks, enabling nursing leaders to meet the evolving demands of home-based care.