Workload balancing: staffing ratio analysis for primary care redesign

Xiang Zhong (), Hyo Kyung Lee (), Molly Williams (), Sally Kraft (), Jeffery Sleeth (), Richard Welnick (), Lori Hauschild () and Jingshan Li ()
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Xiang Zhong: University of Wisconsin - Madison
Hyo Kyung Lee: University of Wisconsin - Madison
Molly Williams: University of Wisconsin Medical Foundation
Sally Kraft: Dartmouth-Hitchcock
Jeffery Sleeth: University of Wisconsin Medical Foundation
Richard Welnick: University of Wisconsin Medical Foundation
Lori Hauschild: University of Wisconsin Medical Foundation
Jingshan Li: University of Wisconsin - Madison

Flexible Services and Manufacturing Journal, 2018, vol. 30, issue 1, No 2, 6-29

Abstract: Abstract The objective of this paper is to investigate the staffing composition of chief care providers (e.g., physician (MD)) and support staff (e.g., medical assistant (MA)) under various task assignment settings to achieve the optimal operational efficiency. Specifically, we examine the effects of workload shifting and identify the proper ratio of MDs to MAs to attain an effective and efficient service level. Based on a Markov chain based framework that characterizes care providers’ activities during patients’ primary care clinic visits, analytical investigation and numerical experiments are conducted. The results articulate that the optimal staffing ratio is achieved when the workloads of MDs and MAs are balanced. To validate the findings under generic primary care clinic settings, discrete event simulation models are developed and extensive experiments are carried out. The sensitivity study elucidates that the balanced-workload optimality is not affected by system variations in patient volume, as well as arrival and service time distributions.

Keywords: Staffing ratio; Primary care redesign; Analytical model; Discrete event simulation; Length of visit; Workload balance (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (3)

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DOI: 10.1007/s10696-016-9258-2

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