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Workload balancing: staffing ratio analysis for primary care redesign

Author

Listed:
  • 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)

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.

Suggested Citation

  • Xiang Zhong & Hyo Kyung Lee & Molly Williams & Sally Kraft & Jeffery Sleeth & Richard Welnick & Lori Hauschild & Jingshan Li, 2018. "Workload balancing: staffing ratio analysis for primary care redesign," Flexible Services and Manufacturing Journal, Springer, vol. 30(1), pages 6-29, June.
    • Handle: RePEc:spr:flsman:v:30:y:2018:i:1:d:10.1007_s10696-016-9258-2
    DOI: 10.1007/s10696-016-9258-2
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    References listed on IDEAS

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    Cited by:

    1. Na Li & Xiaorui Li & Paul Forero, 2022. "Physician scheduling for outpatient department with nonhomogeneous patient arrival and priority queue," Flexible Services and Manufacturing Journal, Springer, vol. 34(4), pages 879-915, December.
    2. Jesús Isaac Vázquez-Serrano & Rodrigo E. Peimbert-García & Leopoldo Eduardo Cárdenas-Barrón, 2021. "Discrete-Event Simulation Modeling in Healthcare: A Comprehensive Review," IJERPH, MDPI, vol. 18(22), pages 1-20, November.
    3. Sujee Lee & Philip A. Bain & Albert J. Musa & Jingshan Li, 2021. "A Markov chain model for analysis of physician workflow in primary care clinics," Health Care Management Science, Springer, vol. 24(1), pages 72-91, March.

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