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Workload balancing: staffing ratio analysis for primary care redesign

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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.

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Authors and Affiliations

  1. Department of Industrial and Systems Engineering, University of Wisconsin - Madison, 1513 University Avenue, Madison, WI, 53706, USA

    Xiang Zhong, Hyo Kyung Lee & Jingshan Li

  2. Dartmouth-Hitchcock, Hanover, NH, 03755, USA

    Sally Kraft

  3. University of Wisconsin Medical Foundation, Middleton, WI, 53562, USA

    Molly Williams, Jeffery Sleeth, Richard Welnick & Lori Hauschild

Authors
  1. Xiang Zhong
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  2. Hyo Kyung Lee
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  3. Molly Williams
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  4. Sally Kraft
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  5. Jeffery Sleeth
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  6. Richard Welnick
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  7. Lori Hauschild
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  8. Jingshan Li
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Corresponding author

Correspondence to Jingshan Li.

Additional information

This work is supported in part by National Science Foundation Grant Nos. CMMI-1233807 and CMMI-1536987.

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Zhong, X., Lee, H.K., Williams, M. et al. Workload balancing: staffing ratio analysis for primary care redesign. Flex Serv Manuf J 30, 6–29 (2018). https://doi.org/10.1007/s10696-016-9258-2

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  • DOI: https://doi.org/10.1007/s10696-016-9258-2

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