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A Systems Approach

Archie S. Golden, MD; Henry Seidel, MD

JAMA. 1978;240(18):1969-1972.

Abstract
A systems analysis approach was applied to a study of health provider jobs in a health maintenance organization to develop a proposal for an improved staffing pattern and an appropriate training curriculum for the provider. Physicians reported performing 512 ambulatory care tasks; health associates, 372; and health assistants, 284. Overlap was found among each group, especially in data-gathering tasks. This led to reallocation of tasks, with the most complex but smallest number assigned to the physician, and the least complex but highest number assigned to the assistant. In turn, a staffing pattern was suggested whereby a team of two physicians, four associates, and eight assistants would be able to manage the visits of 10,000 patients.

(JAMA 240:1969-1972, 1978)

Author Affiliations
From the Johns Hopkins University School of Health Services and School of Medicine, Baltimore.

Footnotes
Reprint requests to the Johns Hopkins University School of Health Services, Hampton House, 624 N Broadway, Baltimore, MD 21205 (Dr Golden).

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