Are we under-utilizing the talents of primary care personnel? A job analytic examination

BACKGROUND: Primary care staffing decisions are often made unsystematically, potentially leading to increased costs, dissatisfaction, turnover, and reduced quality of care. This article aims to (1) catalogue the domain of primary care tasks, (2) explore the complexity associated with these tasks, and (3) examine how tasks performed by different job titles differ in function and complexity, using Functional Job Analysis to develop a new tool for making evidence-based staffing decisions. METHODS: Seventy-seven primary care personnel from six US Department of Veterans Affairs (VA) Medical Centers, representing six job titles, participated in two-day focus groups to generate 243 unique task statements describing the content of VA primary care. Certified job analysts rated tasks on ten dimensions representing task complexity, skills, autonomy, and error consequence. Two hundred and twenty-four primary care personnel from the same clinics then completed a survey indicating whether they performed each task. Tasks were catalogued using an adaptation of an existing classification scheme; complexity differences were tested via analysis of variance. RESULTS: Objective one: Task statements were categorized into four functions: service delivery (65%), administrative duties (15%), logistic support (9%), and workforce management (11%). Objective two: Consistent with expectations, 80% of tasks received ratings at or below the mid-scale value on all ten scales. Objective three: Service delivery and workforce management tasks received higher ratings on eight of ten scales (multiple functional complexity dimensions, autonomy, human error consequence) than administrative and logistic support tasks. Similarly, tasks performed by more highly trained job titles received higher ratings on six of ten scales than tasks performed by lower trained job titles. Contrary to expectations, the distribution of tasks across functions did not significantly vary by job title. CONCLUSION: Primary care personnel are not being utilized to the extent of their training; most personnel perform many tasks that could reasonably be performed by personnel with less training. Primary care clinics should use evidence-based information to optimize job-person fit, adjusting clinic staff mix and allocation of work across staff to enhance efficiency and effectiveness

Carelessness and discriminability in work role requirement judgments: Influences of role ambiguity and cognitive complexity

Fundamental to effective human resource systems is the capture of data regarding work role requirements. However, previous research on factors that influence work role requirement judgments has been largely equivocal. From a sample of 203 incumbents, representing 73 unique occupations, we investigated 2 cognitive sources of influence on carelessness and discriminability in work role requirement judgments. We hypothesized that incumbents perceiving high role ambiguity would provide ratings that were more careless and showed less discriminability, and cognitively complex individuals would provide more careful and discriminating ratings. These influences were hypothesized to vary across different work descriptors and rating scales. Results were supportive, showing effects for cognitive complexity and role ambiguity on ratings, and differential effects depending on the focal descriptor and scale

Work-life balance and gender: challenging assumptions and unravelling complexity

This chapter critically examines the role of gender in work-life balance research. We contextualise the focal topic by first summarising the changing nature of work and domestic roles and the influence of demographic and social shifts. We revisit the meaning of ‘work-life balance’ in light of the diverse and sometimes conflicting conceptualisations used by academics and practitioners. A review of the evidence for gender differences in work-life balance needs and experiences is then provided, with a particular focus placed on caring responsibilities. This leads us to consider the policies and practices that are designed to support work-life balance initiatives are then considered, focusing specifically on flexible working, together with the extent to which these are ‘gender neutral’ both in terms of relevance and uptake. The paper is interspersed with relevant case studies to illustrate the points made. The chapter concludes by setting out priorities for research and practice to promote equitable and effective systemic solutions to improve work-life balance for all