Table 73.1A Taxonomy of Changes in Skill Mix in Health Care

Changing roles
EnhancementIncreasing the depth of a job by extending the role or skills of a particular group of workers
SubstitutionExpanding the breadth of a job, in particular by working across professional divides or exchanging one type of worker for another
DelegationMoving a task down a traditional unidisciplinary ladder
InnovationCreating new jobs by introducing a new type of worker
Changing the interface between services
TransferMoving the provision of a service from one health care setting to another (for example, substituting community for hospital care)
RelocationShifting the venue from which a service is provided from one health care sector to another without changing the people who provide it (for example, running a hospital clinic in a primary care facility)
LiaisonUsing specialists in one health care sector to educate and support staff members working in another (for example, hospital outreach facilitators in primary care)

From: Chapter 73, Strategic Management of Clinical Services

Cover of Disease Control Priorities in Developing Countries
Disease Control Priorities in Developing Countries. 2nd edition.
Jamison DT, Breman JG, Measham AR, et al., editors.
Washington (DC): World Bank; 2006.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.

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