One means of analysing job redesign in health care
and its impact, is through the concept of ‘skill-mix’.
Skill-mix is used variously to refer to the: mix of skills or
competencies possessed by an individual; ratio of senior
to junior grade staff within a single discipline; or mix of
different types of staff within a multidisciplinary team.
There are a number of different organisational processes
underpinning changes to these aspects of skill-mix.
Within a given service, skill-mix change may be
brought about through:
. enhancement – increasing the depth of a job by
extending the role or skills of a particular group of
workers,
. substitution – expanding the breadth of a job, in
particular by working across professional divides or
exchanging one type of worker for another,
. delegation – moving a task up or down a traditional
unidisciplinary ladder,
. innovation – creating new jobs by introducing a new
type of worker.
Changes in skill-mix may also be brought about by
changing the interface between services, including:
. transfer – moving the provision of a service from one
health care sector to another, e.g. substituting
community for hospital care,