DID: a direct measure of delegation

The DID measures the degree of delegation existing in a dental practice at a given time. Its four elements are: 1) the delegable tasks, 2) the personnel involved, 3) the task frequency, and 4) the task time. The formula yields the ratio of the Maximum State of Delegation to the Actual State of Delegation or, in other words, the theoretical potential for delegation divided by the observed state of actual delegation. Both are expressed in cost-related terms based upon the relative costs of the personnel in the practice. The DID has merit as a diagnostic tool to aid the practitioner in assessing his/her staff use. For example, a low DID might indicate an overqualified staff for his/her patient load, or underutilization of auxiliaries. The DID can also be used to compare levels of delegation between several practices at a given point in time. Such an application was made for 17 Washington private practices. In using the DID, it was found that delegation levels varied among the 17 practices; however, on the average the degree of delegation approached only one third of the maximum allowed under law. The DID, in its direct approach to task delegation, is a concept that can be applied to dental practices and, with appropriate adaptation, to other health care settings as well. All the influences on the DID and delegation, however are not fully understood and further study is warranted.