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aach aava achieved Algiers alternative action paths Arne Thesen basic better quality complex concept costs currant decision tree defined Delivery Example Delphi dimension dynamic enhancing human dignity environment Esman Esman's establish evaluation Figure focus greater effectiveness Health Delivery iati IB process idea identified illustration implemented improvement individual enterprise Industrial Engineering information and control institution building process institutional development involved Job enrichment level purposes marking room measurement and scheduling measurement emphasis METHODS ENGINEERING needed nurse nurse shortage obtained operating organisation organization personnel Peter Delp phase problem productivity profit sharing programs PTR approach purpose hierarchy purposeful activity relationships role of MEWM selected situation society specific solutions standard strategy system models systems approach Systems tools target technical assistance TR approach University of Wisconsin-Madison utilization win-lose