The Impact of Work Load on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations
Management Science, 2009
33 Pages Posted: 21 Apr 2011
Date Written: April 15, 2009
Much of prior work in the area of service operations management has assumed service rates to be exogenous to the level of load on the system. Using operational data from patient transport services and cardiothoracic surgery – two vastly different healthcare delivery services – we show that the processing speed of service workers is influenced by the system load. We find that workers accelerate the service rate as load increases. In particular, a 10% increase in load reduces length of stay by 2 days for cardiothoracic surgery patients, while a 20% increase in the load for patient transporters reduces the transport time by half a minute. Moreover, we show that such acceleration may not be sustainable. Long periods of increased load (overwork) have the effect of decreasing the service rate. In cardiothoracic surgery, an increase in overwork by 1% increases length of stay by 6 hours. Consistent with prior studies in the medical literature, we also find that overwork is associated with a reduction in quality of care in cardiothoracic surgery – an increase in overwork by 10% is associated with an increase in likelihood of mortality by 2%. We also find that load is associated with an early discharge of patients, which is in turn correlated with a small increase in mortality rate.
Keywords: healthcare operations, productivity, service operations, optimal control of queues, quality
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