Discretionary Task Ordering: Queue Management in Radiological Services

34 Pages Posted: 23 Oct 2015 Last revised: 12 Apr 2017

See all articles by Maria Ibanez

Maria Ibanez

Harvard Business School

Jonathan Clark

University of Texas at San Antonio

Robert S. Huckman

Harvard Business School; National Bureau of Economic Research (NBER)

Bradley R. Staats

University of North Carolina Kenan-Flagler Business School

Date Written: March 1, 2017

Abstract

Work scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks (batching) and those tasks they expect to complete faster (shortest expected processing time). Moreover, they exercise more discretion as they accumulate experience. Exploiting random assignment of tasks to doctors’ queues, instrumental variable models reveal that these deviations erode productivity. This productivity decline lessens as doctors learn from experience. Prioritizing the shortest tasks is particularly detrimental to productivity. Actively grouping similar tasks also reduces productivity, in stark contrast to productivity gains from exogenous grouping, indicating deviation costs outweigh benefits from repetition. By analyzing task completion times, our work highlights the tradeoffs between the time required to exercise discretion and the potential gains from doing so, which has implications for how discretion over scheduling should be delegated.

Keywords: discretion, scheduling, queue, healthcare, learning, experience, decentralization, delegation, behavioral operations

Suggested Citation

Ibanez, Maria and Clark, Jonathan and Huckman, Robert S. and Staats, Bradley R., Discretionary Task Ordering: Queue Management in Radiological Services (March 1, 2017). Harvard Business School Technology & Operations Mgt. Unit Working Paper No. 16-051. Available at SSRN: https://ssrn.com/abstract=2677200 or http://dx.doi.org/10.2139/ssrn.2677200

Maria Ibanez (Contact Author)

Harvard Business School ( email )

Soldiers Field Road
Morgan 270C
Boston, MA 02163
United States

Jonathan Clark

University of Texas at San Antonio ( email )

One UTSA Circle
San Antonio, TX 78249
United States

Robert S. Huckman

Harvard Business School ( email )

Technology & Operations Management
435 Morgan Hall
Boston, MA 02163
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Bradley R. Staats

University of North Carolina Kenan-Flagler Business School ( email )

McColl Building, CB#3490
Chapel Hill, NC 27599
United States

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