Staffing Teams in the Emergency Department: Understanding the Effects of Team Familiarity and Partner Variety
43 Pages Posted: 22 May 2018 Last revised: 8 Dec 2019
Date Written: December 6, 2019
Problem Definition: In the emergency department (ED), temporary teams of physicians and nurses work together to deliver patient care. We examine how team familiarity and partner variety affect the performance of ED teams and whether the effects vary depending on the length of the lookback window used to calculate each of these measures.
Academic/Practical Relevance: We contribute to the literature on team performance by furthering the understanding around how team familiarity and partner variety affect the performance of temporary and cross-disciplinary teams in complex service settings. We also consider how the length of the lookback window impacts these estimations, which has not been done previously.
Methodology: Using visit-level ED data, we estimate the effects of team familiarity and partner variety in physician-nurse teams on the patient’s time to disposition and likelihood of revisit within 48 hours. We leverage the ad hoc team assignment and the round-robin assignment of patients to these teams as our identification strategy. To measure team familiarity and partner variety, we allow the length of the lookback window to vary from one week to 12 months.
Results: Higher levels of team familiarity improves performance, and the magnitude of this effect increases as the lookback window increases. Higher levels of partner variety for nurses hurts performance, and the magnitude of this effect also increases as the lookback window increases. The level of partner variety for physicians generally does not have a measurable impact on performance.
Managerial Implications: ED managers should staff physician-nurse teams to maximize team familiarity and minimize nurse partner variety, each of which should be measured using a relatively long lookback window. Using simulations, we illustrate that doing so would allow the study ED to treat 7.26 percent more patients without increasing staffing levels.
Keywords: teams, team staffing, team familiarity, partner variety, emergency department, health care, empirical operations
Suggested Citation: Suggested Citation