Familiarity, Load, and Patient Pick-Up: The Positive and Negative Effects of Group Composition on Physician Behavior in the Emergency Department

33 Pages Posted: 29 Jun 2020

See all articles by RJ Niewoehner

RJ Niewoehner

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School

Diwas Singh KC

Emory University - Goizueta Business School

Bradley R. Staats

University of North Carolina Kenan-Flagler Business School

Date Written: June 1, 2020

Abstract

The staffing of parallel servers in a queue has interested operations researchers for decades, resulting in countless mathematical models studying queuing behavior. But to achieve tractability, these models typically assume the service rate and productivity of individual servers is independent of other servers and the status of the system. We question this assumption and consider whether inter-server dependence impacts queue performance, specifically through server task selection. Allowing discretion in task pick-up violates the independent-server assumption, but modelling this discretion becomes feasible with an improved understanding of the system. To this end, we evaluate the impact of worker familiarity on system-level outcomes. Using a year of data from multiple hospital emergency departments, we find greater average familiarity between physicians leads to greater patient pick-up likelihood, lower waiting room census and shorter patient wait times, particularly for severe patients. We also find dispersion in familiarity leads to a reduced patient pick-up likelihood and greater waiting room census with no impact on patient wait times. Furthermore, both effects vary with workload, a common catalyst for further violations of the independent server assumption. We discuss the implications of our work for queuing system managers and healthcare operations, in general.

Keywords: Parallel Servers, Task Assignment, Productivity, Familiarity, Emergency Department

Suggested Citation

Niewoehner, Robert J. and KC, Diwas Singh and Staats, Bradley R., Familiarity, Load, and Patient Pick-Up: The Positive and Negative Effects of Group Composition on Physician Behavior in the Emergency Department (June 1, 2020). Available at SSRN: https://ssrn.com/abstract=3618730 or http://dx.doi.org/10.2139/ssrn.3618730

Robert J. Niewoehner (Contact Author)

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School ( email )

McColl Building
Chapel Hill, NC 27599-3490
United States

Diwas Singh KC

Emory University - Goizueta Business School ( email )

1300 Clifton Road
Atlanta, GA 30322-2722
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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