The Cost of Task Switching: Evidence from Emergency Departments

41 Pages Posted: 11 Jan 2021 Last revised: 18 May 2023

See all articles by Yiwen Jin

Yiwen Jin

University of Calgary - Haskayne School of Business

Yige Duan

Shanghai Jiao Tong University (SJTU) - Antai College of Economics and Management; University of British Columbia (UBC) - Vancouver School of Economics

Yichuan Ding

Desautels Faculty of Management, McGill University

Mahesh Nagarajan

University of British Columbia (UBC) - Sauder School of Business

Garth Hunte

University of British Columbia (UBC) - Department of Emergency Medicine

Date Written: December 29, 2020

Abstract

Problem Definition: Emergency department (ED) physicians treat patients with different symptoms and constantly switch between tasks. Utilizing three years of comprehensive data on patient visits and lab tests from two large EDs, we investigate the impact of task switching on physician productivity, quality of care, and patient routing. We subsequently provide operational solutions based on the identification findings.

Methodology: To address estimation bias due to measurement errors and endogenous patient selection, we refine the sample period and construct an instrumental variable called switching likelihood, which exploits the exogenous composition of waiting patients. By exploring the heterogeneous impact on physician productivity among different patient type pairs from data, we leverage a max bisection algorithm to partition patients into two clusters to minimize the negative impact of task switching.

Results: Our estimates indicate that, at different EDs, a 10% increase in the switching frequency of physicians reduces the number of patients treated per hour by 8.65% - 11.53% on average. However, we find no significant influence on treatment quality. We propose a data-driven queue management method to optimally partition patients into two queues. Based on the simulation of implementing the proposed two-queue system in our collaborating EDs, we find that the average waiting time is reduced by up to 40%.

Managerial Implications: Task switching negatively impacts ED physician productivity, and this impact is more prominent for certain patient type pairs. Being aware of the switch cost, we propose measures to mitigate switch costs, which can considerably reduce ED congestion and patient waiting times.

Keywords: Task switching, emergency department, behavioral queueing, data-driven, queue management, empirical, max bisection, graph

Suggested Citation

Jin, Yiwen and Duan, Yige and Ding, Yichuan and Nagarajan, Mahesh and Hunte, Garth, The Cost of Task Switching: Evidence from Emergency Departments (December 29, 2020). Available at SSRN: https://ssrn.com/abstract=3756677 or http://dx.doi.org/10.2139/ssrn.3756677

Yiwen Jin (Contact Author)

University of Calgary - Haskayne School of Business ( email )

2500 University Drive, NW
Calgary, Alberta T2N 1N4
Canada

Yige Duan

Shanghai Jiao Tong University (SJTU) - Antai College of Economics and Management

1954 Huashan Road
Xuhui District
Shanghai, Shanghai 200030
China

University of British Columbia (UBC) - Vancouver School of Economics ( email )

997-1873 East Mall
Vancouver, British Columbia V6T 1Z1
Canada

Yichuan Ding

Desautels Faculty of Management, McGill University ( email )

1001 Sherbrook St W
Montreal, Quebec H3A 1G5
Canada
5143982482 (Phone)

HOME PAGE: http://https://www.mcgill.ca/desautels/yichuan-daniel-ding

Mahesh Nagarajan

University of British Columbia (UBC) - Sauder School of Business ( email )

2053 Main Mall
Vancouver, BC V6T 1Z2
Canada

Garth Hunte

University of British Columbia (UBC) - Department of Emergency Medicine ( email )

2329 West Mall
Vancouver, BC V6T 1Z4
Canada

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