The Cost of Task Switching: Evidence from Emergency Departments

38 Pages Posted: 11 Jan 2021 Last revised: 28 Jul 2021

See all articles by Yige Duan

Yige Duan

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

Yiwen Jin

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

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

Emergency department (ED) physicians treat patients with different symptoms and constantly switch between tasks. Using a comprehensive data set with over 650,000 patient visits to four EDs, we investigate the impact of task switching on physician productivity, quality of care, patient routing, and patient waiting time. To address estimation bias due to measurement errors and endogenous patient routing, we construct an instrumental variable that exploits the exogenous composition of waiting patients. Our estimates indicate that, at different EDs, switching between different types of patients increases the average pick-to-pick time by 3.4 to 16 percent or 0.8 to 3.1 minutes per patient, and reduces patient throughput rates accordingly. Task switching also affects how physicians route patients, although we find little impact on healthcare quality. Our counterfactual analysis further shows that eliminating the switch cost can reduce the average waiting time per patient by 25.3 to 48.3 percent and the average waiting census by 21.6 to 43.1 percent. To mitigate the switch cost, we suggest ED layout designs to facilitate patient sorting and communication between healthcare workers. Accounting for the switch cost in patient routing will also help.

Keywords: Task switching; emergency department, empirical healthcare management, discretionary task routing, queuing model

Suggested Citation

Duan, Yige and Jin, Yiwen 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

Yige Duan (Contact Author)

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

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

Yiwen Jin

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

2053 Main Mall
Vancouver, BC V6T 1Z2
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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