Can Employees' Past Helping Behavior Be Used to Improve Shift Scheduling? Evidence from ICU Nurses

Abstract

Employees routinely make valuable contributions at work that are not part of their formal job description, such as helping a struggling coworker. These contributions, termed organizational citizenship behavior (OCB), have been studied from many angles in the organizational behavior literature. However, the degree to which the past helping behavior of employees scheduled to a shift impacts that shift's operational outcomes remains an under-explored question. We define two measures of past helping behavior for members of a shift --- the total past helping of each employee and the past helping between each pair of employees --- and hypothesize that they are associated with shift performance. We empirically confirm our hypotheses with detailed scheduling and patient outcome data from six ICUs at a large academic medical center, using the hospital's electronic medical records to identify cases of one nurse helping another. Our empirical results indicate that both measures of past helping are predictive of patient length of stay (LOS), more so than the broadly studied notion of team familiarity. Counterfactual analysis shows that relatively small changes in shift composition can yield significant reduction in total LOS, indicating the managerial significance of the results. Overall, our study suggests the potential value of shift scheduling using data on past helping behaviors, which may have promise far beyond the selected application to ICU nursing.

Keywords: Nurse scheduling, organizational citizenship behavior, hospital operations, empirical operations