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Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations

Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital... Much of prior work in the area of service operations management has assumed service rates to be exogenous to the level of load on the system. Using operational data from patient transport services and cardiothoracic surgerytwo vastly different health-care delivery serviceswe show that the processing speed of service workers is influenced by the system load. We find that workers accelerate the service rate as load increases. In particular, a 10 increase in load reduces length of stay by two days for cardiothoracic surgery patients, whereas a 20 increase in the load for patient transporters reduces the transport time by 30 seconds. Moreover, we show that such acceleration may not be sustainable. Long periods of increased load (overwork) have the effect of decreasing the service rate. In cardiothoracic surgery, an increase in overwork by 1 increases length of stay by six hours. Consistent with prior studies in the medical literature, we also find that overwork is associated with a reduction in quality of care in cardiothoracic surgeryan increase in overwork by 10 is associated with an increase in likelihood of mortality by 2. We also find that load is associated with an early discharge of patients, which is in turn correlated with a small increase in mortality rate. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Management Science INFORMS

Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations

Management Science , Volume 55 (9): 13 – Sep 24, 2009
13 pages

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Publisher
INFORMS
Copyright
Copyright © INFORMS
Subject
Research Article
ISSN
0025-1909
eISSN
1526-5501
DOI
10.1287/mnsc.1090.1037
Publisher site
See Article on Publisher Site

Abstract

Much of prior work in the area of service operations management has assumed service rates to be exogenous to the level of load on the system. Using operational data from patient transport services and cardiothoracic surgerytwo vastly different health-care delivery serviceswe show that the processing speed of service workers is influenced by the system load. We find that workers accelerate the service rate as load increases. In particular, a 10 increase in load reduces length of stay by two days for cardiothoracic surgery patients, whereas a 20 increase in the load for patient transporters reduces the transport time by 30 seconds. Moreover, we show that such acceleration may not be sustainable. Long periods of increased load (overwork) have the effect of decreasing the service rate. In cardiothoracic surgery, an increase in overwork by 1 increases length of stay by six hours. Consistent with prior studies in the medical literature, we also find that overwork is associated with a reduction in quality of care in cardiothoracic surgeryan increase in overwork by 10 is associated with an increase in likelihood of mortality by 2. We also find that load is associated with an early discharge of patients, which is in turn correlated with a small increase in mortality rate.

Journal

Management ScienceINFORMS

Published: Sep 24, 2009

Keywords: Keywords : health-care operations ; productivity ; service operations ; optimal control of queues ; quality

References