A Linear Goal Programming Model for Human Resource Allocation in a Health-Care Organization
Journal of Medical Systems
The Impact of Discharge Decisions on Health Care Quality
Management Science
Modeling and worker motivation in JIT production systems
Management Science
The Effects of Low Inventory on the Development of Productivity Norms
Management Science
Dynamic Programming and Optimal Control
Dynamic Programming and Optimal Control
Dynamic Control of a Queue with Adjustable Service Rate
Operations Research
Outcomes-Adjusted Reimbursement in a Health-Care Delivery System
Management Science
Throughput in Serial Lines with State-Dependent Behavior
Management Science
Managing Patient Service in a Diagnostic Medical Facility
Operations Research
The Labor Illusion: How Operational Transparency Increases Perceived Value
Management Science
Manufacturing & Service Operations Management
The Effects of Focus on Performance: Evidence from California Hospitals
Management Science
An Econometric Analysis of Patient Flows in the Cardiac Intensive Care Unit
Manufacturing & Service Operations Management
Manufacturing & Service Operations Management
Computer Supported Cooperative Work
OM Forum---The Vital Role of Operations Analysis in Improving Healthcare Delivery
Manufacturing & Service Operations Management
Manufacturing & Service Operations Management
Manufacturing & Service Operations Management
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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 surgery---two vastly different health-care delivery services---we 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 surgery---an 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.