IDEAS home Printed from https://ideas.repec.org/a/inm/oropre/v71y2023i3p939-957.html
   My bibliography  Save this article

To Batch or Not to Batch? Impact of Admission Batching on Emergency Department Boarding Time and Physician Productivity

Author

Listed:
  • Arshya Feizi

    (Harvard Kennedy School, Harvard University, Cambridge, Massachusetts 02138)

  • Anita Carson

    (Questrom School of Business, Boston University, Boston, Massachusetts 02215)

  • Jillian Berry Jaeker

    (Takeda Pharmaceuticals, Cambridge, Massachusetts 02142)

  • William Evan Baker

    (University of Vermont Medical Center, Burlington, Vermont 05401)

Abstract

We study the behavior of batching by discretionary workers in the first stage of a two-stage queuing system and explore the trade-off it causes between their productivity and second stage wait times. Specifically, we focus on the behavior of batching admissions by emergency department (ED) physicians. Using data from a large hospital, we show that the probability of batching admissions is increasing in the hour of an ED physician’s shift, and that batched patients experience a 4.7% longer delay from hospital admission to receiving an inpatient bed. Using a mediation analysis, we show that this effect is partially due to the increase in the coefficient of variation of inpatient bed requests caused by batching. However, we also find that batching admissions is associated with an average of 10.0% more patients seen in a shift, and a 2.6 minute reduction in a physician’s average throughput time. An important implication of our work is that workers may induce delays in downstream stages, caused by practices that increase their productivity.

Suggested Citation

  • Arshya Feizi & Anita Carson & Jillian Berry Jaeker & William Evan Baker, 2023. "To Batch or Not to Batch? Impact of Admission Batching on Emergency Department Boarding Time and Physician Productivity," Operations Research, INFORMS, vol. 71(3), pages 939-957, May.
    • Handle: RePEc:inm:oropre:v:71:y:2023:i:3:p:939-957
    DOI: 10.1287/opre.2022.2335
    as

    Download full text from publisher

    File URL: http://dx.doi.org/10.1287/opre.2022.2335
    Download Restriction: no
    File URL: https://libkey.io/10.1287/opre.2022.2335?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:inm:oropre:v:71:y:2023:i:3:p:939-957. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Chris Asher (email available below). General contact details of provider: https://edirc.repec.org/data/inforea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.