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

Arshya Feizi (), Anita Carson (), Jillian Berry Jaeker () and William Evan Baker ()
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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

Operations Research, 2023, vol. 71, issue 3, 939-957

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.

Keywords: Special Issue on Behavioral Queueing Science; emergency department; batching; boarding; productivity; healthcare operations; behavior; empirical; queuing (search for similar items in EconPapers)
Date: 2023
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Citations: View citations in EconPapers (1)

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Persistent link: https://EconPapers.repec.org/RePEc:inm:oropre:v:71:y:2023:i:3:p:939-957

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