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

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 di¤erent healthcare delivery services we show that the processing speed of service workers is in‡uenced by the system load. We …nd that workers accelerate the service rate as load increases. In particular, a 10% increase in load reduces length of stay by 2 days for cardiothoracic surgery patients, while a 20% increase in the load for patient transporters reduces the transport time by half a minute. Moreover, we show that such acceleration may not be sustainable. Long periods of increased load (overwork) have the e¤ect of decreasing the service rate. In cardiothoracic surgery, an increase in overwork by 1% increases length of stay by 6 hours. Consistent with prior studies in the medical literature, we also …nd 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 …nd that load is associated with an early discharge of patients, which is in turn correlated with a small increase in mortality rate. We are grateful to the cardiac anesthesiologists and executives at the teaching hospital where this study was conducted. We also thank the Management Science review team as well as Stefanos Zenios, Chris Lee, and Marcelo Olivares for their insightful and constructive comments on an earlier version of this paper. The authors can be reached at [email protected] and [email protected].