Bob Batt, University of Wisconsin School of Business
Bob Batt, University of Wisconsin School of Business
The Effects of Discrete Work Shifts on a Nonterminating Service System
The Effects of Discrete Work Shifts on a Nonterminating Service System
Hospital emergency departments (EDs) provide around-the-clock medical care and as such are generally modeled as nonterminating queues. However, from the care provider’s point of view, ED care is not a never-ending process, but rather occurs in discrete work shifts and may require passing unfinished work to the next care provider at the end of the shift. We use data from a large, academic medical center ED to show that the patient hazard rate of service completion varies over the course of the shift, and as a result, a patient’s expected treatment time is impacted by when in the doctor’s shift treatment begins. We also show that treatment time increases with self-multitasking (the number of patients currently in process with the focal physician), but decreases with co-worker multitasking (the number of patients currently in process with all other physicians). The magnitude of the self-multitasking effect is much larger. Lastly, we show that while treatment time is unaffected by an end-of-shift handoff, patients that have been handed off are more likely to revisit the ED within 9 days, suggesting that patient handoffs lower clinical quality.