| HBS Working Paper Series
The Diseconomies of Queue Pooling in a Discretionary Task Setting: An Empirical Investigation of Emergency Department Length of Stay
We conduct an empirical investigation of the impact of queue pooling on throughput times in a discretionary task completion setting. Using an Emergency Department's (ED) patient-level data (N = 233,781) from 2007 to 2010, we find that patients' lengths of stay (LOS) were longer when physicians were assigned patients from a pooled queue, compared to when each physician had a dedicated queue. Dedicated queues resulted in a 7 percent decrease in LOS—a 23-minute reduction in LOS for an average patient of medium severity in this ED. We conduct additional analyses that preclude decreased quality as an explanation for the shorter LOS. Instead, consistent with social loafing theory, we propose that dedicated queues provide physicians better visibility into their workload than pooled queues, enabling them to more effectively manage their work. Our paper has implications for health care organizations and others seeking to reduce throughput time, resource utilization, and costs.
discretionary task completion;
Health Care and Treatment;