Doctoral Student

Jillian Berry Jaeker

Jillian Berry Jaeker is a doctoral candidate in the Technology and Operations Management unit with a focus on healthcare operations. Her work centers on resource utilization in hospitals and its effects on operational efficiency and quality of care. Specifically, she explores how state-specific factors, such as workload and resource availability affect productivity and patient outcomes in hospitals. 

Jillian Berry Jaeker is a doctoral candidate in the Technology and Operations Management unit with a focus on healthcare operations. Her work centers on resource utilization in hospitals and its effects on operational efficiency and quality of care. Specifically, she explores how state-specific factors, such as workload and resource availability affect productivity and patient outcomes in hospitals. 

Prior to entering HBS, Jillian graduated from the Massachusetts Institute of Technology in 2008 with a Bachelor of Science in Management (concentration Finance). During that period she interned in a tissue engineering laboratory at Brigham and Women’s Hospital where she worked with adult stem cells to produce new bone tissue in vitro. She interned at the MIT Investment Management Company and was an editor for the MIT Tech.

Working Papers

  1. Increased Speed Equals Increased Wait: The Impact of a Reduction in Emergency Department Ultrasound Order Processing Time

    We exploit an exogenous process change at two emergency departments (EDs) within a health system to test the theory that increasing capacity in a discretionary work setting increases wait times due to additional services being provided to customers as a consequence of reduced marginal costs for a task. We find that an increase in physicians' capacity for ordering ultrasounds (U/S) resulted in an 11.5 percentage point increase in the probability of an U/S being ordered, confirming that resource availability induces demand. Furthermore, we find that the additional U/S demand increased the time to return other radiological tests due to the higher demand placed on radiologists from the additional U/S. Consequently, the average length of stay (LOS) for patients with an abdominal complaint increased by nearly 30 minutes, and the waiting time to enter the ED increased by 26 minutes. We do not find any indications of improved performance on clinical metrics, with no statistical change in the number of admissions to the hospital or readmissions to the ED within 72 hours. Our study highlights an important lesson for process improvement in interdependent service settings: increasing process capacity at one step in the process can increase demand at that step, as well as for a subsequent shared service, and both can result in an overall negative impact on performance.

    Keywords: Technology; Demand and Consumers; Service Delivery; Health Care and Treatment; Business Processes; Health Industry;

    Citation:

    Berry Jaeker, Jillian, Anita L. Tucker, and Michael H. Lee. "Increased Speed Equals Increased Wait: The Impact of a Reduction in Emergency Department Ultrasound Order Processing Time." Harvard Business School Working Paper, No. 14-033, October 2013.
  2. An Empirical Study of the Spillover Effects of Workload on Patient Length of Stay

    We use two years of inpatient data from 243 California hospitals to quantify the relationship between hospital-level workload and patient length of stay (LOS), and its "spillover" effects across patient types. Patients are categorized as medical or surgical, and the effects of same type patient workload (occupancy) on LOS are analyzed. The analysis is repeated with workload replaced by other type patient occupancy, providing a "spillover" effect. We find that the effects of inpatient workload on LOS spillover across patient types, which we theorize results from most inpatients, regardless of type, utilizing the same shared resources (e.g. pharmacy and laboratory). These spillover effects remain even while we find that the effects of workload vary at different time points during a patient's stay: LOS increases as inpatient workload on the day of admission increases, while inpatient workload at the end of the stay has a U-shaped effect on LOS.

    Keywords: Workload; Processing times; healthcare; Working Conditions; Performance Productivity; Time Management; Health Care and Treatment; Health Industry; California;

    Citation:

    Berry Jaeker, Jillian, and Anita Tucker. "An Empirical Study of the Spillover Effects of Workload on Patient Length of Stay." Harvard Business School Working Paper, No. 13-052, December 2012. (Revised July 2013.)

Cases and Teaching Materials

  1. Patient Flow at Brigham and Women's Hospital (B)

    The B Case is an email from the ED Director. He clarifies where the process deviations occurred.

    Keywords: Change Management; Health Care and Treatment; Service Operations; Business Processes; Performance Productivity; Conflict and Resolution; Health Industry; Massachusetts;

    Citation:

    Tucker, Anita L., and Jillian Alexandra Berry. "Patient Flow at Brigham and Women's Hospital (B)." Harvard Business School Supplement 608-172, June 2008. (Revised November 2010.)
  2. Patient Flow at Brigham and Women's Hospital (A)

    Brigham and Women's Hospital challenged a team of physicians to improve patient flow from the Emergency Department to Intensive Care Units (ICUs). One of the team members, Selwyn Rogers, Director of the Surgical Intensive Care Unit (SICU) at Brigham and Women's Hospital, encountered workarounds by two physicians attempting to transfer their patients to the SICU because the other ICUs were full. Reflecting on the wasted effort and confusion caused by the workarounds, Rogers sent an email outlining the situation to the team. His email generated a negative backlash and chain of defensive emails from involved staff who felt criticized.

    Keywords: Change Management; Health Care and Treatment; Service Operations; Business Processes; Performance Productivity; Conflict and Resolution; Health Industry; Massachusetts;

    Citation:

    Tucker, Anita L., and Jillian Alexandra Berry. "Patient Flow at Brigham and Women's Hospital (A)." Harvard Business School Case 608-171, June 2008. (Revised October 2010.)

Other Publications and Materials

  1. Variation in the Effects of Workload Across Hospitals

    Citation:

    Berry, Jillian Alexandra. "Variation in the Effects of Workload Across Hospitals." 2013. (In Progress.)
  2. Differential Effects of Emergent and Scheduled Incoming Surgical Patients

    Citation:

    Berry, Jillian Alexandra. "Differential Effects of Emergent and Scheduled Incoming Surgical Patients." 2013. (In Progress.)