Discretionary Task Ordering: Queue Management in Radiological Services

Maria  Ibanez; Jonathan R. Clark; Robert S. Huckman; Bradley R. Staats

Article | Management Science | September 2018

Discretionary Task Ordering: Queue Management in Radiological Services

by Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats

Abstract

Work-scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks (batching) and those tasks they expect to complete faster (shortest expected processing time). Moreover, they exercise more discretion as they accumulate experience. Exploiting random assignment of tasks to doctors’ queues, instrumental variable models reveal that these deviations erode productivity. This productivity decline lessens as doctors learn from experience. Prioritizing the shortest tasks is particularly detrimental to productivity. Actively grouping similar tasks also reduces productivity, in stark contrast to productivity gains from exogenous grouping, indicating deviation costs outweigh benefits from repetition. By analyzing task completion times, our work highlights the tradeoffs between the time required to exercise discretion and the potential gains from doing so, which has implications for how discretion over scheduling should be delegated.

Keywords: discretion; scheduling; queue; healthcare; learning; experience; Decentralization; operations; service operations; service delivery; Performance; Performance Effectiveness; Performance Efficiency; Performance improvement; Performance Productivity; Decisions; time management; Cost vs Benefits; Health Industry; Operations; Service Operations; Service Delivery; Performance; Performance Effectiveness; Performance Efficiency; Performance Improvement; Performance Productivity; Decisions; Time Management; Cost vs Benefits; Health Industry;

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Citation:

Ibanez, Maria, Jonathan R. Clark, Robert S. Huckman, and Bradley R. Staats. "Discretionary Task Ordering: Queue Management in Radiological Services." Management Science 64, no. 9 (September 2018): 4389–4407. (Working paper available here. Winner of the 2017 Best Paper Competition of the POMS College of Healthcare Operations Management. Featured in Forbes, Quartz, and Inc.)

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Discretionary Task Ordering: Queue Management in Radiological Services

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