IDEAS home Printed from https://ideas.repec.org/a/spr/flsman/v33y2021i3d10.1007_s10696-020-09388-2.html
   My bibliography  Save this article

Improving emergency department performance by revising the patient–physician assignment process

Author

Listed:
  • Lien Vanbrabant

    (UHasselt
    Research Foundation Flanders (FWO))

  • Kris Braekers

    (UHasselt)

  • Katrien Ramaekers

    (UHasselt)

Abstract

Emergency departments (EDs) are continuously exploring opportunities to improve their efficiency. A new opportunity lies in revising the patient–physician assignment process by limiting the number of patients simultaneously assigned to a single physician, which is defined as the application of a case manager approach with limited caseloads. The potential of introducing a case manager approach with limited caseloads as a way to improve physician productivity, and consequently ED performance, is investigated by use of a discrete-event simulation model based on a real-life case study. In addition, as the case manager system is characterised by three parameters that can be customised and optimised (i.e. caseload limit, pre-assignment queueing discipline and internal queueing discipline), the impact of these parameters on the effectiveness to improve ED performance in terms of length-of-stay and door-to-doctor time is evaluated. To the best of our knowledge, this paper is the first to examine the potential of a case manager system with limited caseloads in a complex service system like a real-life ED, and to investigate the impact of the three system parameters on the results. The outcomes of the study show that performance can be improved significantly by introducing a case manager system, and that the system parameters have an impact on the effect size.

Suggested Citation

  • Lien Vanbrabant & Kris Braekers & Katrien Ramaekers, 2021. "Improving emergency department performance by revising the patient–physician assignment process," Flexible Services and Manufacturing Journal, Springer, vol. 33(3), pages 783-845, September.
    • Handle: RePEc:spr:flsman:v:33:y:2021:i:3:d:10.1007_s10696-020-09388-2
    DOI: 10.1007/s10696-020-09388-2
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10696-020-09388-2
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10696-020-09388-2?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Tom Fangyun Tan & Serguei Netessine, 2014. "When Does the Devil Make Work? An Empirical Study of the Impact of Workload on Worker Productivity," Management Science, INFORMS, vol. 60(6), pages 1574-1593, June.
    2. Gregory Dobson & Tolga Tezcan & Vera Tilson, 2013. "Optimal Workflow Decisions for Investigators in Systems with Interruptions," Management Science, INFORMS, vol. 59(5), pages 1125-1141, May.
    3. Sinan Aral & Erik Brynjolfsson & Marshall Van Alstyne, 2012. "Information, Technology, and Information Worker Productivity," Information Systems Research, INFORMS, vol. 23(3-part-2), pages 849-867, September.
    4. Li, Na & Stanford, David A. & Sharif, Azaz B. & Caron, Richard J. & Pardhan, Alim, 2019. "Optimising key performance indicator adherence with application to emergency department congestion," European Journal of Operational Research, Elsevier, vol. 272(1), pages 313-323.
    5. Abo-Hamad, Waleed & Arisha, Amr, 2013. "Simulation-based framework to improve patient experience in an emergency department," European Journal of Operational Research, Elsevier, vol. 224(1), pages 154-166.
    6. Fernanda Campello & Armann Ingolfsson & Robert A. Shumsky, 2017. "Queueing Models of Case Managers," Management Science, INFORMS, vol. 63(3), pages 882-900, March.
    7. Diwas S. Kc & Christian Terwiesch, 2009. "Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations," Management Science, INFORMS, vol. 55(9), pages 1486-1498, September.
    8. Li, Na & Stanford, David A., 2016. "Multi-server accumulating priority queues with heterogeneous servers," European Journal of Operational Research, Elsevier, vol. 252(3), pages 866-878.
    9. Soroush Saghafian & Wallace J. Hopp & Mark P. Van Oyen & Jeffrey S. Desmond & Steven L. Kronick, 2012. "Patient Streaming as a Mechanism for Improving Responsiveness in Emergency Departments," Operations Research, INFORMS, vol. 60(5), pages 1080-1097, October.
    10. Diwas Singh KC, 2014. "Does Multitasking Improve Performance? Evidence from the Emergency Department," Manufacturing & Service Operations Management, INFORMS, vol. 16(2), pages 168-183, May.
    11. Yong-Hong Kuo & Omar Rado & Benedetta Lupia & Janny M. Y. Leung & Colin A. Graham, 2016. "Improving the efficiency of a hospital emergency department: a simulation study with indirectly imputed service-time distributions," Flexible Services and Manufacturing Journal, Springer, vol. 28(1), pages 120-147, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Delasay, Mohammad & Ingolfsson, Armann & Kolfal, Bora & Schultz, Kenneth, 2019. "Load effect on service times," European Journal of Operational Research, Elsevier, vol. 279(3), pages 673-686.
    2. Robert L. Bray & Decio Coviello & Andrea Ichino & Nicola Persico, 2016. "Multitasking, Multiarmed Bandits, and the Italian Judiciary," Manufacturing & Service Operations Management, INFORMS, vol. 18(4), pages 545-558, October.
    3. Lamar Pierce & Daniel C. Snow & Andrew McAfee, 2015. "Cleaning House: The Impact of Information Technology Monitoring on Employee Theft and Productivity," Management Science, INFORMS, vol. 61(10), pages 2299-2319, October.
    4. Michael Freeman & Susan Robinson & Stefan Scholtes, 2021. "Gatekeeping, Fast and Slow: An Empirical Study of Referral Errors in the Emergency Department," Management Science, INFORMS, vol. 67(7), pages 4209-4232, July.
    5. Elena Andreyeva & Guy David & Hummy Song, 2018. "The Effects of Home Health Visit Length on Hospital Readmission," NBER Working Papers 24566, National Bureau of Economic Research, Inc.
    6. Hailong Cui & Sampath Rajagopalan & Amy R. Ward, 2021. "Impact of Task-Level Worker Specialization, Workload, and Product Personalization on Consumer Returns," Manufacturing & Service Operations Management, INFORMS, vol. 23(2), pages 346-366, March.
    7. Yuqian Xu & Tom Fangyun Tan & Serguei Netessine, 2022. "The Impact of Workload on Operational Risk: Evidence from a Commercial Bank," Management Science, INFORMS, vol. 68(4), pages 2668-2693, April.
    8. Choi, Yunsik & Delise, Lisa A. & Lee, Brandon W. & Neely, Jerry, 2021. "Effective staffing of projects for reconciling conflict between cost efficiency and quality," International Journal of Production Economics, Elsevier, vol. 234(C).
    9. Anatoli Colicev & Tuuli Hakkarainen & Torben Pedersen, 2023. "Multi‐project work and project performance: Friends or foes?," Strategic Management Journal, Wiley Blackwell, vol. 44(2), pages 610-636, February.
    10. Paulo B. Goes & Noyan Ilk & Mingfeng Lin & J. Leon Zhao, 2018. "When More Is Less: Field Evidence on Unintended Consequences of Multitasking," Management Science, INFORMS, vol. 64(7), pages 3033-3054, July.
    11. Noa Zychlinski, 2023. "Applications of fluid models in service operations management," Queueing Systems: Theory and Applications, Springer, vol. 103(1), pages 161-185, February.
    12. Tolga Tezcan & Jiheng Zhang, 2014. "Routing and Staffing in Customer Service Chat Systems with Impatient Customers," Operations Research, INFORMS, vol. 62(4), pages 943-956, August.
    13. You-Xuan Lin & Chi-Hao Lin & Chih-Hao Lin, 2021. "A challenge for healthcare system resilience after an earthquake: The crowdedness of a first-aid hospital by non-urgent patients," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-16, April.
    14. Ity Shurtz & Alon Eizenberg & Adi Alkalay & Amnon Lahad, 2022. "Physician workload and treatment choice: the case of primary care," RAND Journal of Economics, RAND Corporation, vol. 53(4), pages 763-791, December.
    15. Xu, Shuling & Hall, Nicholas G., 2021. "Fatigue, personnel scheduling and operations: Review and research opportunities," European Journal of Operational Research, Elsevier, vol. 295(3), pages 807-822.
    16. Mirko Kremer & Francis de Véricourt, 2022. "Mismanaging diagnostic accuracy under congestion," ESMT Research Working Papers ESMT-22-01, ESMT European School of Management and Technology.
    17. Niyirora, Jerome & Zhuang, Jun, 2017. "Fluid approximations and control of queues in emergency departments," European Journal of Operational Research, Elsevier, vol. 261(3), pages 1110-1124.
    18. Susan Feng Lu & Lauren Xiaoyuan Lu, 2017. "Do Mandatory Overtime Laws Improve Quality? Staffing Decisions and Operational Flexibility of Nursing Homes," Management Science, INFORMS, vol. 63(11), pages 3566-3585, November.
    19. Sezer Ülkü & Chris Hydock & Shiliang Cui, 2022. "Social Queues (Cues): Impact of Others’ Waiting in Line on One’s Service Time," Management Science, INFORMS, vol. 68(11), pages 7958-7976, November.
    20. Tinglong Dai & Sridhar Tayur, 2020. "OM Forum—Healthcare Operations Management: A Snapshot of Emerging Research," Manufacturing & Service Operations Management, INFORMS, vol. 22(5), pages 869-887, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:flsman:v:33:y:2021:i:3:d:10.1007_s10696-020-09388-2. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.