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Stress on the Ward – An Empirical Study of the Nonlinear Relationship between Organizational Workload and Service Quality

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  • Kuntz, Ludwig
  • Mennicken, Roman
  • Scholtes, Stefan

Abstract

We discuss the impact of organizational workload on professional service outcomes, such as survival rates in hospitals. The prevailing view in the literature is that service quality deteriorates when organizational workload increases. In contrast, we argue that the relationship between workload and service outcomes is nonlinear and that there is a quality-optimal workload level. Whilst outcomes deteriorate with increasing workload when workload levels are already high, they will improve if workload increases from a low level. We reach this hypothesis by combining three perspectives: (i) the queuing theory perspective, with its focus on congestion, (ii) a discretionary choice perspective, with a focus on decisions made by professionals in response to changes in workload, and (iii) an endocrinological perspective, with a focus on the subconscious eff ects of workload on worker performance through the cognitive impact of stress hormones. Using a patient census of 1.4 million patients in 624 departments across 101 hospitals, we provide empirical support for the nonlinearity hypothesis in the context of hospital survival rates. We further discuss the implications for hospital capacity planning and the wider implications for service operations management.

Suggested Citation

  • Kuntz, Ludwig & Mennicken, Roman & Scholtes, Stefan, 2011. "Stress on the Ward – An Empirical Study of the Nonlinear Relationship between Organizational Workload and Service Quality," Ruhr Economic Papers 277, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    • Handle: RePEc:zbw:rwirep:277
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    Cited by:

    1. Jillian A. Berry Jaeker & Anita L. Tucker, 2017. "Past the Point of Speeding Up: The Negative Effects of Workload Saturation on Efficiency and Patient Severity," Management Science, INFORMS, vol. 63(4), pages 1042-1062, April.
    2. Kamalini Ramdas & Khaled Saleh & Steven Stern & Haiyan Liu, 2016. "Variety and Experience: Learning and Forgetting in the Use of Surgical Devices," Working Papers 0316, University of South Florida, Department of Economics.
    3. 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.
    4. Saghafian, Soroush & Imanirad, Raha & Traub, Stephen J., 2019. "Do Physicians Influence Each Other’s Performance? Evidence from the Emergency Department," Working Paper Series rwp19-018, Harvard University, John F. Kennedy School of Government.

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    More about this item

    Keywords

    Service quality; service outcomes; organizational workload; hospital capacity planning; behavioral operations; stress; Service quality; service outcomes; organizational workload; hospital capacity planning; behavioral operations; stress;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • M11 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Business Administration - - - Production Management
    • M54 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Personnel Economics - - - Labor Management

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