Does Delay Stimulate Speedup? Evidence from Operating Rooms
We study how surgical teams respond to real-time deviations from planned schedules, along with the associated consequences of these responses. Specifically, we investigate whether teams will change their service speed when they are ahead of or behind the original schedule, and whether this affects patient readmission and reoperation rates. We empirically explore these questions using a unique surgery data set that includes both actual and scheduled surgery time stamps. We construct a dynamic panel model and utilize the Arellano-Bond approach for estimation. As a result, we identify a new type of adaptive server behaviour, namely, negative (balancing) feedback, which complements the existing literature on scheduling and behavioural queueing. We find that surgical teams expedite in the subsequent surgery when they fall behind the schedule and vice-versa. Quantitatively, facing one standard deviation (34.5 minutes) increase in delay, the surgical team speeds up during the next surgery by 8.5% - 10% on average. This effect is more evident among cases operated by senior surgeons. The findings lead to a novel instrumental variable to address the endogeneity issues in estimating the impact of surgical speed on surgical quality. Using the instrument, we present the first causal study on the impact of procedure duration on 30-day readmission and reoperation rates. Our research characterizes negative feedback as a representative behavioural pattern that prevails in operating rooms. Understanding this behavioural feature will help hospital managers predict shift end times better and enable them to schedule surgeries to achieve desired efficiency-quality trade-off targets
Year of publication: |
2022
|
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Authors: | Jin, Yiwen ; Ding, Yichuan ; Shechter, Steven ; Arneja, Jugpal S |
Publisher: |
[S.l.] : SSRN |
Saved in:
freely available
Extent: | 1 Online-Ressource (44 p) |
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Type of publication: | Book / Working Paper |
Language: | English |
Notes: | Nach Informationen von SSRN wurde die ursprüngliche Fassung des Dokuments March 1, 2022 erstellt |
Other identifiers: | 10.2139/ssrn.4048352 [DOI] |
Source: | ECONIS - Online Catalogue of the ZBW |
Persistent link: https://www.econbiz.de/10014085341
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