On the Interface Between Operations and Human Resources Management

Boudreau, John W.; Hopp, Wallace J.; McClain, John O.; Thomas, Laura

doi:10.1287/msom.5.3.179.16032

Cited by 385 publications

(296 citation statements)

References 66 publications

Supporting

Mentioning

279

Contrasting

Unclassified

Order By: Relevance

“…Finally, by studying factors that can improve learning within operational systems, our work responds to calls to build more behavioral theory in operations (Boudreau et al 2003;Bendoly, Donohue and Schultz 2006;Gino and Pisano 2008). Altogether, by studying factors that improve individual learning and performance, this work informs not only the practice of healthcare, but operations more generally, as organizations seek to deliver higher-quality output.…”

Section: Resultsmentioning

confidence: 94%

Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance

Staats

2012

M&SOM

114

View full text Add to dashboard Cite

One key driver of improvement in surgical outcomes is a surgeon's prior experience. However, research notes that not all experience provides equal value for performance. How, then, should surgeons accumulate experience to improve quality outcomes? In this paper, we investigate the differential effects of focal and related (i.e., tasks similar to, but not identical to, the focal task) experience. We open up the black box of the volume-outcome relationship by going beyond just dividing experience into focal and related categories, but also considering how subtasks and context (i.e., the organization in which the work takes place) affect performance. To understand these issues, we assemble a novel data set on 71 cardiothoracic surgeons who performed more than 6,500 procedures during a period of 10 years after the introduction of a breakthrough surgical procedure. We find that, as compared to related experience, surgeon focal experience has a greater effect on surgeon performance. We also demonstrate that subtask experience has different, nonlinear performance relationships for focal and related experience. Finally, we find that focal experience is more firm specific than related experience and that nonfirm experience reduces the learning rate for both focal and related experience. We discuss implications of our findings for healthcare delivery and operations management. AcknowledgmentsWe thank Rob Huckman, Gary Pisano, the associate editor, and the anonymous reviewers for helpful comments on earlier drafts of this paper. All errors remain our own. Experience Accumulation & Surgeon Performance-1 - Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon PerformanceOne key driver of improvement in surgical outcomes is a surgeon's prior experience. However, research notes that not all experience provides equal value for performance. How then should surgeons accumulate experience to improve quality outcomes? In this paper we investigate the differential effects of focal and related (i.e., tasks similar to, but not identical to, the focal task) experience. We open up the black box of the volume-outcome relationship by going beyond just dividing experience into focal and related categories, but also considering how sub-tasks, and context (i.e., the organization in which the work takes place) affect performance. To understand these issues, we assemble a novel data set on 71 cardiothoracic surgeons who performed over 6,500 procedures during a period of 10 years since the introduction of a breakthrough surgical procedure. We find that as compared to related experience, surgeon focal experience has a greater effect on surgeon performance. We also demonstrate that sub-task experience has different, non-linear performance relationships for focal and related experience. Finally, we find that focal experience is more firm-specific than related experience and that non-firm experience reduces the learning rate for both focal and related experience. We discuss implications of our findin...

show abstract

Section: Resultsmentioning

confidence: 94%

Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance

Staats

2012

M&SOM

114

View full text Add to dashboard Cite

show abstract

“…Thus, we find that the advantages of having visibility into one's own workload, in combination with both the ability to manage patient flow and an incentive to efficiently manage one's full workload, outweighed the variability-buffering benefit of a pooled queuing system. This paper makes a contribution to the literature on queue pooling because prior research has emphasized customer behaviors (e.g., jockeying) that reduce the process losses of dedicated queues, but fewer papers have empirically tested the impact of server behaviors on the performance of different types of queuing systems (Boudreau et al 2003, Hopp et al 2007, Jouini et al 2008). …”

Section: Introductionmentioning

confidence: 99%

“…This is an important omission because, in practice, employees can often make adjustments to how they manage their work system to achieve a goal, such as increasing their productivity (Hopp et al 2009). Operations management scholars advocate that studies of system performance account for human behavior, which could alter the dynamics between operational variables and performance (Boudreau et al 2003, Jouini et al 2008. Empirical research that examines the interactions between human behavior and the design of operations systems can thus provide new insights for operations management theory.…”

mentioning

confidence: 99%

The Diseconomies of Queue Pooling: An Empirical Investigation of Emergency Department Length of Stay

2015

View full text Add to dashboard Cite

We conduct an empirical investigation of the impact of two different queue management systems on throughput times. Using an Emergency Department's (ED) patient-level data (N = 231,081) from 2007 to 2010, we find that patients' lengths of stay (LOS) were longer when physicians were assigned patients under a pooled queuing system, compared to when each physician operated under a dedicated queuing system. The dedicated queuing system resulted in a 10 percent decrease in LOS-a 32-minute reduction in LOS for an average patient of medium severity in this ED. We propose that the dedicated queuing system yielded shorter throughput times because it provided physicians with greater ability and incentive to manage their patients' flow through the ED from arrival to discharge. Consistent with social loafing theory, our analysis shows that patients were treated and discharged at a faster rate in the dedicated queuing system than in the pooled queuing system. We conduct additional analyses to rule out alternate explanations, such as stinting on care and decreased quality of care. Our paper has implications for health care organizations and others seeking to reduce throughput time, resource utilization, and costs.Key words: pooling, queue management, strategic servers, social loafing, empirical operations, health care 3 IntroductionImproving efficiency and customer experience are key objectives for managers of service organizations.Skillful application of operations management principles may prove helpful for achieving these goals. In this paper, we investigate queue management, a key operational decision. More specifically, we explore the impact on throughput time of using a pooled queuing system or a dedicated queuing system.Prior work on queue management has demonstrated through analytical models that pooling separate streams of identical customers into a single queue served by a bank of identical servers leads to a reduction in waiting time and an increase in server utilization (Eppen 1979, Kleinrock 1976. This occurs because pooling reduces the negative impact of variability in arrival times and processing times. Pooling enables incoming work to be processed by any one server from a bank of servers, which decreases the odds that an incoming unit of work will have to wait for service. This situation compares to the one where the unit of work can only be processed by a single dedicated server.Queuing theorists have advanced this stream of research by identifying conditions under which queue pooling may not yield the expected performance improvements (Debo et al. 2008, van Dijk and van der Sluis 2009, Hopp et al. 2007, Jouini et al. 2008, Loch 1998, Mandelbaum and Reiman 1998. However, few empirical studies have examined the performance of pooled versus dedicated queuing systems. This is an important omission because, in practice, employees can often make adjustments to how they manage their work system to achieve a goal, such as increasing their productivity (Hopp et al. 2009). Operations management scholars advocat...

show abstract

“…Our work complements this line of research by demonstrating an unintended consequence of increased workload on hospital reimbursement rates. Thus, our paper also contributes to the debate on how human factors affect the productivity of a system (Schultz et al (1998), Schultz et al (1999), Oliva and Sterman (2001), Boudreau et al (2003), Mas and Moretti (2009)). …”

Section: Literature Reviewmentioning

confidence: 76%

Physician Workload and Hospital Reimbursement: Overworked Physicians Generate Less Revenue per Patient

Powell

Savin

Savva

2012

M&SOM

116

View full text Add to dashboard Cite

We study the impact of physician workload on hospital reimbursement utilizing a detailed data set from the trauma department of a major urban hospital. We find that the proportion of patients assigned a "highseverity" status for reimbursement purposes, which maps, on average, to a 47.8% higher payment for the hospital, is substantially reduced as the workload of the discharging physician increases. This effect persists after we control for a number of systematic differences in patient characteristics, condition and time of discharge. Furthermore, we show that it is unlikely to be caused by selection bias or endogeneity in either discharge timing or allocation of discharges to physicians. We attribute this phenomenon to a workloadinduced reduction in diligence of paperwork execution. We estimate the associated monetary loss to be approximately 1.1% (95% Confidence Interval 0.4% − 1.9%) of the department's annual revenue.

show abstract

On the Interface Between Operations and Human Resources Management

Cited by 385 publications

References 66 publications

Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance

Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance

The Diseconomies of Queue Pooling: An Empirical Investigation of Emergency Department Length of Stay

Physician Workload and Hospital Reimbursement: Overworked Physicians Generate Less Revenue per Patient

Contact Info

Product

Resources

About