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Jin, Yiwen

University of British Columbia

This doctoral dissertation comprises two independent essays on healthcare delivery analytics. In the first essay, we investigate the impact of task switching on three angles of emergency department (ED) operations: physician productivity, quality of care, and patient routing using comprehensive data of patient visits and lab tests. We find that a 10% increase in the switching frequency of physicians reduces the number of patients treated per hour by 8.65% - 11.53% on average. However, we find no significant influence on treatment quality. We propose an easily implementable data-driven queue management method to optimally partition patients into two queues to minimize switch cost. Further simulation shows that this method can reduce average waiting time by 38%. In the second essay, we study how surgical and cleaning teams adaptively adjust the service speed in response to real-time deviations from the planned schedules and the further impact on surgical quality. Using a unique surgery data set, we unveil that surgical and cleaning teams speed up when they fall behind schedule and slow down when they get ahead of schedule, with a stronger slowdown effect. We further show that a faster-than-scheduled surgical procedure erodes quality by increasing 30-day readmission and reoperation probabilities. Through a counterfactual analysis, we obtain a convex relationship between readmissions/reoperations and end-of-shift times.

Text

2024-07-26

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/88716

Business Administration - Management Science

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/