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

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

Modelling Start-Up Costs of Multiple Technologies in Electricity Markets

This paper analyzes the effects of start-up costs of different technologies in providing electricity power. We explicitly solve a simplified linear formulation of the dispatch problem. Transforming this primal problem, we show that dominated technologies should be used only in the case of limited availability of efficient technologies. Furthermore, we develop a 'pen and paper' algorithm to determine the optimal dispatch

Webcam technology on neonatal wards—examining the objective and subjective workload of nurses: a combined observational and survey study

BackgroundThis study was conducted to estimate the additional objective and perceived workload of nurses resulting from the use of webcams. The successful implementation of webcam technology into routine care requires an analysis to prevent adverse events of increased nursing workload.MethodsThe study took place on three neonatal wards in two University Hospitals in Germany. In the first Hospital, the study was conducted from February to July 2021; in the second one it was conducted between June and November 2021. Data were collected using a combined approach of a standardised diary questionnaire study and passive observations. The participants were accompanied in their daily work and their activities were recorded 65 nurses participated.Results2,031 h were observed in 1,630 observation blocks. In 14.74% of the observation blocks webcam activities were detected. The extent to which the nurses had webcam-related additional workloads was rated as no additional workload in 82.16% of the daily questionnaires (n = 1,026).ConclusionThe observed low workload due to the webcams is in line with the nurses’ perception. The observational data revealed, on a number of different analysis levels, that a limited additional workload was generated. There was no decrease in activity performance observed and no clear indication for interruptions due to the webcam-related activities for the nurses. However, it is important to raise awareness about the individual workload levels for the successful implementation. Additional education programs can be provided for nurses.Trial registrationThe Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755

Modeling and notation of DEA with strong and weak disposable outputs

Recent articles published in Health Care Management Science have described DEA applications under the assumption of strong and weak disposable outputs. As we confidently assume that these papers include some methodical deficiencies, we aim to illustrate a revised approach

Treatment speed and high load in the Emergency Department-does staff quality matter?

Research in the field of operations management and medicine analyzed how workload affects productivity and patient outcomes. However, staff quality has largely been neglected, and if staffing information has indeed been included, then it takes the form of quantitative measures like staff-to-patient ratios. We therefore seek to analyze how education and experience are directly associated with effort. How do responses to workload differ with respect to education and experience? By analyzing a single hospital unit, we are able to establish a link between staff quality and patient outcomes, allowing us to demonstrate empirically that knowledge and experience are highly relevant in staff members' responses to increasing system load. The systematic aligning of staffing with expected system load should therefore consider not only staffing quantity but also staffing quality. Provided with a reliable prediction of system load, this knowledge would allow managers to generate savings since they can assign high-quality staff more effectively