The Impact of Pooling on Throughput Time in Discretionary Work Settings: An Empirical Investigation of Emergency Department Length of Stay

Abstract

We conduct an empirical investigation on the impact of pooling tasks and resources on throughput times in a discretionary work setting. We use an Emergency Department’s (ED) patient-level data (N = 234,334) from 2007 to 2010 to test our hypotheses. We find that when the ED’s work system had pooled tasks and resources, patients’ lengths of stay were longer than when the ED converted to having dedicated tasks and resources. More specifically, we find that dedicated systems resulted in a 9 percent overall decrease in length of stay, which corresponds to a 25-minute reduction in length of stay for an average patient of medium severity in this ED. We propose that the improved performance comes from a reduction in social loafing and a more distributed utilization of shared resources. These benefits outweigh the expected efficiency gains from pooling, which are commonly predicted by queuing theory.