Essays on Emergency Department Physician Performance
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CitationImanirad, Raha. 2020. Essays on Emergency Department Physician Performance. Doctoral dissertation, Harvard Business School.
AbstractIn this dissertation, I examine the problem of physician performance evaluation and investigate ways to improve the performance of physicians in the context of an Emergency Department (ED) setting. In the first chapter — co-authored
with Soroush Saghafian and Stephen Traub — we use Data Envelopment Analysis (DEA) to develop models for evaluating physician effectiveness and efficiency. We apply our DEA models to a large dataset of care delivered by ED physicians and derive effectiveness and efficiency scores for the physicians in our dataset. Using the generated DEA scores, we then conduct a second-stage analysis in which we use a Tobit framework to identify factors that are associated with higher levels of physician effectiveness and efficiency.
In the second chapter — co-authored with Soroush Saghafian and Stephen Traub — we conduct a large-scale empirical investigation into whether and how physicians who work during the same shift affect each other’s performance. We find strong empirical evidence that physicians affect each other’s speed and quality in our setting. We identify spillover from peers’ utilization of shared resources as the main driver of the observed effects and show that during high-volume shifts, the magnitude of the effects increases. We draw conclusions from our results and discuss how they can be utilized by hospital administrators to improve the overall performance of physicians.
In the third chapter — co-authored with Soroush Saghafian and Stephen Traub — we address the question: To which shift should the ED’s high-performing physicians be assigned? Specifically, we empirically examine how assigning a high-performing group of physicians to different shifts of the day affects the daily performance of the ED. Our results demonstrate that assigning a group of high-performing physicians to the first shift of the day has the highest impact on the daily performance of the ED. We further show that physicians’ performance in the earlier shifts of the day has a “domino effect” throughout the rest of the day.
Together these studies provide insights into ED physician performance and shed light on potential ways to improve performance through assigning the right mix of physicians to the right shifts.
Citable link to this pagehttps://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37369525