Negative Effects of Workload Saturation

What is it about?

The paper describes the "n-shaped" relationship between clinician workload and length of stay (LOS) in hospitals. We find that as workload gets heavier, congestion in the hospital at first makes LOS longer. For medical patients each 1% increase in occupancy is associated with an increase in LOS by 23 minutes, while for surgical patients it is 11 minutes. However, around the 74th percentile of occupancy, LOS begins decreasing. We suspect that this occurs because clinicians shift their focus to discharging patients who could go home to make room in the increasing crowded hospital for the incoming flow of newly admitted patients. However, at 94% occupancy, LOS dramatically increases by about 40 minutes for each addition percentage point in occupancy for both medical and surgical patients. Our analysis suggests that this is because the patients remaining in such a highly congested hospital are too sick to be discharged, and the hospital resources are so heavily loaded that it is no longer possible to focus on discharging patients.

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