The Effect of Operational Process Changes on Preoperative Patient Flow: Evidence from Field Research

Abstract

We partnered with a leading U.S. academic medical center to empirically examine the impact of operational process changes designed to improve preoperative flow of patients through the perioperative environment. We focus on the implementation of centralized decision making and the introduction of an information technology (IT) enabled intraoperative prompt, on efficiency, as measured by preoperative patient processing time. We analyze over 33,000 individual surgical cases in a unique field experimental setting to conduct an empirical investigation of the effects of each intervention on patients' time spent in preoperative processing. To identify the causal effect of each process change, we leverage our field experimental research design and cast our analyses in the difference-in-differences modeling framework. We compare the preoperative patient processing time of two distinct patient groups, a treatment group that is impacted by the implemented operational changes and a control group that was not impacted by the changes, before and after each process change. Our results suggest a 3.4% reduction in preoperative processing time with only centralized decision making in place, yet a 10.8% reduction in preoperative processing time when centralized decision making is paired with the IT enabled intraoperative prompt. We also find evidence of a complementarity effect between our process changes and surgeon prior process experience. Our study contributes to the healthcare operations literature by demonstrating the benefits of coordinated information flow within the patient supply chain. We offer insights for hospital managers and healthcare operations scholars alike on the role of information coordination in improving preoperative patient flow with minimal impact on existing resources and staff.