To Batch or Not to Batch? Impact of Admission Batching on Emergency Department Boarding Time and Physician Productivity

Abstract

Trade-offs Caused by Batching Inpatient Admissions from Emergency Departments In “To Batch or Not to Batch? Impact of Admission Batching on Emergency Department Boarding Time and Physician Productivity,” Feizi and coauthors tackle the important problem of identifying causes of emergency department (ED) boarding with the goal of identifying a managerial lever to reduce it. They investigate the impact of batching admissions of ED patients. The authors empirically show that batching occurs frequently at the end of shifts when physicians wrap up their tasks. Interestingly, Feizi et al. find a trade-off. Batching improves individual physician productivity, which explains its prevalence. However, it increases boarding times, an outcome that negatively impacts patients and the hospital. A counterfactual analysis comparing empirical results to theoretical queuing models finds that eliminating batching reduces boarding times by 15%. The paper highlights that boarding can be reduced by physicians completing admissions work as it occurs rather than delaying to the end of shift.