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首页> 外文期刊>Manufacturing and service operations management >Collaboration, Interruptions, and Changeover Times: Workflow Model and Empirical Study of Hospitalist Charting
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Collaboration, Interruptions, and Changeover Times: Workflow Model and Empirical Study of Hospitalist Charting

机译：协作，中断和转换时间：工作流程模型和医院图表的实证研究

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Problem definition: Collaboration is important in services but may lead to interruptions. Professionals exercise discretion on when to preempt individual tasks to switch to collaborative tasks. Academic/practical relevance: Discretionary task switching can introduce changeover times when resuming the preempted task and, thus, can increase total processing time. Methodology: We analyze and quantify how collaboration, through interruptions and discretionary changeovers, affects total processing time. We introduce an episodal workflow model that captures the interruption and discretionary changeover dynamics-each switch and the episode of work it preempts-present in settings in which collaboration and multitasking is paramount. A simulation study provides evidence that changeover times are properly identified and estimated without bias. We then deploy the model in a field study of hospital medicine physicians: "hospitalists." The hospitalist workflow includes visiting patients, consulting with other caregivers to guide patient diagnosis and treatment, and documenting in the patient's medical chart. The empirical analysis uses a data set assembled from direct observation of hospitalist activity and pager-log data. Results: We estimate that a hospitalist incurs a total changeover time during documentation of five minutes per patient per day. Managerial implications: This estimate represents a significant 20% of the total processing time per patient caring for 14 patients per day, our model estimates that a hospitalist spends more than one hour each day on changeovers. This provides evidence that task switching can causally lead to longer documentation time.
机译：问题定义：协作在服务中非常重要，但可能导致中断。专业人士何时酌情酌情抢占个人任务以转向协作任务。学术/实际相关性：可自由裁量的任务交换可以在恢复抢占任务时引入转换时间，因此可以提高总处理时间。方法论：我们分析和量化如何通过中断和自由判断转换来影响总处理时间。我们介绍了一个删除工作流模型，捕获中断和可自由度转换动态 - 每个交换机和工作的剧集，它抢先于哪些协作和多任务处理的设置中。仿真研究提供了证据，即没有偏见，正确识别和估计转换时间。然后我们在医院医学医生的实地研究中部署了模型：“医生”。医院工作流程包括访问患者，与其他护理人员咨询，以指导患者的诊断和治疗，并在患者的医疗图表中记录。经验分析使用从直接观察医院活动和寻呼机日志数据组装的数据集。结果：我们估计一名医院在每天每次患者的5分钟内部进行总转换时间。管理含义：这种估计代表每天为14名患者每天患者总处理时间的大幅增加20％，我们的模型估计一名病房每天在转换时花费超过一小时。这提供了证据，即任务交换可能会导致更长的文档时间。

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