The Impact of Delay Announcements on Hospital Operations

A growing number of hospitals in different countries have begun posting the waiting times at their emergency department (ED). This information is given on website, billboards, and smartphone apps. While the initial motivation to provide this information is to showcase their commitment to good quality of care, from the operational perspective, showing people the wait times may also impact patients’ choice and subsequently affect system performance. In particular, if patients care about the waiting time and tend to choose strategically the hospital with a shorter ED delay, one expects that the load among different hospitals in the same neighborhood will be more balanced. This increased coordination in the network can lead to substantial performance improvement for the hospitals network.

Several interesting questions arise when studying the impact of delay announcement from the operational angle. First and foremost, are patients utilizing delay information when making decisions about which hospital to visit? Second, how much are we able to gain from the load-balancing effect as a result of strategic patient behavior? Lastly, what type of delay information should be provided? In the paper “The Impact of Delay Announcements on Hospital Network Coordination and Waiting Times” by Jing Dong, Elad Yom-Tov and Galit B. Yom-Tov (Management Science, May 2019), the authors investigate these questions through analysis of several data sets, including one containing search queries to measure the exposure of users to wait time information, and a dataset of wait times in over 200 hospitals during a period of 3 months. The results provide empirical evidence that patients take delay information into account when choosing emergency service providers and that such information helps increase coordination in the network, leading to improvements in the performance of the network, as measured by emergency department wait times.

To address the second and third question, the authors combined stochastic modeling with their empirical findings. Together, the analysis suggests that the level of coordination that can be achieved is limited by the patients’ sensitivity to waiting, the load of the system, the heterogeneity among hospitals, and, most importantly, the method hospitals use to estimate delays. In particular, historical moving average estimators, that are used by many hospitals, may cause oscillations in the system due to delayed feedback. This calls for better predictive models of ED delays that would not have time-bias, which is an active area of research in healthcare operations management.

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Dong J, Yom-Tov E, and Yom-Tom GB (2019). The Impact of Delay Announcements on Hospital Network Coordination and Waiting Times. Management Science 65(5):1969–1994.