A note on the trade‐off between waiting times and quality in a constrained hospital market

2020 ◽  
Vol 30 (1) ◽  
pp. 180-185
Author(s):  
Domenico Lisi ◽  
Giacomo Pignataro
Author(s):  
Benjamin Grant ◽  
Itai Gurvich ◽  
R. Kannan Mutharasan ◽  
Jan A. Van Mieghem

Problem definition: We study dynamic stochastic appointment scheduling when delaying appointments increases the risk of incurring costly failures, such as readmissions in healthcare or engine failures in preventative maintenance. When near-term base appointment capacity is full, the scheduler faces a trade-off between delaying an appointment at the risk of costly failures versus the additional cost of scheduling the appointment sooner using surge capacity. Academic/practical relevance: Most appointment-scheduling literature in operations focuses on the trade-off between waiting times and utilization. In contrast, we analyze preventative appointment scheduling and its impact on the broader service-supply network when the firm is responsible for service and failure costs. Methodology: We adopt a stochastic dynamic programming (DP) formulation to characterize the optimal scheduling policy and evaluate heuristics. Results: We present sufficient conditions for the optimality of simple policies. When analytical solutions are intractable, we solve the DP numerically and present optimality gaps for several practical policies in a healthcare setting. Managerial implications: Intuitive appointment policies used in practice are robust under moderate capacity utilization, but their optimality gap can quadruple under high load.


1982 ◽  
Vol 14 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Suleyman Tufekci
Keyword(s):  

2012 ◽  
Vol 11 (3) ◽  
pp. 118-126 ◽  
Author(s):  
Olive Emil Wetter ◽  
Jürgen Wegge ◽  
Klaus Jonas ◽  
Klaus-Helmut Schmidt

In most work contexts, several performance goals coexist, and conflicts between them and trade-offs can occur. Our paper is the first to contrast a dual goal for speed and accuracy with a single goal for speed on the same task. The Sternberg paradigm (Experiment 1, n = 57) and the d2 test (Experiment 2, n = 19) were used as performance tasks. Speed measures and errors revealed in both experiments that dual as well as single goals increase performance by enhancing memory scanning. However, the single speed goal triggered a speed-accuracy trade-off, favoring speed over accuracy, whereas this was not the case with the dual goal. In difficult trials, dual goals slowed down scanning processes again so that errors could be prevented. This new finding is particularly relevant for security domains, where both aspects have to be managed simultaneously.


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