The Effects of Multisiting on Productivity and Quality

Problem definition: In the modern workplace, it is increasingly common for workers to concurrently attend to tasks across multiple physical locations. However, frequent site switching can lead to increased setup and overhead costs. Specifically, workers expend significant time and cognitive effort getting reoriented with personnel, operating processes, tools, and resources whenever they switch sites. In this paper, we look at the productivity and quality implications of multisite work. Academic/practical relevance: Although multisite workplace deployment is increasingly common, its impact on people operations has not been examined in the operations management literature. We contribute to the literature by studying the effect of multisiting on individual worker productivity and quality of output. Methodology: To estimate the effect of multisite operations on performance, we turn to a setting where multisite worker assignment is common—that of physicians who have admitting privileges at multiple hospitals. We collected detailed data on individual physicians practicing in 83 hospitals between 1999 and 2010. Our extensive data set includes detailed operational and clinical factors associated with more than 950,000 patient encounters. Our empirical analysis takes the form of a panel, where we follow a given physician over time and link short-term multisiting to patient-level outcomes. Results: We find that multisiting negatively impacts productivity. Specifically, for each additional site at which a physician works, we observe a 2% increase in patient length of stay. For each site served, the likelihood of a patient developing a complication increases by 3%. Greater travel distance between sites and lack of focus at a given site explain the performance declines due to multisiting. In addition, we find that the performance declines resulting from multisite operation are reduced among low-complexity patients and among highly experienced physicians. Managerial implications: Multisite performance losses need to be traded off against the potential benefits. The negative effects of multisiting can be mitigated by limiting multisite deployment to simpler tasks and among highly experienced physicians. Managers can decrease switching costs of multisite work by standardizing workflows, processes, and tools across sites. In addition, the practice of multisite work can be limited to sites that are physically proximate to avoid the overhead costs associated with excessive travel.