Advancing Health Care Operations: Leveraging Technology and Operational Design
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Healthcare Operations Management
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The dissertation empirically explores solutions to operational challenges—last-mile delivery, scheduling, and resource allocations decisions—faced by health care organizations that leverage technology and work design. In Chapter 1, we examine whether and the extent to which the adoption of a technological innovation, delivery drones, for the last-mile delivery of blood products impacts inventory management of these products and health outcomes at rural hospitals in Rwanda. We find after hospitals begin to receive blood products via drones, all facilities realize improved inventory management in the form of lower on-hand inventory; but only facilities with the shortest lead time increased usage, decreased wastage, and improved health outcomes among health conditions where blood is an input into medical care. In Chapter 2, we explore a potential operational lever—incorporating heterogeneous preferences into schedules—on employee turnover. Leveraging a unique combination of survey, shift schedule, and administrative data, which allows us to directly measure worker utility, preferences for shift schedules, and observe quitting decisions, we find that incorporating preferences into shift schedules decreases the monthly probability of quitting, but only among the most senior nurses in the group. We find that these heterogeneous effects are a result, not of the most experienced workers preferentially getting preferences reflected or differing outside options for experienced workers, but workers of varying tenure accruing differential benefits to their well-being. In Chapter 3, we study how to improve physicians' routing decisions of patients from the ED to inpatient services. Leveraging rich data derived from electronic medical records, we delve into physician decision-making in routing decisions of patients from the ED to inpatient medical services. We explore how they adapt their decision-making processes in the face of increased saliency of capacity information of inpatient services.