In order to better manage the supply-demand mismatches between bed types and patient types, many hospitals engage in capacity pooling by assigning patients from a service with limited or no available beds to an available bed in a unit designated for a difference service. This “off-service placement” is a common occurrence in many hospitals, yet its effects are not well understood, perhaps because of the endogenous selection of off-service patients. In the first paper, we quantify the effect of off-service placement on those patients who have been placed off service; we find that they experience a 25% increase in length of stay and also an increase in likelihood of readmission. In the second paper, we examine the extent to which patients who are placed on service are impacted by the service’s off-service activities. Our findings suggest that this spillover effect is substantial, and that both the level and the volatility of off-service placement impacts those patients who are placed on service. Quantifying these various effects of off-service placement can inform future models of patient flow and enable hospitals to make better informed decisions around capacity allocation and off-service placement.
Hummy Song is an Assistant Professor of Operations, Information and Decisions at the Wharton School at the University of Pennsylvania. Her research is focused on identifying ways to improve the performance of service systems, with a particular emphasis on health care delivery systems. Her work has examined several factors related to patient flow and capacity management in health care delivery settings, including queue configurations, off-service placement, performance feedback, provider turnover, and team staffing. Her research primarily utilizes large datasets derived from electronic health record systems and administrative databases. She has worked with hospitals and health care delivery organizations both in the U.S. and in developing countries. She conducted her undergraduate, master’s, and PhD studies at Harvard University.