David A. Johnston

Purpose: The authors determine how the scheduling and sequencing of surgeries by surgeons impacts the rate of post-surgical complications and patient length-of-stay in the hospital.Design/methodology/approach: Leveraging a dataset of 29,169 surgeries performed by 111 surgeons from a large hospital network in Ontario, Canada, the authors perform a matched case-control regression analysis. The empirical findings are contextualized by interviews with surgeons from the authors’ dataset.Findings: Surgical complications and longer hospital stays are more likely to occur in technically complex surgeries that follow a similarly complex surgery. The increased complication risk and length-of-hospital-stay is not mitigated by scheduling greater slack time between surgeries nor is it isolated to a few problematic surgery types, surgeons, surgical team configurations or temporal factors such as the timing of surgery within an operating day.Research limitations/implications: There are four major limitations: (1) the inability to access data that reveals the cognition behind the behavior of the task performer and then directly links this behavior to quality outcomes; (2) the authors’ definition of task complexity may be too simplistic; (3) the authors’ analysis is predicated on the fact that surgeons in the study are independent contractors with hospital privileges and are responsible for scheduling the patients they operate on rather than outsourcing this responsibility to a scheduler (i.e. either a software system or an administrative professional); (4) although the empirical strategy attempts to control for confounding factors and selection bias in the estimate of the treatment effects, the authors cannot rule out that an unobserved confounder may be driving the results.Practical implications: The study demonstrates that the scheduling and sequencing of patients can affect service quality outcomes (i.e. post-surgical complications) and investigates the effect that two operational levers have on performance. In particular, the authors find that introducing additional slack time between surgeries does not reduce the odds of back-to-back complications. This result runs counter to the traditional operations management perspective, which suggests scheduling more slack time between tasks may prevent or mitigate issues as they arise. However, the authors do find evidence suggesting that the risk of back-to-back complications may be reduced when surgical pairings are less complex and when the method involved in performing consecutive surgeries varies. Thus, interspersing procedures of different complexity levels may help to prevent poor quality outcomes.Originality/value: The authors empirically connect choices made in scheduling work that varies in task complexity and to patient-centric health outcomes. The results have implications for achieving high-quality outcomes in settings where professionals deliver a variety of technically complex services.

This research examines how organizations simultaneously manage their operations and occupational health and safety. Although both safety and operations scholars conduct research in the same operational settings, they have reached different, yet untested, conclusions about the relationship between creating a safe workplace and creating a productive workplace. The results from a series of 10 case studies show that it is possible to create safe and productive workplaces, but that many facilities fail at this task because of problems associated with the culture management creates and the practices management adopts.

In this paper, the authors describe a geographical information system (GIS)‐based software system for managing and integrating multi‐facility warehousing and production systems that are distributed within a relatively large geographical area. The development of the software system is motivated by a unique warehousing environment at the Pine Bluff Arsenal in Pine Bluff, Arkansas. The arsenal scenario is characterized by a novel set of highly limiting warehouse constraints. Although motivated by this unique problem, the software system has been designed to maximize technology transfer capability into diverse general warehouse settings. The paper presents motivation, describes features, and demonstrates the efficacy of operations using the software system. The system is verified and validated in a case study setting. It is demonstrated that the GIS platform offers unique capabilities that enhance problem solutions. In conclusion, the paper offers a contribution to the literature by presenting the use of GIS as an integration strategy in an exciting new area of application.

Organizations are frequently required to make long-term strategic choices regarding the design and manufacture of innovative process equipment and systems which address future needs. An important consideration in such choices is the evaluation of the unique capabilities of available suppliers. Typically, such evaluations must be made relative to multiple attributes or criteria. This paper examines one such supplier evaluation process in the context of a major international manufacturer of telecommunication equipment. The ad hoc method used by the organization to evaluate the multiple factors involved is presented, and an alternative, structured approach to deal with the multiple factors is then discussed.