Optimal Choice for Appointment Scheduling Window under Patient No‐Show Behavior

Observing that patients with longer appointment delays tend to have higher no‐show rates, many providers place a limit on how far into the future that an appointment can be scheduled. This article studies how the choice of appointment scheduling window affects a provider's operational efficiency. We use a single server queue to model the registered appointments in a provider's work schedule, and the capacity of the queue serves as a proxy of the size of the appointment window. The provider chooses a common appointment window for all patients to maximize her long‐run average net reward, which depends on the rewards collected from patients served and the “penalty” paid for those who cannot be scheduled. Using a stylized M/M/1/K queueing model, we provide an analytical characterization for the optimal appointment queue capacity K, and study how it should be adjusted in response to changes in other model parameters. In particular, we find that simply increasing appointment window could be counterproductive when patients become more likely to show up. Patient sensitivity to incremental delays, rather than the magnitudes of no‐show probabilities, plays a more important role in determining the optimal appointment window. Via extensive numerical experiments, we confirm that our analytical results obtained under the M/M/1/K model continue to hold in more realistic settings. Our numerical study also reveals substantial efficiency gains resulted from adopting an optimal appointment scheduling window when the provider has no other operational levers available to deal with patient no‐shows. However, when the provider can adjust panel size and overbooking level, limiting the appointment window serves more as a substitute strategy, rather than a complement.     

Psychosocial safety climate as an antecedent of work characteristics and psychological strain: A multilevel model

Abstract

Psychosocial safety climate (PSC) refers to a specific organizational climate for the psychological health of workers. It is largely determined by management and at low levels is proposed as a latent pathogen for psychosocial risk factors and psychological strain. Using an extended Job Demands-Control-Support framework, we predicted the (24 month) cross-level effects of PSC on psychological strain via work conditions. We used a novel design whereby data from two unrelated samples of nurses working in remote areas were used across time (N=202, Time 1; N=163, Time 2), matched at the work unit level (N= 48). Using hierarchical linear modelling we found that unit PSC assessed by nurses predicted work conditions (workload, control, supervisor support) and psychological strain in different nurses in the same work unit 24 months later. There was evidence that the between-group relationship between unit PSC and psychological strain was mediated via Time 2 work conditions (workload, job control) as well as Time 1 emotional demands. The results support a multilevel work stress model with PSC as a plausible primary cause, or “cause of the causes”, of work-related strain. The study adds to the literature that identifies organizational contextual factors as origins of the work stress process.     

The influence of mapped hazards on risk beliefs: a proximity-based modeling approach

Interview findings suggest perceived proximity to mapped hazards influences risk beliefs when people view environmental hazard maps. For dot maps, four attributes of mapped hazards influenced beliefs: hazard value, proximity, prevalence, and dot patterns. In order to quantify the collective influence of these attributes for viewers’ perceived or actual map locations, we present a model to estimate proximity‐based hazard or risk (PBH) and share study results that indicate how modeled PBH and map attributes influenced risk beliefs. The randomized survey study among 447 university students assessed risk beliefs for 24 dot maps that systematically varied by the four attributes. Maps depicted water test results for a fictitious hazardous substance in private residential wells and included a designated “you live here” location. Of the nine variables that assessed risk beliefs, the numerical susceptibility variable was most consistently and strongly related to map attributes and PBH. Hazard value, location in or out of a clustered dot pattern, and distance had the largest effects on susceptibility. Sometimes, hazard value interacted with other attributes, for example, distance had stronger effects on susceptibility for larger than smaller hazard values. For all combined maps, PBH explained about the same amount of variance in susceptibility as did attributes. Modeled PBH may have utility for studying the influence of proximity to mapped hazards on risk beliefs, protective behavior, and other dependent variables. Further work is needed to examine these influences for more realistic maps and representative study samples.     

The effects of JDC model on burnout and work engagement: A multiple interaction analysis

This study investigated the moderating effects of functional social support (emotional and instrumental support) on the relationship of job demand control with burnout and work engagement. In total, 297 frontline employees from a hotpot restaurant franchise in China were surveyed. The results indicated emotional support, such as caring and inspiration, mitigated the adverse effects of high demand/low control on burnout and work engagement. Instrumental support, such as giving suggestions and solving problems, only mitigated the adverse effects of burnout. Further, the high demand/low control/low emotional support work condition was the most unfavourable for work engagement and burnout; while high demand/low control/low instrumental support was the most unfavourable condition for burnout. The theoretical and managerial implications of this research have been provided to gain a deeper insight into functional social support in the job demand control model.     

Exploring work- and organization-based resources as moderators between work–family conflict,well-being,and job attitudes

Abstract

In modern Western life it is difficult to avoid work–family conflict. Therefore the resources that might reduce its negative outcomes on well-being and job attitudes come into focus. Our study contributes to the work–family conflict literature by exploring the indirect (moderator) and direct role of three work- and organization-related resources, i.e., job control, family supportive climate, organization-based self-esteem (OBSE), in the work-to-family conflict and well-being/job attitude relationship. Theoretically, the study tested the recently developed Job Demands–Resources (JD-R) model in the Scandinavian context. Data for the study were gathered from three differing Finnish organizations (health care district, ICT company, Cardboard mill; n=1252). In line with the predictions of the JD-R model, job demands (time- and strain-based work-to-family conflict) were more robustly associated with strain-based outcomes (physical symptoms), whereas job resources (job control, family supportive climate, OBSE) were more strongly linked to motivational-based outcomes (job satisfaction, organizational commitment). Both job control and family supportive climate moderated the relationships studied; high job control and family supportive climate buffered against the aversive effects of work-to-family conflict on well-being and job attitudes. These indirect effects also varied in relation to the independent, moderator, and dependent variables. However, OBSE did not operate as a buffering factor, although it showed significant direct effects. From a practical viewpoint, our findings suggest that job control and family supportive climate are resources that help employees to reduce the negative effects related to work–family conflict.     

Leadership and organizational learning: A multiple levels perspective

We review theoretical and empirical work relevant to the nexus of leadership with organizational learning. We build on the classic distinction between exploration and exploitation and the 4I framework of organizational learning [Crossan, M. M., Lane, H. W., & White, R. E. (1999). An organizational learning framework: From intuition to institution. Academy of Management Review, 24, 522–537.] to present previous research and offer research directions linking leadership constructs and processes of organizational learning at different levels of analysis. For each of these links, we discuss the mediating effect of organizational context and suggest future research directions. This review is integrated using a model and propositions that depict the role of leaders with regard to new and existing learning.     

Appointment Overbooking in Health Care Clinics to Improve Patient Service and Clinic Performance

The problem of no‐shows (patients who do not arrive for scheduled appointments) is particularly significant for health care clinics, with reported no‐show rates varying widely from 3% to 80%. No‐shows reduce revenues and provider productivity, increase costs, and limit patient access by reducing effective clinic capacity. In this article, we construct a flexible appointment scheduling model to mitigate the detrimental effects of patient no‐shows, and develop a fast and effective solution procedure that constructs near‐optimal overbooked appointment schedules that balance the benefits of serving additional patients with the potential costs of patient waiting and clinic overtime. Computational results demonstrate the efficacy of our model and solution procedure, and connect our work to prior research in health care appointment scheduling.     

A study of mediating variables of the relationship between 360° feedback and employee performance

The 360° feedback has been linked to several positive outcomes like improved performance, better interpersonal communication and smoother work relationships. Both academicians and practitioners would like more clarity regarding the link between 360° feedback and employee performance and the mediating factors in this relationship. This study empirically examines these mediating effects with a sample of executives (N = 198) working in four organizations in western part of India. The results show that interpersonal communication and quality of working life have a complete mediating effect. Leader–member exchange quality and perceived organizational support were found to have a partial but significant mediating effect. An elementary form of an integrated model, which includes all the four mediating variables and their interrelationships, has been developed conceptually. This model is examined and built up empirically using structural equation modelling.     

AN ECONOMIC PRODUCTION QUANTITY MODEL WITH LEARNING AND FORGETTING CONSIDERATIONS

The focus of this work is on the effects of learning on economic production quantity in batch production systems. We assumed that both unit variable manufacturing time and setup time follow a learning curve. We modified the classical Economic Production Quantity model to incorporate these two types of learning phenomena. We also incorporated the forgetting effect in our model so that a fraction of the learning is lost between consecutive lots. We developed a dynamic program to obtain the optimal solution to the problem. We investigated the nonincreasing lot size property and used it to improve the efficiency of our dynamic program. We consider a special case of the model in which all lot sizes are assumed equal. After theoretical treatment, we carried out a computational study of the effect of assuming equal lot sizes on the optimal solutions. The results of our examples strongly indicate that the assumption of equal lot sizes not only simplifies the determination of the optimal solutions, but also provides close approximations to the optimal solutions.     

A Probabilistic Transmission Model to Assess Infection Risk from Mycobacterium Tuberculosis in Commercial Passenger Trains

The objective of this article is to characterize the risk of infection from airborne Mycobacterium tuberculosis bacilli exposure in commercial passenger trains based on a risk‐based probabilistic transmission modeling. We investigated the tuberculosis (TB) infection risks among commercial passengers by inhaled aerosol M. tuberculosis bacilli and quantify the patterns of TB transmission in Taiwan High Speed Rail (THSR). A deterministic Wells‐Riley mathematical model was used to account for the probability of infection risk from M. tuberculosis bacilli by linking the cough‐generated aerosol M. tuberculosis bacilli concentration and particle size distribution. We found that (i) the quantum generation rate of TB was estimated with a lognormal distribution of geometric mean (GM) of 54.29 and geometric standard deviation (GSD) of 3.05 quantum/h at particle size ≤ 5 μm and (ii) the basic reproduction numbers (R₀) were estimated to be 0.69 (0.06–6.79), 2.82 (0.32–20.97), and 2.31 (0.25–17.69) for business, standard, and nonreserved cabins, respectively. The results indicate that commercial passengers taking standard and nonreserved cabins had higher transmission risk than those in business cabins based on conservatism. Our results also reveal that even a brief exposure, as in the bronchoscopy cases, can also result in a transmission when the quantum generation rate is high. This study could contribute to a better understanding of the dynamics of TB transmission in commercial passenger trains by assessing the relationship between TB infectiousness, passenger mobility, and key model parameters such as seat occupancy, ventilation rate, and exposure duration.     

Do Foreigners Cushion Native Jobs? The Case of European Regions in the 1990s

Abstract. This paper investigates whether foreigners cushion native labour during the phases of the economic cycle. The theoretical model, based on the work of Blanchard and Katz (Brookings Papers on Economic Activity 0(1): 1–75, 1992), assumes that foreigners supply labour with a higher wage elasticity than natives. The empirical analysis, based on an unbalanced panel of 161 European regions during 1988–97, shows that following a labour demand shock the variability of native employment growth is lower the higher the proportion of foreign citizens in the local labour force. These results suggest that foreigners absorb some of the effects of the shock, shielding natives from its full impact. The analysis also reveals that the main channel mediating this ‘cushioning’ effect is the inter‐regional migration of foreign workers, followed (as a far distant second) by their higher/lower unemployment rates.     

A matter of time? Challenging and hindering effects of time pressure on work engagement

The aim of our research was to test time-exposure effects of time pressure as a stressor typically considered to be a challenge, rather than a hindrance stressor. We examined the within- and between-person effects of time pressure on work engagement in two diary/panel studies with employees using intervals of five days and three weeks, respectively (Study 1, n?=?350, and n?=?357, respectively) and six to eight weeks (Study 2, n?=?238). We assumed that it is a matter of time whether time pressure acts as a challenge (under short-term exposure) or as a hindrance stressor (under long-term exposure). We found significant positive within-person effects of time pressure on work engagement when controlling for strain in the daily and weekly diary assessment (Study 1), but a significant negative within-person effect in the six to eight weeks’ assessment (Study 2). The between-person effects were significant and negative in all studies. Although a short-term increase can be beneficial for a certain time, stable and long-time exposure of time pressure does rather reduce work engagement. Thus, employers should not keep time pressure permanently high to motivate their employees. However, short-term increases of time pressure (e.g. before a deadline) may serve as a motivating factor.     

Bricks without clay: On urban myths in occupational health psychology

Abstract

There is a lack of intricate research into the relationships between work performance and other variables. This study examined the causal relationship between work, non-work stressors, and work performance. Using longitudinal multi-group data from three groups—university staff, trainee nurses, and part-time employees (overall N=244)—structural equation modelling was employed to explore one-way and reverse competing models. The results produced a good fitting model with one-way causal paths from work-related and non-work stressors (time 1) to job performance (time 2). Nested model comparison analysis provided further evidence to support this best fitting model, emphasizing the strong influence that non-work factors have within the workplace. This study has important implications for theory, methodology and statistical analysis, and practice in the field of work-related stressors and performance.     

Tree‐Based Logistic Regression Approach for Work Zone Casualty Risk Assessment

This study presents a tree‐based logistic regression approach to assessing work zone casualty risk, which is defined as the probability of a vehicle occupant being killed or injured in a work zone crash. First, a decision tree approach is employed to determine the tree structure and interacting factors. Based on the Michigan M‐94\I‐94\I‐94BL\I‐94BR highway work zone crash data, an optimal tree comprising four leaf nodes is first determined and the interacting factors are found to be airbag, occupant identity (i.e., driver, passenger), and gender. The data are then split into four groups according to the tree structure. Finally, the logistic regression analysis is separately conducted for each group. The results show that the proposed approach outperforms the pure decision tree model because the former has the capability of examining the marginal effects of risk factors. Compared with the pure logistic regression method, the proposed approach avoids the variable interaction effects so that it significantly improves the prediction accuracy.     

Application of data mining to minimize fire-induced domino effect risks

Data mining (DM) has been applied in many advanced science and technology fields, but it has still not been used for domino effect risk management to explore minimum risk scenarios. This work investigates the feasibility of DM in minimizing the risk of fire-induced domino effects in chemical processing facilities. Based on DM, an evidential failure mode and effects analysis (E-FMEA), which could bridge chemical facilities’ operational reliability and domino effect risk, is combined with fault tree analysis (FTA) for the occurrence risk modeling of loss of containment (LOC) event of chemical facilities, which is often the triggering point of fire-induced domino effects. Industry specific data such as reliability data, inspection records, and maintenance records are of great value to model the potential occurrence criticality of LOC. The data are used to characterize the LOC risk priority number (RPN) of chemical facilities through FTA and E-FMEA, search and statistics rules are proposed to mine inspection records to assess LOC risk factors. According to the RPN scores of facilities, inherent safety strategies to minimize risk via inventory control are proposed, and their effectiveness is tested using a well-known probit model. In this way, the approach proposes a unit-specific evidence-based risk minimization strategy for fire-induced domino effects. A case study demonstrates the capability of DM in the risk minimization of fire-induced domino effects.     

The role of sense of coherence in well-being at work: Analysis of main and moderator effects

Abstract

The aim of this cross-sectional study was to investigate the role of the sense of coherence (SOC) as a main effect on well-being and also its possible moderating role in the relationship between work characteristics and well-being in a sample of Finnish technical designers (n = 989). MANOVA/MANCOVA analysis with hierarchical decomposition was used so that the demographic variables (age, occupation gender) were controlled throughout. The results offered strong support for a main effect model of SOC: the stronger the SOC, the lower the level of psychosomatic symptoms and emotional exhaustion. Also, some support for a moderating role of SOC on the relationships between perceived work characteristics and well-being was found. However, these relationships explained only a small proportion of the variance of well-being was found. However, these relationships explained only a small proportion of the variance of well-being indicators. These results showed that the strong SOC subjects seemed to be better protected from the adverse effects of certain work characteristics (e.g. pressure of time). Furthermore, good social relations at work emphasized well-being among subjects with a very weak SOC, whereas these relations matered less in determining well-being outcomes in subjects with a stronger SOC. Finally, some work characteristics seemed to have salutary effects on well-being when accompained by a strong SOC and, on the contrary, pathogenic effects when accompained by a weak SOC.     

Employee correlates of sickness presence: A study across four European countries

The model of sickness presence (SP) proposed by Aronsson and Gustafsson consists of two parts. The first postulates SP as an employee's reaction to his/her general state of health, and as depending on employee correlates relating to the individual and the job. The second proposes longitudinal relationships between SP and future health. The present study is the first to test the first part of the model outside Scandinavia. Positive sickness presence factors studied were work involvement and job satisfaction; negative presence factors were financial household contribution, time pressure at work, and perceived job insecurity. Control variables were general health, age, gender and autonomy. Data (N=2348) were gathered from a total of 110 organizations in four European countries (Belgium, Spain, Sweden and the UK) with differing welfare state regime, degree of employment protection, labour market and sickness absence-related indicators. The data were analysed by hierarchical multiple regression per country. The findings partially confirmed the Aronsson and Gustafsson model. In all countries, employee general health status was a prerequisite of SP, and time pressure at work related to SP. In Sweden and the UK, job satisfaction related to SP. In the UK, work involvement related to SP.     

Four-stage process model of the core factors of burnout: The role of work stressors and work-related resources

The impact of work stressors and work-related resources on emotional exhaustion and depersonalization, as the two core factors of burnout, is investigated. According to the German Action Regulation Theory work stressors are conceptualized as regulation problems that lead to work stress in terms of additional effort (e.g. working longer hours), increased intensity of effort (e.g. working at a faster pace), and risky action (e.g. by neglecting safety rules). Consequently, an extended process model consisting of objective work stressors, work stress, emotional exhaustion and depersonalization is proposed. Nurses from three general hospitals (N=482) provided data for evaluating this model. Complete mediation of work stress and emotional exhaustion were analysed by hierarchical regression analysis. The overall model was tested by structural equation analysis in two steps; in the first step the basic model was analysed while in the second step the model was extended by autonomy as a work-related resource. The process model could be confirmed with respect to: (1) the mediating function of work stress and emotional exhaustion, and with regard to (2) the direct impact of autonomy as a work-related resource on work stressors but not on emotional exhaustion and depersonalization. Methodological considerations and implications for work design and burnout prevention are discussed.     

Efficiency Wages: Signals or Incentives An Empirical Study of the Relationship between Wage and Commitment

Efficiency wage theories arguethat firms induce their employees to work in a moredisciplined way by paying high wages. Two basicmechanisms have been pointed out in economics about how these wage premia motivate employees.The incentives-driven `shirking model' impliesthat employees who have a highly paid job workin a more disciplined way so as to avoid beingdismissed. The ``gift exchange' model is basedon the assumption that high wages change therelationship between employer and employee.Empirical evidence on the incentives approachis mixed and a thorough competitive testingagainst the gift exchange model was notpossible due to the fact that the latter wasnot worked out enough. However, there is a relational theory of efficiency wages which isworked out in detail in order to allow directcompetitive testing. This relationalsignaling approach, as it is called, is basedon framing effects and comes to specifichypotheses about the conditions under whichefficiency wages work. These hypothesescontrast sharply with predictions from theincentives approach. The paper presents anempirical test of the theories and shows thatthe data clearly reject the incentive-basedpredictions and confirm the relationalsignaling predictions.