本文精选了运营管理国际顶刊《Manufacturing & Service Operations Management》近期发表的论文，提供运营管理领域最新的学术动态。

When Does Collocation of Physical and Mental Health Services Matter?

原刊和作者：

Manufacturing & Service Operations Management, Volume 28, Issue 1

Vishal Ahuja （Southern Methodist University）

Carlos A. Alvarez （Texas Tech University Health Sciences Center）

Bradley R. Staats （University of North Carolina）

Abstract

Problem definition: A key choice in operational decision making is whether to collocate services. Although prior work has highlighted the benefits of collocation, these benefits may need to be balanced with potential costs. Thus, it is critical to understand not just whether collocation matters, but also when and for whom. We consider collocation in the context of healthcare and ask: Does collocation of mental and physical health resources improve outcomes? This is important, as primary care serves as a gateway to address mental health concerns. We next study collocation’s relationship with patient complexity and with three social risk factors: age, race, and income. Finally, we investigate two pathways through which collocation impacts outcomes. Methodology/results: As America’s largest integrated healthcare system, the Veterans Health Administration offers an excellent setting to investigate these questions. We empirically analyze more than 112,000 patients—over an 11-year period—who suffer from chronic conditions and show evidence of mental illness. We find that collocation is associated with improvement in four key outcomes: hospitalizations, length of stay (LOS), 30-day readmissions, and suicidal behavior. For example, a one-standard-deviation increase in collocation is related to a 3.4% average reduction in LOS, roughly equivalent to a savings of $3.6 million annually, just for our cohort, with the majority of the savings coming from severely ill patients. Further, collocation benefits patients who are younger, are non-Hispanic Blacks, and those with low incomes. Finally, our analysis reveals that collocation improves outcomes (partially) through a reduction in no-shows and an increase in medication adherence. Managerial implications: Our work demonstrates the importance of collocation as a strategic operational lever and offers insights into where to target collocation and, broadly, how to design an operationally efficient system. Theoretically, we advance the location literature, emphasize task complexity as a key moderator, and highlight collocation’s value in addressing health/social inequities.

Link: https://doi.org/10.1287/msom.2023.0662

It Takes Two to Make It Right: How Nurses’ Response to Sepsis Alerts Impacts Physicians’ Process Compliance

原刊和作者：

Manufacturing & Service Operations Management, Volume 28, Issue 1

Mehmet U. S. Ayvaci （The University of Texas at Dallas）

Zahra Mobini （Georgia Institute of Technology）

Özalp Özer （The University of Texas at Dallas）

Abstract

Problem definition: Standardized processes have improved operational performance across various sectors, including healthcare. A persistent gap, however, remains between evidence-based standards and actual clinical practice. Automated alert systems offer a solution by identifying situations where standards apply and prompting workers to act accordingly. In this study, we focus on sepsis, a life-threatening condition, for which timely performance of standard care actions—that is, compliance—is critical, and alert systems are employed to promote such compliance. We empirically examine how a clinical team—comprising two roles, nurse and physician, within a hierarchical structure—delivers care in compliance with standards using a sepsis alert system. This system introduces a workflow that reconfigures the traditional nurse-physician dynamic, enabling nurses to proactively engage in care delivery rather than passively awaiting physician instructions. Within this reconfigured team dynamic, we investigate how nurses’ timely response to sepsis alerts (acknowledging the alert and notifying physicians within a designated time frame) affects physicians’ compliance with sepsis care standards (performing diagnostic or treatment actions within a designated time frame). Methodology/results: Using multiple econometric specifications on data from a large U.S. hospital group with a sepsis alert system, we find that nurses’ timely response positively affects physicians’ compliance with care standards. This positive effect becomes stronger under heavy workloads and weaker as the number of false alerts increases. Furthermore, improved physician compliance, facilitated by nurses’ timely response, leads to shorter hospital stays and fewer intensive care admissions. Managerial implications: Contrary to the traditional view of nurses as subordinates executing physicians’ orders, our findings underscore nurses’ key role in improving physicians’ decision making and support recent initiatives to empower nurses in hospital operations. Our results also emphasize the importance of recognizing interprofessional complementarities as well as the nuances of workload and technology performance when designing workflows and allocating tasks to ensure high-quality care.

Link: https://doi.org/10.1287/msom.2022.0242

Strategic Communications with Socializing Agents Under Unknown Public Health Threats

原刊和作者：

Manufacturing & Service Operations Management, Volume 28, Issue 1

Ailing Xu （Huazhong University of Science and Technology）

Zhenxiao Chen （The Hong Kong Polytechnic University）

Qiao-Chu He （Southern University of Science and Technology）

Ying-Ju Chen （The Hong Kong University of Science and Technology）

Abstract

Problem definition: This paper investigates how governments can design optimal public health policies to inform and guide the public amid uncertain health threats. To capture heterogeneity in social behavior, we introduce a class of socializing agents and examine how the government strategically combines two policy instruments—persuasive communication (messages) and physical or monetary penalties—to incentivize compliance with social restrictions. Methodology/results: We develop a game-theoretic model in which the government commits in advance to both messaging and penalty strategies. The optimal policy exhibits a nonmonotonic structure with respect to the pandemic severity, alternating between the use of messages and penalties. Messages are shown to be most effective when the severity of the pandemic is either mild or moderate to high. Interestingly, socializing agents can indirectly promote compliance among traditional agents because of negative externalities, and the government may reduce penalty levels as pandemic severity increases. Managerial implications: Our findings underscore the strategic value of coordinating messages and penalties as complementary tools in public health policy. When the divergence between individual and governmental incentives is small, costless messages—especially those delivering finely granulated information—can effectively influence public behavior. Notably, we identify a dual role for state-contingent penalties not only in enhancing compliance but also in signaling pandemic severity. Overall, by examining the interplay of multiple policy instruments across different dimensions, our results highlight the importance of behavioral heterogeneity and government credibility in shaping public health policies under competing societal objectives.

Link: https://doi.org/10.1287/msom.2024.0936

Hospital vs. Home Care: Trading off Predischarge and Postdischarge Infection and Mortality Risks

原刊和作者：

Manufacturing & Service Operations Management, Volume 28, Issue 1

Mor Armony （New York University）

Galit Bracha Yom-Tov （Technion–Israel Institute of Technology）

Abstract

Problem definition: Determining the optimal length of stay (LOS) and posttreatment location is critical for hematology-oncology (blood cancer) patients, who are highly vulnerable to life-threatening infections. Early discharge to home care reduces infection risk, whereas extended hospital observation minimizes mortality risks if an infection occurs. We address this trade-off by developing LOS optimization models tailored to these patients. Methodology/results: We develop a newsvendor-type model to explore how infection and mortality risks influence optimal LOS of individual patients. We further consider the social optimization problem in which capacity constraints limit the ability of hospitals to keep patients for the entirety of their optimal LOS. We find that, in the optimal solution to the fluid model used to approximate the original stochastic system, each type of patient is discharged at at most two discrete time points, one of which might be equal to zero or to the optimal uncapacitated length of stay. Based on this analysis, we propose an online index-based speedup policy (ISP) to guide patient discharge decisions. Managerial implications: Our model enables physicians to personalize LOS based on patients’ risk profiles and dynamically adapt to hospital capacity constraints. In a case study, we show that around 75% of the patients need some observation, and a speedup-only policy that discharges all patients at the same discrete time point is optimal for 90% of patient types during high demand. Adopting ISP can reduce the patient mortality rate by 27.7% compared with current practice.

Link: https://doi.org/10.1287/msom.2021.0189

An Operational View on Managing Mass Trauma Events

Manufacturing & Service Operations Management, Volume 28, Issue 1

Noa Zychlinski （Technion–Israel Institute of Technology）

Abstract

Problem definition: Mass trauma events (MTEs) present significant operational challenges. Affected populations require both immediate and prolonged mental health support, complicating response efforts. Posttraumatic stress disorder (PTSD) can have lasting effects and imposes a substantial economic burden, making early intervention critical to improving outcomes. The October 7, 2023, terror attack in southern Israel caused widespread trauma. Survivors, responders, and many others were exposed to extreme atrocities, placing an estimated 5.3% of the population at risk for developing PTSD and related conditions. This crisis underscores the urgent need for practical policies to deliver timely mental healthcare amid a surge in demand on an already-strained system. Methodology/results: We study the coordination of group and individual therapy channels in a multiserver queueing setting. Group therapy can alleviate immediate workload but may lead to increased follow-up demand for individual treatment. Our model captures this trade-off and the interdependence between therapy channels while accounting for key mental health system features, such as patient no-shows and dropouts. Using a fluid approximation, we derive index-based policies tailored to the surge, recovery, and long-term phases of MTEs, integrating time-varying, transient, and steady-state dynamics. Drawing on data from the attack and prior MTEs, we show that our policies can shorten the recovery phase by approximately six months, reduce queue lengths by 31%, and increase total cost savings by 52% relative to a benchmark policy that we adapted to incorporate group therapy, no-shows, and dropouts. These improvements result from embedded channel coordination in our policies. Managerial implications: Our results highlight the value of channel-specific coordination in mental health scheduling policies for traumatized populations. The index-based rules that we propose are simple to implement and offer actionable guidance for practitioners and policymakers managing care delivery after MTEs. Applying these policies can enhance support for at-risk populations, reduce system strain, and strengthen community recovery and resilience.

Link: https://doi.org/10.1287/msom.2024.1488