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Mehmet Ayvaci, Associate Professor of Information Systems, Naveen Jindal School of Management, University of Texas at Dallas.
Title: It Takes Two to Make It Right: How Nurses’ Response to Sepsis Alerts Impacts Physicians’ Process Compliance
Abstract: Standard processes have led to improved operational performance in different sectors, including healthcare. Despite the demonstrated benefits of standards, a wide gap remains between what standards suggest and what typically occurs in practice. Automated alert systems can facilitate compliance with standards by identifying situations in which standards apply and prompting workers to act in accordance with those standards. In this study, we focus on sepsis, a life-threatening health condition, for which timely performance of standard care actions--i.e., compliance--is critical, and alert systems are employed to ensure such compliance. We empirically examine how a clinical team, consisting of the two roles of nurse and physician, provides care in compliance with evidence-based standards using a sepsis alert system. In particular, we study whether and when nurses' timely response to sepsis alerts (i.e., acknowledging the alert and notifying physicians within a designated time frame) impacts physicians' compliance with sepsis care standards (i.e., performing diagnostic or treatment actions within a designated time frame). Using data from a large hospital system in the U.S. with a sepsis alert implementation, we find that nurses' timely response has a positive spillover effect on physicians’ compliance with care standards by reducing the time it takes for physicians to respond. This effect is more pronounced for patients with higher risk of sepsis. Increased physician compliance, resulting from nurse's response, in turn reduces patients' length of hospital stay and the likelihood of admission into the intensive care. Our analysis also suggests that nurses' complementary role in physicians' decision-making becomes stronger as workload increases and weaker as the number of false alerts increases. In contrast to the traditional view of nurses as subordinates primarily following physicians’ orders, our findings underscore nurses' key role in improving physicians’ decision-making, supporting recent efforts to empower nurses in hospital operations. Our results also emphasize the necessity of taking into account inter-professional complementarities as well as nuances of workload and technology performance when designing workflows around technology solutions and allocating tasks to ensure quality care.
Bio: Dr. Mehmet Ayvaci is an Associate Professor of Information Systems at the University of Texas Dallas. His research broadly explores the economics of information and information technology in healthcare, with a specific focus on algorithmic decision-making and human behavior. His interdisciplinary research combines stochastic modeling, optimization, game theory, econometrics, and machine learning. Dr. Ayvaci has published in top journals across various fields, including Information Systems Research, MIS Quarterly, MS&OM, American Journal of Transplantation, and Medical Decision Making. Among his many honors are the Conference of Health IT and Analytics (CHITA) “Best Young Researcher” Award, “Best Paper” Award given by the POMS College of Healthcare Operations Management, and the “Best Published Paper” Award given by the Information Systems Research Journal. His works have received publicity through a variety of channels including coverage in media, news stories in practitioner magazines, and editorials in academic journals. Prof. Ayvaci earned a B.S. degree in Industrial Engineering from Texas A&M University, an M.S. degree in Management Science & Engineering from Stanford University, and a Ph.D. degree in Industrial and Systems Engineering from the University of Wisconsin-Madison.