This paper studies outsourcing decisions for a two-level service process in which the first level serves as a gatekeeper for a second level of experts. The objective of the system operator (the client) is to minimize the sum of staffing costs, customer waiting costs, and mistreatment costs due...

This paper studies service systems with gatekeepers who diagnose a customer problem and then either refer the customer to an expert or attempt treatment. The probability of successful treatment by a gatekeeper decreases as the problem's complexity increases. We determine the optimal staffing...

Many service systems use case managers, servers who are assigned multiple customers and have frequent, repeated interactions with each customer until the customer’s service is completed. Examples may be found in health care (emergency department physicians), contact centers (agents handling...

We consider the work flow in a medical teaching facility, examining the process that involves an initial patient exam by a resident physician, a subsequent conference between the resident and the attending physician, and the attending physician’s visit with the patient. We create an analytical...