The 'Robust' roster: exploring the nurse rostering process.

Area of Science:

• Nursing Workforce Management
• Healthcare Operations Research
• Human Resources in Healthcare

Background:

• Published nurse rosters frequently undergo post-approval modifications, with limited examination of their implications.
• There is a lack of evidence regarding the safety, efficiency, and fairness of 'worked' rosters.
• Electronic rostering systems offer enhanced transparency for scrutinizing post-approval roster changes.

Purpose of the Study:

• To identify and explore the relationships between different stages of the rostering process and the robustness of the final worked roster.
• To assess how shift assignment methods and post-approval changes influence roster rule adherence.

Main Methods:

• Quantitative analysis comparing roster process stages with shifts breaking predefined rules.
• Inclusion of 42 roster periods from 15 wards (November 2009–January 2013).
• Data capture on shift assignment type (request, manual, automatic) and post-approval changes; linear regression analysis.

Main Results:

• Roster robustness is not influenced by the number of staff requests.
• Shift assignment methods prior to approval and the extent of post-approval changes significantly affect roster robustness.
• The quality of the approved roster and subsequent demand- and supply-driven changes determine roster robustness.

Conclusions:

• Roster robustness is contingent on initial approval quality and post-approval adjustments.
• While e-rostering can enhance robustness, manual rostering remains prevalent among Ward Managers.
• Some wards approve rosters despite ongoing rule violations.