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Nurse workforce scheduling in the emergency department: A sequential decision support system considering multiple

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This study introduces a mathematical model for nurse scheduling, significantly improving nurse-patient ratios and shift fairness in emergency departments compared to manual methods. The developed system aids in automatically generating optimal nurse rosters.

Keywords:
goal programmingnurse rostering problemshift scheduling

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Area of Science:

  • Operations Research
  • Healthcare Management
  • Nursing Informatics

Background:

  • Effective nurse scheduling is crucial for patient care quality and staff satisfaction.
  • Traditional manual scheduling methods often struggle to balance competing demands and preferences.

Purpose of the Study:

  • To develop and evaluate a mathematical programming framework for optimizing nurse scheduling.
  • To align nurse rostering with key performance indicators and multiple outcome measures.

Main Methods:

  • A mixed-integer sequential goal programming model was developed using historical emergency department data.
  • The model incorporated nurse-patient ratios, shift fairness, and rest day dispersion.
  • Performance was compared against manually generated historical nurse schedules.

Main Results:

  • The proposed model achieved a maximum nurse-patient ratio deviation of approximately 10%, a significant improvement over the 47% deviation from historical rosters.
  • An online decision support system was created, integrating staff preferences and workload forecasting.

Conclusions:

  • A novel decision support system based on mixed-integer sequential goal programming offers improved nurse scheduling.
  • The framework effectively balances managerial priorities with nurse preferences for automated roster generation.