A chance-constrained program for the allocation of nurses in acute home healthcare

Home healthcare capacity is under great pressure due to demographic developments. Existing literature has exclusively focused on the planning, scheduling, and routing of non-acute care activities. However, similar to other healthcare settings, home healthcare also experiences acute care activities that disrupt operational performance. We study the planning and control of an acute care team for dealing with unplanned and urgent home healthcare activities. Particularly, we focus on determining the number of nurses per care level and their standby locations. The primary aim of this study is to introduce this novel problem, which we define as the acute care team location problem. We formulate this problem as a chance-constrained program. We solve the single location problem to optimality, and the multi-location problem with sample average approximation. The results show that our approach enables decision makers to optimally configure their acute care team, to respond quickly to acute care incidents. From a managerial perspective, our research provides a model that supports tactical capacity planning in HHC organisations and presents a benchmark for acute care management policies.