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Nurse Staffing in Medical Units: A Queueing Perspective

Author

Listed:
  • Francis de Véricourt

    (INSEAD, Singapore 138673, Republic of Singapore)

  • Otis B. Jennings

    (Fuqua School of Business, Duke University, Durham, North Carolina 27708)

Abstract

In this paper, we present a closed queueing model to determine efficient nurse staffing policies. We explicitly model the workload experienced by s nurses within a single medical unit with n homogeneous patients as a closed M / M / s // n queueing system, where each patient alternates between requiring assistance and not. The performance of the medical unit is based on the probability of excessive delay, the relative frequency with which the delay between the onset of patient neediness and the provision of care from a nurse exceeds a given time threshold. Using new many-server asymptotic results, we find that effective staffing policies should deviate from threshold-specific nurse-to-patient ratios by factors that take into account the total number of patients present in the unit. In particular, our staffing rule significantly differs from California Bill AB 394, legislation that mandates fixed nurse-to-patient staffing ratios. Simulations show that our results are robust to delay-dependent service times, generally distributed service times, and nonhomogeneous patients, i.e., those with different acuity levels.

Suggested Citation

  • Francis de Véricourt & Otis B. Jennings, 2011. "Nurse Staffing in Medical Units: A Queueing Perspective," Operations Research, INFORMS, vol. 59(6), pages 1320-1331, December.
    • Handle: RePEc:inm:oropre:v:59:y:2011:i:6:p:1320-1331
    DOI: 10.1287/opre.1110.0968
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    References listed on IDEAS

    as
    1. Opher Baron & Joseph Milner, 2009. "Staffing to Maximize Profit for Call Centers with Alternate Service-Level Agreements," Operations Research, INFORMS, vol. 57(3), pages 685-700, June.
    2. Francis de Véricourt & Otis B. Jennings, 2008. "Dimensioning Large-Scale Membership Services," Operations Research, INFORMS, vol. 56(1), pages 173-187, February.
    3. Yifan Liu & Lawrence M. Wein, 2008. "A Queueing Analysis to Determine How Many Additional Beds Are Needed for the Detention and Removal of Illegal Aliens," Management Science, INFORMS, vol. 54(1), pages 1-15, January.
    4. Shlomo Halfin & Ward Whitt, 1981. "Heavy-Traffic Limits for Queues with Many Exponential Servers," Operations Research, INFORMS, vol. 29(3), pages 567-588, June.
    5. Avishai Mandelbaum & Sergey Zeltyn, 2009. "Staffing Many-Server Queues with Impatient Customers: Constraint Satisfaction in Call Centers," Operations Research, INFORMS, vol. 57(5), pages 1189-1205, October.
    Full references (including those not matched with items on IDEAS)

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