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Modelling the requirement for supplementary nurses in an intensive care unit

Author

Listed:
  • J D Griffiths

    (University of Wales)

  • N Price-Lloyd

    (University of Wales)

  • M Smithies

    (University Hospital of Wales)

  • J E Williams

    (University of Wales)

Abstract

The intensive care unit (ICU) of a hospital is an essential yet costly resource. Consequently, intensive care modelling has become increasingly prevalent in recent years in attempts to increase efficiency and reduce costs. Previous models have usually assumed that the numbers of beds available are restricted; when all beds are occupied, any additional patients are referred elsewhere or elective surgeries are cancelled. In this study, activities at the ICU at a large teaching hospital were modelled using data relating to all admissions to the ICU during the year 2000—a total of 1084 admissions. The unit is unusual in that the majority of patients referred for intensive care therapy are admitted. Bed numbers are increased when necessary to cope with demand. However, nurses are a restricted resource. In order to maintain the required nurse:patient ratio of at least one:one, supplementary nurses are employed during busy periods. Supplementary nurse costs are substantial and so nurse utilization must be closely monitored. The development of a model that calculates the required number of supplementary nurses per shift, and also encapsulates the time-dependent nature of elective surgery admissions and complex duration-of-stay profiles, is presented in this paper. In particular, the model is used to determine the number of rostered nurses that are required to minimize overall nursing staff costs.

Suggested Citation

  • J D Griffiths & N Price-Lloyd & M Smithies & J E Williams, 2005. "Modelling the requirement for supplementary nurses in an intensive care unit," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 126-133, February.
    • Handle: RePEc:pal:jorsoc:v:56:y:2005:i:2:d:10.1057_palgrave.jors.2601882
    DOI: 10.1057/palgrave.jors.2601882
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    References listed on IDEAS

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    1. Kim, Seung-Chul & Horowitz, Ira & Young, Karl K. & Buckley, Thomas A., 1999. "Analysis of capacity management of the intensive care unit in a hospital," European Journal of Operational Research, Elsevier, vol. 115(1), pages 36-46, May.
    2. Ridge, J. C. & Jones, S. K. & Nielsen, M. S. & Shahani, A. K., 1998. "Capacity planning for intensive care units," European Journal of Operational Research, Elsevier, vol. 105(2), pages 346-355, March.
    3. P R Harper & A K Shahani, 2002. "Modelling for the planning and management of bed capacities in hospitals," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 53(1), pages 11-18, January.
    4. F Gorunescu & S I McClean & P H Millard, 2002. "A queueing model for bed-occupancy management and planning of hospitals," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 53(1), pages 19-24, January.
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    Cited by:

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    6. J P Oddoye & M A Yaghoobi & M Tamiz & D F Jones & P Schmidt, 2007. "A multi-objective model to determine efficient resource levels in a medical assessment unit," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(12), pages 1563-1573, December.
    7. Liping Zhou & Na Geng & Zhibin Jiang & Shan Jiang, 2022. "Integrated Multiresource Capacity Planning and Multitype Patient Scheduling," INFORMS Journal on Computing, INFORMS, vol. 34(1), pages 129-149, January.
    8. Fermín Mallor & Cristina Azcárate & Julio Barado, 2015. "Optimal control of ICU patient discharge: from theory to implementation," Health Care Management Science, Springer, vol. 18(3), pages 234-250, September.
    9. Adrian Fletcher & Dave Worthington, 2009. "What is a ‘generic’ hospital model?—a comparison of ‘generic’ and ‘specific’ hospital models of emergency patient flows," Health Care Management Science, Springer, vol. 12(4), pages 374-391, December.
    10. Josephine Varney & Nigel Bean & Mark Mackay, 2019. "The self-regulating nature of occupancy in ICUs: stochastic homoeostasis," Health Care Management Science, Springer, vol. 22(4), pages 615-634, December.
    11. Jie Bai & Andreas Fügener & Jan Schoenfelder & Jens O. Brunner, 2018. "Operations research in intensive care unit management: a literature review," Health Care Management Science, Springer, vol. 21(1), pages 1-24, March.
    12. Fermín Mallor & Cristina Azcárate & Julio Barado, 2016. "Control problems and management policies in health systems: application to intensive care units," Flexible Services and Manufacturing Journal, Springer, vol. 28(1), pages 62-89, June.
    13. Fermín Mallor & Cristina Azcárate, 2014. "Combining optimization with simulation to obtain credible models for intensive care units," Annals of Operations Research, Springer, vol. 221(1), pages 255-271, October.
    14. D Worthington, 2009. "Reflections on queue modelling from the last 50 years," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(1), pages 83-92, May.
    15. D C Lane & E Husemann, 2008. "System dynamics mapping of acute patient flows," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 59(2), pages 213-224, February.
    16. John Bowers, 2013. "Balancing operating theatre and bed capacity in a cardiothoracic centre," Health Care Management Science, Springer, vol. 16(3), pages 236-244, September.
    17. Tippong, Danuphon & Petrovic, Sanja & Akbari, Vahid, 2022. "A review of applications of operational research in healthcare coordination in disaster management," European Journal of Operational Research, Elsevier, vol. 301(1), pages 1-17.
    18. Kortbeek, N. & Braaksma, A. & Burger, C.A.J. & Bakker, P.J.M. & Boucherie, R.J., 2015. "Flexible nurse staffing based on hourly bed census predictions," International Journal of Production Economics, Elsevier, vol. 161(C), pages 167-180.
    19. Yin-Chi Chan & Eric W. M. Wong & Gavin Joynt & Paul Lai & Moshe Zukerman, 2018. "Overflow models for the admission of intensive care patients," Health Care Management Science, Springer, vol. 21(4), pages 554-572, December.
    20. P T Vanberkel & R J Boucherie & E W Hans & J L Hurink & W A M van Lent & W H van Harten, 2011. "An exact approach for relating recovering surgical patient workload to the master surgical schedule," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 62(10), pages 1851-1860, October.

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