Personnel Staffing and Scheduling

Not only do personnel make up approximately 2/3 of the cost of hospital health care, but they also account for an even higher percentage of the quality of care delivered, and patient safety. Additionally, they, with physicians, are the major determinate of how quickly a patient moves through a hospital. The key factor for throughput, quality, and safety, is that the correct number of personnel, with the correct qualifications and correct motivation, be present at the right times and places of the patient’s stay. This is the goal of the personnel staffing and scheduling processes and systems in hospitals. This chapter first briefly reviews the history of the use of modeling for more efficient and effective scheduling and staffing. Then it presents in some detail modeling work to move staff management decisions from the present, where intervention options are severely limited, into the near future (several days) where intervention options are numerous. This significantly improves not only throughput but also quality, safety, and staff satisfaction. This new effort involves the following: (1) Forecasting demand for staff into the near future, (2) Predicting no-shows of prescheduled personnel, and (3) A robust decision support system to include professional judgment and “best practices” allowing the hospital to be able to take advantage of the significant increase in intervention options for staffing (for example) 4 days ahead rather than 4 h ahead. How this effort fits into the larger aspects of staff management is discussed, along with possible future opportunities to use modeling to improve staff management in hospitals.