Consistent Staffing for Long-Term Care through On-Call Pools

• 成果类型: Article
• 署名作者: Slaugh, Vincent W.; Scheller-Wolf, Alan A.; Tayur, Sridhar R.
• 署名单位: Cornell University; Carnegie Mellon University
• 刊物名称: PRODUCTION AND OPERATIONS MANAGEMENT
• ISSN/ISSBN: 1059-1478
• DOI: 10.1111/poms.12917
• 发表日期: 2018
• 页码: 2144-2161
• 关键词: Health care; absenteeism; nursing homes; stochastic models; Schur-convexity

摘要

Nursing home managers are increasingly striving to ensure consistency of care, defined as minimizing the number of unique nurse aides who care for a resident during at least one shift over the course of one month. Unfortunately, managers often struggle to provide consistent care, primarily due to last-minute nurse aide absences and choosing to staff these absences with aides from an external rental agency. We are the first to study the use of an on-call pool-aides on staff who may be called in to work in the event of absences-as an operational strategy to improve consistency. We provide structural results for the relationship between the number of aides in the on-call pool, staffing cost, and inconsistency level. We also show that a restricted on-call pool-in which the slots in the pool are distributed as evenly as possible across units-outperforms an open, or unrestricted, on-call pool. We further demonstrate that converting full-time positions to part-time positions can improve consistency of care if the part-time aides' on-call pool participation rate is sufficiently high. Numerical results for a typical 100-bed and a 200-bed facility demonstrate that an on-call pool can (a) reduce the staffing costs due to absences by 24% while also (slightly) reducing the inconsistency level, or (b) significantly reduce the inconsistency level without increasing costs.