Keeping pace with the ebbs and flows in daily nursing home operations

Health Care Management Science - Tập 22 - Trang 350-363 - 2018
René Bekker1, Dennis Moeke2, Bas Schmidt3
1Department of Mathematics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
2KennisDC Logistiek, HAN University of Applied Sciences, Arnhem, The Netherlands
3Deloitte, Amsterdam, The Netherlands

Tóm tắt

Nursing homes are challenged to develop staffing strategies that enable them to efficiently meet the healthcare demand of their residents. In this study, we investigate how demand for care and support fluctuates over time and during the course of a day, using demand data from three independent nursing home departments of a single Dutch nursing home. This demand data is used as input for an optimization model that provides optimal staffing patterns across the day. For the optimization we use a Lindley-type equation and techniques from stochastic optimization to formulate a Mixed-Integer Linear Programming (MILP) model. The impact of both the current and proposed staffing patterns, in terms of waiting time and service level, are investigated. The results show substantial improvements for all three departments both in terms of average waiting time as well as in 15 minutes service level. Especially waiting during rush hours is significantly reduced, whereas there is only a slight increase in waiting time during non-rush hours.

Tài liệu tham khảo

Atkinson J (1987) Flexibility or fragmentation? The United Kingdom labour market in the eighties. Labour Soc 12(1):87–105 Atlason J, Epelman M, Henderson S (2008) Optimizing call center staffing using simulation and analytic center cutting-plane methods. Manag Sci 54(2):295–309 Avramidis A, Deslauriers A, L’Ecuyer P (2004) Modeling daily arrivals to a telephone call center. Manag Sci 50(7):896–908 Backhaus R, Verbeek H, van Rossum E, Capezuti E, Hamers J (2014) Nurse staffing impact on quality of care in nursing homes: a systematic review of longitudinal studies. J Am Med Dir Assoc 15(6):383–393 Van den Bergh J, Beliën J, De Bruecker P, Demeulemeester E, De Boeck L (2013) Personnel scheduling: a literature review. Eur J Oper Res 226(3):367–385 Bhulai S, Koole G, Pot A (2008) Simple methods for shift scheduling in multiskill call centers. Manuf& Serv Oper Manag 10(3):411–420 Borst S, Mandelbaum A, Reiman M (2004) Dimensioning large call centers. Oper Res 52(1):17–34 Bredström D, Rönnqvist M (2008) Combined vehicle routing and scheduling with temporal precedence and synchronization constraints. Eur J Oper Res 191(1):19–31 Brown L, Gans N, Mandelbaum A, Sakov A, Shen H, Zeltyn S, Zhao L (2005) Statistical analysis of a telephone call center: a queueing-science perspective. J Amer Statist Assoc 100(469):36–50 Cezik M, L’Ecuyer P (2008) Staffing multiskill call centers via linear programming and simulation. Manag Sci 54(2):310–323 Di Giorgio L, Filippini M, Masiero G (2014) Implications of global budget payment system on nursing home costs. Health Polic 115(2):237–248 Dutch Healthcare Authority (2013) Annual statement of the Dutch healthcare system 2013, from fact to focus. Dutch Healthcare Authority (NZa) Utrecht Eveborn P, Flisberg P, Rönnqvist M (2006) Laps Care–an operational system for staff planning of home care. Eur J Oper Res 171(3):962–976 Gans N, Koole G, Mandelbaum A (2003) Telephone call centers: tutorial, review, and research prospects. Manuf Serv Oper Manag 5(2):79–141 Higginson I, Whyatt J, Silvester K (2011) Demand and capacity planning in the emergency department: how to do it. Emerg Med J 28(2):128–135 Hingstman T, Langelaan M, Wagner C (2012) De dagelijkse bezetting en kwaliteit van zorg in instellingen voor langdurige zorg [Daily utilization and quality of care in long-term care institutions]. NIVEL, Utrecht Van der Horst A, Erp F V, Jong J D (2011) Trends in gezondheid en zorg [Trends in health and care], CBS policy letter. CBS The Hague Hulshof P, Kortbeek N, Boucherie R, Hans E, Bakker P (2012) Taxonomic classification of planning decisions in health care: a structured review of the state of the art in OR/MS. Health Syst 1(2):129–175 Jack E, Powers T (2009) A review and synthesis of demand management, capacity management and performance in health-care services. Int J Manag Rev 11(2):149–174 Lieder A, Moeke D, Koole G, Stolletz R (2015) Task scheduling in long-term care facilities: a client-centered approach. Oper Res Health Care 6:11–17 Lipszyc B, Sail E, Xavier A (2012) Long-term care: need use and expenditure in the EU-27 (NO. 469). Directorate General Economic and Monetary Affairs (DG ECFIN). European Commission, Brussels Mankowska D, Meisel F, Bierwirth C (2014) The home health care routing and scheduling problem with interdependent services. Health Care Manag Sci 17(1):15–30 Ministry of Economic Affairs (2014) National reform programme 2014. The Netherlands. Ministry of Economic Affairs, The Hague Moeke D, van de Geer R, Koole G, Bekker R (2016) On the performance of small-scale living facilities in nursing homes: a simulation approach. Oper Res Health Care 11:20–34 Moeke D, Koole G, Verkooijen L (2014) Scale and skill-mix efficiencies in nursing home staffing: inside the black box. Health Syst 3(1):18–28 OECD (2017) OECD Health Statistics 2016. http://www.oecd.org/els/health-systems/health-data.htm Rais A, Viana A (2011) Operations research in healthcare: a survey. Int Trans Oper Res 18(1):1–31 Rasmussen M, Justesen T, Dohn A, Larsen J (2012) The home care crew scheduling problem: preference-based visit clustering and temporal dependencies. Eur J Oper Res 219(3):598–610 Sanford A, Orrell M, Tolson D, Abbatecola A, Arai H, Bauer J, Cruz-Jentoft A, Dong B, Ga H, Goel A et al (2015) An international definition for “nursing home”. J Am Med Dir Assoc 16(3):181–184 Schut E, Sorbe S, Hoj J (2013) Health care reform and long-term care in the Netherlands OECD Economics department working paper NO. 1010. OECD Publishing, Paris Sloane P, Miller L, Mitchell C, Rader J, Swafford K, Hiatt S (2007) Provision of morning care to nursing home residents with dementia: opportunity for improvement? Amer J Alzheimer’s Disease Dementias 22 (5):369–377 Soyer R, Tarimcilar M (2008) Modeling and analysis of call center arrival data: a bayesian approach. Manag Sci 54(2):266–278 Spilsbury K, Hewitt C, Stirk L, Bowman C (2011) The relationship between nurse staffing and quality of care in nursing homes: a systematic review. Int J Nurs Stud 48(6):732–750 Spruit M, Vroon R, Batenburg R (2014) Towards healthcare business intelligence in long-term care: an explorative case study in the Netherlands. Comput Hum Behav 30:698–707 Taylor J (2012) Density forecasting of intraday call center arrivals using models based on exponential smoothing. Manag Sci 58(3):534–549 Van Eeden K, Moeke D, Bekker R (2016) Care on demand in nursing homes: a queueing theoretic approach. Health Care Manag Sci 19(3):227–240 Véricourt Fd, Jennings OB (2011) Nurse staffing in medical units: a queueing perspective. Oper Res 59 (6):1320–1331 VWS (2014) Hervorming langdurige zorg: naar een waardevolle toekomst [Long-term care reforms: towards a valuable future] (Kamerbrief). Ministry of Health, Welfare and Sport (VWS), The Hague Yankovic N, Green L V (2011) Identifying good nursing levels: a queuing approach. Oper Res 59(4):942–955