Health Care Management Science

, Volume 22, Issue 2, pp 350–363 | Cite as

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

  • René BekkerEmail author
  • Dennis Moeke
  • Bas Schmidt


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.


Nursing home care Scheduled care Demand patterns Staffing Waiting times Scheduling 



The authors would like to thank Ruben van de Geer for support with the modification of the simulation model.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of MathematicsVrije Universiteit AmsterdamAmsterdamThe Netherlands
  2. 2.KennisDC LogistiekHAN University of Applied SciencesArnhemThe Netherlands
  3. 3.DeloitteAmsterdamThe Netherlands

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