Disaggregation planning, scheduling, and allocation of nursing staff

Abstract

Nursing salaries make up the largest single element of hospital costs. Thus the effective planning, scheduling, and allocation of available nursing staff to patient care requirements is perhaps the most important tool available to control hospital health care delivery costs. This paper presents the requirements and constraints for nursing staff and describes procedures for more effective utilization of nursing staff, utilizing disaggregation principles. The three levels of disaggregation are:

• 1. Forecasting and planning. This involves forecasting overall nursing staff requirements over a year, taking into account such considerations as seasonality of patient census, staff vacation requirements, and new patient care programs.

• 2. Scheduling. This refers to the preparation of staff schedules, shift by shift, taking into account staff requirements and nursing unit constraints. These schedules are typically developed for a period two to eight weeks ahead.

• 3. Allocation. This is a process of reallocation of nursing staff on a day-to-day and shift-to-shift basis, to take into account short-time fluctuations in patient requirements, unforeseen staff absences, and availability of supplementary nursing staff.