Identifying Good Nursing Levels: A Queuing Approach

Yankovic, Natalia; Green, Linda V.

Abstract

Nursing care is arguably the single biggest factor in both the cost of hospital care and patient satisfaction. Inadequate inpatient nursing levels have also been cited as a significant factor in medical errors and emergency room overcrowding. Yet, there is widespread dissatisfaction with the current methods of determining nurse staffing levels, including the most common one of using minimum nurse-to-patient ratios. In this paper, we represent the nursing system as a variable finite-source queuing model. We develop a reliable, tractable, easily parameterized two-dimensional model to approximate the actual interdependent dynamics of bed occupancy levels and demands for nursing. We use this model to show how unit size, nursing intensity, occupancy levels, and unit length-of-stay affect the impact of nursing levels on performance and thus how inflexible nurse-to-patient ratios can lead to either understaffing or overstaffing. The model is also useful for estimating the impact of nurse staffing levels on emergency department overcrowding.

Más información

Título según WOS: ID WOS:000295030200010 Not found in local WOS DB
Título de la Revista: OPERATIONS RESEARCH
Volumen: 59
Número: 4
Editorial: INFORMS
Fecha de publicación: 2011
Página de inicio: 942
Página final: 955
DOI:

10.1287/opre.1110.0943

Notas: ISI