Nurse Staffing in Medical Units: A Queueing Perspective
Nurse Staffing in Medical Units: A Queueing Perspective
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DOI：
10.1287/opre.1110.0968
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发表时间：
2011-11-01
影响因子：
2.7
通讯作者：
Jennings, Otis B.
中科院分区：
文献类型：
--
作者：
de Vericourt, Francis;Jennings, Otis B.
在本文中，我们提出了一个封闭的决策模型，以确定有效的护士配备政策。我们明确地模拟了s名护士在一个单一的医疗单位与n个同质的病人作为一个封闭的M / M / s / / n排队系统，其中每个病人之间的交替需要帮助和不经历的工作量。医疗单位的绩效是基于过度延迟的概率，即病人需要护理和护士提供护理之间的延迟超过给定时间阈值的相对频率。使用新的多服务器渐近结果，我们发现，有效的人员配置政策应该偏离阈值特定的护士与病人的比例的因素，考虑到目前在单位的病人总数。特别是，我们的人员配备规则显着不同于加州法案AB 394，立法规定固定的护士与病人的人员配备比例。仿真结果表明，我们的结果是强大的延迟相关的服务时间，一般分布的服务时间，和非同质的病人，即，不同敏锐度的人
In this paper, we present a closed queueing model to determine efficient nurse staffing policies. We explicitly model the workload experienced by s nurses within a single medical unit with n homogeneous patients as a closed M / M / s / / n queueing system, where each patient alternates between requiring assistance and not. The performance of the medical unit is based on the probability of excessive delay, the relative frequency with which the delay between the onset of patient neediness and the provision of care from a nurse exceeds a given time threshold. Using new many-server asymptotic results, we find that effective staffing policies should deviate from threshold-specific nurse-to-patient ratios by factors that take into account the total number of patients present in the unit. In particular, our staffing rule significantly differs from California Bill AB 394, legislation that mandates fixed nurse-to-patient staffing ratios. Simulations show that our results are robust to delay-dependent service times, generally distributed service times, and nonhomogeneous patients, i.e., those with different acuity levels.