Forecasting and Dynamic Adjustment of Staffing Levels in Hospital Operating Rooms

Abstract

This paper presents a forecasting mechanism of operating room workload and dynamic adjustment policy on the staffing level decisions, which may be used by hospitals to better schedule the operating rooms. Staffing levels are usually determined months in advance when little information about the surgeries and their durations is known. This lack of information leads to a mismatch between the staffing level and the actual surgical duration, which results in excessive labor costs. This paper proposes a new dynamic staffing policy according to which hospital administrators adjust nurse staffing levels as information on the different types of surgeries arrives sequentially. The staffing level adjustments are accompanied with cost in order to incorporate the unwillingness to change. Using this dynamic framework, it is shown that a threshold policy defined by two adjustment levels is optimal. Numerical results using data from a large academic center suggest that the practical appeal of the dynamic policies will be greater where they will face the largest resistance: in hospitals where management considers dynamic labor adjustments to be impractical due to their complexity and thus implied costs.

Keywords: Hospital Operating Rooms Nurse Staffing, Demand Forecasting, Dynamic Programming