Scale and skill-mix efficiencies in nursing home staffing: inside the black box

Moeke, Dennis; Koole, Ger; Verkooijen, Lineke

doi:10.1057/hs.2013.9

Cited by 10 publications

(22 citation statements)

References 26 publications

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“…When it comes to the delivery of healthcare in a nursing home setting, care workers can be regarded as the most important resource as they are responsible for the daily care and supervision of clients. Furthermore, they account for a significant proportion of the total costs of nursing home care [24].…”

Section: A Queueing Theoretic Approachmentioning

confidence: 99%

“…From a client-centered perspective, in which the client's needs and wishes are the starting point for the delivery of care [2], 'quality of care' can be defined as the extent to which needs and preferences of the nursing home residents are being met [25]. According to Moeke et al [24] an important aspect of client-centered care is that nursing home residents do not want to adjust their lives to the schedule of care workers, but want to have influence on the moment (day and time) at which care will be delivered. In practice, nursing homes face ever-tightening financial constraints.…”

Section: Introductionmentioning

confidence: 99%

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Care on demand in nursing homes: a queueing theoretic approach

Eeden¹,

Moeke

Bekker³

2014

Health Care Manag Sci

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Nursing homes face ever-tightening healthcare budgets and are searching for ways to increase the efficiency of their healthcare processes without losing sight of the needs of their residents. Optimizing the allocation of care workers plays a key role in this search as care workers are responsible for the daily care of the residents and account for a significant proportion of the total labor expenses. In practice, the lack of reliable data makes it difficult for nursing home managers to make informed staffing decisions. The focus of this study lies on the 'care on demand' process in a Belgian nursing home. Based on the analysis of real-life 'call button' data, a queueing model is presented which can be used by nursing home managers to determine the number of care workers required to meet a specific service level. Based on numerical experiments an 80/10 service level is proposed for this nursing home, meaning that at least 80 percent of the clients should receive care within 10 minutes after a call button request. To the best of our knowledge, this is the first attempt to develop a quantitative model for the 'care on demand' process in a nursing home.

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Section: A Queueing Theoretic Approachmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Care on demand in nursing homes: a queueing theoretic approach

Eeden¹,

Moeke

Bekker³

2014

Health Care Manag Sci

Self Cite

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“…The studies by Vanberkel et al (2012) and Wright and Mahar (2013) examines pooling effects on the nursing staff in a hospital setting. The study of Moeke et al (2014) examines scale efficiencies in a nursing home context.…”

Section: Research In Nursing Homesmentioning

confidence: 99%

“…Studies on skill substitution (also referred to as skill-mix or hierarchical qualifications) are provided by Gibbs et al (1991) and Spilsbury et al (2011) in a hospital setting, and by Moeke et al (2014) in a nursing home setting. Different from this paper, these studies do not provide an optimization approach for the task scheduling problem at hand and they focus on the impact of skill substitution on staffing costs.…”

Section: Research In Nursing Homesmentioning

confidence: 99%

“…As stated by Moeke and Verkooijen (2013) and Moeke et al (2014), the goal of a client-centered nursing homes is to provide their residents with the care they require in such way that it becomes possible for them to live the life they prefer. The optimization problem that arises in this context is to design schedules for the delivery of health care tasks that meet the time preferences of the clients as closely as possible.…”

Section: Introductionmentioning

confidence: 99%

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Task Scheduling in Long-Term Care Facilities: A Client-Centered Approach

et al. 2014

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In this study, we analyze a task scheduling problem with small time windows and care workers with different levels of qualification in a nursing home. A set of care tasks has to be assigned to a given number of care workers, so that the total earliness and tardiness from the nursing home residents' preferred time is minimized.To optimally solve this scheduling problem, we formulate a mixed integer program (MIP) and develop a dynamic programming (DP) approach. The numerical analysis shows the reliability of this optimization approach as well as of a heuristic DP approach. A sensitivity analysis with real-world demand data shows the impact of hierarchical qualification levels and large-scale scheduling.

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

Bekker

Moeke

Schmidt³

2018

Health Care Manag Sci

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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.

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Scale and skill-mix efficiencies in nursing home staffing: inside the black box

Cited by 10 publications

References 26 publications

Care on demand in nursing homes: a queueing theoretic approach

Care on demand in nursing homes: a queueing theoretic approach

Task Scheduling in Long-Term Care Facilities: A Client-Centered Approach

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

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