Towards a model of Strategic Roster Planning and Control: an empirical study of nurse rostering practices in the UK National Health Service

Abstract

Despite the criticality of nurse rostering practices, there is a surprising lack of attention paid to this managerial activity both in practice and in the health-service management literature. This paper reports the results of an inductive, empirical study of rostering practices in the UK National Health Service with a view to developing a shared understanding of roster planning processes and of what constitutes rostering effectiveness. A survey of rostering practices in 50 wards, followed by five in-depth, longitudinal case studies, revealed the complexity of rostering activities, and identified the main design parameters, which were used to specify rostering systems and to prepare periodic rosters. Rostering activities were perceived to directly impact upon service delivery, resource utilization and nurse retention. A number of poor rostering practices were identified, which could lead to dysfunctional behaviour. This analysis points to a clear managerial imperative to improve local competencies in roster planning and control, recognizing their strategic significance in contributing to hospital effectiveness. A 'Strategic Roster Planning and Control (SRPC)' model is proposed, which may provide a framework for evaluating rostering effectiveness, and a platform for the sharing of best practice, in order to stimulate organizational learning and achieve nationwide improvements in hospital performance.

The nurse rostering problem: from operational research to organizational reality?

“…This is considered an undervalued, stressful and unpopular task (Silvestro & Silvestro 2008). This is considered an undervalued, stressful and unpopular task (Silvestro & Silvestro 2008).…”

“…In the absence of a roster policy, a ward manager may choose to resolve a conflict of interest between the organization and her staff by allowing individuals to define their own rosters, possibly to the detriment of other staff, the hospital and the patient. Wards may claim to be 'self-rostering', but, in the absence of formal rules, this can result in some individuals being treated preferentially (Silvestro & Silvestro 2008). Wards may claim to be 'self-rostering', but, in the absence of formal rules, this can result in some individuals being treated preferentially (Silvestro & Silvestro 2008).…”

The ‘Robust’ roster: exploring the nurse rostering process

“…On paper, rosters poor legibility is commonplace. As Silvestro and Silvestro (, p. 103) note, ‘Repeated amendments to the roster, by different staff members at different times and generous daubs of ‘typex’ can make rosters so difficult to read that it is not surprising that arithmetic errors are made’. Kerr and Timony () suggest that postapproval changes can involve as many as 50% of the originally rostered shifts.…”

“…Consequently, 'rostering' may be used to describe aspects of requirement (staff demand planning), budgeting or shortterm scheduling, all of which are closely interrelated (Drake 2013). Rostering is a complex task, which affects patient care, staff job satisfaction and hospital budgets (Silvestro & Silvestro 2008). Despite this, rostering receives limited attention from healthcare researchers (Silvestro & Silvestro 2008, Kerr & Timony 2009).…”

“…Rostering is a complex task, which affects patient care, staff job satisfaction and hospital budgets (Silvestro & Silvestro 2008). Despite this, rostering receives limited attention from healthcare researchers (Silvestro & Silvestro 2008, Kerr & Timony 2009). Meanwhile, the focus of Operational Management research is the development of models and algorithms for the initial scheduling of rosters (Burke et al 2004, de Causmaecker & Vanden Berghe 2011.…”