IDEAS home Printed from https://ideas.repec.org/a/pal/jorsoc/v56y2005i2d10.1057_palgrave.jors.2601882.html
   My bibliography  Save this article

Modelling the requirement for supplementary nurses in an intensive care unit

Author

Listed:
  • J D Griffiths

    (University of Wales)

  • N Price-Lloyd

    (University of Wales)

  • M Smithies

    (University Hospital of Wales)

  • J E Williams

    (University of Wales)

Abstract

The intensive care unit (ICU) of a hospital is an essential yet costly resource. Consequently, intensive care modelling has become increasingly prevalent in recent years in attempts to increase efficiency and reduce costs. Previous models have usually assumed that the numbers of beds available are restricted; when all beds are occupied, any additional patients are referred elsewhere or elective surgeries are cancelled. In this study, activities at the ICU at a large teaching hospital were modelled using data relating to all admissions to the ICU during the year 2000—a total of 1084 admissions. The unit is unusual in that the majority of patients referred for intensive care therapy are admitted. Bed numbers are increased when necessary to cope with demand. However, nurses are a restricted resource. In order to maintain the required nurse:patient ratio of at least one:one, supplementary nurses are employed during busy periods. Supplementary nurse costs are substantial and so nurse utilization must be closely monitored. The development of a model that calculates the required number of supplementary nurses per shift, and also encapsulates the time-dependent nature of elective surgery admissions and complex duration-of-stay profiles, is presented in this paper. In particular, the model is used to determine the number of rostered nurses that are required to minimize overall nursing staff costs.

Suggested Citation

  • J D Griffiths & N Price-Lloyd & M Smithies & J E Williams, 2005. "Modelling the requirement for supplementary nurses in an intensive care unit," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 126-133, February.
    • Handle: RePEc:pal:jorsoc:v:56:y:2005:i:2:d:10.1057_palgrave.jors.2601882
    DOI: 10.1057/palgrave.jors.2601882
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1057/palgrave.jors.2601882
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1057/palgrave.jors.2601882?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. F Gorunescu & S I McClean & P H Millard, 2002. "A queueing model for bed-occupancy management and planning of hospitals," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 53(1), pages 19-24, January.
    2. Kim, Seung-Chul & Horowitz, Ira & Young, Karl K. & Buckley, Thomas A., 1999. "Analysis of capacity management of the intensive care unit in a hospital," European Journal of Operational Research, Elsevier, vol. 115(1), pages 36-46, May.
    3. Ridge, J. C. & Jones, S. K. & Nielsen, M. S. & Shahani, A. K., 1998. "Capacity planning for intensive care units," European Journal of Operational Research, Elsevier, vol. 105(2), pages 346-355, March.
    4. P R Harper & A K Shahani, 2002. "Modelling for the planning and management of bed capacities in hospitals," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 53(1), pages 11-18, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Eduardo Pérez & David P. Dzubay, 2021. "A scheduling-based methodology for improving patient perceptions of quality of care in intensive care units," Health Care Management Science, Springer, vol. 24(1), pages 203-215, March.
    2. D C Lane & E Husemann, 2008. "System dynamics mapping of acute patient flows," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 59(2), pages 213-224, February.
    3. Tippong, Danuphon & Petrovic, Sanja & Akbari, Vahid, 2022. "A review of applications of operational research in healthcare coordination in disaster management," European Journal of Operational Research, Elsevier, vol. 301(1), pages 1-17.
    4. J P Oddoye & M A Yaghoobi & M Tamiz & D F Jones & P Schmidt, 2007. "A multi-objective model to determine efficient resource levels in a medical assessment unit," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(12), pages 1563-1573, December.
    5. Josephine Varney & Nigel Bean & Mark Mackay, 2019. "The self-regulating nature of occupancy in ICUs: stochastic homoeostasis," Health Care Management Science, Springer, vol. 22(4), pages 615-634, December.
    6. Fermín Mallor & Cristina Azcárate, 2014. "Combining optimization with simulation to obtain credible models for intensive care units," Annals of Operations Research, Springer, vol. 221(1), pages 255-271, October.
    7. D Worthington, 2009. "Reflections on queue modelling from the last 50 years," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(1), pages 83-92, May.
    8. Vincent Knight & Izabela Komenda & Jeff Griffiths, 2017. "Measuring the price of anarchy in critical care unit interactions," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 68(6), pages 630-642, June.
    9. Amir Elalouf & Dmitry Tsadikovich & Sharon Hovav, 2021. "A simulation-based approach for improving the clinical blood sample supply chain," Health Care Management Science, Springer, vol. 24(1), pages 216-233, March.
    10. P R Harper & N H Powell & J E Williams, 2010. "Modelling the size and skill-mix of hospital nursing teams," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(5), pages 768-779, May.
    11. Liping Zhou & Na Geng & Zhibin Jiang & Shan Jiang, 2022. "Integrated Multiresource Capacity Planning and Multitype Patient Scheduling," INFORMS Journal on Computing, INFORMS, vol. 34(1), pages 129-149, January.
    12. Fermín Mallor & Cristina Azcárate & Julio Barado, 2015. "Optimal control of ICU patient discharge: from theory to implementation," Health Care Management Science, Springer, vol. 18(3), pages 234-250, September.
    13. Jie Bai & Andreas Fügener & Jan Schoenfelder & Jens O. Brunner, 2018. "Operations research in intensive care unit management: a literature review," Health Care Management Science, Springer, vol. 21(1), pages 1-24, March.
    14. Fermín Mallor & Cristina Azcárate & Julio Barado, 2016. "Control problems and management policies in health systems: application to intensive care units," Flexible Services and Manufacturing Journal, Springer, vol. 28(1), pages 62-89, June.
    15. Kortbeek, N. & Braaksma, A. & Burger, C.A.J. & Bakker, P.J.M. & Boucherie, R.J., 2015. "Flexible nurse staffing based on hourly bed census predictions," International Journal of Production Economics, Elsevier, vol. 161(C), pages 167-180.
    16. Azcarate, Cristina & Esparza, Laida & Mallor, Fermin, 2020. "The problem of the last bed: Contextualization and a new simulation framework for analyzing physician decisions," Omega, Elsevier, vol. 96(C).
    17. Adrian Fletcher & Dave Worthington, 2009. "What is a ‘generic’ hospital model?—a comparison of ‘generic’ and ‘specific’ hospital models of emergency patient flows," Health Care Management Science, Springer, vol. 12(4), pages 374-391, December.
    18. John Bowers, 2013. "Balancing operating theatre and bed capacity in a cardiothoracic centre," Health Care Management Science, Springer, vol. 16(3), pages 236-244, September.
    19. Yin-Chi Chan & Eric W. M. Wong & Gavin Joynt & Paul Lai & Moshe Zukerman, 2018. "Overflow models for the admission of intensive care patients," Health Care Management Science, Springer, vol. 21(4), pages 554-572, December.
    20. P T Vanberkel & R J Boucherie & E W Hans & J L Hurink & W A M van Lent & W H van Harten, 2011. "An exact approach for relating recovering surgical patient workload to the master surgical schedule," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 62(10), pages 1851-1860, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kim, Seung-Chul & Horowitz, Ira, 2002. "Scheduling hospital services: the efficacy of elective-surgery quotas," Omega, Elsevier, vol. 30(5), pages 335-346, October.
    2. repec:dgr:rugsom:02a63 is not listed on IDEAS
    3. Josephine Varney & Nigel Bean & Mark Mackay, 2019. "The self-regulating nature of occupancy in ICUs: stochastic homoeostasis," Health Care Management Science, Springer, vol. 22(4), pages 615-634, December.
    4. Vahab Vahdat & Jacqueline Griffin & James E. Stahl, 2018. "Decreasing patient length of stay via new flexible exam room allocation policies in ambulatory care clinics," Health Care Management Science, Springer, vol. 21(4), pages 492-516, December.
    5. J K Cochran & K Roche, 2008. "A queuing-based decision support methodology to estimate hospital inpatient bed demand," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 59(11), pages 1471-1482, November.
    6. Akkerman, Renzo & Knip, Marrig, 2002. "Reallocation of beds to reduce waiting time for cardiac surgery," Research Report 02A63, University of Groningen, Research Institute SOM (Systems, Organisations and Management).
    7. Dominic J. Breuer & Shashank Kapadia & Nadia Lahrichi & James C. Benneyan, 2022. "Joint robust optimization of bed capacity, nurse staffing, and care access under uncertainty," Annals of Operations Research, Springer, vol. 312(2), pages 673-689, May.
    8. P R Harper & S Phillips & J E Gallagher, 2005. "Geographical simulation modelling for the regional planning of oral and maxillofacial surgery across London," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 134-143, February.
    9. John Bowers, 2013. "Balancing operating theatre and bed capacity in a cardiothoracic centre," Health Care Management Science, Springer, vol. 16(3), pages 236-244, September.
    10. Yariv Marmor & Thomas Rohleder & David Cook & Todd Huschka & Jeffrey Thompson, 2013. "Recovery bed planning in cardiovascular surgery: a simulation case study," Health Care Management Science, Springer, vol. 16(4), pages 314-327, December.
    11. Willoughby, Keith A. & Chan, Benjamin T.B. & Marques, Shauna, 2016. "Using simulation to test ideas for improving speech language pathology services," European Journal of Operational Research, Elsevier, vol. 252(2), pages 657-664.
    12. Yue Zhang & Martin L. Puterman & Matthew Nelson & Derek Atkins, 2012. "A Simulation Optimization Approach to Long-Term Care Capacity Planning," Operations Research, INFORMS, vol. 60(2), pages 249-261, April.
    13. Goutam Dutta & Ajay Naik & Dipa Gosai & Priyanko Ghosh, 2021. "A mathematical model for predicting length of postoperative intensive care requirement following cardiac surgery in an Indian hospital," OPSEARCH, Springer;Operational Research Society of India, vol. 58(2), pages 330-350, June.
    14. Utley, Martin & Gallivan, Steve & Davis, Katie & Daniel, Patricia & Reeves, Paula & Worrall, Jennifer, 2003. "Estimating bed requirements for an intermediate care facility," European Journal of Operational Research, Elsevier, vol. 150(1), pages 92-100, October.
    15. Valdmanis, Vivian & Bernet, Patrick & Moises, James, 2010. "Hospital capacity, capability, and emergency preparedness," European Journal of Operational Research, Elsevier, vol. 207(3), pages 1628-1634, December.
    16. Fermín Mallor & Cristina Azcárate, 2014. "Combining optimization with simulation to obtain credible models for intensive care units," Annals of Operations Research, Springer, vol. 221(1), pages 255-271, October.
    17. Md Asaduzzaman & Thierry Chaussalet & Nicola Robertson, 2010. "A loss network model with overflow for capacity planning of a neonatal unit," Annals of Operations Research, Springer, vol. 178(1), pages 67-76, July.
    18. Jing Li & Ming Dong & Wenhui Zhao, 2015. "Admissions optimisation and premature discharge decisions in intensive care units," International Journal of Production Research, Taylor & Francis Journals, vol. 53(24), pages 7329-7342, December.
    19. Vincent Knight & Izabela Komenda & Jeff Griffiths, 2017. "Measuring the price of anarchy in critical care unit interactions," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 68(6), pages 630-642, June.
    20. Yuta Kanai & Hideaki Takagi, 2021. "Markov chain analysis for the neonatal inpatient flow in a hospital," Health Care Management Science, Springer, vol. 24(1), pages 92-116, March.
    21. Thomas J. Best & Burhaneddin Sandıkçı & Donald D. Eisenstein & David O. Meltzer, 2015. "Managing Hospital Inpatient Bed Capacity Through Partitioning Care into Focused Wings," Manufacturing & Service Operations Management, INFORMS, vol. 17(2), pages 157-176, May.

    More about this item

    Keywords

    simulation; health; hospitals;
    All these keywords.

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pal:jorsoc:v:56:y:2005:i:2:d:10.1057_palgrave.jors.2601882. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.palgrave-journals.com/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.