Fundamentals of queueing theory (2nd ed.).
Fundamentals of queueing theory (2nd ed.).
A Linear Goal Programming Model for Human Resource Allocation in a Health-Care Organization
Journal of Medical Systems
Finite and Infinite QBD Chains: A Simple and Unifying Algorithmic Approach
INFOCOM '97 Proceedings of the INFOCOM '97. Sixteenth Annual Joint Conference of the IEEE Computer and Communications Societies. Driving the Information Revolution
A Simulation Optimization Approach to Long-Term Care Capacity Planning
Operations Research
Optimizing Intensive Care Unit Discharge Decisions with Patient Readmissions
Operations Research
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Nursing care is arguably the single biggest factor in both the cost of hospital care and patient satisfaction. Inadequate inpatient nursing levels have also been cited as a significant factor in medical errors and emergency room overcrowding. Yet, there is widespread dissatisfaction with the current methods of determining nurse staffing levels, including the most common one of using minimum nurse-to-patient ratios. In this paper, we represent the nursing system as a variable finite-source queuing model. We develop a reliable, tractable, easily parameterized two-dimensional model to approximate the actual interdependent dynamics of bed occupancy levels and demands for nursing. We use this model to show how unit size, nursing intensity, occupancy levels, and unit length-of-stay affect the impact of nursing levels on performance and thus how inflexible nurse-to-patient ratios can lead to either understaffing or overstaffing. The model is also useful for estimating the impact of nurse staffing levels on emergency department overcrowding.