Modeling nurse-patient assignments considering patient acuity and travel distance metrics.

Balancing workload among nurses on a hospital unit is important for the satisfaction and safety of nurses and patients. To balance nurse workloads, direct patient care activities, indirect patient care activities, and non-patient care activities that occur throughout a shift must be considered. The layout of a hospital unit and the location of a nurse's assigned patients relative to other resources on the unit are also important factors in achieving workload balance. In most hospitals, a unit charge nurse is responsible for the shift assignment of patients to nurses based on experience and past practices. The nurse-patient assignment process is also often a manual process in which the charge nurse must sort through multiple decision criteria in a limited amount of time. In this paper, a methodology for the construction of balanced nurse-patient workload assignments is proposed. Through the illustration of this methodology new scoring metrics are developed using measures currently available on, or from, the hospital unit. It was demonstrated that the complex scheduling problem can be captured. While the methodology was illustrated for a scheduling problem commonly encountered on a hospital unit, the approach can be adapted to other workforce scheduling problems in which measures of workload are required and composed of elements imposed by the work environment, variability within the required tasks, and a measurable perception of the relative intensity of the work elements.