更聪明的调度:调度决策对护士助理更替的影响

Kevin Mayo, Eric Webb, George Ball, Kurt Bretthauer
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摘要

研究问题:长期护理机构的高流动率加剧了护理人员的短缺,这一趋势只会随着美国人口的老龄化而恶化。兼职认证护理助理(CNAs)在这些设施中提供大量的患者护理。cna的年更替率也很高,这可能损害健康结果并增加护理成本。在本研究中,我们实证分析了调度决策对兼职CNA离职的影响。我们探讨了三个研究问题,检查了CNA计划工作的数量和与谁一起工作。我们试图从经验上回答(1)工作时间和(2)同事可变性如何影响兼职CNA的流动率,以及(3)同事可变性是否调节工作时间和CNA流动率之间的关系。方法/结果:使用来自美国最大的养老院组织之一的新数据,其中包括美国157家机构的6,221名兼职cna在26个月期间的数据,我们确定了经理可以使用的两种调度杠杆来影响更替。随着工作时数的增加,周转率先降低后增加,工作时数与周转率呈非线性u型关系。我们还发现,同事的高度可变性增加了人员流动率,同时也缓和了工作时间对人员流动率的影响。在事后分析中,我们证明高CNA周转率对患者健康有负面影响。管理启示:这些发现表明,管理者可以利用兼职CNA调度来减少人员流失率,提高护理质量和成本。具体来说,我们证明了管理者可以通过增加工作时间、一致地安排同事在一起以及同时做这两件事来减少CNA的流通量。补充材料:在线附录可在https://doi.org/10.1287/msom.2021.0533上获得。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Scheduling Smarter: Scheduling Decision Impact on Nurse-Aide Turnover
Research problem: High turnover rates in long-term nursing facilities exacerbate the existing shortage of caregivers, a trend that will only worsen as the population of the United States ages. Part-time certified nursing assistants (CNAs) provide a significant amount of patient care in these facilities. CNAs also have high annual rates of turnover, which can harm health outcomes and increase the cost of care. In this study, we empirically analyze the effect of scheduling decisions on part-time CNA turnover. We explore three research questions that examine both how much and with whom a CNA is scheduled to work. We seek to empirically answer how (1) hours worked and (2) coworker variability influence turnover for part-time CNAs and if (3) coworker variability moderates the relationship between hours worked and CNA turnover. Methodology/results: Using novel data from one of the nation’s largest nursing home organizations, which includes data for 6,221 part-time CNAs at 157 facilities in the United States over a 26-month period, we identify two scheduling levers managers may be able to use to influence turnover. As hours worked increase, turnover first decreases and then increases, demonstrating a nonlinear U-shaped relationship between hours worked and turnover. We also find that high coworker variability increases turnover while also moderating the effects of hours worked on turnover. In post hoc analyses, we demonstrate that high CNA turnover has negative impacts on patient health. Managerial implications: These findings suggest that managers may be able to leverage part-time CNA scheduling to reduce turnover, improving both the quality and cost of care. Specifically, we demonstrate that managers can reduce CNA turnover by increasing hours worked, scheduling coworkers together consistently and doing both simultaneously.Supplemental Material: The online appendices are available at https://doi.org/10.1287/msom.2021.0533 .
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