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Workload leveling of nursing wards in Leiden University Medical Center

Tjoonk, J. (2010) Workload leveling of nursing wards in Leiden University Medical Center.

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Abstract:Introduction In this report, which was written in the period April – December 2010, we study the variability in bed demand at the LUMC Division 1 wards caused by the elective surgery planning. A high variability in bed demand is unfavorable for many reasons, but particularly personnel planning. This study proposes a decision support tool that quantifies the steadystate ward bed demand for a given master surgical schedule - the cyclic OR block plan. We use this tool to generate and evaluate alternative MSSs that level the bed demand. Approach We use the model of Vanberkel (2009) to model the expected bed demand resulting from an MSS. We extend the model with a heuristic in order to generate alternative MSSs that improve workload leveling by swapping OR blocks. We introduce the workload level performance indicator which is defined as the sum of the quadratic difference with the mean bed demand for every day in the MSS, to compare the alternatives. Results The heuristic reduces the workload level performance indicator with 46,9% percent, taking into account only the Division 1 ORs, by making four OR swaps The maximum bed demand is reduced from 74 (the initial model output) to 71 beds, indicating the possibility of decreasing the number of staffed beds An improved workload leveling and reduction of the maximum bed demand is possible when more OR time is available on Monday. The performance indicator of workload leveling then reduces by 65,1% and the maximum bed demand decreases from 74 to 70 beds, but eight swaps are needed to reach this performance Conclusions The best two swaps are to swap empty OR blocks of Monday with Traumatology blocks of Tuesday and Thursday in the second week of the MSS The proposed best swaps considers swapping OR blocks that have a high expected value of OR production (the input parameter of expected number of patients that follows from one OR block) The importance of higher level of detail of the MSS is invalidated in the LUMC case, since the same decisions are proposed by the heuristic when the level of detail is reduced Recommendations Inform the physicians about the outcome of this study Discuss the possibilities of the OR swaps that follow from the proposed best swaps In order to improve the workload leveling of the wards, the OR center should carry out more procedures on Monday by moving OR blocks from Tuesday to Thursday in the second week of the cycle to the Mondays Discuss the possibilities of exchanging OR time with non-division 1 specialties
Item Type:Essay (Master)
Leiden University Medical Center
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Industrial Engineering and Management MSc (60029)
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