Sustainable Nurse Scheduling With Burnout Consideration

Nurse shortage is a worldwide challenge of today’s healthcare system.Many countries are confronted with the ongoing shortage crisis of highly qualified nursing professionals.As a country with huge population,China especially faces a critical nurse shortage problem as a main donor of healthcare providers to other countries.Therefore,fully utilizing the nurse professionals who have to satisfy the high demand of patients is of great concern to hospital managers in China.Nurse scheduling is a quite classical problem in operations research community.The problem is to decide the configuration of shifts for each individual nurse subject to a set of constraints,such as the coverage demand,labor regulation and nurse preference.In the scientific literature,various programming methods combined with optimization algorithms are used to solve the highly constrained NP-hard problem.However,few studies consider the psychological factor,such as burnout state of nurses into the personnel scheduling problem in hospital.Burnout is a chronic and job-related state causing psychological and physical dysfunction within an individual.Exposed to death and illness and faced with inevitable regular shift work,nurses are more likely to suffer from burnout syndrome.Burnout cannot only cause physiological sickness and psychological issues but also influence the quality of hospital care as well.Therefore,it is important to identify potential factors of burnout and understand how to alleviate burnout syndrome among nurses.A better management strategy that aims to generate shifts compliant with nurse needs and their related burnout problems is the topic investigated in this research.In this thesis,we focus on nurse scheduling problem considering burnout syndrome.Many potential factors contribute to burnout syndrome of nurses.In the first stage,experiments are conducted in hospital to explore the significant organizational factors related to nurse shift scheduling.Based on the results of experiments,a nurse night shift assignment Markov Decision Process model considering burnout is proposed to determine the optimal night shift number for an individual nurse with specific burnout level.At the nurse scheduling level,a mathematical programming model with burnout consideration is constructed to provide a more sustainable roster planning.From a modeling point of view,the shift assignment Markov Decision Process model is the main contribution of the thesis,together with the nurse rostering model.However,managing all the knowledge from medical,psychological and organizational area in a unique framework is another significant contribution of the thesis.