Research On The Beds And Nursing Human Resource Optimization In Inpatient Department Based On Grade Nursing

Although the government financial budget of medical resources is constantly increasing in recent years,the medical service supply still can't meet the growing needs of patients.On one hand,the number of medical resources per thousand of population of China is at a low level in the world.On the other hand,hospitals' department managers always adopt the empirical management method to allocate medical resources.This phenomenon also leads to the waste of medical resources which deepen the gap of supply and demand.Inpatient department is the main income source of hospitals.The solution of its management problem is helpful to improve the service ability and profitability of the hospital.The core of inpatient management is the allocation of medical resources.Therefore,this paper designed a bed and nursing human resource coordination allocation model and a nurse scheduling and assignment model in order to improve the efficiency of medical resources utilization,medical service capacity and reduce the operating cost of one department at the same time.Firstly,based on progressive patient care,this paper divided one inpatient department into several care units according to the principle of grading nursing and studied the cooperative allocation problem of hospital beds and nursing human resource.Queuing network and conditional expectation were applied to infer the distribution of daily hospitalization in each unit,in the case of random arriving rate and uncertain length of stay of patients.An integer programming model was built to minimize the total cost including the shortage or idle cost of hospital beds and nurses and nurse wage cost.Dynamic programming algorithm with significant global optimization ability was used to solve the model and the optimal value of beds and nurses was obtained.Secondly,according to the result of the last model,a two-stage stochastic programming model was proposed to solve nurse scheduling and nurse-patient assignment problem.The sample average approximation was used to transform the stochastic problem into deterministic problem,and the L-Shaped method was used to solve this two-stage problem.Several numerical experiments showed that the scheme of resource allocation proposed in this paper is superior to the current method.This paper has four main contributions:1)established a beds and nursing human resource coordination allocation model;2)considered the acuity degree of patient in the model;3)used sample average approximation to transform a stochastic problem into a deterministic problem;4)proposed a new scheme of bed and nursing human resource allocation.