Nurse-to-patient ratios in hospital staffing: A queueing perspective

Francis de Véricourt and Otis B. Jennings
Additional contact information
Francis de Véricourt: ESMT European School of Management and Technology
Otis B. Jennings: Duke University

No ESMT-08-005, ESMT Research Working Papers from ESMT European School of Management and Technology

Abstract: The immediate motivation of this paper is California Bill AB 394, legislation which mandates fixed nurse-to-patient staffing ratios as a means to address the current crisis in the quality of health care delivery. Modeling medical units as closed queueing systems, we seek to determine whether or not ratio policies are effective at managing nurse workload. Our many-server asymptotic results suggest that ratio policies cannot provide consistently high service quality across medical units of different sizes. As a remedy, we recommend policies that deviate from the restrictive linear nature of ratio policies, employing the "square root rule" commonly used to staff large service systems. Under some quality of care assumptions, our policies exhibit a type of "super" pooling effect, in which, for large systems, the requisite workforce is significantly smaller than the nominal patient load.

Keywords: queueing system; health care; public policy; nursing; staffing; manyserver limit theorems (search for similar items in EconPapers)
Pages: 28 pages
Date: 2008-07-03
New Economics Papers: this item is included in nep-hea and nep-ias
References: Add references at CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
http://static.esmt.org/publications/workingpapers/ESMT-08-005.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:esm:wpaper:esmt-08-005

Access Statistics for this paper

More papers in ESMT Research Working Papers from ESMT European School of Management and Technology Contact information at EDIRC.
Bibliographic data for series maintained by ESMT Faculty Publications ().