Exploring nurse scheduling with cyclical scheduling methods The main focus of this paper is to explore the use of cyclical scheduling methods in nurse scheduling through literature review. Cyclical scheduling can be effectively used to schedule work shifts in hospitals and other situations in terms of time saving because computer software and mathematical programming is not needed. Additionally, scheduling is one of the main topics in this course, and as a result, this practice will facilitate the understanding of scheduling processes.
As an example, a hectically method is used to cover a 7-week, three work shifts (day, evening, night) schedule for 20 nurse staff. Some additional charts and diagrams will be included to help demonstrate this topic. Hospital administrators, managers and other companies, such as manufacturing or service companies, who need to frequently implement work shifts, may be interested in the effectiveness of cyclical scheduling. Introduction Together with the increasing elderly population, the demand for caring personnel is also increasing rapidly, which gives the healthcare industry much more pressure than before.
A hospital needs to increase its number of staff to guarantee its service, and control its budget at the same time. According to the American Association of Colleges of Nursing and the Bureau of Labor Statistics’ Employment projections for 2010-2020, the number of employed nurses is projected to grow to 712,000, or a 26% increase. Staffing and scheduling are time-consuming and frustrating tasks, and thus we have several methods such as centralized scheduling, unit scheduling, and self-scheduling. These methods all have their own distinct advantages and disadvantages, but we will focus on cyclical scheduling.
Cyclical scheduling, which has been used for many years in industry, was first introduced to health care system in sass. It provided a more efficient way to solve complex problem by using a repeated pattern consistently over several weeks. It provides the staff a clear vision to schedule Jobs and workers in a long head time. It also allows subsets of the organization to build its own cycles under the overall pattern. Overloaded workers and schedules with low efficiency can be avoided by the application of this method.
Cyclical scheduling keeps a fair balance between nurses, even though it may be kind of insensitive when it is applied with regards to illnesses, vacations and personal problems. We will compare some advantages and disadvantages of cyclical scheduling with the other scheduling methods. After that, a case study showcasing the methodology of cyclical scheduling using nurse staff will be shown. In this particular case, the Head Nurse in the Pediatrics Ward at the Colorado General Hospital was spending almost 40 hours to make a 7-week schedule for a total of 20 nurse staff.
This wasted 1 week of work every 7 weeks, and thus lowered efficiency. To solve this problem, the Head Nurse approached a nearby college to provide possible solutions. One solution was Analysis Analysis of cyclical scheduling To start off, cyclical scheduling is a method of schedule construction that involves a nurse working a cyclic schedule for n weeks and is repeated over time. In this method, all of the nurses would do the exact same work. However, their first shift will start at different times.
This particular type of scheduling is useful when a hospital has shifts that are distinct as well as if the nurses have to complete a certain number f tasks per day and per shift. There are several main advantages for employing cyclical scheduling for nurse staff. First, nurses will know their schedules further in advance, allowing them to prepare for their duties more effectively. Second, the same scheduling blocks are used repeated, thus reducing the amount of scheduling work that has to be done.
Third, the work is distributed evenly and it creates a fair work environment. Finally, work rotations are assigned in a manner that is healthy. This prevents nurses from taking on too many consecutive shifts that may reduce their attentiveness and therefore endanger the patients in a hospital. Compared to centralized scheduling, which involves an administrative section of a hospital to plan all of the schedules; cyclical scheduling has much better employee feedback and influence on the location.
Depending on the desirability of a certain ward, cyclical scheduling can take those preferences into account impartially. Centralized scheduling, although consistent, fails to take those into account. Compared to unit scheduling, which involves a Head Nurse creating all of the schedules, cyclical scheduling reduces the effects of favoritism. Favoritism is when nurses that are more familiar with the Head Nurse get better schedules and shifts. This is often related to seniority as well, with the newer nurses getting graveyard shifts in the busiest hospital wards.
As a result of reducing favoritism, there is a better mix of nurses, both experienced and inexperienced, and thus results in better care for all of the patients. A shift that only has inexperienced nurses may encounter problems that can be easily solved had there been an experienced member present. Compared to self-scheduling, where each nurse is responsible for creating and maintaining their own work schedule, cyclical scheduling is much faster and more efficient in accomplishing this task. This also leads to certain shifts being overstaffed or understaffed.
To demonstrate the effectiveness of cyclical scheduling, examine the following case, where a group of 20 nurse staff are put into the most efficient schedules. Case study Description of the problem This paper provides a realistic case to illustrate the effectiveness of cyclical for 13 registered nurses, 4 practical nurses and 3 nurses’ aides. There are three shifts each day: day, evening and night shifts. All personnel are required to work a maximum of 2/3 of their time in an off shift (evening and night shifts) and they cannot work all the time in one shift time period.
The key to this case as well as the whole method is the requirement of the minimum coverage of each shift: Day shift: 3 Urn’s, 1 LAP, 1 Aide, Night shift: 2 URN’S, 1 LAP, Evening Shift: 3 Urn’s (2 on weekend), 1 LAP, 1 Aide. Other requirements that related to the method are displayed as follows: (1) Of the 1 1 registered nurses, 5 work a day-evening rotation, 5 work a day-night rotation, and one worked all three-shift periods. 2) A registered nurse can work a maximum of 7 shifts without a day off. (3) The practical nurses and the aides must have two days off every week (Sunday through Saturday) and no overtime is allowed. 4) Each staff member has 50% of the weekends off. (5) Double backs were to be kept to a maximum of two per planning period to reduce physical and mental strain. (A double back is working an off-shift, and then continuing to work the day shift the next day. ) Cyclical approach There are several steps to deal with this problem using cyclical approach. (1) Develop a schedule, which has a period that is equal to the number of people Ewing scheduled. In this case, the staffs are divided into three types and two categories (day-evening and day-night rotators). 2) All the rotations that needed to be settled are as follows: 6 Urn’s on day-evening rotation, 5 Urn’s on day-night rotation, 2 Alp’s on day-evening rotation, 2 Alp’s on day-night rotation, 3 Aides on day-evening rotation. The staffing requirements for weekends had also been reduced to meet the personnel constraints. (3) Determine each RAN must cover the number of each evening-shifts each week. In this case, RAN must work on 3 weekdays (Monday through Friday) and 2 weekends Saturday and Sunday) of evening shift each week during each 6-week period.
This makes a total of 19 evening-shifts, which fulfills our original 2/3rd-of-all-shifts constraint. (4) Begin the schedule by scheduling only one nurse of her 12 days off for the 6-week period. Then use ‘X’ to sign the specific days off. (See Table 1) (See Table 2) There is 11 Day shifts (42 Days-12 Days off-19 off-shifts = 11 Day shifts) remain to be scheduled. (See Table 3) After completing the first nurse’s schedule, RAN g’s schedule can be started a week later than RAN 1, and then RAN g’s follows RAN g’s. Similar, the day-night nurses with a 5- week schedule could also be done by this way. 5) Repeat the same pattern for each of the other nurses. Replace each one by one week from the previous nurse thus scheduling the remaining personnel. By looking at the tables, you can see how the off-shifts are broken into blocks. As a result, the days will fall into the corresponding blocks and they can be used to scheduling vacations. When the first nurse’s schedule is complete, the following days will be filled by starting the schedule for Registered Nurse number 2 a week after Registered Nurse number 1.
Consequentially, the third Registered Nurses schedule will then start a week after Registered Nurse number 2. After the schedule has been filled, a look over the schedule will confirm that all of the evening shifts have been covered. This same procedure can then be utilized for the day and night shift nurses consisting off 5 week schedule with 10 days off, 14 off, and 11 day shifts. Compared with other non-quantitative methods, this method needs to incorporate some common sense. For example, if the cyclical example in Table. Is used with off shifts, then the normal day shifts will be covered as well. Actually, there will be days with more nurses than needed, and it will allow the hospital to grant more vacations or holidays. The following schedules can be made after making a pattern for the other nurses. Scheduling each nurse a week after the previous one does this. This makes a schedule that can cover an entire year, and thus is very predictable. This benefits nurses as they can plan family vacations or other events much further in advance without disrupting their work.
Another step that can be taken is to give each nurse a number, which determines the order they get to pick their schedule. This can be done either through random lottery or seniority. Allowing nurses to look forward to the weekends for the year and then choose the most favorable ones for them can also do it. Finally, the resulting schedule is the responsibility of the nurse to follow, and if they want to make any changes, they must switch it directly with the nurse on that has a shift on the day they want to switch.
Conclusion Cyclical scheduling has been used for decades in making schedule for shift- personnel. It has been confirmed to be an effective and timeserving method especially hen compared to huge amount of work, which uses computer programming. In our case, it takes about 3 hours to finish the schedule of 20 nurses, 3 shifts and 7 weeks per period; whereas it usually takes more than a day to finish these work by using computer programming. Bout creating a certain period of work shift of one person based on the number of people who are assigned to the specific Jobs. Then let others start with following the exact same schedule but only one week later. So it is easy to get the schedule of certain numbers of people in the same number of weeks. As a result, the case from he paper developed a satisfied schedule for 6 Urn’s on day-evening shifts and 5 Urn’s on day-night shifts, which fulfill all the requirements. The method is displayed methodically, which is easy for people to understand and use.
Cyclical scheduling can not only be used in nurse scheduling, but also in all other situations as long as there is a need of 24-hour shift work such as custom service, production line and etc. The method could be a great time saver when adopted by organizations. Further improvement Although this paper provides a significant advantage in scheduling shift work, there re still things that need us to further explore. Firstly, this paper makes arbitrary decisions when putting every nurse into each specific shift.
It doesn’t take potential issues into consideration, such as not all the nurses could endure have 4 days off in a row and then work 7 consecutive days. Further research should be done to incorporate nurses’ personal preference since staffs moral would have substantial influence on their performance. Additionally, the schedule is so strictly formatted that all the schedules would be changed if one staff has an emergency and needs a day off. The schedule is more effective if it is made more flexible.
Further research should be done to combine other scientific methods with cyclical scheduling to deal with emergency. Finally, the basic method of cyclical scheduling in this paper works well in 24 hours work shift. However there’s not so much work that needs 24 hours surveillance. Further research could be done to find out a method that suits not only full-day shifts, but also part of the day shifts.