Exploring the workload balance effects of including continuity-based factors in nurse-patient assignments

Abstract

Workload balance in nurse-patient assignments is important for ensuring quality in patient care. Unbalanced workloads can lead to high levels of nursing stress, medical errors, lower-quality outcomes, and higher costs. Studies have pro-posed assignment strategies based on patient acuity, location, and characteristics of specialized units. These methods do not address the part of workload associated with continuity in care coordination, and the potential benefits associated with continuity-based assignments. We present the results of a pilot simulation study comparing an acuity-oriented method to a continuity-based approach, using acuity as a measure of workload. Our results suggest that a purely continuity-based approach can result in skewed workloads when measured by patient acuity. In future work, we plan to consider hybrid methods, which may be able to provide the benefits of both continuity and acuity based methods