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Determining emergency department (ED) nurse staffing decisions to balance quality of service and staffing costs can be extremely challenging, especially when there is a high level of uncertainty in patient demand. Increasing data availability and continuing advancements in predictive analytics provide an opportunity to mitigate demand uncertainty by using demand forecasts. In this work, we study a two-stage prediction-driven staffing framework where the prediction models are integrated with the base (made weeks in advance) and surge (made nearly real-time) nurse staffing decisions in the ED. We quantify the benefit of having the ability to use the more expensive surge staffing and identify the importance of balancing demand uncertainty versus system stochasticity. We also propose a near-optimal two-stage staffing policy that is straightforward to interpret and implement. Last, we develop a unified framework that combines parameter estimation, real-time demand forecasts, and nurse staffing in the ED. High-fidelity simulation experiments for the ED demonstrate that the proposed framework has the potential to reduce annual staffing costs by 10%–16% ($2 M–$3 M) while guaranteeing timely access to care. This paper was accepted by David Simchi-Levi, healthcare management. Funding: J. Dong was partially supported by the Division of Civil, Mechanical and Manufacturing Innovation [Grant CMMI-1944209]. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2021.02781 .
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Optimal Routing Under Demand Surges: The Value of Future Arrival Rates
When having access to demand forecasts, a crucial question is how to effectively use this information to make better resource allocation decisions, especially during demand surges like the COVID-19 pandemic. Despite the emergence of various advanced prediction models for hospital resources, there has been a lack of prescriptive solutions for hospital managers seeking concrete decision support, for example, guidance on whether to allocate beds from other specialties to meet the surge demand from COVID-19 patients by postponing elective surgeries. In their paper “Optimal Routing under Demand Surge: the Value of Future Arrival Rate,” the authors present a systematic framework to incorporate future demand into routing decisions in parallel server systems with partial flexibility and quantify the benefits of doing so. They propose a simple and interpretable two-stage index-based policy that explicitly incorporates demand forecasts into real-time routing decisions. Their analytical and numerical results demonstrate the policy’s effectiveness, even in the presence of large prediction errors.
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- Award ID(s):
- 1944209
- PAR ID:
- 10492641
- Publisher / Repository:
- INFORMS
- Date Published:
- Journal Name:
- Operations Research
- ISSN:
- 0030-364X
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1287/opre.2022.0282
