Designing computer support for daily hospital staffing decisions.

This paper relates issues encountered in extending a centralized computer-based nurse scheduling system to support daily staffing decisions in a hospital environment. When calculating the daily staffing needs on each nursing unit, the conceptually simple interactive staffing system incurred considerable costs in categorizing patients according to level of care required. Two years of historical data collected daily in a 568 bed St. Louis hospital were used to test the sensitivity of relative staffing requirements to daily fluctuations in patient-care distributions. A periodic sampling plan appears adequate for updating distributions which can then be applied to current census in estimating daily staffing needs. Recommendations for implementing such a system are offered.