A Queueing Model for Nurse Staffing

Nursing care is probably the single biggest factor in both the cost of hospital care as well as in patient satisfaction. Yet, there is a widespread dissatisfaction with the current methods of determining nurse staffing levels, including the most common one of using target minimum nurse-to-patient ratios. In this paper, we develop a queueing model to help identify nurse staffing levels in hospital clinical units based on providing timely responses to patient needs. The two-dimensional model incorporates the demands for nursing care that arise from changes in the census level of the unit as well as from current patient needs. We also develop a very accurate one-dimensional heuristic model which can be more readily implemented. This work is being done in conjunction with a major New York City hospital as part of a project to test the feasibility of using queueing theory to help guide nursing decisions.