SBIR-STTR Award

The shortage of healthcare workers is accelerating. An longer-living, ageing population is demanding more medical service while healthcare worker retirements and high turnover is decreasing the worker pool. Shortages can be reduced or eliminated by scheduling only the number of staff needed to meet the hour-by-hour demand for medical service and using flexible shifts to do so. Think of bank teller scheduling, where more staff are scheduled at peak demand. Current attempts to schedule to demand are relatively primitive: a small number of quantized fixed shifts, for example: 7am-3pm, 8am-4pm, 10am-6pm, 3pm-11pm, 7am- 7pm, 7pm-7am, etc. is allowed. The pre-determined fixed shifts are input parameters to the scheduling process and workers are assigned to the shifts. The scheduler's objective is to fill enough morning, afternoon and evening shifts to meet expected demand for medical service throughout the day. In our innovation, fixed shifts are replaced with flexible shift parameters; specifically, a range of start times and shift lengths which become inputs to the scheduling algorithm. The actual shift assigned to a worker on any particular day is computed with the objective to have just enough workers to meet hour-by-hour demand for medical service. Phase I will determine the efficacy of flexible shift scheduling to meet demand for medical service and estimate the possible efficiency. Phase II will develop an algorithm that automates the process using flexible shifts and Monte-Carlo simulation. The literature indicates 2-15% FTE efficiencies are possible by using flexible shifts, corresponding to an annual societal economic impact of $1.7 billion to $8 billion. The commercialized product will be a new module for DOCS Scheduler, our scheduling software that currently is being used by 120 healthcare organizations. Our current product schedules using fixed shifts. The addition of a flexible shift scheduler module providing FTE efficiencies of 2-15% would be a market-changing competitive advantage.

Public Health Relevance:
An ageing population with increasing lifespan, coupled with healthcare worker retirements and high turnover, is exacerbating the shortage of healthcare workers. The USA nurse shortage of 200,000 workers in 2008 is estimated to be 1,000,000 by 2014. Healthcare worker shortages can be significantly reduced, possibly eliminated, and healthcare worker morale improved, by using flexible shifts that are harmonious with worker lifestyles to schedule staff precisely according to demand for medical service.

Public Health Relevance:
Project Narrative An ageing population with increasing lifespan, coupled with healthcare worker retirements and high turnover, is exacerbating the shortage of healthcare workers. The USA nurse shortage of 200,000 workers in 2008 is estimated to be 1,000,000 by 2014. Healthcare worker shortages can be significantly reduced, possibly eliminated, and healthcare worker morale improved, by using flexible shifts that are harmonious with worker lifestyles to schedule staff precisely according to demand for medical service.

Thesaurus Terms:
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The shortage of nurses and medical technologists is accelerating. Shortages can be reduced by scheduling staff to precisely meet the hour-by-hour demand for medical service. Think of bank teller scheduling, where more staff are scheduled at peak demand. Current attempts to schedule to demand are relatively primitive: a small number of quantized fixed shifts, for example: 7am-3pm, 10am-6pm, 3pm-11pm, 7am-7pm, 7pm-7am, etc. is allowed. The pre-determined fixed shifts are rigid input parameters for the scheduling process and workers are assigned to the shifts. In this innovation, fixed shifts are replaced with flexible shift parameters; specifically, a range of start times and shift durations that are harmonious with worker lifestyles. These parameters become elastic inputs for the scheduling algorithm. The actual shift assigned to a worker on any particular day is computed with the objective to have just enough workers to meet the hour-by-hour demand. Phase I research successfully determined the efficacy of worker-friendly, flexible shift scheduling and found savings of 4 percent are possible. Four percent can cut the current worker shortfall significantly and corresponds to annual savings of $3.5 billion in healthcare costs. Despite many scientific studies of flexible shift scheduling, there is a dearth of practical commercial applications primarily due to the complexity of technologies employed in the research. In Phase II, a simple but powerful technology, Monte-Carlo simulation, will be employed. The hypothesis is that a Monte-Carlo simulation can be developed that uses worker-friendly, flexible shift parameters to precisely meet the hour-by-hour demand for medical service. The Specific Aim is to find an objective function that quantifies the goal of meeting hour-by-hour demand and a set of shift perturbations for the Monte-Carlo process to use during the simulation. The commercialized product will be a new module for DOCS Scheduler, Acme Express Inc.'s healthcare staff scheduling software that is already in the marketplace. The current DOCS Scheduler was designed for salaried (physicians) staff and uses fixed shifts. Using flexible shifts is an entirely different innovation and focuses on shift workers like nurses and medical technicians. A new module that saves 4 percent in healthcare staffing costs will be a market-changing, competitive advantage for Acme Express, Inc.

Public Health Relevance:
An ageing population with increasing lifespan, coupled with healthcare worker retirements and high turnover, is exacerbating the shortage of healthcare workers. The USA nurse shortage of 200,000 workers in 2008 is estimated to be 1,000,000 by 2014, with similar estimates for medical technologists. Phase I found that healthcare worker shortage can be reduced by 4 percent and healthcare worker morale improved by using flexible shifts that are harmonious with worker lifestyles to schedule staff precisely according to demand for medical service. In Phase II, Acme Express, Inc. will employ a simple but powerful technology, Monte-Carlo Simulation, to automatically build the staff schedule, minimize periods of overstaffing, and significantly reduce healthcare labor costs.

Public Health Relevance Statement:
Project Narrative An ageing population with increasing lifespan, coupled with healthcare worker retirements and high turnover, is exacerbating the shortage of healthcare workers. The USA nurse shortage of 200,000 workers in 2008 is estimated to be 1,000,000 by 2014, with similar estimates for medical technologists. Phase I found that healthcare worker shortage can be reduced by 4% and healthcare worker morale improved by using flexible shifts that are harmonious with worker lifestyles to schedule staff precisely according to demand for medical service. In Phase II, Acme Express, Inc. will employ a simple but powerful technology, Monte-Carlo Simulation, to automatically build the staff schedule, minimize periods of overstaffing, and significantly reduce healthcare labor costs.

Project Terms:
Age; Algorithms; American; Businesses; Care, Health; Chief Executive Officers, Hospital; Clinical; Computer Programs; Computer software; Cost Savings; Coupled; Discipline of Nursing; Goals; Grant; HOSP; Health Care Costs; Health Care Providers; Health Costs; Health Personnel; Healthcare; Healthcare Costs; Healthcare Providers; Healthcare worker; Hospital CEO; Hospital Chief Executive Officers; Hospitals; Hour; Human Resources; Institution; Investments; Knowledge; Length of Life; Life Style; Lifestyle; Longevity; Manpower; Manuals; Marketing; Measures; Medical; Methods; Mission; Morale; Nurses; Nursing; Nursing Field; Nursing Profession; Ohio; Personnel, Nursing; Phase; Physicians; Population; Position; Positioning Attribute; Process; Productivity; Research; Retirement; SCHED; Saving, Cost; Savings; Schedule; Scheduling and Staffing; Services; Software; Survey Instrument; Surveys; Technology; Time; Work; college; commercial application; commercialization; computer program/software; cost; design; designing; flexibility; health care personnel; health care worker; health provider; healthcare personnel; improved; innovate; innovation; innovative; life span; lifespan; medical personnel; meetings; personnel; phase 1 study; public health relevance; simulation; treatment provider