Nurse absenteeism and staffing strategies for hospital inpatient units

Inpatient staffing costs are significantly affected by nurse absenteeism, which is typically high in U.S. hospitals. We use data from multiple inpatient units of two hospitals to study which factors, including unit culture, short-term workload, and shift type, explain nurse absenteeism. The analysis highlights the importance of paying attention to heterogeneous absentee rates among individual nurses. We then develop models to investigate the impact of demand and absentee rate variability on the performance of staffing plans and obtain some structural results. Utilizing these results, we propose and test three easy-to-use heuristics to identify near-optimal staffing strategies. Such strategies could be useful to hospitals that periodically reassign nurses with similar qualifications to inpatient units in order to balance workload and accommodate changes in patient flow. Although motivated by staffing of hospital inpatient units, the approach developed in this paper is also applicable to other team-based and labor-intensive service environments.