Lucile Packard Children’s Hospital (LPCH) handles some of the highest acuity cases in the nation and is revered as one of the country’s top hospitals. LPCH currently conducts their nurse staffing assignment manually, incorporating a multitude of factors such as shift types, nurse skills, policies and regulations, and variability in OR utilization and procedure lengths. The effective allocation of nurses to procedures can yield significant improvements in terms of the reduction of idle time and overtime.

After careful analysis of LPCH’s perioperative staffing system, we constructed a mixed integer program (MIP) optimization model that determines the number of nurses of each skillset to be assigned to each shift for each day during Summer 2019 to meet the case demand while minimizing nurse hours. We tested new 10-hour and 11-hour shifts to better align nursing supply with case demand. Ultimately, our model produced staffing assignments that could cover OR demand with fewer FTEs (up to an 8% reduction) and less idle time (up to a 37% reduction) than the existing staffing schedule.

Next steps include testing the recommendations for Summer 2019, refining the surgical demand forecast during and after block hours, and identifying the total number of nurses required on staff to account for nurse call-offs, vacations, and training.