Simulation and optimization of healthcare workforce need

Three projects are presented, which between them, illustrate the use of different OR techniques to assist with the modelling of workforce need. They cover two important healthcare settings: inpatients and intermediate care. Two of the projects demonstrate different ways of combining simulation with mathematical programming, in both cases enhancing the solution given by the simulation alone. The first project considers the question of how many permanent nurses a hospital should employ. Demand for the different nurses is generated by a Discrete Event Simulation (DES) and a stochastic program then evaluates the optimal number of Whole Time Equivalents (WTEs) to employ. The second project considers the capacity needed for a redesigned provision of intermediate care services at a rehabilitation hospital. Intermediate care supports the early discharge from, and admission avoidance to, an acute hospital setting. A DES model is presented which enabled analysis of patient flows to evaluate bed and staffing needs. The third project again considers intermediate care, looking at the types and skills of the workforce required within a rehabilitation team. A Monte Carlo simulation generates a demand for each of a number of different patient interventions. A linear program then optimizes the composition of the team, based on the skills of the different members of staff.