A modeling framework for evaluating proactive and reactive nurse rostering strategies — A case study from a Neonatal Intensive Care Unit

We develop a modeling framework for rostering, absence and demand uncertainty realization, and rerostering to perform detailed quantitative analyses of the robustness of nurse rosters. The framework reflects a real-life problem observed at the Department of Neonatal Intensive Care (DNIC) at St. Olavs Hospital in Trondheim, Norway, but is general and has a high transfer value with respect to using it to analyze roster robustness at other departments. We present multiple proactive strategies to enhance the stability of a roster and a reactive rerostering problem used to improve the flexibility. An extensive case study is performed using historical data from the department. The results show that there is a great potential to improve the stability and flexibility of the rosters using the best combination of strategies. We show that allowing nurses to trade extra weekend work for extra days off, assign surplus work hours evenly over all work shifts, and consider the absence profile of nurses when making the rosters are key strategies to create robust rosters.