Abstract
Continuity of care is a critical element for delivering quality of care in inpatient units, however it has rarely been considered in nurse-patient assignment (NPA) models. The nursing literature suggests that continuity of care helps reduce medical errors and readmissions and increases patient satisfaction. Balancing patient assignments to nursing staff is also critical to avoid overwork and burnout. This study investigates the relationship between continuity of care and workload balance in NPA decisions in hospital inpatient units. We develop an NPA heuristic to guide continuity-care assignment while addressing the trade-off with workload balance. The heuristic prioritizes higher-acuity patients to the objective of continuity of care, while assignment of lower acuity patients seeks to minimize workload imbalance. A discrete event simulation model of an inpatient hospital unit is used to evaluate how the heuristic addresses the tradeoff between the two objectives under distinct work design scenarios. The heuristic enables significant increases in continuity of care for specific patient segments while limiting the impact on workload balance. We discuss implications for theory and managerial practice.
