Modeling the benefits of cross-training to address the nursing shortage

Abstract

This paper seeks to offer insight into cross training strategies that could be effective in aiding in alleviating the nurse shortage issue and its potential to negatively impact on patient safety and mortality. We develop optimization models to evaluate the benefits of cross-training, in particular chaining practices, on nurse workforce planning under stochastic demand, and determine the optimal allocation of both regular and cross-trained staff at a minimum cost. We demonstrate the benefits of cross-training in terms of a reduction in the total number of nurses required to satisfy demand across multiple departments as well as from an economic (i.e. overall cost savings) perspective, while simultaneously meeting the hospitals service and quality of care requirements. In particular, the results indicate that cross-training strategies could help with optimal utilization of constrained nursing resources and thereby limit the negative implications of the growing nurse shortage crisis.