Scheduling Models for an Inpatient Nursing Unit

SchedulingModels for an Inpatient Nursing Unit

SchedulingModels for an Inpatient Nursing Unit

Theinpatient nursing unit has been using an inappropriate schedulingmodel that has hampered the process of are delivery. The 8/40 (eighthour forty workweek) is the major cause of the challenges that thenursing unit is currently facing. The current scheduling system andpattern do not allow the unit to cover the needs of patientsadequately. This is confirmed by the patient’s level ofsatisfaction, which has remained below the targeted level of 80 %.The scheduling is also of poor quality given that it has failed toimpress the members of staff working for the nursing unit. From thecase study, the morale of members of staff is low and the annualsurveys show that employee satisfaction has been decreasinggradually. In addition, the scheduling is quite cyclical, which meansthat it is relatively stable. However, the relative stability stiflesflexibility, which means that the current scheduling will not allowthe nurses to undergo the anticipated 608 hours training withoutinterruptions. This is an indication that the current scheduling andpattern cannot accommodate changes in the environment. Moreover, thecurrent scheduling is expensive to maintain. This is confirmed in thecase by the fact that the nursing unit is forced by circumstanceswhere it has to hire two registered nurses at a premium of about 250% of the average pay of the current registered nurses.


Thenursing unit should adopt the ten-hour shift and stop using thecurrent five hour shift plan. The ten hour shift has several benefitsto the organization, employees, and clients. For example, the tenhour shift is accompanied by several days off and weekend days off.The allocation of off days to employees gives them an experience awork-life balance, which improves their satisfaction (Amenodola,Hamilton &amp Slipka, 2011). Therefore, adopting the ten hour shiftplan will increase the level of nurses’ satisfaction. In addition,the ten hour shift allows nurses to work with workers and increasesthe availability of nurses during the peak hours. Therefore adoptingthe ten hour shift plan will result in an increase in the quality ofcare and reduce the cost of hiring an additional number of nursesfrom the agency.

Inaddition, the availability of nurses during the peak and low hourswill facilitate the continuity of care irrespective of the number ofclients visiting the nursing unit at any given time. The ten hourshift plan is associated with an increase in the amount of timeavailable for nurses to attend in-service education and meetings.This confirms that a change of shift plan to a ten hour plan willhelp the nursing unit implement the training program that requires6-8 hours since the plan is more flexible.

Althoughthe ten-hour shift is associated with numerous benefits, it hasseveral shortcomings. The shift plan requires more members of staff,which means that the nursing unit might be required to hire morenurses for an efficient implementation of the plan. In addition, theten hour shift promotes fatigue (Ozcan, 2009). Fatigue might reducethe benefits of quality of care obtained from continued care.

Theflexible scheduling plan can help the nursing unit in coping withfluctuations in the number of patients or demand for care. Thenursing units can adopt the flexible scheduling by creating a pool offull- and part-time nurse who are allocated duties depending ondemand. This scheduling option will allow the nursing unit to addressthe challenge of nurse shortage and ensure that the unit is wellstaffed during the peak and the low periods.

Barriersthat should be considered when implementing a change in staffscheduling

Thenursing unit should expect to face two major challenges whenimplementing the recommended scheduling plan. The first challengethat should be considered is the values of the workforce. Any policyadopted by the company, but goes against the values of the workforceis likely to face rejection from employees (Ozcan, 2009). The secondchallenge that the nursing unit is the possibility of adapting thenew changes to the goals and values of the nursing unit. Failure toinclude the views of the employees and organizational objectives canhinder the process of implementing the recommended scheduling plan.

Performancemeasures that should be monitored

Involvingthe members of staff and the quality of outcomes are two performancemeasures that can be monitored to determine whether the schedulingchanges are positive. At first, involving the members of staff fromthe planning stage all the way to the implementation stage can ensurethat their views are properly integrated into the scheduling plan.This creates a sense of ownership, motivate employees, and reduceresistance to changes in schedules (Ozcan, 2009). Secondly, the mainobjective of any health care facility is to provide quality care andenhance the therapeutic outcome. Therefore, measuring the quality ofthe treatment outcome before and after implementing the newscheduling plan is an effective way of determining whether thesechanges are positive or negative.

Additionaloperations-related strategy that might assist the unit in dealingwith challenges

Thenursing unit can work with and encourage nurses and other members ofstaff to create their personal development plans. By doing this, thenursing unit will be able to mentor and coach the members of staffwith objective of increasing their competence, skills, andaccomplishment (Quast, 2012). The accomplishment and sense ofcompetence are some of the key factors that enhance the morale ofemployees significantly.


Theinpatient nursing unit should adopt the ten-hour shift pattern andthe flexible scheduling plan in order to address its pressingchallenges. The nursing unit should be prepared to addressesassociated with the workforce values and inadequate alignment of thenew changes in scheduling with the organizational values. Theeffectiveness of changes in scheduling can be determined by the staffinvolvement and quality outcomes.


Amenodola,L., Hamilton, E. &amp Slipka, M. (2011). 10-hour shifts offer costsavings and other benefits to law enforcement agencies. NationalInstitute of Justice.Retrieved July 16, 2015, from

Ozcan,Y. (2009). Quantitativemethods in health care management: Techniques and applications.New York, NY: Jossey Bass.

Quast,L. (2012, January 10). Five tips for motivating employees. Forbes.Retrieved July 16, 2015, from