A TWO-STAGE SCHEDULING METHOD FOR NURSE SCHEDULING AND ITS PRACTICAL APPLICATION

Abstract

The creation of nurses' schedules is a critical task that directly affects the quality and safety of patient care, as well as nurses' well-being. In most Japanese hospitals, head nurses of each ward shoulder this responsibility, and the work is both physically and mentally demanding. Recent challenges, such as the growing shortage of nurses and increasingly diverse working styles, have further increased complexity, fueling demand for automated nurse scheduling systems. Although modern integer programming solvers can generate feasible schedules within a practical time frame, many hospitals still rely on manual scheduling. A key reason is that tacit knowledge, considerations unconsciously applied by head nurses, cannot be fully formulated into explicit constraints, rendering solver-generated schedules impractical for use. To address this issue, we propose a novel “two-stage scheduling method” that separates the problem into a night-shift stage and a day-shift stage, with targeted manual adjustments by head nurses after the night-shift stage. This interactive process makes it possible to produce nurse schedules that are suitable for real-world implementation. Furthermore, to promote the practical adoption of automated scheduling, we present case studies from acute and chronic care hospitals where systems based on the proposed method have been deployed. We also discuss implementation challenges and corresponding solutions.