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.

护理的连续性是在住院病房提供优质护理的关键因素，但在护患分配 (NPA) 模型中很少考虑到这一点。护理文献表明，护理的连续性有助于减少医疗错误和再入院，并提高患者满意度。平衡患者与护理人员的分配对于避免过度劳累和倦怠也很重要。本研究调查了医院住院部 NPA 决策中护理连续性和工作量平衡之间的关系。我们开发了一种 NPA 启发式方法来指导连续性护理分配，同时解决与工作量平衡的权衡。启发式优先考虑较高敏锐度的患者以实现护理的连续性目标，而较低敏锐度患者的分配则力求最大限度地减少工作量不平衡。住院医院单元的离散事件模拟模型用于评估启发式方法如何在不同的工作设计场景下解决两个目标之间的权衡。启发式方法可以显着提高特定患者群体的护理连续性，同时限制对工作负载平衡的影响。我们讨论了对理论和管理实践的影响。