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Research problem: High turnover rates in long-term nursing facilities exacerbate the existing shortage of caregivers, a trend that will only worsen as the population of the United States ages. Part-time certified nursing assistants (CNAs) provide a significant amount of patient care in these facilities. CNAs also have high annual rates of turnover, which can harm health outcomes and increase the cost of care. In this study, we empirically analyze the effect of scheduling decisions on part-time CNA turnover. We explore three research questions that examine both how much and with whom a CNA is scheduled to work. We seek to empirically answer how (1) hours worked and (2) coworker variability influence turnover for part-time CNAs and if (3) coworker variability moderates the relationship between hours worked and CNA turnover. Methodology/results: Using novel data from one of the nation's largest nursing home organizations, which includes data for 6,221 part-time CNAs at 157 facilities in the United States over a 26-month period, we identify two scheduling levers managers may be able to use to influence turnover. As hours worked increase, turnover first decreases and then increases, demonstrating a nonlinear U-shaped relationship between hours worked and turnover. We also find that high coworker variability increases turnover while also moderating the effects of hours worked on turnover. In post hoc analyses, we demonstrate that high CNA turnover has negative impacts on patient health. Managerial implications: These findings suggest that managers may be able to leverage part-time CNA scheduling to reduce turnover, improving both the quality and cost of care. Specifically, we demonstrate that managers can reduce CNA turnover by increasing hours worked, scheduling coworkers together consistently and doing both simultaneously. Supplemental Material: The online appendices are available at https://doi.org/10.1287/msom.2021.0533. [ABSTRACT FROM AUTHOR]

In this article, we present strategies to help combat the U.S. nursing shortage. Key considerations include providing an attractive work schedule and work environment—critical issues for retaining existing nurses and attracting new nurses to the profession—while at the same time using the set of available nurses as effectively as possible. Based on these ideas, we develop a model that takes advantage of coordinated decision making when managing a flexible workforce. The model coordinates scheduling, schedule adjustment, and agency nurse decisions across various nurse labor pools, each of differing flexibility levels, capabilities, and costs, allowing a much more desirable schedule to be constructed. Our primary findings regarding coordinated decision making and how it can be used to help address the nursing shortage include (i) labor costs can be reduced substantially because, without coordination, labor costs on average are 16.3% higher based on an actual hospital setting, leading to the availability of additional funds for retaining and attracting nurses, (ii) simultaneous to this reduction in costs, more attractive schedules can be provided to the nurses in terms of less overtime and fewer undesirable shifts, and (iii) the use of agency nurses can help avoid overtime for permanent staff with only a 0.7% increase in staffing costs. In addition, we estimate the cost of the shortage for a typical U.S. hospital from a labor cost perspective and show how that cost can be reduced when managers coordinate. [ABSTRACT FROM AUTHOR]

The article discusses that the journal related to production and operations management in the U.S. is encouraging readers to pass papers with a focus that makes work more patient oriented and interpreted in broad sense. It states that the papers should focus on healthcare studies with relevance to operations management. It mentions that the papers will be presented at the conference at Indiana University on October 9-10, 2015.