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Faced by a severe shortage of nurses and increasing demand for care, hospitals need to optimally determine their staffing levels. Ideally, nurses should be staffed to those shifts where they generate the highest positive value for the quality of healthcare. This paper develops an approach that identifies the incremental benefit of staffing an additional nurse depending on the patient mix. Based on the reasoning that timely fulfillment of care demand is essential for the healthcare process and its quality in the critical care setting, we propose to measure the incremental benefit of staffing an additional nurse through reductions in time until care arrives (TUCA). We determine TUCA by relying on queuing theory and parametrize the model with real data collected through an observational study. The study indicates that using the TUCA concept and applying queuing theory at the care event level has the potential to improve quality of care for a given nurse capacity by efficiently trading situations of high versus low workload.

Human decision making in the newsvendor context has been analyzed intensively in laboratory experiments, where various decision biases have been identified. However, it is unclear whether the biases also exist in practice. We analyze the ordering decisions of a manufacturer who faces a multiproduct newsvendor problem with an aggregate service-level constraint. We find that the manufacturer broadly exhibits the same biases as subjects in the laboratory and is prone to another bias that has not been identified before, that is, group aggregation. The bias can be attributed to the multi-product problem of the manufacturer, and refers to the observation that the service levels are not optimized for individual products, but rather for product groups. Our data allow us to analyze the performance of a manufacturer in detail and we find that target service levels are achieved effectively, but not efficiently. We provide rationales for the manufacturer's ordering behavior, discuss managerial implications, and quantify the financial benefits of debiasing ordering decisions.

Human decision making in the newsvendor context has been analyzed intensively in laboratory experiments, where various decision biases have been identified. However, it is unclear whether the biases also exist in practice. We analyze the ordering decisions of a manufacturer who faces a multiproduct newsvendor problem with an aggregate service-level constraint. We find that the manufacturer broadly exhibits the same biases as subjects in the laboratory and is prone to another bias that has not been identified before, that is, group aggregation. The bias can be attributed to the multi-product problem of the manufacturer, and refers to the observation that the service levels are not optimized for individual products, but rather for product groups. Our data allow us to analyze the performance of a manufacturer in detail and we find that target service levels are achieved effectively, but not efficiently. We provide rationales for the manufacturer's ordering behavior, discuss managerial implications, and quantify the financial benefits of debiasing ordering decisions.

Human decision making in the newsvendor context has been analyzed intensively in laboratory experiments, where various decision biases have been identified. However, it is unclear whether the biases also exist in practice. We analyze the ordering decisions of a manufacturer who faces a multiproduct newsvendor problem with an aggregate service-level constraint. We find that the manufacturer broadly exhibits the same biases as subjects in the laboratory and is prone to another bias that has not been identified before, that is, group aggregation. The bias can be attributed to the multi-product problem of the manufacturer, and refers to the observation that the service levels are not optimized for individual products, but rather for product groups. Our data allow us to analyze the performance of a manufacturer in detail and we find that target service levels are achieved effectively, but not efficiently. We provide rationales for the manufacturer's ordering behavior, discuss managerial implications, and quantify the financial benefits of debiasing ordering decisions.

We examine inventory decisions in a multiperiod newsvendor model. In particular, we analyze the impact of budget cycles in a behavioral setting. We derive optimal rational decisions and characterize the behavioral decision-making process using a short-sightedness factor. We test the aforementioned effect in a laboratory environment. We find that subjects reduce order-up-to levels significantly at the end of the current budget cycle, which results in a cyclic pattern during the budget cycle. This indicates that the subjects are short-sighted with respect to future budget cycles. To control for inventory that is carried over from one period to the next, we introduce a starting-inventory factor and find that order-up-to levels increase in the starting inventory.

Aim: This study analysed how nursing workloads in a neonatal intensive care unit (NICU) depended on the type of respiratory support provided, and how this relationship varied by the infant's postnatal age and weight. Methods: We used a prospective study design in a NICU in a tertiary perinatal centre in Germany. This entailed collecting data on nursing activities by observing 41 nurses for 155 hours between June 2015 and November 2015 and measuring the average nursing capacity required for direct care. Regression analysis was used to test for differences in nursing workloads between respiratory support types. Results: Mechanically ventilated infants each required an average of 60% of the time one nurse had available to spend on direct care during the periods observed. In contrast, those receiving noninvasive ventilation only required 34% and special care infants required 13%. After the first 72 hours of life, mechanically ventilated infants required an average nursing capacity of 40%, while infants receiving noninvasive ventilation required 32% and special care infants required 25%. Conclusion: Invasive support was associated with higher workloads than noninvasive support. The differences were partially moderated by individual factors, such as the infant's age. The findings should be replicated within a multicentre design.

Aim: To investigate the drivers of perceived work intensity among neonatal intensive care unit nurses. Background: The consequences of high work intensity have been studied extensively, yet setting-specific drivers have received less attention. Design: Prospective, longitudinal and monocentric study design. Methods: The study combined data from standardized diary surveys and passive observations of study nurses. Data were collected over a period of 6 months in 2015. We considered two scenarios: (1) the perception of normal work intensity relative to non-normal work intensity; and (2) the perception of high work intensity relative to non-high work intensity. Perceived work intensity was then analysed using mixed-effects probit regression models. Results: We found that when direct and indirect care were provided more frequently than administrative and other duties were performed, the evaluated nurses perceived their work intensity to be higher. We also found that nurses who more frequently provided care for sick and preterm infants were less likely to perceive their work intensity as normal and this effect was stronger among nurses who cared for infants under mechanical ventilation than nurses who cared for infants receiving non-invasive respiratory support. Conclusion: In the interest of both nurses and infants and the pursuit of a reduction in perceived work intensity and the provision of better neonatal care, caution must be applied when assigning infants to nurses. Further research is needed to validate these findings using a multicentre study design.

Coordinating supply chains is an important goal for contract designers because it enables the channel members to increase their profits. Recently, many experimental studies have shown that behavioral aspects have to be taken into account when choosing the type of contract and specifying the contract parameters. In this paper, we analyze behavioral aspects of revenue-sharing contracts. We extend the classical normative decision model by incorporating reference-dependent valuation into the decision model and show how this affects inventory decisions. We conduct different lab experiments to test our model. As a result, human inventory decisions deviate from classical normative predictions, and we find evidence for reference-dependent valuation of human decision makers. We also show how contract designers can use the insights we gained to design better contracts. (C) 2015 Elsevier B.V. and Association of European Operational Research Societies (EURO) within the International Federation of Operational Research Societies (IFORS). All rights reserved.