Date of Award


Degree Name

Doctor of Philosophy


Industrial and Manufacturing Engineering

First Advisor

Dr. Steven Butt

Second Advisor

Dr. Tycho Fredericks

Third Advisor

Dr. Azim Houshyar

Fourth Advisor

Dr. Gerald Sievers


A critical consequence of the current nurse shortage in the US may be an increase in the workloads on hospital nurses. Heavy workloads have been identified as a major cause of job dissatisfaction among hospital nurses and may ultimately lead to a reduction in the quality of patient care. A focus on the balancing of the workload among scheduled nurses through patient assignments can help to alleviate the chance of assigning excessive workloads to one or more nurses during a shift. Nurse-to-patient assignment, the final stage of the nurse planning was the main intention of this study. It is reasonable to assume that this stage has a direct connection to the workload on a nurse during the shift. However, in addition to balancing direct patient care needs among the nursing staff, total workload balance must also consider indirect patient care and unit-related activities that are required of nurses and which are often affected by the layout of the hospital unit. Therefore, enhanced and supplementary workload measures were considered in this study in an effort to improve upon previous nurse-to-patient assignment methodologies.

Measures of "good" and "balanced" assignments were developed through consultation with the charge nurses working on this unit and through the use of the Analytical Hierarchical Process (AHP). A new patient acuity scoring system was developed specifically for use by nurses in making nurse-to-patient assignments. A distance scoring system was also developed to indicate the total relative distance a nurse would traverse during her shift based on her assignments. The resulting nurse-to-patient assignments were found to be as good, or better, than the assignments produced manually by the unit charge nurses. Results also indicated that the variability of the nurse-to-patient assignments were greatly reduced in terms of total nurse workload, total patient workload, and total distance traveled during the shift.

This work is the first to explicitly consider incorporating travel distances into the construction of a nurse's patient assignment and to use AHP to define the importance of each workload measure in making the nurse-to-patient assignments. Additional key findings, future work and possible research directions are discussed.

Access Setting

Dissertation-Open Access