Robust nurse-to-patient assignment in home care services to minimize overtimes under continuity of care

Home Care (HC) providers are complex organizations that manage a large number of patients, different categories of operators, support staff and material resources in a context affected by high variability. Hence, robust resource planning is crucial for operations in HC organizations, in order to avoid process inefficiencies, treatment delays, and low quality of service. Under continuity of care, one of the main issues in HC planning is the assignment of a reference nurse to each assisted patient, because this decision has an impact on the workload assigned to the nurse for the entire patient's length of stay. In this paper, we derive an analytical structural policy for solving the nurse-to-patient assignment problem in the HC context under continuity of care. This policy accounts for randomness related to both the demands from patients already assigned to nurses and the demands from new patients who need assignments. The policy is compared to other previously developed approaches, and applied to a relevant real case.