Application of the Assignment Model in

Optimizing Healthcare Workforce

A. Introduction
Overview
This paper focuses on the Assignment Model that is useful in the distribution of
employees in shifts within health facilities. The purpose is to reduce both understaffing and over
staffing and at the same time also consider basic needs and demands of the patients.

Objective
To seek for an Assignment Model solution to the problem of human resource planning
and scheduling of doctors, nurses and other staff within the hospital to correctly assign staff to
patient care, reduce overtime, and in turn manage the labor expenses in a cost-efficient manner.

B. Statement of the Problem

Situation
Health organizations, especially hospitals, require staffing specialists to schedule the
healthcare workers (doctors, nurses, receptionists, etc.) to various shifts, ranges from day, night,
and even weekend shifts, and different departments ranging from the emergency unit, Intensive
Care Units or general wards. This is challenging since staff is required to work on a twenty-four-
hour basis seven days in a week while the number of staff that should be working during any
given shift depends with the number of patients and the severity of their conditions.

Scheduling today is not effective and results in such problems as inadequate staff during
peak demand, overloading employees or having too many staff during low demand. Moreover,
there indicate that overtime costs are more than what it should be because the company is not so
good at planning for its workforce.

Goal
To seek for effective manpower planning and guarantee that all of the important areas of
the health care organization are staffed properly and permanently, and enhance well-being of
employees, thus reducing rates of work-related burnout.
C. Project Scope
The project is centered on staffing distribution of healthcare human capital including
doctors, nurses and support staff to the different shifts in the hospital. Resources are the number
of healthcare workers who are currently available while tasks refer to forthcoming tasks such as
staffing of different sections in the facility such as emergency, surgical, ordinary wards among
others. Examples of constraints consist of cost restraints (overtime costs), workforce (nursing
staff as compared to medical staff), time (number of shifts) and location (various hospitals or
different departments within the same hospital).

Key assumptions
 Resources (staff) and tasks (shifts) can be best described as elements that are finite in this
case, that is, there is a finite number of available workers and a finite number of shifts.
 Every employee in the health care setting must have minimum qualification and skills for
performing tasks during the shift or department.
 Such flexibility of shifts is not good for workers, especially concerning the stability in
assignments to guarantee job satisfaction and effectiveness.

Expected outcomes
 Optimization of the time cards with regard to overtime costs and better distribution of the
hospital’s funds on human resources.
 Enhanced human resources, would mean that in the vital areas there is no time where one
is short staffed and the employees themselves are not overworking themselves with long
shifts.

D. Literature Review
The literature review of the Assignment Model on resource allocation to identify the
theoretical background and overview of the practical implementation of this model. The
Assignment Model has its foundation on the Linear Programming (LP) which is tactical
formulation of allocating resources to an organization’s activities. This model is more appropriate
for scenarios where there are few resources (persons, machines) who are supposed to work on
activities (shifts, projects) and constraints include; each resource can be assigned to a single task
and a task can only be assigned to a single resource. The effectiveness of LP techniques is evident
in the achievement of these assignments to an optimal level since the main objective of most of
these assignments is normally to minimize the total cost or the total time in a specific case.
 With regard to related applications, Assignment Model has been widely utilized in
numerous realms of practice, including manufacturing application where it is applied in job
sequencing and service application in which it is utilized in resource allocation problem like
employee allocation. In the health care industry this model can be applied in workforce
management where many organizations want to schedule their employees in order to give
adequate coverage of hospitals with least number of overtime costs to be incurred yet the care of
the patients should not be compromised.

The most popular software tools for Linear Programming are Microsoft Excel’s Solver,
which is used for setting up and solving the LP problems into a single excel spreadsheet program.
For complex and larger size problems, other programs such as Google OR-Tools and IBM ILOG
CPLEX provides an efficient solution. They include the ability to offer solutions to large data,
numerous constraints and objectives which make them suitable for practical applications such as
determination of workforce in a hospital or even scheduling of activities in large organizations.
By these technological tools, the Assignment Model contributes to enhanced practical use in
evaluating and transforming resource patterns across different sectors.

E. Methodology
The procedure for applying the Assignment Model to improve the workforce scheduling
in hospital environment starts with information gathering where a lot of information about the
resources and tasks at hand is collected. This includes data about the workers in the hospital, the
doctors, the nurses, the administrative workers, their specialties, qualifications and the shift they
are willing to work. In the same way, information about the tasks including the number of shifts,
specific department requirement and minimum number of staffs per shift is gathered. Then a cost
matrix is determined in which each cell is designed to represent the cost of putting a worker on a
particular shift. It may include the cost incurred through overtime working, traveling or
employees’ dissatisfaction due to their assigned shift.

Secondly, the model is derived to give a mathematical representation for the problem
under study. The objective function is to minimize the total cost derived for scheduling staff to
different shifts to ensure that cost such as over time is reduced or that some areas are not
understaffed. The constraints of the formulation include the constraint that every worker must be
allocated to one shift only and there is at least one qualified staff in every shift. Others are,
 establishing the rule that certain departments must have workers with certain skills, and imposing
strict hour’s limits per worker to conform with certain labor laws. Linear optimization method is
employed in Step 3 to solve the assignment problem. There is software that executes this model,
for example, Excel’s SOLVER for optimizing the shift assignment with reference to the stated
objective function and constraints. More complex cases or a larger hospital chain also, for
instance, may require using tools such as Google’s OR-Tools or IBM ILOG CPLEX. The fourth
step is to apply it practically in which real resource data, real task data and the cost matrix are
entered into the spread sheet, the annual configuration SOLVER model is established.

The model is validated in step 5 by entering sample data or a pilot scenario arising from
previous schedules for a hospital. This makes it possible to determine whether the model provides
better outcomes in the form of cost reduction, productivity increase, and, most importantly,
worker satisfaction than the conventional scheduling techniques. Some modifications may be
made depending on the result of the test to cater for the realities like; absenteeism and any other
emergent shift. The last step, Step 6, is therefore concerned with evaluating the outcomes which
include comparing the assigned optimized processes with the current system. Specific outcome
measures that may be used include cost saving, completion time, and level of satisfaction of the
workers who operate the model. Hypothesized advantages of the optimized solution include
reduced degree of labor expense, better shift assignment, and increased employee satisfaction.
Therefore, by maintaining this structured approach the Assignment Model for resource allocation
into schedules within the hospital workforce planning is both functional and extremely effective.

F. Solution and Results

Hospital Staff Patient 1 Patient 2 Patient 3
Staff 1 10 13 3
Staff 2 9 18 5
Staff 3 6 14 3
 The diagram represents a network model in a health workforce system, where hospital
staffs (origin nodes) are assigned to different patients (destination nodes) The connections
between workers and patients (arcs) indicate the number of days each worker can spend for
delivery to each patient.

The network model contains the following components.

1. Origin nodes: These are hospital staff (Staff 1, Staff 2, Staff 3) who are available to provide
care.
2. Destination nodes: These represent patients (Patient 1, Patient 2, Patient 3), each with specific
care requirements (1 unit in this case).
3. Arcs (Assignments): The arrows between staff and patients represent possible assignments by
staff to patients. The numbers on the arcs indicate the number of days each member of staff
can care for each patient.
4. Resources: Each employee has 1 unit available (resources), which represents the amount of
care that can be provided.
5. Demand: Each patient requires 1 unit of care (demand) from staff.
 The goal is to optimally provide staff for patients, ensuring that each patient receives
exactly 1 unit of care, while minimizing costs, which may be related to other factors such as
number of patient days or quality efficiency is related. The matrix above shows the potential costs
(in days of care) for each staff and patient selection, which can help determine the most cost-
effective staffing allocation for patients

As in the transportation problem, we use double- subscripted decision variables, with x12
denoting the assignment of Staff 1 to patient 1, x12 denoting the assignment of Staff 1 to patient
2, and so on. Thus, we define the decision variables for the assignment problem as:

Xij = 1 if staff i is assigned to client j

0 otherwise

where i = 1, 2, 3, and j = 1, 2, 3

Using the notation and the completion time data, we develop completion time expressions:
Days required for Staff 1’s assignment = 10x11 + 15x12 + 9x13
Days required for Staff 2’s assignment = 9x21 + 18x22 + 5x23
Days required for Staff 3’s assignment = 6x31 + 14x32 + 3x33

Thus, the objective function is:

Min 10x11 + 15x12 + 9x13 + 9x21 + 18x22 + 5x23 + 6x31 + 14x32 + 3x33

The constraints for the assignment problem reflect the conditions that each staff can be assigned
to at most one patient and that each patient must have one assigned staff. These constraints are
written as follows:
x11 + x12 + x13 =< 1 Staff 1’s assignment
x21 + x22 + x23 =< 1 Staff 2’s assignment
x31 + x32 + x33 =< 1 Staff 3’s assignment
x11 + x12 + x13 = 1 Patient 1
x21 + x22 + x23 = 1 Patient 2
x31 + x32 + x33 = 1 Patient 3
Combining the objective function and constraints into one model provides the following 9-
variable, 6-constraint linear programming model.

Min 10x11 + 15x12 + 9x13 + 9x21 + 18x22 + 5x23 + 6x31 + 14x32 + 3x33
s.t.
x11 + x12 + x13 <= 1
x21 + x22 + x23 <= 1
x31 + x32 + x33 <= 1
x11 + x21 + x31 =1
x12 + x22 + x32 =1
x13 + x23 + x33 =1

The solution for the assignment problem:

Variable Value Reduced Costs
X11 0.00000 0.00000
X12 1.00000 0.00000
X13 0.00000 2.00000
X21 0.00000 1.00000
X22 0.00000 5.00000
X23 1.00000 0.00000
X31 1.00000 0.00000
X32 0.00000 3.00000
X33 0.00000 0.00000
Optimal Objective Value = 26.00000

Optimal Staff Assignments

Staff Assigned Patient Days
Staff 1 2 15
Staff 2 3 5
Staff 3 1 6
Total 26
G. ANALYSIS
The Assignment Model used in the present scope of healthcare is aimed at using each
existing staff member to fulfill the care of a particular patient in order to reduce the cost of care
necessary for that patient – expressed in days of care. The model formulated in this paper is a
linear model that employs an objective function that minimizes the total ‘cost’ entailed in staffing
and at the same time guarantees all the care needs of the patient are matched to an available staff
once.

The objective function that specifies the total cost where every staff was assigned to the
patient who would require the shortest number of care days is an optimization function. From the
assignments, the total lowest cost attained in this case is 26 days. The schedule proposed assigns
Staff 1 to patient 2 with 15 days, Staff 2 to Patient 3 with 5 days, and Staff 3 to Patient 1 with 6
days. Every assignment corresponds to the need and free time because each employee is assigned
to appear only once and multiple personnel are not scheduled for the same patient.

The modelling also takes into account constraints for example having one staff member
assigned to a patient and vice versa having a patient with only one staff member assigned to
him/her. This eliminates both over-application of workforce and under-application because the
needs of the patient are well determined and met.

Ultimately, the model looks at the numbers for each concern, compares the costs down
from the initialized total to find other solutions that may lead to a slightly varying result but each
choice is the most effective. For instance, Patient 1 will be assigned to Staff 3 or Patient 3 will be
assigned to Staff 2 are any other arrangements that do not give lower cost compared to those
assigned now.

H. CONCLUSION
The Assignment Model is an effective approach for reducing costs in health care
workforce scheduling as well as providing useful operational improvements. In eliminating the
total staffing cost of the patient care, the model addresses the problems of the health care facilities
in cutting down labor costs, particularly in cases where they have relied on overtime, all in a bid
to deliver quality care efficiently. This approach optimizes the job calendar to distribute
workloads and spreads the hour loads in a manner that benefits the staff and the patients by
avoiding overworking the staff leading to minimized burnout. Further, if each patient has his or
 her needs met through the right staff, then the model also indirectly improves patient care by
offering individual attention and may even improve the chance of positive outcomes. This makes
it possible to use the model for more complex scheduling needs of a single department, different
shifts or even an entire large-scale healthcare institution. In summary, the Assignment Model has
formulated a sound and effective approach for solving the common healthcare puzzle of
achieving standard practice economy and optimizing staffing agencies’ solutions for quality
patient care.

As the research has demonstrated the Assignment Model is a simple and effective method
for employing resources to achieve improved human attained objectives within the healthcare
field. As the coordination of resources with the patient’s demands efficiently and economically, it
is a useful method of achieving operational and clinical objectives. If successfully adopted, lower
cost, better retention of employee and hence higher patient satisfaction are some of the benefits
that health institutions involved will reap from the assignment model.

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