A Two-Stage Stochastic Integer Programming Approach to Integrated Staffing and Scheduling with Application to Nurse Management

We study the problem of integrated staffing and scheduling under demand uncertainty. This problem is formulated as a two-stage stochastic integer program with mixed-integer recourse. The here-and-now decision is to find initial staffing levels and schedules. The wait-and-see decision is to adjust these schedules at a time closer to the actual date of demand realization. We show that the mixed-integer rounding inequalities for the second-stage problem convexify the recourse function. As a result, we present a tight formulation that describes the convex hull of feasible solutions in the second stage. We develop a modified multicut approach in an integer L-shaped algorithm with a prioritized branching strategy. We generate 20 instances (each with more than 1.3 million integer and 4 billion continuous variables) of the staffing and scheduling problem using 3.5 years of patient volume data from Northwestern Memorial Hospital. Computational results show that the efficiency gained from the convexification of the recourse function is further enhanced by our modifications to the L-shaped method. The results also show that compared with a deterministic model, the two-stage stochastic model leads to a significant cost savings. The cost savings increase with mean absolute percentage errors in the patient volume forecast.