ANALYSIS OF ALTERNATIVE SCHEDULING POLICIES FOR HOSPITAL NURSES

The persistent shortage of nurses adversely affects the productivity, quality of care, and operating costs in most acute care hospitals. Aggravating the shortage are high nurse turnover rates, approaching 200% in some institutions. Policies to ensure adequate staffing levels and provide more attractive work schedules are alleged to improve nurse retention. However, their cost is seldom discussed. We compared expected nursing expense and workforce requirements to staff eight medical and surgical nursing units of a large hospital for 1 month, under 12 different scheduling policies alleged to improve turnover. Using simulation and an integrated staffing and scheduling methodology, we found that the expected nursing wages and workforce requirements for some policies differed by as much as 33%. In this hospital, the expected labor costs for certain policies could erode the benefits expected from improved retention. In contrast, other policies appear to allow high utilization of nursing resources, enhancing the expected benefits of reduced turnover with significant reductions in expenses for labor, recruiting, training, and fringe benefits.     

LOAD CUBING AT R. J. REYNOLDS

R. J. Reynolds Tobacco USA (RJR) is currently implementing a microcomputer-based decision support system to computerize and optimize the selection of patterns for loading cases of finished product into truck trailers at RJR's Central Distribution Center. This system allows for the efficient loading of trucks with less supervision. Total annual savings from reduced personnel and shipping costs is approximately $850,000. In addition to these benefits, the system is a stepping stone for trailer loading automation and the integration of a comprehensive load planning system.     

A Comment on Second-Order Polynomial Regression Models

In a recent article, Chatterjee and Greenwood [1] addressed the problem of multicollinearity in polynomial regression models. They noted that there is a high correlation between X and X²; therefore, a second-order polynomial model suffers the consequences of collinearity. Chatterjee and Greenwood [1] suggested a method they believe will overcome the problem. The contention of the present comment is that the suggested method accomplishes nothing and, indeed, has the potential to lead the unwary researcher to the wrong inference and misinterpretation of his results.     

Some Comments on the Validity of EOQ Formula under Inflationary Conditions

In an earlier issue of Decision Sciences, Jesse, Mitra, and Cox [1] examined the impact of inflationary conditions on the economic order quantity (EOQ) formula. Specifically, the authors analyzed the effect of inflation on order quantity decisions by means of a model that takes into account both inflationary trends and time discounting (over an infinite time horizon). In their analysis, the authors utilized two models: Current-dollars model and Constant-dollars model. These models were derived, of course, by setting up a total cost equation in the usual manner then finding the optimum order quantity that minimizes the total cost. Jesse, Mitra, and Cox [1] found that EOQ is approximately the same under both conditions; with or without inflation. However, we disagree with the conclusion drawn by [2] and show that EOQ will be different under inflationary conditions, provided that the inflationary conditions are properly accounted for in the formulation of the total cost model.     

The Effects of Personality Type on Choices Made in Strategic Decision Situations*

Jung's personality-theory typology is used as a framework for exploring the effects of cognitive style on the type and radicalness of choices made in strategic decision situations. Extending the work of Haley and Stumpf [23], it is proposed that individuals with different personality-type preferences exhibit cognitive styles that are associated with specific biases in the pattern of choices they make. Through participation in an interactive behavioral simulation, 407 participants confronted over one hundred ill-structured decision situations and proposed whatever actions they perceived appropriate. The results support the hypothesized relationships that individuals with different personality-type preferences (i.e., sensing-thinking, intuition-thinking, sensing-feeling, and intuition-feeling) take patterns of actions that reflect specific biases (i.e., selective perception, positivity, social desirability, and reasoning-by-analogy, respectively). The implications of these findings for evaluating the likely effectiveness of strategic decisions and making senior-level staffing decisions are discussed.     

Outlaws or in-laws? Queer theory, LGBT studies, and religious studies

Many queer theorists, like many queer activists and perhaps many LGBT people in general, regard religion as so inimical to their purposes and lives that it is not even worthy of critique; references to religion in queer theory, queer studies, and even LGBT studies are usually sparse, brief, and generally derogatory. Likewise, within most of the field of religious studies, queerness is rarely an issue of concern or even consciousness except in the context of organizational tensions over the proper roles of "homosexuals." While there is a growing body of work that brings these two fields together, the study of religion seems to be adapting only haltingly and partially to contemporary developments inLGBTstudies and queer theory. This essay assesses the current state of the "proto-fields" of LGBT studies and queer studies in religion, offers suggestions for new directions in the future, and considers the potential benefits of the interaction of these fields.     

Women's experience of revealing perinatal bladder function--implications for midwifery care

Comments of women engaged in a longitudinal study of urinary leaking from first trimester to 12 months following birth provide the data for this paper. Useful insights into the factors contributing to the maintenance of silence and ways to break the barriers to discussion of urinary incontinence before, during and following pregnancy were revealed. Given the prevalence of 30% of Australian women experiencing urinary leaking following pregnancy, it is imperative that midwives engage in discussion and support prevention of this unwelcome outcome of childbirth.     

Master Production Rescheduling Policy in Capacity-Constrained Just-In-Time Make-To-Stock Environments

This paper describes a simulation experiment to evaluate the relative effectiveness of rescheduling policies in capacity-constrained, just-in-time (JIT) make-to-stock production environments. Three performance measures were analyzed: average finished goods inventory, total units of sales lost, and a measure of schedule instability. Among the three loading methods we studied (level loading, front loading, and back loading), none was superior across all three performance measures. Level loading was the most robust, while back loading had an interaction effect with forecasting model and capacity level. Time fence scenario was found not to be as significant a factor in system performance as reported by previous research. Once an acceptable time fence scenario is selected, attempts to optimize this factor do not appear to offer significant improvement. It was found that higher demand variation, larger forecast errors, and tight capacity lead to the degradation of system performance. Judicious use of slack capacity helps a system to incorporate the periodic schedule changes typical of JIT systems.