How can we optimise nursing shift patterns to balance costs, patient outcomes and staff wellbeing?

Nurses form the largest group of NHS staff, with most providing care in 24-hour settings. The
organisation of this workforce, which includes the designing of shift patterns, has a profound impact on
patient care. Shifts can be organised in many ways (e.g., 8-hour vs. 12-hour shifts), depending on the
desired balance of outcomes like costs, patient safety, and staff wellbeing. Previous research has shown
the benefits and drawbacks of using various shift patterns, however, the problem of how 'best' to
organise nursing shifts is not yet solved.
When designing shift pattern models, two questions are usually asked: "What factors should be included
in the model?" and "What is the best balance of these factors so that good outcomes are achieved?" The
data used to answer these questions should ideally come from diverse sources. Also, because of the
complex relationships among factors, careful analysis and model testing is required. This project
proposes to answer these questions and apply these considerations through four phases.
First, a literature review will be completed to identify conventional shift-related factors and current gaps
in research knowledge. Second, interviews with nursing staff and patients will be undertaken to
understand real-world contexts and scheduling preferences. Third, analysis of a large dataset with NHS
staff/patient data will be performed to uncover important relationships between shift variables and
relevant outcomes. Finally, the information gained from these phases will be combined with advanced
modelling techniques, ultimately resulting in a shift pattern system that is evidence-based and applicable
to practical settings.