Shift work, a prevalent practice among nursing personnel, is integral for ensuring uninterrupted provision of hospital patient care [1]. Scheduling refers to the allocation of time and people to perform a defined activity and involves assignment of nurses to shifts, under constraints of time, efficiency, and cost. The schedule should ensure optimal distribution of resources, maintaining the nurse-patient ratio, minimizing the nurse shortage, and utilizing additional staff efficiently and effectively [2]. Common objectives for nurse scheduling include one or a combination of the following: minimizing the number of constraint violations, minimizing the number of nurses, minimizing overtime, maximizing the coverage, maximizing satisfaction of personal preferences [3].
It is important that nurses' schedules are written in a way that does not compromise the work process in the organization, but accommodates their needs and preferences [4]. Nurses' job satisfaction is largely determined by their working hours and is an important component of the quality of their working life [5]. Hence it is crucial to provide knowledge on how to reduce the potentially negative effects of shift work which can cause disturbed circadian rhythms in employees, and a number of adverse psychological and physical changes [6]. These impact on neuro-behavioural and physiological functioning, on psychomotor performance [7, 8] and menstrual regularity [9], interfering with sleep quality and duration [10], raising burnout and dissatisfaction at work [11], emotional exhaustion and decreased self-esteem [12], and increasing cardiovascular disease-related mortality [13], the risk of developing Type 2 diabetes [14] and fatigue [15]. The adverse consequences of insufficient staffing can have far-reaching effects on various facets of healthcare operations. These include decreased staff satisfaction, increased turnover among nursing personnel, diminished hospital performance, and ultimately, a negative impact on patient experience [16].
The array of constraints linked to nurse scheduling issues is extensive, encompassing at least the following overarching constraints: coverage, maximum (minimum) days on, maximum (minimum) hours, personal preference, single night, succession, the number of weekends that nurses may work over a period, weekends in a row, minimum/maximum number of consecutive free days, number of consecutive shift types, balancing the workload among personnel, and nurses who should or should not work together [3].
Approaches like mathematical programming, heuristics, simulation and others have been implemented to address variations of the nurse scheduling problem [3]. Recently, digital (i.e. electronic, computerized) scheduling has developed rapidly. It involves the use of an electronic program to manage information about shifts, annual leave, sickness absence, task details and the workspace of each staff member [17].
Despite decades of research, a significant number of lead nurses continue to rely on paper-based scheduling methods although they are time-consuming and prone to unnecessary errors [3, 18]. According to El Adoly (2018), ward nurses spend more than one working day per month manually coordinating and revising the schedule. Not only leaders: research indicates that each nurse dedicates approximately 10 minutes per shift to schedule management [19]. The trigger is that unscheduled nurse absences require a modification of the original schedule. These absences are often related to personal leave, medical or sick leave, school activities, and other reasons. This process of re-scheduling involves contacting several nurses to negotiate and agree on the new shift they will now work [20].
Since the inception of research in this field, it has been established that electronic scheduling systems facilitate precise staffing and ensure alignment with staff qualifications and preparedness, provide for employee satisfaction with on-time, accurate and fairly planned time schedules, relieve all professional nursing staff of staffing functions, and facilitate budgetary control through efficient management reports. Also, electronic scheduling increases employee satisfaction due to early posting of schedules, fairness in scheduling, acceptance of employee requests, and minimal errors in the handling of schedule details [21]. The implementation of electronic scheduling leads to the abandonment of unnecessary paperwork, including its errors [18]. With the help of electronically generated schedules, nurse leaders can very quickly appropriately allocate the available workforce and balance work according to its requirements and the needs of patients [22]. Compared to the manual method, it is observed that electronic scheduling saves a considerable amount of time preparing the schedule and leads to better control over the nurses’ time in delivering quality patient care [16].