Dynamic Redeployment of Nurses Across Hospitals: A Sample Robust Optimization Approach

Abstract: Problem definition: We study a workforce redeployment problem in hospital networks, where clinical staff, such as nurses, are temporarily reassigned from overstaffed to understaffed sites to address short-term imbalances. This practice of ``internal travel,'' which gained traction during the COVID-19 pandemic to tackle nurse shortages, presents new operational challenges that require tailored analytical support. Key requirements such as advance notice and short-term secondments must be incorporated. Moreover, in rapidly evolving environments, reliance on historical data leads to unreliable forecasts, limiting the effectiveness of traditional sample-based methods. Methodology: We formulate the problem as a stochastic dynamic program and incorporate demand uncertainty via a sample robust optimization (SRO) framework. Using linear decision rule approximation, we reformulate the problem as a tractable linear program. Results: We evaluate the impact of key network design components on system performance. Network connectivity has the largest effect in reducing the total cost, number of redeployments, and travel distance, but its benefits depend on aligning the secondment duration with the network structure. Full connectivity without proper secondments can be counterproductive. The SRO approach outperforms the traditional sample-average method in the presence of demand surges or under-forecasts by better anticipating emergency redeployments. Managerial implications: Internal travel programs offer a promising strategy to alleviate workforce shortages in healthcare systems. Our results highlight the importance of network design, aligning secondment durations with the network structure, and adopting planning methods that are robust to demand surges or inaccurate predictions.