The ‘Robust’ roster: exploring the nurse rostering process

Aim - To identify and explore the relationships between stages of the rostering process and the robustness of the worked roster.

Background - Once published, a nurse roster is often subject to many changes. However, post-approval changes and their implications are rarely examined. Consequently, there is little evidence to determine whether a ‘worked’ roster was safe, efficient or fair. Electronic rostering systems provide greater transparency of the rostering process allowing postapproval changes to be examined more thoroughly.

Design - Using quantitative data, this study compares the outcomes from different stages of the roster process with the shifts breaking roster rules.

Methods - This study covered the period November 2009–January 2013 and included forty-two roster periods from fifteen wards. For each of the rosters, data specifying the type of shift assignment (request, manual and automatic) and number of shifts changed after approval (response variables) were captured. Linear regression analysis was then used to identify and explore the relationships between these response variables and the number of shifts breaking rules.

Findings - Roster robustness is unaffected by the number of staff requests, Yet, how shifts are assigned before approval and the number of changes postapproval have a marked effect on the robustness of the roster.

Conclusions - Roster ‘robustness’ is determined by the quality of the approved roster and subsequent postapproval demand- and supply-driven changes. Despite evidence that e-rostering can improve roster robustness, many Ward Managers prefer to roster manually. On some wards, rosters are approved, regardless of the number of rule breakages occurring.