On the performance of small-scale living facilities in nursing homes: A simulation approach

Scientific evidence on the impact of small-scale living facilities (SSLFs) on quality of life of nursing home clients remains scarce. In this study a simulation model is developed to examine the performance of SSLFs, in terms of meeting the time preferences of their residents. We model scheduled care using historical data and unscheduled care using a Poisson–Gamma mixture model. The model is used to explore the impact of a change in demand characteristics, duration of care delivery, travel time, allocation flexibility, shifts, number of clients and allocation policy. The results show that to further improve the performance, the focus should lie on: (1) increasing the allocation flexibility of care workers and the number of clients per SSLF, and (2) time dependent staffing. Furthermore, this study shows that simulation is a useful tool for assessing and improving daily nursing home operations. The presented simulation model provides a basis for building a decision support tool for nursing home managers.