Residential care

Residential Care (RC), sometimes called as institutional/long-term care, assists adults and children with various traditional health services (e.g., mental health, complex chronic, disability, Alzheimer, dementia and hospice) and assistive care services (e.g., caregiving and social support). RC services are usually delivered in the form of (a) facility-based care, (b) community-based care, and (c) home-based care. Facility-based care refers to facilities/homes that provide 24-hour nursing and personal care for their residents. Community-based care provides people in need with communal and pre-planned services, while home-based care enables them to receive care services in their homes. Given that such services are mainly used by seniors, world population aging may cause enormous challenges in providing on-time RC, where RC facilities play an important role.

The COVID-19 pandemic has increased the complexity of service delivery in RC facilities. The spread of this virus has significantly impacted the delivery of service in RC facilities in Canada. Estimates suggest that 62–82% of deaths in Canada due to COVID-19 have occurred among residents of RC facilities. Many deaths may have been prevented if enough attention was paid to preparing the RC sector. The lack of efficient planning, including staff scheduling, has revealed significant inadequacies within this sector. Like Canada, RC facilities in several other developed countries, such as the US, the UK, Spain, etc., have suffered from the COVID-19 pandemic.

The transmission of COVID-19 mainly occurs due to person-to-person contact through (a) droplets/aerosol and (b) contact with a contaminated surface. With this in mind, there are six potential ways for the transmission of this virus among residents and Staff Members (SMs), (a) a resident is infected by SMs, (b) a resident is infected by other residents, (c) an SM is infected by residents, (d) an SM is infected by other SMs, (e) an SM is infected outside of RC facilities and (f) residents are infected by visitors. Given the vulnerability of residents in RC facilities during pandemic conditions, infection prevention strategies are considered as the most effective approaches to reduce overall fatality in this population.

This project investigates the current scheduling methods in RC facilities by considering the impacts of communal spaces (e.g., shared rooms) and a cohorting policy (classification of residents based on their risk of infection) on the spread of infectious diseases. We deploy Advanced Analytics to address this problem. Based on numerical results, first, our holistic approach is capable of considering multiple stakeholders with conflicting interests. It can create smart trade-offs between their interests and find high-quality solutions with respect to all performance metrics. Second, we found that forcing an SM to serve only one cohort within a shift puts pressure on RC facilities because this policy (a) requires more SMs to feasibly serve all residents, (b) creates unbalanced workloads for SMs, and (c) considerably decreases the utilization of SMs. However, using this policy has the potential to be an effective measure to reduce the spread of COVID-19 in RC facilities. Since RC facilities are struggling with a shortage of resources, especially SMs, our finding is in line with the literature that asked the government of Canada to increase the staffing capacity of RC facilities in order to make them able to deal with upcoming pandemics.