To Each Their Own (Shifts): Incorporating Heterogeneous Worker Preferences into Shift Work Schedules

Abstract

Shifts are the dominant way to organize work in many contexts requiring 24/7 coverage. While the detriments of shift work are well-documented both at the individual and organizational levels, its deployment is often unavoidable given round-the-clock staffing needs. We explore a potential operational lever-incorporating heterogeneous preferences over shift characteristics, which we refer to as the shift choice system-to mitigate ramifications of shift work on worker well-being and turnover. Leveraging rich and novel survey, shift, and administrative data, we document that inpatient nurses exhibit heterogeneous preferences over shift schedules, driven by both pecuniary and non-pecuniary considerations. We also show that nursing managers largely reflect preferences into scheduled shifts, albeit imperfectly. We find that the shift choice system improves worker well-being, as measured by self-reported fatigue and work-life balance. Using a difference-in-differences approach, we also estimate a 0.58 p.p. decrease in probability of quitting, but only among more experienced nurses. We find these effects are not driven by differences in the degree to which preferences are reflected in scheduled shifts, but rather by corresponding improvements in fatigue and work-life balance that are concentrated among more experienced nurses. We do not find evidence to suggest that the shift choice system affects care quality. Our results indicate that allowing for shift choice is an effective responsible scheduling strategy that can improve worker well-being and reduce turnover for highly experienced nurses.

Keywords: responsible scheduling, worker preferences, empirical operations, health care