  The flexibility level allowed in nursing care delivery and uncertainty in
infusion durations are very important factors to be considered during the
chemotherapy schedule generation task. The nursing care delivery scheme
employed in an outpatient chemotherapy clinic (OCC) determines the strictness
of the patient-to-nurse assignment policies, while the estimation of infusion
durations affects the trade-off between patient waiting time and nurse
overtime. We study the problem of daily scheduling of patients, assignment of
patients to nurses and chairs under uncertainty in infusion durations for an
OCC that functions according to any of the three commonly used nursing care
delivery models representing fully flexible, partially flexible, and inflexible
care models, respectively. We develop a two-stage stochastic mixed-integer
programming model that is valid for the three care delivery models to minimize
expected weighted cost of patient waiting time and nurse overtime. We propose
multiple variants of a scenario grouping-based decomposition algorithm to solve
the model using data of a major university oncology hospital. The variants of
the algorithm differ from each other according to the method used to group
scenarios. We compare input-based, solution-based and random scenario grouping
methods within the decomposition algorithm. We obtain near-optimal schedules
that are also significantly better than the schedules generated based on the
policy used in the clinic. We analyze the impact of nursing care flexibility to
determine whether partial or fully flexible delivery system is necessary to
adequately improve waiting time and overtime. We examine the sensitivity of the
performance measures to the cost coefficients and the number of nurses and
chairs. Finally, we provide an estimation of the value of stochastic solution.
