Creating a fair anesthesia schedule while ensuring each shift is appropriately covered is often challenging, especially when processes and rules are not well-defined
Many hospitals and practices lack a centralized, single source of truth for scheduling; it is often a mix of paper, Excel, and a standalone scheduling system that requires manual intervention to meet the organization's needs. Implementing a physician scheduling solution that can handle the complexities of your organization will help you successfully manage your clinical needs and the needs of your physicians.
Documenting your processes, creating a shared vision, communication, and embracing change are key in creating an equitable and efficient schedule.
Document Your Processes
There are often more schedules in your hospital or practice and more stakeholders with control over those schedules than you may have initially accounted for. Documenting your processes can bring clarity to the real number of active schedules and stakeholders. After you determine these numbers, ask yourself and those in your department who run the schedule a few high-level discovery questions. These questions will help you reflect on your own policies, which can be very illuminating.
- How do you take in requests?
- How do you track fairness and balance for call assignments?
- How do you publish out your schedule?
When documenting how your schedule works, you need a clear understanding of what call means to your Anesthesia team. The variety of sub-specialty call can make this difficult. You might schedule both an overnight call that is on-site and a call where you’re working at home with a pager and may not get called in. Determining all the potential shifts that fall under that label and assigning stress levels will bring stability to your scheduling base as stress and call shifts will be more evenly distributed across the team.
Create a Shared Vision
An important component of schedule optimization is setting realistic goals for individual teams and departments. Taking a step back and looking at a high-level view to figure out what your key resources are, who your physicians are, and how you need to schedule them, will help identify what your schedule workflow really is.
You also need to determine why you schedule the way you do. Do you only schedule that way because that’s how it’s always been done and how it has been passed down? Or is it an executive policy? Gather with other schedulers in your group and examine your practices. You’ll gain an understanding of where your scheduling processes are similar and where there are gaps. This will bring your policies in line so there’s one set of expectations for everyone in the practice. Doing this is an eye-opening experience. Often, schedulers won’t have visibility into how their peers are running their schedules, but one scheduler could have a very efficient way of creating their schedule that other departments are not capitalizing on.
Communication is Key
Anesthesia scheduling can be particularly hard due to the number of sub-specialties within the field. For example, your cardiac specialists may be the most specialized anesthesiologists you have, so they need to be scheduled first to ensure that cases that only they can cover are properly staffed. This top to bottom approach allows you to fairly distribute work across your team based on shifts, calls, and stress levels.
Specialized physicians will also float between different groups with different scheduling practices. This can become problematic if there isn’t communication across the whole practice. If one group schedules a physician on their most stressful call shift, the other group they work with should have that knowledge, to prevent back to back call assignments. This communication starts to shift the schedule towards being more equitable and less stressful.
When you begin to shine a light on your processes, this is the time to make changes. Review the basic tenets of how you create your schedule and ask what improvements can be made. However, once you identify the areas for improvement, change management will be the hardest part of the process. You have to understand what, why, when, and how changes will happen so you can effectively communicate it to your team and explain that it’s for the betterment of the practice.
Flexibility around current and future change is crucial. You need the foresight to understand that your staffing, the services you cover, and your facilities aren’t static. Having processes in place to easily make adjustments to rules and policies will ease any future changes.
Although all physician scheduling processes have many of the same overarching workflows, Anesthesia can become nuanced due to the sub-specialties and variation in call assignments. Diving into your processes and analyzing why some of them are in place (is it an executive policy or is it an unwritten rule?) can illuminate pitfalls in your scheduling practices. The most important takeaway though, is that creating fair schedules will keep your physicians happy and your practice running efficiently.