Will replacing your current physician scheduling solution help you on the road to operational excellence?
You have physician scheduling automation in place, but there’s still much manual effort involved in scheduling physicians, staff, and residents.
If you are unsure about whether you are getting what you need out of your physician scheduling solution, then consider these questions as a way to guide your assessment of your current environment.
Question 1: Have you mastered physician scheduling automation but are seeking greater automation for your department or practice?
Often, physician scheduling system automation only successfully builds 50-60% of the schedule and are not maintained as the practice evolves. This is a problem when you start as a 90 person practice and grow into a 180 person practice with new rules around locations and coverage. If the rules are not maintained in your physician scheduling system, you wind up with a situation where automation is building the wrong stuff.
There are two aspects to consider when looking for a new system, the technical side, and the service side. The technical side, is the product capable of the automation? Then the service side, has the vendor taken the time to stay up to date on what your practice’s changes and what you need?
Question 2: Are you allowing your providers to log in and make requests directly within the schedule?
Requests include vacation, open shifts where you need coverage, and on-call shifts. You get to pick your poison and get your on-call shifts out of the way when it is convenient for your personal schedule. When looking for a system, consider one that is capable of sensibly enforcing rules and parameters appropriate to your needs; whether it is just requests for vacation or you want to build your on-call schedule through requests.
Question 3: Do you allow your providers to swap schedules electronically?
Many systems have swap capability built in, but they’re often very rudimentary and just take requests to edit the schedule. Your system should look at the integrity of the whole transaction. There are three key places to watch for rule breaks and making sure you have the right matrix of compatibility.
First, if you swap your on-call shift for someone’s weekend night shift, you will most likely need the next day off, but you could work the next night. Second, you don’t want people swapping into conditions that are not allowed or suboptimal. For example, you wouldn’t want a non-exempt provider picking up a shift that moves them into overtime and the other provider into undertime. Lastly, your rules should take into account physician specialties. If your pediatric cardiac physician needs a shift covered, you want to make sure that someone on staff that day can cover that specific clinical specialty. You want every component of that shift and the post-shift implications to be considered, not just a system that accepts requests.
Question 4: Do you have a compensation strategy that requires time tracking?
One thing that is common among many scheduling systems, is that they don’t have native time tracking or they don’t integrate with other time tracking systems well. So your time data and your scheduling data can’t be readily used together. You have to ask yourself, do you require time tracking with the way you work. If you do, you should have a scheduling system that supports that need directly. A physician scheduling system that integrates time and scheduling data will be able to attribute time to a specific shift, or track incentive pay for a picked up on-call shift.
Question 5: Do you have exempt employees that are eligible for premium time or differential pay?
If you’re a non-exempt employee, you’re not exempt from rules around overtime. Often in hospitals, nurses and advanced practice providers fall into this category and have an hourly component to their pay. You have to carefully track and calculate those who are eligible for overtime because it can drive things like differential pay. Premium pay is focused more around physicians who have a base salary but get paid more for extra coverage time that they’re doing. Those physicians will most likely not be included in any enterprise time and attendance. Look for a system that provides a tactical time and attendance platform to track that premium time directly.
Question 6: Do you share your provider schedules with other healthcare organizations?
Many scheduling systems are insular, they’re not good at sharing information, or they share it with no security. When you open a schedule from some vendors, you are opening up massive amounts of information. Finding a physician scheduling system that allows you to narrowly share just the information that you want to share is key. This will give you the confidence that other organizations aren’t going to be able to understand your coverage strategy, pay structure, and things that are a part of your intellectual property and operations of how your organization works. Security counts when it comes to sharing schedules.
Question 7: If you do pay codes and pay calculations how do you keep track pay codes and premium pay rules?
Pay codes and pay calculations often align with time and attendance in your physician scheduling system. Your time data, schedule data, and information about the personnel should be integrated. You should be able to look at your data and say, this is a per diem staff member, covering this kind of shift, at this time. Then based on that, run through a matrix to produce wage hours or wage dollars which can be used to drive payroll.
Question 8: How do you then apply those rules? How long does it take you to do this?
Pay rules and wage rules in many systems often come with massive amounts of cost, consultation, and scripting to get you going. However, technology has evolved to a point where clients can do their own pay rules and make changes to those rules without having to engage with a consultant that will do coding to change it. When you can make changes within the scheduling system yourself, you don’t wind up with stale rules with the inefficiencies of those calculations as contracts and various aspects of your practice change over time.
Question 9: Can you answer the question of when and where overtime is occurring?
Having a system with the ability to draw clinical activity information, scheduling activity information, and time information is essential in data collection. Understanding when overtime is happening, which shifts are driving over time, and what clinical work is happening during those times creates a detailed analysis of how, when, and why overtime is occurring.
Question 10: How much money do you think you’re paying for not accurately tracking your overtime?
If you replace your physician scheduling system with one that integrates overtime tracking, it will substantially drive your ROI. With just basic overtime analysis, you’ll get a deep understanding of how your department or practice functions and how you can optimize your schedule.
Many physician scheduling systems will work and enable basic analytics, but you shouldn’t stay with your system because of familiarity. Replacing your old system with one that allows greater automation, self-scheduling, pay rules, and overtime integration will put you on the road to operational excellence.
Topics: Operational Excellence