|
Scheduling physicians to keep a hospital well staffed is essential, but it’s not easy. A number of hospitalist scheduling options have emerged, in the ongoing effort to keep patients cared for and help physicians maintain a work-life balance, as well as recruit good doctors.
Here is a look at four methods used in hospitals across the country.
Shift-Based Scheduling
Shift-based scheduling is used by 40% of hospitalist groups, according to a study done by the Society of Hospital Medicine, or SHM. The fact that it gives doctors backup and they know who the go-to person is when problems happen are seen as major advantages. It also speeds up the admissions process.
But this leaves open what type of shift arrangement works best for patients and for doctors. The most common is block scheduling, like seven days on and seven days off.
Call-Only Scheduling
Call-only is seen as an effective way to schedule if patient volumes are low. It is the most financially friendly of all the models. The usual approach is to have one physician on call for a 24 hour period.
According to SHM research, call only is going out of favor. Its use is down 11%, from a high of 36% to the current 25% of all programs surveyed.
Hybrid Scheduling
This combines on-call scheduling with shift work, a model that has grown 8%, according to SHM. It gives both doctors and the hospital flexibility.
It is an effective model for facilities that are in a state of flux, that have a growing number of patient, but still not enough to support a fully shift-based scheduling method.
Staggered, Flexible Scheduling
An option that is growing in popularity is the staggered, flexible strategy for scheduling doctors. Under this plan, the same number of doctors come in each day as would if the hospital used a shift-based model. But instead of working set hours, the number of hours that physicians are on duty varies according to manpower needs.
The problem with shift schedules at many hospitals is that there can be too many doctors available at certain times of the day for the requirements of good patient care.
But with a staggered schedule, the doctors have the flexibility to take off early if work is slow, though they are required to stay on call in case needs pick up. And when work gets busy, those same physicians are expected to work extra hours.
One advantage for physicians is that they have more control over their time, working less intense schedules, with a result of experiencing less burnout. The argument is that working seven days on and seven days off effectively squeezes a full year’s worth of work into a time frame of half a year. With staggered scheduling, using flexible shift lengths and shorter days, doctors work the same number of hours, but over a longer period of time. It also matches the necessary manpower to the needs of patient care, which can change daily.
Creating the right schedule that meets the needs of patients, physicians and administrators is a complicated art. Many factors influence the right approach. What is clear is that hospitalists need to research to find the best fit. Choose your scheduling strategy carefully. It will have a major impact on improving the scheduling process.
|