As with so many other aspects of life, the COVID-19 pandemic has shaken up what healthcare organizations thought they knew about provider scheduling. No longer can they take for granted that existing scheduling workflows will work equally well in all scenarios.
If nothing else, the pandemic has taught health systems to expect the unexpected. It’s not quite enough just to satisfy today’s needs. It’s imperative health systems also anticipate worst-case scenarios ranging from pandemics and natural disasters to mass casualty events and terror attacks. In all of these cases, health systems must be capable of mobilizing staff at a moment’s notice.
The term “preparedness” is used a lot in healthcare, but COVID-19 has greatly expanded our view of exactly what it means. Who should be prepared—only physicians? What about nurses and medical assistants? What about the staff who turn over rooms, and even the rooms themselves?
It has become clear that health systems must be ready to optimize schedules across the enterprise. True preparedness requires the ability to schedule medical assistants, laundry staff and cleaning crews with the same precision as front-line providers—with additional visibility into the physical space available for those providers to use.
When large numbers of people need care simultaneously, healthcare organizations face provider capacity, physical space and financial pressures all at once.
Lesson learned: Balance provider schedules
When you run a machine hard enough, you quickly see which parts are susceptible to breaking. The pandemic has shown how easily provider schedules can break down and become overwhelmed. In fact, providers were a significant casualty in 2020. After working 12+-hour days for months at a time, many sought either early retirement or part-time work to prevent burnout.
That’s not good news since many regions faced provider shortages even before the pandemic. The Association of American Medical Colleges estimates a shortage of 54,100-139,000 physicians by 2033, and statistics indicate the shortage of registered nurses will continue at least through 2030. Combined with the pandemic experience, many expect a provider crisis over the next few years.
Therefore, health systems must think about how they will attract and retain future providers, many of whom will have different motivators than in the past. Many of those entering the medical profession seek professional purpose and a better work/life balance. They’re ready to trade some financial compensation for more quality of life—which means health systems must be prepared to support more flexible schedules.
Twenty years ago, all the providers within a group or department worked similar rotations because it was too difficult to allow preference-based schedules. Today, that’s no longer the case.
As any scheduler will tell you, there are no “black-and-white” schedules. There is no single perfect algorithmic solution. Schedules across providers, staff and teams are filled with compromises, making all of them various shades of gray.
However, enterprise scheduling systems that leverage metaheuristics and detailed rulemaking can accommodate those compromises by rapidly running millions of schedule iterations and scoring them according to how well they match the desired rules. Such solutions evaluate all of the tough decisions involved and develop just the right shades of gray to balance enterprise and department needs with personal preferences.
Lesson learned: Enterprise view is essential
Meeting the staffing demands of an entire health system and its disparate departments is often a delicate balancing act. Each clinical department has unique scheduling obligations, so they can’t be treated the same. An emergency department, for example, has very different staffing rules and requirements than an anesthesiology group or a primary care clinic.
Front-line providers can’t be scheduled in isolation, either. What good is it to have ten physicians on call without the other clinicians, staff and rooms necessary for them to do their jobs?
These intricacies are why health systems benefit from having a single source of scheduling truth. There are many ways to use enterprise scheduling data to ease the management of clinical teams, locations, and on-call processes—all of which are incredibly important in both routine and crisis scenarios.
Executives and leaders can better manage staff capacity globally through solutions that offer a diversity of functionality at the department level, yet still roll up into a holistic enterprise view. Alternatively, health systems can also integrate diverse scheduling systems in a plug-and-play fashion to arrive at good enterprise visibility.
Either way, data about providers’ workloads and preferences can be used to accommodate current needs as well as prevent burdens for future physicians. By understanding each physician’s interests, work preferences and other information, healthcare organizations can support current and future providers alike.
Benefits now and future
The pandemic has taught us healthcare is, in essence, a form of infrastructure. Even in unforeseen circumstances, it’s essential for health systems to have the ability to mobilize providers, staff, equipment and physical space—all while minimizing provider burnout.
It’s a complex challenge. Health systems must consider provider, department, enterprise and patient needs. There is no simple, algorithmic solution. However, with the flexibility and simplicity inherent in a metaheuristic approach to scheduling, healthcare organizations can be prepared. They can protect their current provider populations with a better work/life balance that promises to engage future providers too.
About Rich Miller
Rich Miller is the Chief Strategy Officer of QGenda, a healthcare workforce management provider, enabling organizations to optimize capacity across the enterprise. Leading physician groups, hospitals, academic medical centers, and enterprise health systems use QGenda to optimize their workforce which allows them to provide the best possible patient care.