Building More Efficient Schedules for Academic Hospitals

Schedules in Academic Hospitals

Balance Teaching, Research, and Patient Care

Academic medical centers and teaching hospitals play an important role in the overall health system, but the expanded scope of teaching, research, and patient care means academic hospitals routinely face higher patient care costs than nonteaching hospitals.

Average Inpatient Hospital Cost Per Case1

Hospital Costs Per CaseIn such a competitive financial environment, academic healthcare organizations need a more efficient way to manage resources to ensure they can perform their critical social mission. Because labor costs are at an all-time high—likely accounting for up to 60% of hospital operating budgets2—clinical staffing is one of the most critical areas to monitor when it comes to resource management and utilization. Unfortunately, it’s no easy task.

Provider scheduling has proven to be more difficult in an academic setting.

Provider schedules must be able to balance individual departments’ scheduling requirements, organizational standards, provider preferences, and patient demand. Academic healthcare organizations require schedules that can serve as an anchor to operations, factoring in:

  • The unique needs of individual departments.
  • The overall organization’s objectives and goals.
  • Providers’ scheduling preferences.
  • Patient demand for certain care services.
  • Clinical, teaching, and research responsibilities.
  • Training requirements for residents across specialties.

The responsibility of orchestrating academic schedules falls to schedulers, who spend an average of 291 hours annually turning the above laundry list of requirements into provider schedules—often manually, or with little to no automation. Schedulers work hard building on-call lists, calendars, and schedules that meet their organization’s needs, but it’s not always a feasible task. As the hospitalist team at UNC Health, an academic medical center, grew, their scheduler felt that manually scheduling the department’s providers had become nearly impossible.

“The difficulty was we grew very rapidly. It got to where I was spending so many hours creating the schedule, and it had just gotten so complex that it almost became impossible to create. We have to take into consideration providers’ preferences, the many different services that we have. We also have particular services that only some of our providers can cover, such as the procedure service. There are so many different factors that come into play that have to be considered.”

– Administrative Coordinator, Hospitalist Division, UNC Health

Fortunately, UNC Health managed to streamline the scheduling process with Optimized Provider Scheduling powered by Lightning Bolt. Click below to see a video about UNC’s story.

Creating Complex Schedules While Saving Time

An advanced scheduling solution can be instrumental in saving schedulers time as well as creating more effective and efficient schedules. By building out rules that dictate a department’s schedules, schedulers can auto-generate provider schedules and share them globally across their organization to increase schedule visibility and give time back to supporting clinical teams.

“It has allowed me time to do other work besides just scheduling. Scheduling is only a part of what I do.”

Administrative Coordinator, Hospitalist Division, UNC Health

Uncertain how to find a scheduling platform that meets your organization’s needs? Download our new guide, Choosing an Enterprise Scheduling Solution, for a detailed discussion of how rules-based scheduling works and the capabilities you should expect from a scheduling solution.

Efficiently Utilizing Clinical Staff and Resources

In addition to generating significant time savings, an advanced provider scheduling system can also help healthcare organizations better manage their most important resource: clinical staff. Here are four ways an optimized scheduling solution can eliminate excess, cut costs, and increase revenue:

  1. Build schedules that take provider productivity into consideration.
  2. Align provider supply and patient demand to identify and optimize missed revenue opportunities.
  3. Access analytics across shifts, departments, and locations to guide decision making.
  4. Reduce turnover by ensuring shift equity with schedule transparency and provider autonomy over their schedules.

Check out our recent blog post to explore how an advanced optimized scheduling solution can streamline operations and drive efficiency for your organization.

 

Resources:

1. Estimating the Mission-Related Costs of Teaching Hospitals, Project HOPE, Lane Koenig, Allen Dobson, Silver Ho, Jonathan M. Siegel, David Blumenthal, and Joel S. Weissman, Health Affairs—Vol. 22, No. 6—Pages 112-122, November 2003: psnet.ahrq.gov/primer/duty-hours-and-patient-safety
2. Labor Management Trends, Healthcare Financial Management Association, Navigant, Aug. 2018: guidehouse.com/-/media/www/site/insights/healthcare/2018/navigant-hfma-2018-labor-pulse-survey.pdf

Battle Resident Burnout With Better Scheduling

Battle Resident Burnout

Grueling work hours have long been a part of medical training. But growing conversations about resident burnout and well-being, in addition to the impact of unsustainable working hours on patient care, eventually led to a serious revaluation of resident working hours. In 2003, the Accreditation Council for Graduate Medical Education (ACGME) limited working hours for residents to 80 hours per week and no more than 24 consecutive hours.1

So, how can academic healthcare organizations meet the ACGME’s regulations and reduce burnout while providing exceptional practice experiences? Addressing the hours providers work in a given week is a great place to start. Scheduling can play a huge role in promoting resident satisfaction and well-being, which support high-quality patient care.

Five Ways Better Scheduling Can Improve Resident Satisfaction

  1. Ensuring Shift Equity and Sustainable Work Hours
  2. Increasing Schedule Transparency and Visibility
  3. Simplifying Shift Swapping and Time-Off Requests
  4. Sharing the Schedule in a Timely Fashion
  5. Helping Administrators Better Support Clinical Staff

1. Ensuring Shift Equity and Sustainable Work Hours

Set scheduling rules that limit weekly work hours and ensure fair shift distribution.

In academic medicine, meeting the 80-hour work week guidelines is even more difficult than it seems. A multitude of scheduling factors—including physicians’ teaching requirements, research duties, and clinical responsibilities—must be considered. As a result, it can be difficult to manually prioritize work limits and shift equity with other scheduling rules.

An advanced scheduling solution can easily accommodate for complex scheduling variables once rules are set to limit work hours and balance providers’ varying responsibilities. What’s more, the system should also have the ability to factor in things like providers’ preferences and ensure that certain shifts, like weekends, nights, and call, are distributed as evenly among providers as possible.

It’s a tall order, right? But essential. The right provider scheduling solution will simplify the schedule complexity required to improve outcomes for academic healthcare organizations. We dive deeper into the capabilities that different types of organizations should expect in our new guide, Choosing an Enterprise Scheduling Solution.

2. Increasing Schedule Transparency and Visibility

Increase schedule visibility and transparency by centralizing real-time schedules in a single location.

Creating schedules is one thing, but making sure providers can access the latest schedule is another issue altogether. Locating an up-to-date schedule can be a huge source of frustration for providers and it can also have a big impact on patient care. An advanced digital scheduling solution makes the latest schedules from across your organization accessible to providers at any time from any device at any location.

The ability to easily view the schedule across devices not only cuts down on frustration by making it simpler to view the schedule, find and contact the on-call provider, and communicate with colleagues, but it also increases transparency into how schedules are created. For example, if a resident goes on their mobile app to request Friday off and sees that two other team members have already requested that day off, it may be less surprising if the request is denied.

The reporting capabilities available in the scheduling platform should also promote transparency by allowing schedulers to share reports around shift equity, time off requests approval, and more.

3. Simplifying Shift Swapping and Time-Off Requests

Make the processes easy for swapping shifts and requesting time off.

The lack of a simple, standardized process for shift swapping and time-off requests can make it unnecessarily challenging to find the right person to take over a shift when needed. It can also lead residents to swap shifts without letting the proper administrators know, resulting in outdated, inaccurate schedules that delay communication and patient care.

Centralizing shift swapping, time-off requests, and other scheduling requests on a single digital scheduling platform puts the schedule back in provider hands, giving them more autonomy and control over how and when they are scheduled without leaving administrators in the dark.

4. Sharing the Schedule in a Timely Fashion

Quickly auto-generate gap-free schedules so residents can access next month’s schedule today.

Creating schedules can be incredibly time consuming, especially in academic settings. Schedulers often try to balance teaching, research, and patient care with organizational, departmental, and individual provider needs. Resulting time constraints mean that providers often receive their schedules at the last minute, making work-life balance nearly impossible.

An advanced scheduling solution can simplify schedule creation with rules built to meet each team’s unique needs. Different departments within an organization can then auto-generate gap-free schedules built to their specifications, which helps administrators complete and distribute schedules more quickly. Complete schedules are instantly available for care team members and administrators across the organization to access any time.

5. Helping Administrators Better Support Clinical Staff

Free up administrators’ time so they can better support the needs of clinical staff.

Administrators spend roughly 291 hours annually managing provider schedules. For academic facilities with more complex schedules, the number is likely far more. That’s valuable time administrators could spend to better supporting clinical staff.

Jessica Angerman, the Program Coordinator for the Boston Children’s Hospital and Boston Medical Center Combined Residency Program, says Optimized Scheduling powered by Lightning Bolt has created a better culture for residents and administrators alike.

“Our leadership team of program directors and associate program directors really like to foster a good culture between the admin team and leadership and the residents. Lightning Bolt has definitely helped us reach the residents in a more personal way. A lot of the times our administrative team doesn’t get to meet with them one-on-one because they’re so busy. It’s really given us that opportunity to understand where they are day-to-day and what their work includes, and they understand more of what our work includes.”

Jessica Angerman, Program Coordinator, Combined Residency Program, Boston Children’s Hospital and Boston Medical Center

Watch the full interview with Jessica to learn more.

Increase Resident and Care Team Satisfaction With Better Scheduling

To learn more about how we can support better scheduling at your organization, click below to contact a scheduling specialist.

 

Resources:
1. Duty Hours and Patient Safety, Agency for Healthcare Research and Quality, Patient Safety Network, Sept. 7, 2019: psnet.ahrq.gov/primer/duty-hours-and-patient-safety

Improve Healthcare Operations With Clinical Workforce Analytics

Scheduling-AnalyticsWith rising labor costs,1 growing expenses, falling EBITDA, and decreasing operating margins,2 healthcare organizations need new strategies for controlling costs and improving operational efficiency. While analytics are often used to inform strategic decision making such as supply chain management, some healthcare organizations are missing the opportunity to use analytics to maximize their most important resource: their clinical workforce.

Let’s explore how an advanced provider scheduling solution can deliver analytics that play an essential role in improving healthcare operations.

Four Ways Workforce Analytics Improve Operations

  1. Reduce waste by adjusting staff levels to meet trends in patient demand.
  2. Ensure patient access and minimize leakage by maximizing clinical capacity across locations.
  3. Improve provider retention by increasing work-life balance and schedule autonomy.
  4. Optimize clinical staffing models to enhance productivity.

1. Reduce Wasted Resources

Advanced scheduling analytics allow your organization to identify trends in patient demand and service utilization across locations and departments to adjust staffing levels over time. You can analyze demand for specific services, determine the number of clinicians needed to deliver those services for a given timeframe, and reduce staff and labor costs when patient demand tends to be lower. Here is an example:

The Chief of Surgery wants to better understand seasonal trends in patient demand for elective surgeries. He runs a report and finds that case numbers are much lower during January and February. With granular insights into provider supply and patient demand, he is able to project exactly how many surgeons are needed during each shift. He asks the department scheduler to reduce staffing levels for January and February.

2. Ensure Patient Access

After using analytics to identify trends in patient demand, you can respond to rising demand by proactively increasing staff levels to improve patient access and increase revenue. For example:

The Emergency Department’s Medical Director runs a report and finds that during the summer months, the need for pediatric emergency care greatly increases. Currently, the team only staffs a single pediatric emergency physician. The Medical Director contacts the department scheduler and requests for a pediatric advanced practice provider to be added to the schedule for June through August.

In the example above, the ED has both increased patient access to pediatric emergency care and increased clinical capacity—helping the department generate more revenue based on a particularly common type of service for the specific timeframe.

3. Improve Provider Retention

A key approach to cost reduction is to improve provider retention. Replacing a single physician can cost anywhere from $500,000 up to $1 million, according to the American Medical Association (AMA).3 That means focusing on provider satisfaction and retention could save your organization hundreds of thousands of dollars.

According to the 2020 Medscape National Physician Burnout & Suicide Report, spending too many hours at work is a key contributor to provider burnout.4 But what is the definition of “too many hours” and how can you help prevent provider schedules from reaching the threshold?

Scheduling analytics help ensure that certain shifts, like weekends and call, are evenly distributed across a team of providers. You can also share reports with your team that show even shift distribution to eliminate any possible suspicion of unfairness, which may not completely eliminate the issue of spending too many hours at work, but it helps address a source of provider dissatisfaction.

4. Optimize Staffing Models

Not all providers and care team members are alike. Some prefer to work more than others, some practice part-time, and they each vary in their preferences and productivity levels, making it challenging to optimize staffing models by specialization and availability alone. Advanced reporting provides the detail needed to enhance your organization’s staffing models for productivity.

Over time, you can note which providers are more productive during specific shift times to create rules that schedule individual providers for their most productive shifts as needed. You can also review the larger impact of certain staffing models on productivity and adjust your scheduling rules on a macro level. Without scheduling analytics, this type of insight and optimization is nearly impossible. With the evolving demands and expectations in healthcare, it is also essential.

Interested in improving operations, reducing labor costs, and increasing patient and provider satisfaction with better clinical scheduling?

Learn more about the clinical workforce analytics available in our Optimized Provider Scheduling solution and how they can enhance your organization’s operations.

Resources:

  1. Labor Management Trends, Healthcare Financial Management Association, Navigant, Aug. 2018: guidehouse.com/-/media/www/site/insights/healthcare/2018/navigant-hfma-2018-labor-pulse-survey.pdf
  2. Hospital profitability withers in November as volumes, revenues lag, Becker’s Healthcare, Morgan Haefner, Becker’s Healthcare Review, Jan. 2, 2020: beckershospitalreview.com/finance/hospital-profitability-withers-in-november-as-volume-revenues-lag.html
  3. At Stanford, physician burnout costs at least $7.75 million a year, American Medical Association, Sara Berg, American Medical Association, Nov. 17, 2017: ama-assn.org/practice-management/physician-health/stanfordphysician-burnout-costs-least-775-million-year
  4. Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide, Medscape, January 15, 2020: medscape.com/slideshow/2020-lifestyle-burnout-6012460 – 5

Manage Patient Surge with Advanced Provider Scheduling

Patient Surge: Meet Demand with Optimized Provider Scheduling

A key part of any emergency preparedness plan is ensuring patients have access to the care they need—when they need it! During any widespread emergency or disaster, every healthcare organization—whether it’s a small local practice or a large health system—must ensure it has the tools in place to meet unexpected patient surge. One of the most important tools for responding to rising patient demand during a crisis: an advanced provider scheduling solution.

Ensure Patient Access by Responding in Real Time

Unpredictable circumstances call for quick responses. An advanced provider scheduling solution enables an organization of any size to respond to unexpected patient surge in real time. Let’s walk through an example.

A natural disaster occurs near Central Hospital, a medium-sized acute care facility. The emergency department is not adequately staffed to meet the increase in patient demand. The department’s administrator launches the scheduling solution and sends a communication to all the department providers not already working to request additional coverage. When providers accept, they are immediately added to the schedule so they can report to the emergency department to provide coverage. The ability to make these quick changes might mean that a patient who otherwise would have had to wait longer due to overwhelmed clinical staff can now get the urgent care they need at the right time.

In addition to providing administrators the ability to communicate with clinical staff, an advanced scheduling solution also enables providers to easily communicate with administrators if emergency circumstances prevent them from being able to cover a shift. Instead of sending emails back and forth to colleagues and administrators trying to find shift coverage, providers can simply send a shift swap request to all available colleagues from the mobile application in less than a minute. When a colleague accepts the request, the change is reflected in real time for all team members to see.

Increase Visibility Across Locations and Departments

In a crisis, visibility into who is working where is key. Without a centralized scheduling solution, healthcare organizations lack both a single source of truth for evaluating staffing needs across locations/departments and the ability to quickly enact staffing changes.

For a hospital, enhanced visibility allows administrators and clinical leaders to ensure adequate staffing across several departments. For example, at a northern California hospital preparing for seasonal wildfires, administrators can evaluate coverage to ensure contingent departments, like the emergency department and the burn unit, have an adequate number of scheduled providers to respond to incoming wildfire injuries.

This level of visibility also enables health systems and multi-site group practices to evaluate staffing needs across all in-network locations in order to meet patient demand. For example—a multi-site group pediatric practice may offer weekend visits with exclusive hours at a specific practice location during flu season; with enhanced visibility administrators can predict weekend shift coverage needs and equitably allocate the appropriate amount of clinical staff to that specific location based on patient demand.

Enhance Communication & Collaboration Workflows

Particularly for a hospital or health system, improved schedule transparency not only allows leaders to make informed staffing decisions, but also empowers care teams to better communicate and collaborate. Collaboration between different specialty departments or providers across locations is essential during an emergency response.

For example:

During a surge in patient admission to the hospitalist department, an administrator makes a request for additional hospitalist coverage. As additional coverage is required, it is essential the coverage updates to the schedule are accessible to all care team members in real time, assuring your team the right messages are delivered to the right provider at the right time. With a scheduling solution, you ensure schedule changes are visible in real time, so your staff can easily contact the correct providers quickly—launching a call, text, or email to a provider directly from the application.

Ensure Ample Coverage in Any Crisis with an Agile Scheduling Solution—Launched in Just 48 Hours

The benefits of a scheduling solution for emergency preparedness are wide-ranging, but scheduling solutions can take up to three months to implement. Need an immediate scheduling solution to prepare your organization for patient surge? Learn more about our Rapid Surge Scheduling solution which is ready to launch just 48 hours.

Optimized Scheduling Drives Hospitalist Satisfaction

31% of hospitalists are not satisfied with their schedules.

Today’s Hospitalist 2019 Career & Compensation Survey reveals that hospitalists are unsatisfied with their schedules, citing a lack of flexibility, inability to take vacation, and inequitable distributions of shifts like weekend and call.1 Other top complaints included burnout, administrative tasks, and an overwhelming patient census.

One root cause of these issues? Ineffective provider scheduling.

Learn how optimized scheduling can increase hospitalist satisfaction at your organization by incorporating provider preferences, simplifying scheduling workflows, and aligning provider supply with patient demand. Click the image below to download the infographic.

To learn more about how PerfectServe can support better hospitalist scheduling at your organization, click below to contact one of our Scheduling Specialists.

 

 

Resources:
1. Today’s Hospitalist 2019 Career & Compensation Survey: todayshospitalist.com/salary-survey-results/