Optimizing Nurse-to-Provider Ratios for Better Patient Care

Executive Summary

• Lansing Pediatrics relied on manual Excel schedules for nurses, leading to staffing imbalances—both overstaffing and understaffing—and constant schedule reworks.
• Because Lansing already had success using Lightning Bolt for physicians, they decided to shift nurse scheduling to Lightning Bolt as well.
• Switching to Lightning Bolt allowed nurses to choose preferred days off while maintaining key coverage, giving them more control over their schedules and improving work-life balance.
• The system automatically balances nurse-to-provider ratios throughout the day, ensuring the right staffing for patient demand.
• Real-time scheduling updates save 2–3 hours daily by allowing nurse managers to focus on patient care instead of managing shift changes.

Replacing Manual Physician Scheduling Workflows

Practice Administrator Cory Amendt plays a key role in managing Lansing Pediatrics’ complex provider schedules. Just a few years ago, the practice was still building schedules for doctors and nurses by hand. Schedules had fixed shifts and designated days off for both parties, and they were shared via an Excel spreadsheet and printed in 6 different locations throughout the building. When a provider called out or a change occurred, the entire schedule had to be rebuilt, reprinted, and redistributed. Translation? Schedules took up a lot of time.

Cory knew the practice needed a scheduling upgrade, so he started researching the market for provider scheduling technology and discovered Lightning Bolt. By implementing the automated scheduling platform, Lansing transitioned to a variable schedule that updates in real time, improving coordination across providers while also enabling more effective patient and room scheduling. It was night and day versus the prior scheduling method.

“In terms of a solution, Lightning Bolt was the right solution for what we were trying to fix.”

Cory Amendt
Practice Administrator

Nurse Schedules: The Problem with Manual Workflows

After moving providers to Lightning Bolt, Cory and his team initially kept nurses on the same fixed shift schedules. However, this approach quickly led to inefficiencies.

“There were some days we were overstaffed with nurses, and some days we were understaffed,” Cory said. “Any time a nurse would leave or if we had to hire somebody new, we’d have to take a whole fresh look at the schedules to figure out where to plug the new person in. That ultimately led to having to negotiate schedule sessions.”

Using Excel to build nurse schedules was a primary driver of suboptimal staff-to-patient ratios. After all, there’s only so much manual manipulation one person can do before mistakes and oversights start to happen. As frustrations grew, Cory began to ask an important question: If Lightning Bolt could create better schedules for physicians, could it do the same for nurses?

Above all, Lansing Pediatrics needed to ensure the right number of nurses and providers were available each day to deliver efficient, high-quality patient care. That meant Lightning Bolt would need to optimize individual nurse schedules while consistently maintaining the appropriate nurse-to-provider ratios based on daily patient volume.

Optimizing Nurse-to-Physician Ratios for Patient Loads

With support from Lightning Bolt specialists, Cory and his team restructured their nurse scheduling workflows. The practice transitioned from a rigid shift structure to a more flexible scheduling model that allows nurses to select a preferred day off, while still preserving a small number of fixed shifts where needed. This approach gave nurses greater autonomy over their schedules, helping improve work-life balance and overall satisfaction.

Once nurse preferences are accounted for, Lightning Bolt automatically schedules the appropriate number of nurses to maintain optimal nurse-to-physician ratios during key daily time blocks—early mornings (7:30–8), mornings (8–12), afternoons (12/1–5), and evenings (5–6 or 5–7). This ensures consistent coverage that closely aligns with patient demand while optimizing staffing levels throughout the day.

Now that the staffing ratios are dialed in, Lansing has seen some notable downstream impacts.

A More Accessible Schedule

In addition to improving nurse-to-physician ratios, Lightning Bolt has significantly increased schedule transparency across the practice. Through the app, nurses can easily view their schedules and submit shift-change requests. When changes are approved, the schedule updates in real time, ensuring accurate coverage across specialties without manual intervention.

Lightning Bolt also gives nurses visibility into their schedules up to 3 months in advance. Previously, nurse schedules were more likely to have a 1-week runway— perhaps publishing on Sunday for the week ahead. This kind of extra visibility is beneficial for a few reasons:

• It allows nurses to plan their lives around work more effectively. For example, if you want to schedule your kid’s doctor visit a few months ahead of time, that becomes harder when you’re waiting until the week of the appointment to make sure your own schedule won’t interfere.
• Before Lightning Bolt, gaps or oversights in the weekly schedule often led to a unique kind of burden for nurse managers. If a nurse manager built a schedule and forgot one of their nurses asked for time off to go to an appointment, they often felt compelled to cover the shift themselves. Knowing that surprises like this could pop up at any time made it challenging for schedule builders to have peace of mind and predictability.

Tangible Time Savings

Cory estimates that Lightning Bolt has eliminated roughly 2 to 3 hours of work for nurse managers each day, which usually involved editing and redistributing Excel schedules as changes rolled in.

With Lightning Bolt, Lansing Pediatrics has created a more flexible, efficient, and transparent workflow. Thanks to real-time updates, balanced nurse-to-provider ratios, and hours saved each day, the practice ensures patients get the attention they need from nurses who can focus on delivering high-quality care.

The Key to Lansing’s Success

For Ryer Hedderman, a scheduling consultant who worked closely with Cory and the Lansing team throughout implementation, this group presented a unique challenge that ended up being the key to their success.

“Most groups focus separately on physician and nurse schedules, but they don’t try to connect them intelligently,” he said. “Lansing was a fun challenge because we brought all of their schedules together in Lightning Bolt so nurses can be dynamically scheduled where they’re needed most and where they’ll have the biggest impact for patients and their team.”

Ryer also explained why schedule flexibility is such a big crowd pleaser: “We’ve seen great adoption of this more flexible scheduling model because we’re now able to take into account requests from nurses. This means they have more autonomy over their off day and vacation time, which was not the case when they were on a fixed schedule. They also feel more supported when they’re on the clock since we’re actively balancing supply and demand, so they don’t face the understaffing and overstaffing problems that were common before.”

Simply put, what used to be scheduling chaos is now a well-oiled machine.