Background:
Many hospitalist groups recognize the importance of ensuring that the individual preferences, strengths, and practice styles of their providers are taken into account while determining the work schedule for the practice. Rigid schedules with longer scheduled periods per provider can minimize care transitions for patients, whereas flexible schedules allow hospitalists to seek a balance between variable patient census or acuity‐based staffing versus vacation and downtime requirements. In essence, “Seven On–Seven Off” rarely represents reality. Variability in practitioner preferences, such as daily patient load, acuity, shift and care site preference along with the constantly changing practice requirements, make this scheduling problem challenging. Purpose: To achieve goals in patient care quality while meeting varying individual physician downtime requests and practice styles by using a software‐based tool that optimizes physician schedules. Description: Organizations turn to optimizing the scheduling of available physicians so that both individual and institutional needs are met. As the number of practitioners and requirements increase, managing a schedule becomes a daily time‐consuming headache that leads to simplification of the schedule back to a rigid system. The only realistic alternative is group and individual practitioner scheduling via artificial intelligence algorithms capable of handling the complexity. Our sophisticated scheduling system allows practitioners to easily specify work patterns and preferences, which are used to generate a schedule that can be accessed via the Internet. The scalable algorithms used are similar to algorithms we have implemented in computer chip manufacturing fabs to schedule expensive machines. This is a highly combinatorial problem involving millions of constraints and variables, not unlike the physician scheduling problem. Our approach transforms the requirements into a set of mathematical equations that are then solved simultaneously to produce a schedule that meets all requirements.
Conclusions:
Embracing innovative technology to handle changing scheduling requirements allows us to meet any number of scheduling problems head on. The Web‐based system provides the our hospitalists more flexibility and the ability to work according to their preferred pattern. The use of the system also allows hospitalists to increase their income by working more shifts while still scheduling off‐time, vacation, and medical education blocks within their established rules, as they wish. The system improves overall provider utilization, which also increases income for the practice. It leads to fairer schedules, reduces conflicts, and supports an important practice goal of limiting provider turnover, which improves the group's overall satisfaction, efficiency, and bottom line.
Disclosures:
T. Ahlstrom ‐ Lightning Bolt Solutions, client