Physician Scheduling

Physician Scheduling www.oncalls.com Who’s On-Call? By Jacob M. Reider, MD “Who’s on-call?” Anyone who works in a hospital understands that the answer to this question is of paramount importance to patient care. Despite advances in technology over the last few years, many call schedules are still created on paper. The time may have come, however, for the pencils to finally rest. Software that supports the creation and management of a call schedule is now available from any computer for quick and easy access to the physician’s whereabouts What is the call schedule? The call schedule for a group of physicians or healthcare workers is a sensitive and important document that is created and updated on a regular basis. Holidays, vacations, illness, and equity are key factors that must always be considered in the creation of a call schedule. Otherwise, conflicts over accountability and responsibility are inevitable. In residency programs, the chief resident is often charged with the task of building the call schedule. For physician groups, often the junior member earns this “privilege” … putting him/her in the middle of a whirlwind of expectations that may have been brewing for years. Often, debate over who has done more (or less) call will become an issue; and the one who worked Thanksgiving last year will most certainly object to working it again this year! The process the “old fashioned way” Creation of a manual call schedule often begins with the solicitation of requests. Since people need to plan vacations ahead of time, often there will be negotiations among members of a group to determine who will take call for the major holidays of the year. Larger groups and many residency programs have request forms that need to be filled out in order to request time off. Smaller groups may just ask the person in charge of the call schedule to “make sure I’m off on the 14th it’s my wife’s birthday.” What happens when four people ask for the same week off? Tracking the requests and determining the status of a request is a key element in the initial steps of building a call schedule. When too many people vie for the same time off , there has to be a fair, systematic way of determining who does and gets what. Tracking the requests and the date and time that they came in is therefore an imperative component of the creation of a fair call schedule. In addition to requests for time off, many providers will express preferences for when they want to work. For example, Dr. Jones may like Tuesdays, while Dr. Smith prefers to work Wednesdays. The creation of the manual call schedule is usually performed at this point: requests and preferences have been determined, and now the administrative member of the group puts together a schedule for a given time period usually a month which will determine who works when and where. This is a painstaking process when done at the kitchen table with pencil and eraser. Part of the scheduler’s duties include calculating days on & off for each provider, while ensuring that requests and preferences are honored whenever possible. Publication When complete, the call schedule is faxed, e-mailed, mailbox-stuffed, and hand delivered to everyone involved including hospital and office operators, answering services, and hospital emergency rooms. While the sharing of this schedule in so many forms is a great feat, a challenge remains for the manager of a call schedule at this point: how to update the already published schedules when the inevitable changes occur? While faxes, a-mails and mailbox-stuffing can deliver a newer version of the schedule, there is no way for the end-users of this schedule to know with certainty that the schedule in their hand is the most recent revision. The Technological Solution With the advent of the Internet, publication of call schedules via the world-wide-web is an obvious alternative to the analog delivery methods. Users would know that the version that they are accessing is the most authoritative one, and the schedule could be updated from anywhere, and accessed from anywhere. Users could log in to the website, enter requests and preferences, and run reports so an accurate count of who’s done the most Saturday nights would be only a mouse-click away. Administrators could use such a system to automatically count the calls, and even insure that Dr. Jones isn't scheduled to work at the Hospital when she’s on vacation in Hawaii. The paper schedule simply can't do that by itself. Over the last 24 months, a small team of physicians and software developers in Albany, New York, has developed an end-to-end tool for the creation and management of call schedules. Oncalls (www.oncalls.com) is a simple, robust application that performs all of these functions well. There will always be arguments over who worked Thanksgiving in 1988, but with web-based call schedule software, management of this complex and thankless job can be much less challenging. Jacob M. Reider, M.D., is a practicing family physician in Albany, New York. He is the Associate Dean of Biomedical Informatics at Albany Medical College, Medical Director of Hospital Informatics at Albany Medical Center, and is the founder of Oncalls. - # # # -