When was the last time your physician group got together to discuss on-call? Was it to simply decide the Holiday coverage for the year, or did the discussion include several “by the way” comments and decisions? Were the results formally recorded and agreed upon or were some things assumed?
It’s always surprising to me how much information is not documented, and how often the “nitty-gritty” only comes to light when something happens to the primary Scheduler when there is a change in Provider staffing level, or an incident takes place.
Since the discussion of the On-Call scheduling process involves collaboration among all the physicians to establish rules and expectations, this is a great chance for buy-in and better team compliance. Capturing and documenting the agreement of what is considered to be “fair” is crucial to figuring out a repeatable Process to attain “fair” and equitable future schedules.
This seems obvious, yet I frequently encounter frustrated Schedulers who have lost time and accountability within groups who do not have this “understanding” in writing and adhere to it. They keep reinventing the wheel, allowing so many exceptions that the rules are more “suggestions”, and the schedules become a series of scenarios. Ultimately not documenting and following a Process costs the group money and possibly much more in Provider dissatisfaction and turnover.
A Process defines what tasks need to be performed, by whom, when, why and in what sequence so the information gathered can be used to create a fair and timely On Call Schedule. It enables successful steps to be repeated, making the process manageable and predictable. By making sure nothing is missed, you can establish time-frames, sequencing, and see the effects of delay and bottle-necks. Result? A Good Process represents what is currently being done, not what you think is being done.
Even in a small scheduling group, certain activities always take place. Who will be approving or denying requests? What are the deadlines, and how will they be enforced? Who needs to see the schedule information when it is complete? How will it be “published” and will IT need to be involved? Delay and misunderstandings mean frustration and a “rush job” to get the schedule out later! Documenting a Great Process provides “guidance” for coordination, accountability, and control of the tasks and personnel involved in generating/publishing the schedule.
Expectations are out there in your group whether you document your Process or not! Once a Process is established, used, and evaluated, a foundation is set. The On-Call Schedule impacts so much of your colleagues’ business and family-life planning that compliance is easier if everyone knows there is a documented agreement to adhere to the same “rules” for everyone. If changes to the Process are needed, scenarios for change can be tried based on a firm, known basis instead of trying various intellectual “what if” exercises from scratch. It’s all about meeting expectations, now and in the future. An established, documented On-Call Scheduling Process is the best place to start.
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