By Amy Engebretson, Senior Customer Project Manager
You can build on the native problem-solving of your “inner 5-year-old” to turn out a better on-call schedule. However, you must be open to the idea of changing something!
If you are having problems creating your On-Call Schedule because of a tangle of rules and preferences, or having difficulty publishing your calendar by the deadline, take a step back and take a global overview from a birds-eye level. Do you really not have any options to change how your call scheduling is done? Anyone with a five-year-old at home has been exposed to the “Three Whys” or a variation of it.
Frequently, the questions children ask in innocence are very inspirational and clear-sighted. Five-year-olds just don’t quit with the first quick answer either, they simply ask a follow-up “Why” question to find a different route to achieve their goals. In their eyes, they didn’t fail, they have simply discovered a way to NOT get something and will continue to prod and poke to discover a way to accomplish what they want.
Tap into your inner “five-year-old”. Assemble your scheduling team and use the “Three Whys” methodology to separate the “symptoms” from “cause” until you identify a root cause you can solve. The team should represent the people involved in and affected by the call schedule, and preferably they have observed the situation first hand.
Why Three levels of “Why?” If we don’t ask at least three “Whys”, we find ourselves always responding to the symptoms on the surface and not solving the core problems regarding the call schedule. By repeatedly asking the question “Why” you can peel away the layers of an issue, get to the root cause and find something you can change to improve things. Keeping the “Whys” to only three (okay maybe five) helps avoid overthinking the problem and getting into tedious detail. If you go too far, you get away from your own sphere of influence and control, making the scope of the problem bigger and much tougher to fix.
Beware of being too general with what you want to accomplish. “We want the on-call schedule to be fair.” Is an example of a general goal. Okay, what does “fairness” look like and to whom? What is a symptom of an “unfair” schedule? Try to ask the questions in a general way, but a bit more specific than “fair”.
The person on the Call-Scheduling team with the least experience may be the most valuable member of the team because he/she may have the least preconceived expectations. This “innocent questioner” may ask a relatively simple question that generates a complex answer, revealing assumptions not otherwise noticed.
Result? A genuine fresh view regarding the on-call schedule, and possibly new options!
Example 1: You calculate the tallies on a spreadsheet because you like the layout and the reports, but you don’t update it as often as you’d like.
Example 2: The on-call schedule is always flirting with being late for release.
Beware of the “blame game” with your answers! The idea is to drill down to a root, definable problem that may have a different, optional action taken, not to assign blame to specific people. Perhaps the action is to modify an existing policy or submit requests in a different format. If you must look at “Who”, how about “Who are other experts who can be consulted?”, “Who do we know similar to us that has a successful calendar?”, and “Who should we have included on this team?”
Change is hard. Usually, the “fix” impacts at least one person who doesn’t see an immediate benefit. The discussion may even dissolve into “Why Me?,” “Why Now,” “Who Decided,” and “Why Not” type of defensive conversation.
Try respectful listening and asking “What If”? See if the door of possibilities doesn’t stand open a bit wider for your team as you search for a way to improve your current scheduling process and achieve a new on-call schedule everyone can get behind. Change is a process of building consensus while trying something; it rarely happens all at once.
Connect Physician Scheduling