On-Call Schedules: Templates, Patterns, Rules… Oh My!

Ever feel like you are the On-Call scheduling Wizard of Oz for your physicians? Here comes Dorothy, the ScareCrow, Tin Man, and the Friendly Lion, each with their wish list for you to fill.

Which of the tools in your bag of tricks should you use when? What is the difference between a Master Template, a Scheduling Pattern, and On-Call scheduling Rules?

There are three basic ways to cover the ground to get your physician on-call schedule done. They can be used alone, but most frequently they are used in some combination.

Templates and a Template Scheduler. A Master Template uses a repeating rotation of a scheduling sequence. The Template repeats the same Provider, doing the same job, on the same day of the week eventually… followed by the next person in the sequence. Assignments are not random. Providers are assigned depending on which job, on which day, in which week of the Master Template sequence the Provider is being scheduled.

A Master Template is especially useful to fill the schedule with a Provider’s standard assignments, such as Satellite Clinics. You can “weave” in a sequence of assignments within the Template that will pre-fill future assignments, or use the Template to fill a current schedule. The main thing to remember is that a Master Template uses a “fixed sequence” of specific Provider-Job, day of the week, and week within the scheduling rotation.

Once the active scheduling period has been populated using the Template Scheduler, you can make whatever changes you need in order to accommodate variances due to Holidays or vacations.

Example of a simple Master Template:

  • Week 1: Job 1 on Mondays are always scheduled with BEV, Tuesday with ELI
  • Week 2: Job 1 on Monday with ELI
  • Week 3: Job 1 on Monday with DOC
  • Week 4: Job 1 on Monday with BRAM
  • …Eventually starting again with BEV on Monday and Tuesday with ELI.

Example Master Template

The advantage of using a Master Template is that you have absolute control over everything: the spread, the tallies, and the sequence of assignments for each Provider. You know exactly what they will be before you start applying the Master Template to the active scheduling area, with no surprises. If you use a Template to schedule your on-call prior to the Providers requesting vacation, they can plan their family events well in advance, request vacations when they are not already scheduled, or make swaps to clear a date… all starting out with a known “fair” spread and even tallies.

If you use the Template Scheduler after the vacations and Holiday assignments are already in place, the application will place a flag in the active scheduling area instead of the Provider called for in the Template, indicating a conflict.

Pattern Scheduling. Pattern Scheduling resembles using a Master Template without absolute control. It is actually a cascade of events that may not repeat, or events repeat after an extended period of time. Templates always have Patterns, but Patterns are not always Templates!

In a Pattern, Monday- Friday assignments do not necessarily flow from one provider to the next in a predetermined order. Rules are usually used to accomplish the desired Pattern, especially for weekends, and rules can be chained together to accomplish complex results. In fact, sometimes the Pattern is more important than fair tallies as it may be more important not to break the sequence of assignments.

Notice, a Pattern’s rules are usually “any selected provider” instead of specifying any *particular* Provider, but it can be set up regarding a particular provider if so desired, such as “If Frank is Job 1 on Monday, he is OFF the next day”.

If you have teams, you most likely have a Patterned Schedule for the weekends. Sometimes these are quite complex, and most eventually do repeat over time.

Examples involving more than one job:

  • If any provider is assigned Job 1 on Sunday, he gets Job 1 the following Thursday and gets Job 4 on the following Monday…
  • If any provider is assigned Job 1 on Tuesday, he gets Job 1 on Fri/Sat/Sun and gets Job 5 on the following Monday.

Example simple pattern:

Sometimes a Pattern repeats eventually, with the same persons in sequence for the same jobs Monday – Friday, but rarely if the weekends are filled in advance. A completed on-call schedule that uses patterns usually appears to be more random than a schedule completed using a Master Template.

Rules without AutoScheduling. Rules always come into play whether you are creating either a Master Template or using a Pattern for your schedule, even if the rules are “in your head”. As you manually schedule, Rules can help fill in the Master Template with the pre-determined order you want, really speeding up the process of putting this together. Of course, you can always manually pick-and-click exactly what you want, but rules make it much less likely you will “mess up” the sequence. The advantage here is to take care of Provider preferences that aren’t really “hard rules”, but more “nice to have”, such as “I’d like to serve Wednesdays more often than the other weekdays if I can”.

Example Patterned Schedule with preferences:

Rules with AutoScheduling. Rules are also engaged when an AutoScheduler is used to populate a physician on-call schedule. The most common use of Rules is to link Friday/Saturday/Sunday calls together to maintain fairness regarding the weekend on-call assignments. The AutoScheduler automatically randomly fills around various pre-scheduled vacation and Holiday assignments, and regulates on-call spread (call frequency) overall… so the on-call schedule tallies end up being even in spite of various Providers being unavailable due to vacation. Rules can be created to ensure you have a backup person for the Job being scheduled when appropriate or to be sure your Providers are not scheduled for On-Call too closely within the month.

Like the Wizard of Oz, you have tools at your disposal to help fulfill your Provider’s wishes, but they will not replace your creative wit to use them well and appropriately. Remember what the Wizard gave the ScareCrow who wanted brains, the Lion who wanted courage, and the Tin Man who wanted a heart?

Key takeaway:

For absolute control of the On-Call schedule spread/frequency, tallies and sequence, use a Master Template.

For an On-Call schedule using a “cascade” of events in an if/then fashion not tied to any particular Provider, use a Pattern and Rules to create it. You remain in control of how “random” it is. You may or may not end up with a Master Template.

To create an on-call schedule with even tallies, “randomness” to the assignments, Rules to harness weekend expectations but more variable weekday assignments, use an AutoScheduler.

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