Perfection, the ultimate desire! Is the pursuit worth it? Is a physician on-call schedule “perfect” when everyone is satisfied? Is that even possible?
Automated physician on-call scheduling software can do many things such as save you time, help you generate consistent results, and provide transparency of the fair process. But software can never solve in-house political problems or replace the leadership of a seasoned on-call scheduler making an educated judgment call.
Some schedulers get so excited about the possibilities envisioned with their new scheduling software, they forget it’s a tool, and it’s not going to solve world peace.
Traps some eager schedulers, new to on-call software tend to fall into:
Perfect is when “all the Doctors are happy”, really? This is the ultimate desire and is often expressed. However, it is also often impractical. The irony is that while “perfect” may exist as a concept that keeps us trying to make the schedule better, anything we judge as “perfect” changes after a cooling-off period. This is why we can judge something perfect one day, and flawed the next day without making a single change. The only thing that actually changed was our ability to judge the quality objectively.
A “good” on-call schedule, created in a documented manner by a consistent scheduler, who understands why the schedule “looks like that” because he/she uses a repeatable process … may be more valuable than having a “perfect” on-call schedule one month out of the year, and disaster the rest.
Too many conditional rules chained together actually hinder getting the doctor’s on-call schedule out due to all of the various constraints. This is especially true if the rules are in flux or “designed by committee”.
Some rules may be in place to avoid “looking stupid” by forgetting something. These are fine for the most part, but when they are there to “cover your ass” for an outlier incident, they also limit flexibility. Document why a rule is being used. Where did it originate? Is the rule for on-call still pertinent? Are you letting Dr. Difficult dictate your scheduling process?
If the goal is to generate a reliable, justifiable schedule, then you need the right scheduler, using the proper scheduling software, following the correct process every time. The “correct process” and “every time” seem to be the most difficult pieces. Scope creep (solving a different problem), and a “scheduling team” made up of changing opinions are significant hazards not solved by the on-call scheduling software.
Key Takeaway: “Good” may be a better goal than absolute perfection for the physician on-call schedule when using new on-call scheduling software. The scheduler needs to avoid being trapped in a permanent state of dissatisfaction with every schedule created. He may not need to make it perfect, but make it better, and even better the next time.
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