6 Tips for Emergency Medicine Physician Scheduling

Best Practices and Practical Tips for Emergency Physician Scheduling

There is nothing typical about scheduling for emergency medicine physicians. The emergency room staffing model is driven by multiple factors. This could mean that your hospital has single, double, triple, overlapping physician coverage or more.  

Not only is each hospital different, but each physician has their own scheduling preferences. Physician preferences in combination with the emergency departments staffing model could be a potential scheduling nightmare without advanced preparation. Here are tips to improve your emergency physician scheduling process. 

1
Best Practices for Provider Scheduling

With all of the complexities, it is best to use scheduling software to save time and minimize hassles, communicate effectively with providers, obtain time off requests, and allow providers to switch shifts between each other, giveaway shifts, or pick up shifts all at the click of a button. Here are the best practices you need to keep in mind.

  • No more than four shifts or 32 hours per week per provider
  • Shifts of the same type should be distributed fairly among all providers (excluding part-time/locums tenens providers)
  • Consecutive night shifts should be limited to no more than three shifts in a row
  • Avoid short turnaround (less than 12 hours) times between shifts 
  • Weekends off should consist of at least two consecutive days off, with no night shift prior
  • Forward shift rotations if possible going from day to mid/swing to night
  • Shorter night shifts (8-10 hours) for higher volume facilities should be considered

2
Request Scheduling Preferences

Emergency Physicians
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Many emergency medicine physicians appreciate having a work-life balance just like the rest of us.  This is just one reason why it is important to know and incorporate their scheduling preferences into each schedule. It is also important for physician retention and productivity. While it is not always ideal to accommodate all preferences, depending on the staffing model and whether or not the ED is fully staffed, it is still important to accommodate certain preferences so the physicians won't get burned out.

Preference Examples

  • Short work stretches with short periods of time off
  • Long work stretches with long periods of time off
  • Two days off after a stretch of night shifts
  • No more than 3 shifts a week
  • No more than 5 shifts in a row
  • No night shift prior to the weekend off/time off request

You will need to develop notes or spreadsheets to ensure you can track all of their needs and requests before setting the schedule.

  • Ensure fairness in assigning night, weekend, and holiday coverage. This can be accomplished by assigning an equal share of days, nights, weekends, and holidays among providers
  • Ensure appropriate time off between a certain number of shifts or certain shifts such as a minimum of two days off after a stretch of three or more days or a minimum of two days off after a night shift or stretch of nights
  • Accommodate scheduling preferences to allow providers work-life balance, prevent burnout, and be successful at physician retention
  • Accommodate time-off requests when possible without jeopardizing the ability to adequately staff the emergency department as needed

3
Preparing for Holidays, Spring Break, and Summer Vacations

Emergency Physicians
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Holidays, spring break, and summer vacations do not have to be a complete disaster (even though it feels that way). At times, it appears as though everyone wants the same days off but the emergency department must continue to operate 24/7. However, every holiday means does not have the same significance to every physician. To effectively manage the schedule, start out early in the year preparing for holidays, spring break, and summer vacations by:

  • Asking physicians to volunteer to work a set number of the major holidays (Easter, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Christmas Day, and New Year's Eve/Day). This set number depends on how many physicians are on the roster.
  • Asking physicians to submit their dates for spring break and summer vacations as early as January. This gives you plenty of time to see if there will be a problem in coverage and some physicians may be willing to change their plans if they are made aware well in advance.  
  • Recruit part-time physicians and reach out to locums tenens companies to get additional physicians to help out during these times.

4
Writing the Schedule

Emergency physicians
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The best advice for writing a schedule is to write as far in advance as possible. Writing the schedule up to six months in advance is where you want to be. A more realistic goal, however, is 45-60 days. You may get some push-back but I would suggest asking for time off requests at least 90 days in advance. This will provide ample time to identify where you may have a lapse in coverage and explore alternative solutions for getting any open shifts filled (i.e. recruiting new physicians).

5
Use Scheduling Software

Emergency physicians
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Scheduling software can produce a schedule in a matter of minutes. Even large schedules that might take a scheduler 40 hours to accomplish manually can be generated in 20 minutes or less using scheduling software. It also utilizes the most out of physician availability and takes into consideration physician preferences and time ​-off requests. Setting up parameters in the system takes a lot of time but is worth it in the long run.  

For example, instead of a scheduler having to remember to give the Medical Director the first Tuesday of every month off for a meeting, the scheduling software will take this into account. 

6
Confirming Schedules

Emergency physicians
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No scheduler wants to get a call at 6 a.m. stating that a physician has not shown up for his/her shift and have to scramble to find last minute coverage. Although this may not fully eliminate no-shows, send a copy of the schedule to all scheduled physicians and ask them to look over the schedule for any scheduling conflicts and to confirm their shifts. This is especially important for part-time physicians that may work for other facilities. There is a possibility that they may double book for the same day or simply forget they are scheduled to work. Having them confirm shifts holds them accountable and indicates that they are aware that they are scheduled to work specific shifts.

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