I’ve seen it happen time and time again.
A single mistake in a roster cascades into a series of scheduling nightmares.
And it happens quite often.
Imagine if a nurse had to take a sick leave, and no one could cover his shift.
So his teammates had to take up all his responsibilities.
Or, imagine that the scheduling staff just approved a doctor’s annual leave,
and later they found that this decision would result in a staff shortage.
But they couldn’t call him back.
So the team had to go on with the shortage.
These incidents occurred because we didn’t think through everything while planning the roster.
They could have been avoided.
But how would I have known?
It is indeed hard to balance everything in a schedule.
Especially when you need to take into account all factors: like staff availability, preference, fairness, and so on.
Many believe this is just the status quo that we need to live with.
Like diabetes, hypertension, and all those chronic conditions.
Fortunately, there is a way we can systematize this process.
Just as we systematize our history, physical examinations, so we don’t miss out on anything.
I will list 7 proven strategies to minimize human errors in roster scheduling, so you can avoid these pitfalls in your next roster.
1. Organize your staff availability and preferences
List all your dates, and staff names on a spreadsheet (if you use one).
I like to do it like this.
list everyone’s duty on a blank spreadsheet.
Dates on the columns, names on the rows.
Then, fill out everyone’s annual leaves, and shift preferences like this.
Fill in annual leaves and shift requests.
This format makes it easy to spot staff shortages.
Just screen vertically on each day.
Say, if you need 2 staff on each day, then you must not approve any more leaves on 2/7.
If you are already scheduling using this format, you have a clearer overall picture already.
2. Familiarize yourself with your rules and local regulations
It might seem easy to articulate particular rules of your ward:
“Each call is allocated to 1 person.”
“Each person can only call at most once per 3 days.”
“Each staff should attend to calls of their seniority (e.g. 1st Call, 2nd Call, 3rd Call)”
But don’t forget about the local compliance (which deserves an article of its own).
Say, it is compulsory to have at least 1 rest day every 7 days.
If you cannot make it, you need to substitute it with some other rest day within 30 days of the original rest day.
It is so easy for medical professionals to work overtime, to a point where we’re somehow even proud of this culture.
However, we are not machines, and we need rest.
The rules and regulations are here to make sure we deliver the best care with well-rested professionals.
3. Try to overestimate staffing needs
Look back at this table.
on 2/7, you may need to reject Bruce Wu’s leave request if he applies for it. So that if anything urgent happens for Jane, there is people to cover her up.
Assuming we need 2 staff on call every day, this schedule seems fine.
But Bruce was suddenly found to have contracted TB, so he’s off for a while.
Then the roster breaks down.
Because there is no staff available to compensate for his leave.
If possible, always try to overestimate staffing needs for each day.
Have 1-2 spare slots for if anything suddenly goes wrong.
Having a plan B will never hurt.
4. Plan ahead and allow for buffers
Don’t stack calls for your staff.
Say, you want to arrange 5 weekday calls for one of your staff, and there are 2 options:
- Shifts on the 1st, 4th, 6th, 10th, and 17th day
- Shifts on the 2nd, 7th, 15th, 22nd, and 28th day.
Which is better?
If you’re like most people, the 2nd option seems to be better.
Because it spaces out shifts across the month.
Not only does that alleviate staff workload, but it also allows you to adjust your schedule for ad hoc changes easily.
And it also seems fairer to your team, boosting team morale.
In contrast, option 1 packs everything in the first half of the month, and leaves the second half weirdly empty.
So try your best to space their shifts across the month as evenly as possible.
5. Double check mechanism
How can I overemphasize this? It is always better to have someone check your work.
Like how we would ward round every day to make sure things are going fine for our patients.
As you finish your part of scheduling, it is always a good idea to find someone to proofread it for you.
They might be able to catch a misarrangement you missed.
Or they might be able to advise an arrangement for a period of staff shortage.
Having someone to check on is always good.
6. Team communication
Even with a second opinion, we might not catch every error.
But for individual staff, it probably is easier to spot mistakes on their part.
And you need a culture that encourages them to report these issues as soon as possible.
Them reporting issues early is not only protecting their interests,
but also increasing the chance of solving this issue before it becomes a pressing matter.
To foster such behaviour, you can be very open and welcoming to all sorts of opinions,
and understand that these reports are not criticisms, but a way to make things better for everyone.
7. Use a digitalized solution/programmatic scheduling
Despite one’s best efforts, sometimes it is just too time-consuming to make a schedule manually every month.
In these cases, one might turn towards rule-based scheduling algorithms.
This topic deserves a full discussion on its own. However, the main principle is to map out the scheduling problem as a mathematical model and solve it accordingly.
The advantage is that programs are excellent in keeping your roster compliant. If any rule makes the roster impossible, the program will be able to indicate infeasibility.
Many mathematical solvers out there allow you to do this: Gurobi, CPLEX, ORTOOLS, etc.
But this method requires you to be proficient in both programming and mathematical modeling techniques, which might pose higher barriers.
Because of this, we provide a service to customize setting up mathematical models for your custom ward.
In general, for larger, more complex ward rules, programmatic scheduling is an excellent way to eliminate human errors.
Conclusion
It is of utmost importance that roster schedules have as few human errors as possible, no matter for team morale, staff satisfaction, or compliance with local regulations.
Above we outline multiple methods to reduce or eliminate human errors, but not everyone would suit your needs.
At the end of the day, it is up to you to decide which is suitable for you, and which is not. However, I hope that we have provided a repertoire of approaches that can help you with roster scheduling.