Amy's blog about training

Holiday On Call Scheduling: Get It “Fair” by Starting Now

Posted by Amy Engebretson on Sun, Jan 27, 2013 @ 07:13 PM

holIDAYSOn Call Scheduling software that includes Provider Requests, Holiday History and Holiday Reports can allow you to forecast your Holiday schedule and make everyone happier.

Some of the “hottest” discussions about On Call take place regarding Holiday coverage. It’s not too early to start solving the problem, long before this year’s holidays arrive! Doing so allows for maximum planning within your Group and takes the stress of major summer/winter holidays off the table so families can plan their time together. What goes into the mix?

Rules: Your Physicians must establish some ground rules when it comes to holiday coverage and scheduling. First, all shifts must be covered. Every Physician Group has a different idea of how that should be accomplished and what is “fair”. Some extend shift times to free up a person, knowing the patient volume takes a dip as well. Other groups split up the four-day holidays (such as Memorial Weekend and Memorial Day) into a 2-by-2 pattern. Still others grant holidays “off” in exchange for covering certain weeks elsewhere (such as covering part of Ramadan or Rosh Hashana in exchange for Christmas or New Years).

Second, the Holiday Schedule must be fair both for the current year and on a year to year basis. Everyone must participate unless you have agreement otherwise. This means the regular docs will work a holiday and some of the time surrounding a holiday… meaning it is really unusual to have anyone on vacation over the entire holiday stretch. If Physicians are allowed to go on vacation for two weeks at the end of December, coverage can be pretty thin if anyone comes up sick or there is an at-home family emergency.

Strategies: There are several strategies I have seen used to maintain fairness. Being consistent and making sure that expectations are upheld is the most important component. Most frequently, I have seen the Holidays split up and alternated between years depending on the number of providers in the Group, such as balancing Labor Day against Memorial Day, Christmas against Thanksgiving and New Years.  In smaller Physician groups, a provider may get New Years (and therefore not Christmas this year), Labor Day (and therefore not Thanksgiving this year). Some Groups alternate the Holidays all through the year, taking care not to schedule the same Provider for a Holiday for two years in a row. Others split the staff in half (A and B), alternating the holidays between A and B though an entire two-year set, and whichever one a Provider has off this year, he will work next year.

Holiday History: Verifying fairness is greatly simplified if you have reports showing who covered which Holiday over the previous years. On Call scheduling software makes this easy and transparent. Since the reports are are on-line, in a central location, they are never lost in someone’s drawer or tied to an individual scheduler’s computer. Print the report, take it to the Holiday Planning meeting for Physician discussion and signup for the coming year, and you’re done.

Vacation caution: Vacations during peak holiday season are usually quite tricky. If there is enough staff, vacations can be accommodated for a few days leading into Christmas, or right after New Years for those not scheduled for the Holidays. Although a Provider is willing to work “his holiday”, taking a vacation over a majority of the holiday period is generally unfair to the rest of the group. Working in additional vacation after the Holiday schedule is already turned out seems to work better and could allow for a nice chunk of time off if it doesn’t stretch staff too thin.

Physician sign-up: There is always the option of taking Provider Requests and seeing how it works out. A Provider Request area can track who requests what and when, especially useful if you are using a first-come-first serve method. It is easiest if the Physicians sign up FOR a Holiday rather than allowing requests off for the Holiday dates! Many Groups have at least one Provider who doesn’t have a family event on Christmas itself and wouldn’t mind covering it in exchange for having New Year’s free. This works best if no one is forced to work the same Holiday for two years in a row, and if the Holiday requests and assignments are completed for an entire year at a time.

Remember, “Okay” doesn’t mean “okay forever”.  Physicians with no kids now may want to be home with babies next year. Physicians with grown children may prefer to see their colleagues home with their families, or may want to take off and be with their own long-distance grandchildren this year. Kids aren’t the only consideration! Certain Holiday services may be important to an individual. The list goes on and on...

Scheduling scenarios: Best case scenarios let the Physicians prioritize their holidays and preferences amongst themselves with a “Pay It Forward” philosophy. The Holiday schedule may already be “published”, but amicable swaps can be made in agreement between two Physicians if done well in advance. Also, the majority of Groups split up holiday coverage so if a Provider works Thanksgiving Thursday/Friday, they get Saturday/Sunday off. Labor Day and Memorial Day holidays and weekends can be handled in a similar fashion.

There are a lot of benefits when it comes to scheduling Holidays well in advance with year-on-year fairness in mind. Plans with friends and family, back-up babysitter planning can be accommodated if the On Call schedule is known… and these are only a few of the obvious issues. Not only do the Physicians feel more satisfied with their Group, the entire Group benefits as everyone pitches in and does their share rather than leave it to a few members of the team.

Key takeaway: Holiday planning and the on call schedules are a huge stressor for many physicians and their families. Scheduling holidays a year at a time in advance, with year-on-year fairness and a “pay it forward” attitude can maximize Group planning and improve provider satisfaction about the Holiday schedule.

Topics: call schedule improvement, on call schedule fairness, holiday scheduling