Physician On-Call Scheduling and On-Call Management Blog
by Justin Wampach

No Thanks, I’m Too Busy to Automate On-Call

Posted by Justin Wampach on Tue, Jul 24, 2018 @ 10:27 AM

If you are a physician or administrator who creates the call schedule for the doctors using Excel, this post is specifically for you. I have heard the phrase over and over “I’m too busy to even look at something new”, “we’re too busy with (fill in the blank)”, and “the doctors are so busy” so often that it doesn’t even phase me anymore.   After some thoughtful reflection, I was unable to identify a group of professionals who are not busy. Can people be so busy that they can’t take time to learn something relevant to their business that will save time?  Really? 

Adjuvant Technologies is the second company I started. In my first company and even the first few years of Adjuvant, I was always busy. Often times too busy to eat lunch or even arrive home at a reasonable hour. Over the years, trusted advisors, as well as members of my Board of Directors would advise me to begin to off-load some of the administrative duties that were always making me so busy. One of the main reasons that prevented me from giving up some of these tasks was the daunting task of turning things over to someone else, bringing them up to speed, and then managing the process. It seemed easier to just do it myself. Although nervous, I thought I would take the advice and give it a try.

Freeing Up Precious Time

No Thanks, I’m Too Busy to Automate On-Call

One of the first things I “turned over” to someone else was the daily book-keeping and accounting duties. Although it was a long set-up process, looking back it was one of the best moves I made.  Although I am still very involved, I do not have to perform all of the daily duties.  This gives me more free time to do my job, which is selling, writing blog posts and running the business. 

When I look back several years, doing the accounting was a way for me to keep busy with a task that was relatively simple, gave me some sense of accomplishment and was easier than picking up the phone and trying to talk to a doctor or clinic manager who was always too busy. It was actually some form of not having to do my job because I was busy with something else. 

When I look at this in contrast to on-call physician scheduling software, I do wonder why there are so many busy doctors who take on the task of creating, updating, and communicating the call schedule for themselves and their partners.  And on top of that, when they do it by hand or with Excel, not taking advantage of software such as Call Scheduler.  Perhaps it is like doing a brain teaser, something to take their mind off of work, patients, families, and other “stuff” that looms in doctors' minds. 

Facilitating Growth

In my company we have decided intentionally not to be “too busy” to look at and explore things that will help me and the team manage and grow the business.  Because we are open to new, relevant ideas and concepts, we continue to find “bits of goodness” that hopefully, my competitors are “too busy” to see. One example of this is the blog you are currently reading. Although we try and write weekly, sometimes we miss that goal. Most companies are far too busy to blog, just ask them. 

Another example is that we use a robust Customer Management System (CRM) to manage all of our sales and customer activity. Many companies don’t use CRM systems like this because they are “too busy to set-up and continue to enter information into”. We invested in this system so we can do a better job memorializing the conversations and interactions that we have with our customers. This should make it easier on our prospects and customers in the long run. 

I try and make decisions that are in the best interest of the business and our customers. If I am too busy to look at something new that can save me time and help our customers, I may need to re-evaluate if I am doing my job.

Key Takeaway:  Maybe you are too busy NOT to look at something like physician scheduling software.  

 

Do you know what time you're spending on schedule creation and changes is  costing you? Find out. Download Free Cost Calculator

 

Topics: adopting on-call software

Does Anyone Care How Much Time You Spend on the On-Call Schedule?

Posted by Justin Wampach on Tue, Jul 03, 2018 @ 08:28 AM

I was just reading a great blog post from a company that schedules restaurant employees and it was talking about an employee of the company displaying at a trade show and trying to talk to attendees as they walk by the booth.

The vendor said, “Hi, would you be interested in knowing more about online employee scheduling and forecasting?”  The man hesitated.  A-HA!  A browser! He turned and said, “What, you mean a tool to do the schedule on the computer?”  I replied, “Yes, absolutely, and a great deal more.”  He then said something I have since heard several times, but as this was the first time I’d heard it, it surprised the heck out of me.  He said, “I pay my manager a salary and I don’t care how long it takes them or how hard it is. That’s why they’re salaried.” 

This made me think of how many times I hear from the person creating the on-call schedule that no-one seems to understand or care how difficult it is or how long it takes. 

How Long Does it Take to Build an On-Call Schedule?

Over the past several years I have commented many times about trying to understand and articulate the value of your time when creating, maintaining, and publishing the call schedule.  If your partners or your boss is not aware how much time and energy is being spent, chances are it will never change.  I would go as far as to say that if you are being asked to do this task at night or on the weekends of your own time, and you are not an owner or stakeholder, you might want to strongly consider politely giving the project back.

Managing Overtime in Your Clinic or Practice 

GettyImages-947192610

It’s a common assumption that salaried workers can be asked to work overtime without being compensated extra. That assumption is not always true.

It’s not whether you’re salaried but whether you meet the test for exempt status as defined by federal and state laws. An employee that is exempt from the Fair Labor Standards Act is not entitled to overtime. An employee that is non-exempt from FLSA is entitled to overtime. The official stance is:

A salaried employee must be paid overtime unless they meet the test for exempt status as defined by federal and state laws or unless they are specifically exempted from overtime by the provisions of one of the Industrial Welfare Commission Wage Orders regulating wages, hours, and working conditions.

If you are salaried and are non-exempt, then you can calculate your overtime pay like this:

  1. Multiply the monthly remuneration by 12 (months) to get the annual salary.
  2. Divide the annual salary by 52 (weeks) to get the weekly salary.
  3. Divide the weekly salary by the number of legal maximum regular hours (40) to get the regular hourly rate.

As mentioned above it is somewhat different if you are an owner or stakeholder in the business. Although if you have a true partnership (an arrangement where parties agree to cooperate to advance their mutual interests) you should not allow any unfair treatment between partners. This causes friction in the relationship and could eventually cause a disillusion in the partner agreement.

One easy way to accomplish this is to answer the following questions (at least annually):

  1. What are your duties in the clinic outside of patient care?
    • Do I still like doing it?
    • How much time does it take?
    • How much does it cost?
    • Is this a good use of my time?
    • Are there any tools (like software) that can assist me?
  2. What are your partner’s duties in the clinic outside of patient care?
    • Do they still like doing it?
    • How much time does it take them?
    • How much does it cost them?
    • Is this a good use of their time?
    • Are there any tools (like software) that can assist them?
  3. Are these duties still a good fit for you and your partners?

Key Takeaway:  By reviewing and answering these questions you are showing your business savvy and also showing your partners that you care.

 

See Call Scheduler in action and experience the time and headache you'll save. Request Live Demo

Topics: adopting on-call software

How to Convince Your Partners to Try New Call Scheduling Software

Posted by Justin Wampach on Mon, May 14, 2018 @ 08:29 AM

A New Day

When was the last time you tried something new? What convinced you to try it? Was it a co-worker, family member, or good friend? And were you glad for the experience whether you enjoyed it or not? Studies actually suggest that trying new things improves our overall happiness and well being and can lead to improved mental health.

How to Convince Your Partners to Try New Call Scheduling SoftwareWe often try new things easily in our personal life — a new food, a new activity, or a new book. But trying new things in the workplace can present more of a challenge. We may fear trying a new technique or system could fail, and leave us worse off than before. Or we may feel like we don't have the time to learn anything new at work with schedules packed full of meetings, appointments, and obligations. However, just like in our personal lives, we can benefit from trying new things in the workplace leading to improvements in our satisfaction with our jobs and helping us do our jobs better. 

New Practices in Medicine

In medical clinics, doctors often work to convince their partners and colleagues to try new things whether it is a new drug, treatment, or approach to treating patients. Doctors may also try to convince their partners to incorporate new software into a practice. Software can enhance a medical practice by streamlining different processes from documenting patient contacts to improving the physician schedule and on-call schedule. If you're ready to try new software but your partners aren't quite there, try these tips to convince other doctors in your practice to try something new.

Educate

We may decide not to try something new simply because we don't know anything about it. Giving your partners information about new software will help them feel more comfortable with the unknown and familiarize themselves with something new. Studies have shown that people actually fear unknown outcomes more than they do negative outcomes. Education takes away the unknown factor of new software and can help raise your partners' comfort level.

Testimonials 

We are all more likely to try something new if someone we know and trust has already tried it and had a positive outcome. Gather positive testimonials from trusted physicians you know either personally or by reputation to share with your colleagues. Many medical clinics have implemented physician scheduling software and the company you're considering can provide you with testimonials or you may know physicians in your specialty or geographic region who have stories to share.
 

Eliminate the Risk

What have you got to lose? You've heard that one before.

When the answer is truly nothing, then it's easier to try something new. Physician scheduling software usually comes with a 90-day risk-free trial period. During this time, the software company provides education and training to the clinic employees, support as new software is implemented and a guarantee that if the software doesn't work for the clinic, the practice owes nothing. By eliminating the risk, you give the partners in your clinic more of a reason to try new software.

Trying new things in the workplace brings about all kinds of benefits. You can save time, money and streamline difficult and complicated systems like the physician schedule. When you're ready to make a change but your partners aren't, remember these tips to encourage others to try new things.

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Topics: software for scheduling physicians, physician scheduling, on-call software, adopting on-call software, call scheduling

Consider Letting an Expert Create the Physician On-Call Schedule

Posted by Justin Wampach on Wed, Nov 05, 2014 @ 03:31 PM

ID-100211192Over the last 10 years the number of physicians who are now in charge of creating the physician work and on-call schedule has continued to increase.  One of the top reasons for this is due to the increasing degree of complexity that is involved in making all of the parts fit together.  For many advanced specialty practices the days of just creating a simple primary and back-up on-call schedule are long gone.  As metropolitan practices continue to merge and form mega-groups or fold into large health care systems the number of “jobs” or things that need to be scheduled in any given day increases.  It is not unusual for a Cardiology or Radiology or even a Pathology group to service several hospitals, clinic sites, outpatient surgery centers and emergency rooms.  All of these individual locations pared with the unique skill sets like interventional, non-interventional, or the ability to offer an opinion on a frozen section of most anything and even reading certain types of pictures.  As you know most of these specialty doctors work so many long hours that they need three, four, five or six weeks of vacation each year as well as CME days.  As you know, there are a lot of moving parts to the physician schedule.

Back in the “good old days” it was easy to create a simple rotation or even a random schedule that you could justify fairness with an Excel or hand scratched tally report, not any more.  Many physicians don’t work full time, now its point this and point that.  And last but not least many doctors have partners who are also physicians so these complex schedules need to be coordinated so that they can actually have holydays and time off together.  It’s no wonder you can’t find an administrative assistant type person and pay them $15-20 per hour to try and figure this out.  It’s also challenging because some of the doctors aren’t, shall we say, not so diplomatic about voicing their frustrations to the administrative people who are trying their best to accommodate everyone’s needs.  So what do you do?  You can keep doing what your doing.  But do we really need medical doctors taking time instead of seeing patients and creating RVU’s or spending time with their families or should they be making physician on call schedules?

The answer is no.  What you really need are four things working together and you can alleviate or at least be on a path or alleviating the physician scheduling pain.

  1.  Clear process.  Someone needs to take the time and document all of the unique things that someone needs to take into consideration when creating the physician schedule.  Rules, jobs, skills, etc.  There has to be a plan or else it’s like asking someone to build you a house, and you say “there is no plan, I will just know it when I see it”, so build and I will tell you what I like and you can tear down what I don’t like and you can try again, over and over until I am satisfied.
  2. A local physician decision maker.  Someone still needs to approve vacations, time off requests, change requests and break ties.
  3. A willingness to let go.  I hate to break it to you Doctor, but although you may be an incredibly talented physician or surgeon, you are not the best schedule creator.  In fact if you do not believe me, ask your partners.  You don’t do it often enough to be good.  You may be ok, but you are not good and surely not great.  Juggling all of these moving parts and getting them to line up into a workable, fair schedule is not an easy task.  Give the experts some credit and let them do the heavy lifting.  And by the way, by expert I don’t mean you assigning this to someone in your clinic or group who has some extra bandwidth.  I mean someone who creates 50-500 schedules per year and has created for every specialty.  A true specialist.
  4. Last but not least you need to be willing to pay a specialist what they are worth and also spend money on software so that they have the proper tools to get this job done.  A 10 person Cardiology group may spend $500 per month on outsourced call scheduling to a specialty scheduling company like Call Scheduler, but you have to ask yourself how much your spending today to get the results that you are not happy with. 

 Key Takeaway:  Deciding to use outsource scheduling services is no different than hiring a painter to paint a fresco in your home, or going to a mechanic to have your BMW serviced on or going to a Cardio Thoracic Surgeon to have an Aortic Valve replaced.   Experts have their benefits.

Request a Consultation on Outsourced Call Scheduling

 

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

Topics: outsourced scheduling, adopting on-call software

Why Would Anyone Buy On-Call Scheduling Software?

Posted by Justin Wampach on Fri, Sep 05, 2014 @ 02:34 PM

ID 10026801According to Harvard Business School Professor Theodore Levitt, “People don’t want to buy a quarter-inch drill. They want to buy a quarter-inch hole!”  

Hospitals, clinics and doctors buy on-call scheduling software for peace of mind, knowing that people will know the right doctor to call in case of an emergency, because there are serious consequences for sick patients in an Emergency Department without access to on-call physician specialists.

Let’s break that down; Medical practices who buy on-call scheduling software are buying peace of mind knowing that other people (office staff, ED clerks, Answering Service, ED Doctors (people with eyes on the patient)) know the right doctor to call (not the one that worked yesterday, not the one who has to travel 30 miles in the morning, not the one in surgery) in case of an emergency, because there are serious consequences for sick patients in an Emergency Department without access to on-call specialists.  Plain and simple, our customers are not really buying software, but instead they are making an investment to be sure that they are not incorrectly woken up at 3:00am when they are not on-call. 

Similarly, hospitals who buy and use on-call software do so to preserve revenue from sick patients who present to their Emergency Room with a condition that requires more attention that an Emergency Physician can provide.  After all, without specialists, patients need to be sent to a different hospital that has the necessary resources to help the patient. As the patient goes, so goes the money.  Plain and simple, hospitals are buying on-call software so that they do not loose critical Emergency Department revenue.

Now that we both understand the “why”, the next question is “how” do you make this happen?  A company like Adjuvant helps fulfill doctors and hospital’s needs with specialized software products that contain valuable features like a “rule based scheduling engine” or a “provider request area” or “tallie reports”.  

The reasons a group of doctors create a call schedule in the first place are so they are not called incorrectly at all hours of the night by the Emergency Departments, and to evenly distribute the on-call shifts so that no one physician is overburdened.  The purpose of on-call scheduling software is to help achieve the desired outcome of a fair, and evenly distributed call schedule with the least amount of effort.

Call Scheduler Customers typically have these 6 things in common:

  1. They understand how important on-call is to health care in each community
  2. They are willing to work their fair-share of on-call shifts to assist sick patients in need
  3. They are looking for tools that will assist them in creating evenly distributed, fair call schedules
  4. They are looking for tools that can assist them in keeping up with all of the changes that occur each day
  5. They are looking for clear information to send to the hospital and their answering service so it is easy for them to determine who the correct person is to call
  6. They are looking for a vendor-partner to work with that understands the unique, specific needs regarding physicians on-call

Key Takeaway:  We try to find people that are looking to find a better process and system to give them peace-of-mind.

 Image courtesy of Keattikorn at FreeDigitalPhotos.net

Topics: adopting on-call software

Pricing On-Call Scheduling Software like Champagne or Beer?

Posted by Justin Wampach on Fri, Aug 22, 2014 @ 03:23 PM

ID 100188174When I was a kid my dad always used to tell me that I had champagne taste on a beer income.   What he was really trying to say is that I always wanted better stuff than I could afford or wanted to spend. 

Let’s say that you are searching for a call scheduling software program for you and your partners, how do you know what is reasonable to spend on on-call software?  How do you know if something is as valuable as it costs?  Ask yourself the 5 questions below, before you start comparing price.

  1.  What are you trying to accomplish.  This is truly the first question that you need to ask.  What are you looking to get out of your new software?  List the top 3 or 4 features that are most important to you.  Remember, software features are like automobile accessories, they are all cool as hell, but often cost more than the benefit.  Don’t list anything that you’re not willing to pay for.
  2. What is it costing you today to create, maintain and communicate the call schedule?.  Do you know the answer to this question?  Do others in your group realize that it is costing someone something today?  What will you say to those who say “it’s not costing us anything today”?
  3. Who will benefit from the new software?  Remember that scheduling software has three distinct components, creation, maintenance and communication.  Each of these components benefit different people.  If you have a doctor who is creating the schedule for her 10 partners, than not only with the doctor who creates the schedule benefit from software, but all of the other doctors will benefit from the changes and communication features.  Basically you need to ask who you are trying to help, the doctors, the hospital or your clinic staff. 
  4. What is the value of the benefit?  How valuable is it if a doctor doesn’t have to reschedule all of her appointments due to an error in the on-call schedule?  How valuable is it for all the doctors to have a “fair and equitable” on-call schedule?  How valuable is it that the hospital has an accurate call scheduler for your medical group?  How valuable is uninterrupted free time on the weekend for a doctor?  Each of these has value, how much is for you and your partners to decide.
  5. Who has to pay?  Is the practice owned by the doctors or are you part of a larger integrated health system?   What is more important, profit or productivity and efficiency and provider satisfaction?

Each of the questions above is designed to help you identify and see things “of value” in on-call software.  People tend to see more value in solutions when their problems are very painful, both personally and professionally.  If you discover after answering these questions that your problem is not really a problem, or those that pay don’t see a problem, than all the software you look at will probably be too expensive.

A typical sales inquiry will be from a doctor with 10 partners who has been doing the call schedule at night and on the weekends for years.  None of the partners are happy with the results.  Occasionally the wrong doctors get called incorrectly, sometimes patients are rescheduled due to call schedule errors, and we have even had a doctor not show up because he didn’t know he was on-call.  The doctor spends about 40 hours per year of his personal time to create the schedule.  This issue is hot inside of the clinic.  The partners are unhappy and ready to change.  The doctor who creates the schedule has said that either he gets help with some software or someone else can do the damn call schedule.  Do you think that this groups problem would justify spending $20 per doctor per month?  Let’s compare the benefits of software:

  • Scheduling engine and rules to help reduce the time it takes the doctor to create the schedule
  • Fair and balanced tally reports that can be used to provide fairness
  • The hospital has on-line access to your “live” call schedule
  • No schedule errors that would require you to reschedule patients
  • Extra free time for the doctor who creates the schedule
  • Call schedule is available on-line for doctors and staff to review
  • Doctors can see their call schedule on their smart phones.

Now, are all of these benefits worth $2640 per year?  That’s for you to decide.

Key Takeaway:  Each benefit that you expect to receive will have a cost associated with it.  The question is do you have champagne needs but a beer budget?  If so, its time readjust your expectations.

image courtesy of Gualberto107 at FreeDigitalPhotos.net

Topics: adopting on-call software

The 10 Golden Rules of Buying On-Call Software

Posted by Justin Wampach on Thu, Aug 07, 2014 @ 03:21 PM

The “Golden Rule” is a generally accepted ethical code that essentially states that one should treat others as one would like others to treat oneself.  One should not treat others in ways that one would not like to be created.  This rule promotes equality and truly relies on a person empathizing with others.

I realize that this is a dog-eat-dog world, and everyone is out for themselves, but is that really beneficial in healthcare.  Is that mentality going to help patients?  Aren’t healthcare professionals supposed to hold themselves to a higher standard?  I have not always found this to be the case.

If I had a magic wand, here are 10 wishes that I have for prospective customers;

  1. Be honest with me.  My goal is to help anyone who has a need around scheduling doctors.  If you are just researching or really don’t want to talk to a sales person, or have no further interest, its ok, just say so.  You’re not going to hurt my feelings.  It would be best to know so I do not bother you.  After all my goal is to help, not piss you off.
  2. Return my phone calls and emails.  If you request a call or ask me a question via email, would you please respond.  I am always surprised when someone fills out a form on our website and asks for a person to contact them and then when we do, we never get a response.  I think it’s even ok to call or email someone to tell them “not now”.  Just communicate.  After all, you asked for it.
  3. It’s ok to say no.  This seems to be a tough one for many people.  It appears easier for many to just go silent and ignore people who are trying to follow-up with you.  Again, it’s ok to say no to someone.  A professional is not going to take it personally.  After all, I am here to help, If you aren’t interested in my help, or don’t believe I can help, then just say so.  I promise not to argue with you and try to change your mind.
  4. Honor your commitment.  When you buy something, dedicate the resources and give it an honest effort.  Also be ready to change.  We get a lot of people who want change, but are unwilling to do anything to make the change happen.  This is similar to a very sick patient who refuses to take their meds, but still complains about their illness to the doctor.
  5. Know what you are trying to achieve.  If you are in the middle of changing everything related to your physician on-call schedule (new rules, new process, just trying a new way), it might not be the best time to introduce new on-call software.  You have to know what you want in order for us to help you achieve that goal.  If you don’t know what you want in terms of rules or results, trust me, we will not be able to make you happy.
  6. Put a little trust in me and my team.  We work with clinics, hospitals and doctors every day, all day.  We see a lot.  You may need to step outside of your comfort zone and put some trust into the people you are partnering with.  All we want to do is help, let us.  After all you did seek us out because we are the experts. 
  7. Don’t be a jerk.  Again, we are trying to help.  All we want to do is help you succeed.  Please be nice.
  8. Pay your bill.  Service is a two way street.  We help you, you pay us.  We should not have to call and ask for our money.  Imagine how frustrating it would be if we made our customers go through the same process to get help as we have to go through to get paid. 
  9. Ask for help.  No question is too big, too small, or too stupid to ask.  We love talking to our customers so please do not hesitate to call when you need help.  We want to help.
  10. Have realistic expectations.  Do you have any idea how hard it is to replace a blank sheet of paper?  It is harder than you could ever imagine because you can do anything you want.  Software has parameters, limitations and processes based on what and how a majority of people use the service.  You are not going to find on-call scheduling software that will completely duplicate the way your paper process works today.  Ooh by the way, the paper process that I am referring to is the one that stinks so bad that you are looking for software to replace it.  Remember crawl, walk then run.

Remember that sales people are all trying to do is our jobs to the best of our ability.  Just because we are trying to help you by selling you something doesn’t mean that they don’t deserve the golden rule.  After all, look around your office, every single thing in it was sold to someone at some time. 

Key Takeaway:  Don’t only be nice when you need something (like a demo after hours or a price), be nice all the time and you will create a lasting vendor partner relationship that will greatly benefit both parties.

Topics: adopting on-call software

Four Drivers for On-Call Management Software Success

Posted by Justin Wampach on Wed, Jul 23, 2014 @ 02:42 PM

ID 10031660When was the last time that you or a family member needed to go to the Emergency Department at a hospital?  Whenever it was, it is very likely that you or someone in the next room or down the hall needed a consultation from a specialist.  Many non-medical people don’t realize that Emergency Room Physicians are trained to perform emergency resuscitation, start intravenous lines, or take other steps to stabilize the patient before transfer to another hospital department. Less serious injuries, such as lacerations or broken bones, can be treated in the ED.  Other patients that need to be admitted to the hospital will need to be seen by a specialist, such as a Cardiologist, Surgeon or Neurologist.  These highly specialized physicians are not just sitting around in a back-room somewhere in the hospital waiting for a patient to come-in.  Instead they are at their medical practice seeing patients or at home spending time with family and friends and take turns serving as “on-call resources” for Emergency Room Physicians.

Most hospitals mission statements are about patient care, staff and physician satisfaction, quality outcomes and perhaps something about being community oriented.  Yet when you look around an organization often you find areas where none of this has been considered for years.  How on-call works in a hospital or health system is a great example.  Where else do you find as much “old school” paper processes, Excel spreadsheets, 3-ring binders, fax copies and sticky notes as in the office of the person who manages the daily call roster.  Buying and implementing a new on-call management system seems pretty easy, Google some key-words, find some vendors, choose a vendor, get funding, create a contract, install the system and go-live.  If only it were that easy.

I would like to highlight four key areas that need to be carefully considered if you want a successful implementation of your new on-call management system.

Vision 

Creating an on-call management system for a hospital or health system takes vision.  The reason for this is because on-call is one of the very rare items in a hospital or health system that affects almost every department and most every healthcare provider.  Because of this it is important to view this as a system wide issue, rather than department specific.  For example, if you look at this from a “telecommunications” perspective, you may solve the hospital operator’s problem, while creating a problem in the local medical groups or clinics.  Someone with vision needs to see and understand how each department uses on-call and buy a system that can reasonably accommodate everyone’s needs.  Don’t allow this project to be just about one department.

Commitment to change

Once you can visualize the big picture and have converted it into a vision then it needs to be translated into “why”.  The entire organization needs to clearly understand why accurate, live and accessible on-call information is imperative to meet the hospitals mission.  Why it’s important for providers and patients, and how it can change outcomes.  When your team understands why, if they agree, they will make a commitment to change.  If you can’t clearly articulate the “why” the project will not be successful because some people will choose not to participate in your project due to a number of reasons.  This would be like a department choosing not to use electronic medical records.  The “why” needs to be compelling enough that people who push back will be given an ultimatum for the good of the mission.

System wide view / Interoperability / Integration

Most on-call systems that are in place today are paper based.  Specialty Clinic call schedules do not communicate with the hospital.  Daily changes are a nightmare because of everyone who needs to be notified.  And there is a lot of double entry and transposition from paper schedules into Excel.  Clearly none of these systems talk to each other or integrate with each other.  When purchasing your new system be sure that you are solving all of the problems that exist, including how to create the physician on-call schedule in the first place.  When I hear about a Telecom Department installing a new on-call module that allows the operators to manually enter call schedules into a phone system so that doctors can be paged easily, I think to myself, wow, not only did they not solve the problem, but they did not understand or see the big picture.  I am willing to bet my Ipad that there is not a Hospital or Health System Administrator that would buy an on-call system to help operators by placing more workload on doctors and specialty clinics that provide most of the revenue to the hospital.  Never in a million years!  Be sure the hospital system talks to and passes information back and forth to the clinic system.  This will eliminate double entry and transposition of paper into a computer and truly give you an integrated system.

Iterations

If you expect to go from a paper based on-call system that regularly fails to a new electronic on-call management system without an iterative approach, you’re in for a real treat.  That’s like going from a big-wheel today to a car tomorrow. It’s not a good idea and will increase your chances for people to say, “Let’s go back to the old way, this will never work”.  Plan on implementing your new on-call system one step at a time.  Each step will build on the success and failures of the steps before it.  Because this new system has so many users and uses, it will take some time to make everyone happy.  By being up front with your users and setting proper expectations about how the installation will take place you can install a great system and make everyone happy, just not all at once.

Key Takeaway:

If you thought that buying a new call management system was the hard part, I am sorry to tell you that that was the easy part.  The hard part is managing the 4 key areas that I have highlighted above to get your new software installed and useable for everyone.

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Interested in learning more check out this blog post "Budgeting for a Hospital On-Call Management System".

 

Image courtesy of Scottchan / FreeDigitalPhotos.net

Topics: call schedule management, adopting on-call software

10 Things to Consider if Your Physician Scheduler is Retiring

Posted by Justin Wampach on Thu, Jul 10, 2014 @ 11:34 AM

ID 100213451Is the person who creates, maintains and communicates your physician on-call scheduling going to be retiring soon?  Guess what, you are probably not aware of how much work and thought goes into creating a “good” schedule for the doctors. I have heard over and over, “when Jan, our scheduler, retired we gave her job to someone within the medical group to assume the duties.  The new person is complaining about how complicated it is, and now her other duties are not getting done.  We had no idea how much work it took to do the schedule, she must have done a lot of the work at home”.  If you are not yet in this circumstance, you soon will be.

In most medical practices the person who creates, maintains and communicates the doctor’s schedule is a trusted member of the team who has been with the practice for a while.  Often they are physicians, sometimes they are practice administrators, and sometimes they are administrative staff workers.  Regardless of their position, many of these people are taking their work home with them, and believe me that is not going to happen with the next generation of physician schedulers.  And if by chance you find a good one that is willing to take work home, expect to provide comp time or pay them overtime.  The days of getting someone to work for free are over!

If you are currently in or will be in this situation, don’t worry there are ways that you can be pro-active and prevent any problems before they arise.  First and foremost be aware of what is not being done during business hours and why.  As an administrator or owner you should always be mindful of the workload you are assigning your team members and I think it should raise concern if you have people who are consistently unable to get their work done during normal business hours.  Next I would strongly review what your current process is for creating the doctors schedule.  If you are still doing this task with paper and a pen or Excel you are behind about 10 years.  You could be spending 2-3 times the amount of time that other medical groups spend to do the same job.  If that’s the case, you really need to consider moving into call scheduling software.

Before you go to google and search for “call scheduler” or “doctor scheduling software” or “on-call software” and jump into vendor demos, you should strongly consider each of the 10 items listed below.

Top 10 things to consider if your physician scheduler is retiring:

  1.  Before the current scheduler retires be sure to document (in writing) the exact steps that she/he goes through to do the following:
    1. Create a holiday schedule
    2. Receive and approve provider requests
    3. How many jobs (assignments) need to be scheduled each day
    4. Which jobs (assignments) are the most difficult to schedule
    5. Each rule or expectation for each provider
    6. How long do you schedule for
    7. How do you prove fairness
    8. How do you process changes
    9. How do you communicate the schedule to doctors, staff and the hospital
  2. Form a small work group to discuss the good, bad and the ugly about the current scheduling process.  What’s working? What isn’t?  Now is the time to get all of that on the table.
  3. What are the top 4 features that you need the software to have
    1. Rules
    2. Scheduling engine
    3. Tally reports
    4. On-line access for our doctors and staft
  4. What are some other features that would be nice to have but are not deal-breakers
    1. Ability to print
    2. Ability to link up with doctors smart phones
    3. Reminders
  5. Who is going to be the new scheduler
  6. What percentage do you expect this part of the person’s job to be?
  7. What is your budget to modernize and create a new physician scheduling process?
  8. When do you need your next schedule to be complete?
  9. Who needs to be involved in the decision making?
  10. How will you get the physicians to participate with the new system and new processes?

Once you have a very firm grasp of the 10 items above, you are in a great position to search Google for “call scheduler” or “doctor scheduling software” or “on-call software” and begin to speak to vendors.  Any GOOD vendor is going to ask you each of the 10 questions listed above, you will already be prepared.

The long and short of this post is that you need to be aware of the aging baby-boomer population, especially if your scheduler is one of them.  You also need to stay on top of where the work is getting done and how complex it is to create the schedule. 

Key Takeaway:  If you choose to hire a replacement, buy them software so that they can accomplish their duties during the work day.  If that is not the best option then consider outsourcing the call scheduling job to a company that specializes in that type of work.  

"Image courtesy of Stuart Miles / FreeDigitalPhotos.net".

Topics: adopting on-call software

Ready to Change your Hospital's On-Call Management System?

Posted by Justin Wampach on Thu, Apr 24, 2014 @ 02:49 PM

ID 100108574Change is hard.  Novelist Mark Twain said, “The only person who likes change is a wet baby.” 

Most hospitals in the United States still manage their on-call information using a series of 3-ring binders and Excel.  Most users of these systems will tell you that the current paper based on-call system is inherently broken and because of that patients, doctors and staff members suffer equally.  There are many reasons why hospitals have decided not yet to make the change.   Some are still wrestling with government mandates such as Electronic Medical Records, Meaningful use, and ICD-10.  Others are financially not in a position to invest in new technology.  I think the largest hurdle is that most organizations want to change and stay the same at the same time.  My goal is to change the way these organizations think about on-call.

In case this is your first time reading my blog, there are many reasons to adopt a new on-call management system, listed below are some of the top reasons.

Improve patient care 

  • Critical patients that require specialized care have better outcomes when unnecessary time is not spent trying to locate and contact the on-call physician.
  • Rapid access to on-call physicians for assistive consultation by ER Doctors can increase the throughput of the department.
  • Accurate information given to smaller hospitals in your area can lead to increased transfers to your facility.

Reduce Daily Expenses

  • Monthly collection and verification of on-call schedules from community specialty clinics is very time consuming.
  • Daily creation of the “daily call-roster” takes on average 2 hours each day to create and distribute.
  • Maintaining changes to the “daily call-roster” is a never ending job, and is often incorrect.

Manage Risk

  • Federal EMTALA Law mandates that your hospital maintain “accurate on-call” records, including changes that show the original provider and a change log.
  • On-call EMTALA violations are $50,000 per infraction.
  • Allowing physicians to manage their own schedules and changes can create EMTALA violations.

You would think that with all of the compelling reasons to make a change, it would be rather simple to adopt a new on-call system to benefit the doctors and patients.  Think again.  Healthcare can be very resistant and obstructive to improvements that are not directly related to revenue creation. 

In some cases even if the on-call project is approved via a budget, the implementation can be sabotaged due to people’s pushback and reluctance to change.   Managing this process is imperative to having a successful project.

According to author John Maxwell, there are better times to change than others, here is his checklist to help navigate the process.

  • Will this benefit the followers?
  • Is this change compatible with the purpose of the organization?
  • Is the change clear and specific?
  • Are the top 20% influencers in favor of the change?
  • Is it possible to test the change before making a total commitment to it?
  • Are physical, financial and human resources available to make this change?
  • Is the change reversible?
  • Is the change the next obvious step?
  • Does the change have both short and long range benefits?
  • Is the leadership capable of bringing about this change?
  • Does everything else indicate that the timing is right?

Changes in healthcare on-call technology are necessary.  It is also important to know why, when and how you are going to make the change happen and be sure that you have adequate support.   On-call management systems benefit the entire organization.  New systems that create and enhance communication between patients and providers is positive for everyone.  Just remember that the “change” will be the hardest part.

Key Takeaway:  Will the change get the best of you, or will you get the best of the change?

Image courtesy of stockimages / FreeDigitalPhotos.net

Topics: call schedule management, adopting on-call software