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

How do you know when your oncall management system needs an upgrade?

Posted by Justin Wampach on Fri, Jan 13, 2012 @ 02:58 PM

helpIn my last blog post "Who should manage on-call in a hospital, medical or administration?" we identified who the key players are that are involved in many Hospitals and why I felt that call schedules and daily call roster creation that is managed by the medical staff works better. 

How do you know if oncall management at your hospital is the best it could be?  That depends on where this daily critical service resides in your hospital.  Are you hearing or seeing of these symptoms?

  • Clinics in your community fax or email their monthly call schedule to the hospital.
  • Community clinics call schedules are kept in faxed paper form in a 3-ring-binder at the hospital.
  • Someone at the hospital is responsible for collecting community clinics on-call schedules and keeping track of them.
  • Someone at the hospital creates a paper "daily call roster" and faxes, emails or tubes the roster to areas throughout the hospital.
  • Who is on-call for a certain specialty is not available on your intranet.
  • Providers have to call someone to determine who is on-call.
  • Providers changing on-call shifts at the last minute is frustrating and confusing to the Emergency Department.
  • Occasionally the wrong doctor is called or paged due to incorrect oncall information.
  • The Transfer Center is frustrated with the quality of their oncall information.

The above are symptoms of an on-call process that needs updating and modernization within the hospital.  In a hospital, the question of "who is on-call for ...?" is asked hundreds of times per day in a medium sized facility.  Knowing the answer and having it be correct is easy when you are using an on-call management system.  

If your already thinking about upgrading or installing an oncall system, be sure to check out our Whitepaper on "Justifying the cost of an on-call system", that will identify some of the value buckets that you can use with your leadership team to identify current costs so that you can do an ROI.

When your oncall management system works, here is what you will experience:

  • Community clinics make call schedules for their doctors using software and they do not have to send the hospital copies of their schedule.
  • The hospital oncall management system "electronically talks" with each of the clinics on-call systems to "grab" the necessary information that the hospital needs. 
  • The hospital oncall management system automatically maintains a live "daily call roster" that contains accurate information from the clinic schedules showing who is oncall for each specialty.
  • Accurate on-call information is easily accessed by the Emergency Department, Transfer Center, Telecom, and on the Hospital Intranet for everyone else. 
  • Last minute or evening changes can easily be made, documented and communicated to the hospital call schedule.   
  • The wrong doctor is not called.

In summary, not having an adequate oncall management system can cause disruption in service to your patients and irritation by your physicians and staff.  This is a process worth improving.  The benefits are worth the investment.

Topics: daily call roster, call schedule management, adopting on-call software, on call scheduler

Who should manage on-call in the hospital medical or admin?

Posted by Justin Wampach on Thu, Jan 05, 2012 @ 03:43 PM

choiceWho should manage on-call in the hospital?  That’s a great question.  In a hospital on-call has many sides.  There is the creation of the individual specialty clinic call schedules, the creation and maintenance of the daily on-call roster, maintaining providers contact numbers and maintaining provider protocol information.

The purpose of on-call in the hospital first and foremost is to serve the emergency department physicians who need specialists to assist them in the admittance and treatment of presenting patients.  This is done via a daily on-call roster that is used to determine which physician is responsible by law to respond and help.  Secondarily it is used by many others within the organization, physicians, nurses, and administration to support patient care.

Although each hospital is very different, I have seen on-call management over and over in the following areas; Medical Staff Office, Emergency Department, Information Systems, Telecommunications and Nursing Support.  Med Staff, nursing support and the ED are all medical units.  IS and Telecom are administrative units.  They both have a different view point.

Who are the players involved in on-call at a hospital?

  1. The hospital Medical Staff Office dictates who and how on-call will be covered for each specialty. 
  2. Specialty clinic staff creates, maintain and publish a call schedule for their group of physicians.
  3. Physicians agree to the oncall assignments they are responsible for covering.
  4. Someone in the hospital receives and manages all of the on-call schedules from specialty clinics.
  5. Someone in the hospital creates a daily on-call roster.
  6. Someone in the hospital distributes the daily on-call roster throughout the organization.
  7. Someone in the hospital makes changes to the daily call roster as they come up, both day and night.
  8. The Emergency Department uses the daily call roster to determine which physician to call.
  9. The hospital operator often pages the requested doctor.
  10. The patient who is sitting in a bed waiting for all of this to happen so that they can be seen and admitted or discharged.

We have found that organizations may have better results if on-call is managed in the Medical Staff Office.  Here's why. 

  1. The Vice President of Medical Affairs has clout and a title that can get things done in an organization.  When they mandate that something is done a certain way, it is usually done that way.  For example, standing orders or credentialing.  Other physicians respect this person and will comply with their requests.
  2. The Medical Staff Office already deals with the physicians on a daily basis.
  3. If there is a issue with a specialty clinic not complying, the Medical Staff Office can deal with it from a physician management point of view.
  4. Policy and procedure will be created with the best interest of the patient in mind.  No politics or job protection going on.

When on-call is managed properly every player listed above is considered when making decisions regarding on-call.  On-call information is readily accessible by all the players listed above, and to the patient the process is seamless and they think that the specialist was already in the hospital when they presented to the ED.  It just works. 

When on-call is not managed properly, you can and will have a host of problems.  Be sure to check out my next Blog Post when I will highlight what those problems look like and provide some proposed solutions.

To answer my above question, I think it is better to manage on-call in a medical department; I have seen better results (regarding compliance and data accuracy) and faster implementation of on-call management. 

Remember, the right provider in the right place at the right time does not happen by accident.

Topics: daily call roster, medical staff office, call schedule management, physician scheduling software, on call schedule, call scheduling