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

Free On-Call Scheduling Software

Posted by Justin Wampach on Tue, Jun 19, 2018 @ 09:36 AM

Medical Groups should be providing valuable tools for physicians to use, for free, to create maintain and communicate their on-call and work schedules.  Physicians should have access to free tools to use to do their job. Free to the physicians, not free to the medical group. In some professions, it is acceptable to expect the resource to provide his/her own tools to be able to complete the job. Think the building industry or mechanics.

Is Free Scheduling Software Too Good to be True? 

Free On-Call Scheduling Software

If I could go back in time and be sitting in some of the early meetings at the large pharmaceutical companies when they had the brain-child idea of buying their way into the physician’s office using free drug samples, I would definitely have had something to say. This model has plagued the non-pharmaceutical medical industry for more than 40 plus years as medical offices have an expectation of being able to try something for nothing before they buy it or even consider it.

In 2010, Adjuvant, the maker of Call Scheduler spent money to customize a way for doctors to come to our website and request a free-30-day-trial of our Call Scheduler Lite product. We thought this would work because many doctors are not available to speak with our sales team during the day, they're too busy seeing patients. We thought it would be great to give them a self-serve method that they could do when it was convenient for them. The free trial was for our product to help them create, maintain, and publish a call schedule for their partners. In addition to our investment to automate the set-up process, we also needed to create many do-it-yourself videos so that the doctors would know how to set-up the system and be able it use it. 

We had a large number of doctors sign-up for the free trial.  Out of the total group of doctors that signed-up for the service, the large majority of them never completed the set-up part where you enter the doctors' names. Not one of the free trials turned into a sale. Why? I’m not sure.  I have some thoughts though.

  1. No money was invested (easy come easy go).
  2. Realized there was work involved, perhaps the volume seemed overwhelming.
  3. Realized that they did not have all of the necessary information to set-up the system.
  4. They thought that our set-up interface sucked and therefore moved on.
  5. They really didn’t have a problem.

On-Call Scheduling Make Better Tools

Many of the physicians who look at our Call Scheduler demos and or that call into the office are still creating the work and on-call schedule for their partners on their own time, and by hand without any tools other than perhaps Excel. That is so important I am going to say it again, most of the Physicians that I speak with (several hundred each year) still have to create the call and work schedule for all the partners on their own time, and without any tools. This averages about 40 hours per year, of nights and weekends.

In many industries outside of medicine, this concept would have ended 20 years ago.

For example in the technology/software industry if you don’t provide time and tools for your most valuable employees, or if you expect them to perform duties that are time-consuming, and difficult, and on top of it, have people gripe about the results, they would pack up and go somewhere else. Technology people are so valuable and in such demand they will simply leave. I have learned over the past 10+ years that most physicians are very mild mannered people. They are not looking to rock the boat, nor are they looking to make a big deal out of something that others find trivial. The physicians who fit this profile are typically the ones who get talked into doing the on-call schedule for their partners.

I think that a few items are at play when we talk about doing work for free without the proper tools.  First, medical groups are very cost conscious organizations about certain things.  Like all good businesses it is important to make investments in the places that show a financial return.  For example, an MRI machine has a large cost, but also has a large return.  The individual physicians are expensive to employ, but also have a large return on investment.  Tools and services are often seen as a burden, and are considered optional.  The second item at play is that many groups have certain doctors doing scut work, like the on-call schedule, because they will do it and not push back. 

The Ultimate Buy-In

Or if they do push back, they can be easily bullied into taking on the added responsibility, for free, without any tools.  In my opinion, both of these things are pretty sad. I say that because it is a very black and white way of looking at the world, and unfortunately there are many shades of gray. For example, when you’re looking at a return on investment sometimes it can be easy to forget about the “soft” benefits and only look at the “hard” benefits. An example of a soft benefit would be physician satisfaction or work/life balance. Everyone wants to see a hard dollar return on everything that is not considered essential to whoever makes the decisions.

Funny story, a new service was being offered in my community, Oopie Poopie Scoopy service. It was a guy who came around each week to clean up dog waste.  At first I thought who in the world would ever use this or spend money on something like this. Until I became a pet owner of a 75lb Husky /German Sheppard mix. Let me tell you, it was the best $40 per month that I had ever spent. Once I had the crappy job (pun intended) and my mind changed, quickly! 

Sometimes it is important to look at things from someone else’s perspective. I hear physicians tell me all of the time “my partners won’t pay for software, they don’t think we need it and it will not benefit everyone, only me, the person who creates the schedule”.  Obviously, they are wrong, on-call scheduling software benefits all of the physicians, the staff, and even patients in the end. Each person will benefit in a different way, some will be greater than others, but everyone still benefits.   

 

I have said it before and I will say it again, if you are a physician in a practice that is doing the call schedule for free, on your own time, without any tools, STOP.  Politely go back to your partners or practice administrator and say, no thank you. The same way you would if they asked you to clean the toilets without rubber gloves. I am willing to bet my last pair of clean socks that either you or the next person will get at the very least some software to help them out.  

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

  

Topics: scheduling software, on call schedule, free scheduling software

The On Call Schedule Calendar is More Than a Calendar

Posted by Justin Wampach on Fri, Jun 08, 2018 @ 07:41 AM

When I began my career at Adjuvant, I needed to find my passion for the industry. How the hell do you find passion for creating, maintaining, and publishing call schedules? I will be honest, it took me awhile.

Why an On Call Schedule Calendar Company Emerged

More Than Just a Schedule

I was constantly asking myself the question, why on-call, why physician scheduling, why work with doctors in the first place? That is a good question, most of them are almost impossible to get ahold of, very close with their money, and are not the quickest decision makers.

Still looking for passion, I first centered around creating good software, after all, we are a software company, right? I also developed a passion for running a good business, after all, I am a businessman, right?

And then I started talking to not only current customers of ours but more importantly new prospects who were sharing stories about why they were calling us.

The Importance of Managing a Doctor On Call Schedule

Would you believe me if I told you that the physician on-call schedule is one of the most important schedules with the clinic and the hospital? Here's why;

  1. How can you schedule staff and patients until you know where the Doctor is or is not?
  2. Why would you need support services like x-ray and lab if there is not a Doctor available to see patients?
  3. Who is needed most in the Emergency Department at every hospital in the US?
  4. Who is needed the most during a complicated delivery or procedure?

Inside of every square in an on-call calendar, there is a person's name. That name represents a trained medical doctor who will drop everything and come and help you when they are called.  Some of them will be so busy with calls that they will sleep at the hospital until they are relieved. This is the person who is going to help my family member when they show up at 3:00 am in the morning at my local hospital with chest pains or after a car accident.

On-call doctors and professionals are unsung heroes and deserve to be treated that way. This is where I found my passion. I realized that our company doesn't just make software or try to convince doctors to become more efficient with their time, our software makes sure that when you need them the most, the doctor is there, no matter what day or time.  We help professionals save lives. 

On Call Calendar is More Than Just a Calendar

I am certain that there have been instances, especially with our OB/Gyn clients when the information in our system allowed for a process to be expedited. This is when the difference between 1 and 5 minutes could be the difference between life and death. We helped!

The on-call schedule is more than just a calendar, it is some of the most valuable and useful information that a hospital and clinic have. If you are the person that creates, maintains, and publishes doctors' call schedules, please remember how important your job is.

If you are a physician who is taking call assignments, please know that we take our job and yours very seriously and will continue to do whatever we can to make sure that you are in the right place at the right time. Oh, and by the way, thank you. 

I can't say that enough. 

Call Scheduler can save you time, money, and scheduling headaches. See how we  did this for 7 Day Clinic of ND. Download Case Study

 

Topics: software for scheduling physicians, physician scheduling, on-call software, physician scheduling software, doctor scheduling software, on call schedule, call scheduling

Are you a victim of someone else's decision not to by oncall software?

Posted by Justin Wampach on Thu, May 24, 2012 @ 02:13 PM

dont be a victimIn many physician owned medical groups business decisions are made in a group setting.  Often times the group's administrator will collect items that require decisions and bring them to a bi-monthly meeting where the stakeholders can decide if and how they want to spend the groups money.

In a previous blog post "Call Scheduling: A Thankless Job" I talked about the history of why there is a doctor creating the schedule in the first place.  I also give some advice on what to do if your partners do not value the extra work that you do.

I speak with physicians all the time who are tasked with creating the call schedule, but when they ask their partners for some assistance in the form of software like Call Scheduler, they deny the request.  Why do they do this?  I think it is because creating the call schedule is not their problem, and they either don’t realize how difficult it is, or they don’t care.  If the shoe were on the other foot, their decision might be different.  The unfortunate thing about this scenario is that many times the physician scheduler does not want to push back or make waves and instead will just "do it" to keep the peace.  This causes dissatisfaction between the physician partners and it will manifest itself in some way at some point within the group.  It may not be identified or even discussed, but believe me; if you have been the victim of this behavior someday you will want to get the group back.

Just yesterday I received an email from a newly minted Chief Resident.  As you know, one of the glorious duties of the Chief is to create the call schedule for the troops.  Most cases the University department has a small budget to help the Chief out with expenses like call scheduling software.  This young doctor told me that he has to pay for it himself.  I was surprised that he was willing to do that.  What that says to me is that the work is so bad that a student would be willing to pay for a solution that ultimately benefits the University.

In situations other than the Chief Resident, a doctor that has been given a difficult task, such as physician call scheduling, without any tools to complete the job, should strongly consider giving the job back to his or her partners.  Why?  Because if it is important to your group that the right doctor show up in the right place at the right time (EMTALA law) to serve your and others patients, than it should be important enough to the group that the person doing the job has the proper tools to do the best job possible, especially if your time is as valuable as a physician.

I think the worst thing you could do is say, "ok" and go on about your duties.  If you can, demand that your group fix the problem.  You’re a Doctor; your time is very valuable and, should not be wasted.  If this is your scenario remember your time is being undervalued, you are being undervalued and being on-call is being undervalued.  Don't let that happen, in this case you have the ability to make it stop.

If you are the victim of someone else’s decision not to buy on-call software, hopefully this will be some good food for thought.

Topics: call scheduling software, oncall, on call, adopting on-call software, on call schedule

10 Mistakes Doctors Have Made Buying On-call Software (part 2)

Posted by Justin Wampach on Fri, May 11, 2012 @ 09:48 AM

describe the imageDoctors who wish to enhance their practice and provide better care and service to their patients and themselves by using physician scheduling software are on the right track. Unfortunately, they don’t always go about it the right way.

Last week we posted three of the top ten mistakes that doctors have made when purchasing call scheduling software.  Here is a recap of the top 3, along with number four through ten.

  1. Wanting too many bells and whistles. 

  2. Trying to save a penny. 

  3. Thinking someone else understand your business.

  4. Losing sight of the basics – KISS:  Your primary aim is to improve your productivity, and you should always keep this in mind! Anything else should come later. For example, we have clients who request payroll integration in their on-call software. But delaying an order or cancelling an order based on just this one feature is unjustified. Nice to have is not the same as “essential” – and adding too many features just results in “bloatware”. It is a mistake to want your software to do too many things right from the start. Get what is essential, and build from there.

  5. Waiting for something better:  Doctors often keep on waiting for something better to come along. Unless you don’t jump in the water, you aren’t going to learn how to swim. Some of the best run private hospitals have been early adopters of technology. Today they might still be using legacy systems, but they are much better run than non IT friendly setups. It’s true that software will evolve over time, but you cannot wait for perfection. Software is always a work in progress, which gets improved and polished incrementally.

  6. Thinking your staff shares your vision:  Many good doctors buy the perfect software and then find that it does not help them at all. Often they blame the software for being unfriendly or useless. Most doctors fail to understand that their staff is one of the key stake holders in this process. Unless the staff uses the software, it is bound to fail. The software may be the best in the world, but if it is not used properly, it isn’t living up to its potential. Doctors need to be firm and to share their vision for the software with their staff. It is a mistake to assume that software will be easily adopted by support staff, nurses and fellow doctors. Provide lots of training – and if some members refuse to use this, you need to take them to task.

  7. Not nurturing innovation:  The biggest stake holders in this industry are the doctors. It is important for them to nurture innovation. Sometimes it is valuable to take a risk or allow a software company to go that extra mile in providing a feature which will change the process flow of your clinic. Doctors who refuse to try out products which provide extra features or new age ideas because they do not understand its utility are closing the door on innovation. A doctor who asks me to block some modules to save money because he feels he will not use them is basically closing his own mind to the potential of using new processes to improve his practice. Do not buy the module in the beginning, but keep an open mind.

  8. Underestimating the complexity of your needs:  Running a clinic is running a small business. It’s a complex enterprise, and often doctors over-estimate their ability to do a good job. Ideally, you should be focused on taking care of your patients, so your staff can run the clinic. If you find you are spending time on routine administrative tasks, this means you are wasting your time and money. There are only 24 hours is your day – learn to use them sensibly. A good doctor scheduling software program will help you to improve your productivity and that of your staff, if you use it to its fullest extent.  Don’t get stuck buying a cheap program which was designed for a small shop – you will end up being unhappy and dissatisfied.

  9. Delaying a decisions:  The single biggest mistake a doctor makes in buying call scheduling software is when he delays his decisions – whether it is thinking about his needs; talking to the vendor; spelling out his requirement; installing the program ; or getting training for his staff. As a result, the vendor is frustrated; the doctor is confused; the staff is anxious. Start small – but start today!

  10. Not providing enough time for training.  While doctors understand that learning a new medical procedure can take time, unfortunately, they are not willing to invest the same time in training their staff – and themselves – in learning how to use the software properly.  This can cause a lot of frustration and when this happens, many doctors just give up on the idea of using any software at all, because they feel their staff is either too busy or not willing to learn something new.  Give your team the benefit of the doubt, also lead by example.  Show your team how important this change is by being a part of it.

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Topics: call scheduling software, physician software, physician scheduling, on call, on-call software, physician scheduling software, doctor scheduling software, on call schedule, call scheduling

Do you know your cost to create and maintain your on call schedule?

Posted by Justin Wampach on Fri, Mar 23, 2012 @ 10:19 AM

calculatorWe all know what a pain-in-the-butt it is to create, maintain and publish an on call schedule for the doctors in your specialty clinic.  (If you’re new, here is why it sucks)

  • The process is very time consuming to create a schedule
  • The results are perceived as unfair
  • It is difficult to publish to the internet 
  • The providers want access to their schedule on their phone
  • Constant swaps and changes throughout the month

Because of the items listed above we are seeing more and more specialty groups having an administrator or physician create, maintain and publish the physician on-call schedule.  Many of them are even asked to do it on their own time.

Let’s say for example that you are and administrator or physician who is tasked to do the call schedule.  Perhaps you are interested in exploring if there is some software available that can assist you, how do you know how much is too much to pay? Well, the first question you need to ask yourself is, "how much is it costing me today"?  Do you know what your costs are?  Many doctors and administrators do not know and in fact some of them will say that it is not costing anything because they have to do it on their own time at home. 

As a business manager or owner, the "cost" of something is a very important number.  How will you know if you can cut your cost if you don't know what it is to begin with?  Because I have heard this over-and-over we decided to build a cost calculator to help you.  This is very different from a traditional ROI calculator.  The differences are major because an ROI calculator is a sales tool, and a cost calculator is a management tool.

If you do not know what it costs you today to create, maintain and publish your physician on-call schedule I would encourage you to answer our brief 8 question form and learn your cost.  It will take you less than 5 minutes to learn your results.  If you use Call Scheduler's cost calculator, you can be assured that this is a management tool.  We will not be using it to "sell you" our software. 

We want knowledgeable prospects and we are willing to make investments to help the entire medical community understand the costs around creating, maintaining and publishing a call schedule for your doctors.

To give it a try, click hereto begin.

Is outsourcing right for you?


Topics: physician software, physician scheduling, on call, on call schedule, call scheduling

Call scheduling done wrong: 10 things you can do to make it worse

Posted by Justin Wampach on Thu, Mar 15, 2012 @ 10:29 AM

call scheduling things not to doMost physicians agree that anything to do with on-call stinks.  But there are things that your practice can do to make it better or worse for your providers.  If you really want to make it as bad as it can be, do these 10 things and you will see it go from bad to worse quickly.

  1. Don't compensate one of your doctors for creating and maintaining the call schedule, make them do it for free. 
  2. Force your scheduler to do the work of creating, maintaining and publishing the call schedule on their own time at home.
  3. Allow each of the doctors the ability to have any rule or preference that they want.
  4. Negotiate next to impossible rules and scheduling accommodations for new providers that are joining the group.
  5. Allow all of your providers to decide when they are going to take days off and be on vacation after the oncall schedule is published.
  6. Try to balance your provider tallies monthly.
  7. Force your scheduler to "catch people up" when they take time off after the schedule has been created.
  8. Print out a paper copy of the schedule and give it to the providers.
  9. Allow your providers to make changes and swaps between themselves without any process or procedure.
  10. All of your providers to schedule themselves with or without software.

By following all 10 of the items listed above, you can create the worst-of-the-worst scenario for your providers.  You can be sure that this will help you accomplish the following:

  1. Longer wait times for your patients in the ER
  2. The wrong doctor getting called in the middle of the night
  3. Unfair tallies and workload for some doctors
  4. Higher turnover rate of person creating the schedule
  5. Unhappy physicians

There is another approach to call scheduling, doing it the right way.  In a recent blog post 3 Cost Effective Steps to a Modern Call Schedule you can learn about another approach.  This one may give you, your providers and patients a better outcome.

Topics: oncall, on-call software, doctor scheduling software, on call schedule, call scheduling

Are the New York Giants a better team than your management team?

Posted by Justin Wampach on Mon, Feb 06, 2012 @ 11:25 AM

manning

What does Eli Manning and the New York Giants team have in common with you and your team at the clinic?  You're probably saying, not much, but there is a lot more similarities in the two teams than you might think.

              

Football Team

Medical Practice

Highly paid players Highly paid doctors
Large up-front investment Large up-front investment
Each player is a specialist Each doctor is a specialist
Paid staff to support team Paid staff to support doctors
Players want to be on a winning team  Doctors want to be in a winning practice
Highly paid coaching staff Highly paid management team
Players can be traded Doctors can leave

One of the major differences is that football players listen to their coaching staff.  Although the players make more money and have more status and influence, when they get together as a team, they listen to their leader and are all on the same page with the same goal in mind, WIN.  Let’s compare that to a physician owned clinic.  In that scenario, the Doctors run the show and although there is an administrator, I don't think that many groups look them as business experts.

In the game of Football, what is needed to win is points.  You get points by scoring touchdown and field goals.  You score touchdowns and field goals by working together as a team.  Out on the field, everyone is important.  In this past Super Bowl, if Eli Manning didn't have teammates defending him, he could not do his job.  The team wouldn't be ready to play if there wasn't staff and facilities for practices.  It also would not be possible without fans.  Who wants to play in an empty stadium?  Everyone is a star on the team.  Although some stars are better than others, everyone’s contribution is key to success.  A football team is a well oiled machine.  When the machine works it is in its best position to win games.

In the business of Medicine, what is needed to win is profit.  You earn profit by treating patients.  You treat patients by working together as a team.  In the clinic everyone is important.  Without certain members of your team, for example, maintenance, physician on-call scheduler, accounting, you cannot effectively compete.  When you compete without your staff, you are at a disadvantage and increase your chances of loosing.  There are no stars on the team, everyone is equally as important.  If you strive to provide the same level of quality and service each time, everyone’s contribution needs to count.

So when you ask yourself if the New York Giants are a better team than your management team, show me the rings. 

Although I am not a big sports fan, I am always fascinated at how teams work together for a common goal, winning.  I think that health care and independent clinics specifically can learn some valuable lessons from how these big-fancy teams win.


Topics: oncall, on-call software, doctor scheduling software, on call schedule, call scheduling

Top 7 Reasons to Outsource your on-call schedule

Posted by Justin Wampach on Fri, Feb 03, 2012 @ 02:16 PM

outsourcingMy company for years has been hymming and hawwing about offering an outsourced call schedule generation and publishing service to our customers.  I was finally able to convince our Board of Directors that this would be a great service to offer busy clinics and doctors who find this task to be one of the worst.  Here is some of the justification that I used when I was trying to sell the idea to my Board of Directors, perhaps you will find it useful if you need to talk with whoever makes these decisions in your practice.

Just so we are all on the same page, Outsourcing is the process of contracting a business function to someone else, according to website Wikipedia.  Typically the business function is something that is commonly performed in-house.  The concept of outsourcing helps firms perform well in their core competencies and reduces the rise of skills or expertise shortage in areas of the company. 

The top reasons for outsourcing call schedule creation and publishing;

  1. Cost savings, the lowering of the overall cost of the service to the clinic.  Our schedulers are faster and more experienced than yours.  Therefore it costs us less to produce similar results.
  2. Focus on core business, if your people are your most valuable resource, then free them up from tasks that do not generate revenue.  Let them focus on what is important.
  3. Knowledge and wider experience.  With all due respect, our schedulers are more experienced than yours; because we have worked with so many different specialty groups we have seen-it-all.  This experience allows us to bring something to the table that you may have not had before.
  4. Catalyst for change.  An organization can use an outsourcing agreement as a catalyst for a major change that could not be achieved before.  This is a perfect scenario for doctors who have been unwilling to change their rules and scheduling methods, making creation nearly impossible.  
  5. Process improvement.  Most organizations do not have the physician schedule creation process documented.  If something happened to the scheduler, most clinics would be left with a big mess.  Outsourcing can improve a process by creating a standard way to achieve the same results and then documenting the process.  If you choose to take the schedule creation back in-house, most likely it would come to you in better shape than when you originally handed it off.
  6. Take it back.  Outsourcing is not permanent; you can take back the work at any time.
  7. Scalability.  With the consolidation of practices happening at lightning speed, it’s not a bad idea to think about how you would handle an increase in workload in the creation of oncall information.  

Call Schedule creation and publishing can be done remotely and delivered digitally and our company can leverage the scale and economy of outsourcing to deliver high value services at a vastly reduced end customer prices.  As you can see the reasons for outsourcing are plentiful, considering the low level of risk associated with a service such as outsourced on-call schedule creation, I think it is definitely worth giving it a try if your practice is constantly struggling with the horrible job of creating, maintaining and publishing the oncall schedule.

Is outsourcing right for you?

Topics: physician scheduling, outsourced scheduling, on call schedule, call scheduling

3 Cost Effective Steps to a Modern On Call Schedule

Posted by Justin Wampach on Fri, Jan 20, 2012 @ 03:21 PM

old school new schoolHow much time do you currently spend creating, maintaining and publishing your physician oncall schedule?  What tools do you use to assist you?  If you are still creating the schedule by hand and then entering it into Excel or Outlook so that it is accessible to your Doctors online, you might be a good candidate to modernize your process.

The reasons for modernization are pretty simple to understand, the main features that most new users love are:

  1. The ability to program rules into the system
  2. A scheduling engine that will assist you in placing people in jobs
  3. Automatic tallies to prove fairness
  4. Easy way for providers to request and document time off 
  5. Simple way to view the on-call information online

If your ready to take the next step and look at the "new way" here are a few tips that will assist you so that you do not waste your time.

1.  Access your requirements.  What are the top 3-5 things that you expect the software to assist you with.  Put them into a priority list.  Remember that software will not solve world hunger or all of your scheduling needs, make sure you know what is most important for you to get the most value.

2.  Evaluate solutions.  Go to www.google.com and search for call scheduling software or physician scheduling software. Check out a few of the top search results companies and see what they have to offer.  Use the top 3-5 requirements that you discovered above and make sure the software has those features.  Check out a demo.  Look at the references page to see what their current customers think of the product.  The best piece of advice I can give you for this step is to make a decision.  Updating a software system in an office should be a fairly simple decision.  Just make sure that you have an out if it turns out not to be the right choice. 

3.  90-day-trial.  I am a big advocate of trying before buying.  Keep in mind that call scheduling software requires set-up and data entry to use the system, but it is worth the effort for a fair evaluation.  As long as you have a full feature trial I would also suggest finding a paid trial.  With a paid trial you will most likely have free training and support.  These are critical services as a software newbie.  I would pick a trial over a money back guarantee any day, why?  Because in a “money back guarantee” you’re not the one who decides if you get your money back, the person that has your money is.  Don't pay for services in advance and take that risk.  All SaaS call scheduling software providers offer monthly, pay-as-you-go options.

Modernizing your on-call scheduling process with software is an easy investment that will become more valuable each time you use it.

 


Topics: call scheduling software, oncall, physician scheduling, physician scheduling software, doctor scheduling software, adopting on-call software, on call schedule

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