2019 VSPA Fall Conference Scheduling Survey Dr. Kari Severson and - - PowerPoint PPT Presentation

2019 VSPA Fall Conference Scheduling Survey

Fall 2019

• Dr. Kari Severson

and Anna Schilz

Do your ER Doctors and Technicians have a set schedule, or does it rotate based on staffing and business needs? ER Doctors have a combination of rotating and set schedules. Technicians have a set schedule. However, there are often adjustments due to being short-staffed or training new technicians. All our ER doctors have a rotating schedule. The ER doctors have one, and the Criticalists have another. Our ER technicians are in two groups, those with fixed and those with rotating. Some of our leads need a fixed because they have a consistent office day. The requirement of a fixed schedule is that

• ne day is a Saturday or Sunday.

DVM’s: some have a set schedule because of childcare or seniority. Most rotate it is not consistent. Technicians have a set schedule.

• Rotates. Would love a set schedule but we dont have enough ER docs, so we have relief which

varies in availability which affects the schedule for all Fairly set schedule. For DVMs and LVTs, on a 2 wk rotation, minor variations based on PTO for

• thers, etc.

Most rotate, some techs have a set schedule Set schedule

Do your SPECIALTY Doctors and Technicians have a set schedule, or does it rotate based on staffing and business needs? Specialty Doctors and Technicians' schedules are set and are either Mon-Thurs or Tues-Fri. All of the specialty doctors are on a fixed schedule, with the exception of the Criticalists. The Surgeons rotate their on-call schedule. All of the technicians are on a fixed schedule. They are all required to be part of surgery/procedure

• n-call, so that schedule is made in the fall for the next year.

To answer the next question "are specialty technicians required to work holidays and weekends", I answered both but its part of the on-call. If they don't want to work on-call, they have the option

• f working ER holidays instead.

Specialty DVM’s are on a set schedule with changes only due to vacations and time away. Surgeons work their on call schedule out amongst the group. Technicians have a set schedule. Pretty set except IM docs rotate Saturdays. Techs in IM have alternating weekly set schedules....ie week a, week b and repeat. Set schedule for both. Fairly set schedule. For DVMs and LVTs, on a 2 week rotation, minor variations based on PTO for

• thers, etc. (Same as ER DVMs and LVTs)

Are your specialty technicians required to work holidays and weekends?

What are your ER Technician shifts? Varied: Su,M,T 4a-4p/4p-4a, 5a-5p/5p-5a, 6a-6p/6p-6a, 7a-7p/7p-7a or 8a-8p/8p-8a. W, Th, F same general hours/schedules. Saturday same hours but rotating. Technicians Day shift is 7:30-3:30pm Evening is 3:00-11:00pm. Overnight is 10pm - 8am. There is a 12-8 swing each day as well. TA shifts are 6a-2p, 2p-10p Triage 8a-12a, 4p-12a, 10p-8a. Everybody is scheduled 4 days a week. First shift is 8am - 5pm during the week. 8am - 8pm on the weekends. Second shift is 4pm - 1am during the week. 12pm - 12am on the weekends. Thirds shift is 12am-9am during the week. 8pm-8am on the weekends.

What are your ER Technician shifts? Day 7a to 5p Evening 4p to 1a Overnight 11p to 8a Swing shift 12p to 9p (this may vary) 10 hours long, 7am, 12p, 2p, 4p, 8p, 10p, but depends on the day which shift times we have 1st, 2nd and 3rd shift, mostly 7 on 7 off, some 3/4 day mirrored schedules 10 hour day shifts between 7a and 8p. 12 hour night shifts 7p to 7a. Some are shifted an hour either direction. We are trying to have more of a swing shift and also get night shift on 10s

How many weekends a month do your ER Technicians work? Varies depending on their schedule. Most are 50/50. Either they rotate through or work either Sat or Sun if they are fixed. 2 weekends/month. Too variable to say accurately Every other weekend Depends on the person, some 2, some all Two

What are your ER DVM shifts? Rotating shifts are:

• 1. F, Sa, Su 4a-4p
• 2. F, Sa, Su 4p-4a
• 3. Su, M, T 12p-12a
• 4. M, T, W 4p-4a

Fixed shifts are:

• 1. rotating W, Th, F or Th, F, Sa 6a-6p
• 2. Su, M, T, W 6a-6p (Criticalist)
• 3. rotating Su, M, T or M, T, W 4a-4p
• 4. W, Th, F 12p-12a; e/o Sa 12p-12a, M 4p-4a

Two locations Bigger location: 8a-3p - two doctors (a criticalist and an ER DVM) 3p-10p - two doctors 10p-8a - two doctors Smaller location Mon-Fri: 8a - 6pm (Criticalist) 6pm - 8am Sat-Sun 8a-8p 8p-8a

What are your ER DVM shifts? 7am-7pm, 11am-11pm, 7pm-7am Day shifts are either 7 AM to 6 PM or 8 AM to 6 PM. Overnights are 6 PM to 8 AM. We have differing swing shifts that are usually 4 PM to midnight during the week and 12 PM to 12 AM on the weekends. Our DVM’s have been reluctant to reduce the overnight shift to a 12 hour shift. However I see this as a need at some point in the future. Day DVM‘s do not want to increase to a 12 hour shift 7a to 7p, 6:30p to 7a. If we had more docs, we may change to 3 overlapping 10 to 11 hour shifts in a 24 hr period. Weekday day 7a to 4p Weekday swing 2p to 2a Weekday overnight 4p to 7a Weekend day 7a to 7p Weekend Swing 12p to 12a (this shift may vary in time) Weekend overnight 7p to 7a

How many weekends a month do your ER DVMs work? Depends on the schedule. They work 50% of weekends in a 6-week rotation. Two Roughly 4 to 6 Every other 2-3 Two (accept the designated 'day shift' doc)

Do you offer shift incentives for DVMs and if yes, how much? DVMs are salaried and those who work the rotating shifts are paid at a higher rate due to the inconvenience and less desirable shifts. If DVMs pick up an extra shift for coverage, they are compensated at $125/hour (same as per diem rate). Not for DVMs. The overnight and evening tend to be busier, so those result in more production. Not as part of their regular schedule, but if they pick up extra shifts they get paid more to work an

• vernight then they would a day or swing

No n/a No No

Do you offer shift incentives for Technicians and if yes, how much? Yes, Su-Th 6p-6a additional $2/hour; F and Sa 6p-6a additional $3/hour; Sa and Su 6a-6p additional $1/hour. All evening staff (Tech, TA, Triage, CSR) gets 3% differential. All overnight staff (Tech, Triage) gets 8% differential. There is no differential that is weekend specific. Second shift gets 10% shift incentive and third shift gets 20%.

• Yes. Overnight get $2 per hour more

Overnight has shift differential ($2.50/hr); Strongly considering adding differential for evening shift as well. No 2nd shift has a $1 differential, 3rd has a $2 differential

What scheduling software do you use and would you recommend it? Google documents - not recommended. But we are piloting MS Teams. We use Impromed and we would absolutely not recommend it. We are in negotiations to switch to EzyVet. W2W I highly recommend it. When to work. Yes, I recommend it. Whentowork - yes. when I work. Its ok since we are a smaller group, there may be better stuff for larger groups when 2 work, yah, I think they like it

Do you build time into the doctors shifts for records and/or rounds Yes but due to patient load they often stay later to complete records.

• No. They are required to finish records before they leave, unless it's to the point that it would be

ridiculous to drive home. They do have remote access to finish from home as well. In an ideal world, records would be able to get done during the shift but we know there are plenty

• f times doctors of stay late to do them. We kind of include some rounds into the schedule. For

example the goal would be to schedule an ER doctor for approximately 35 hours a week instead of 40, knowing that the extra time for rounds has not been built into the shift Not yet, but would if we had more full time docs Ideally, by having swing DVMs, they would utilize this time to keep up with records and prepare for rounds. Yes Yes we try for the last hour of their shift to be reserved for records

When a specialist is away from the practice, do their technicians automatically get reallocated to

• ther doctors, departments, or days? If not, what do they do?

Specialty Techs will either take time away at the same time as their doctors or they will be reallocated to another service, primarily ER. If the technician does not want the day off, their lead will find another service or project for them to work (there is ALWAYS someone who needs help). If the technician wants the day off, they are required to put in a request. It may be denied if another service is short staffed that day. If granted off, they are using their PTO. Techs can either use PTO if they request to or they will get reallocated to departments that need extra help. Occassionally, but the need is rare in IM. Surgery will work ER or take time off We keep a limited # of team members on that service on reduced hours usually to keep up with calls, etc as well as projects that are pending. Remainder of team is reallocated and/or may elect to take time off or be off due to service being closed. Some do A mix, if needed they may be reallocated (and it is often needed), they can also do projects or take time off

Do you have on-call Technicians? If yes, for what departments? Yes for surgeries for our Surgery and Neurology services On-call techs for Emergency if someone calls out sick or the ER is busy and can't handle the patient load. Yes. ER - voluntary on-call 24/7. Gets covered maybe 30% of the time. Anesthesia - a portion of specialty techs for multiple departments participate. May be called in for surgery, endoscope, MRI/neuro, or if several laceration repairs are stacked up in ER (3-4 or more). Procedures - gets called in whenever anesthesia called in to assist with surgery/procedure. The anes/procedure team are also used when a service has a procedure/surgery running later then

• expected. Mostly dentistry with a more complicated case then expected.

Ventilator case: not scheduled, we have a "team" and we just call down the list until we find someone.

Do you have on-call Technicians? If yes, for what departments? All specialty departments (although for Onco and Cardio they may only need to come in if there are transfers) We have on call techs for surgery. The techs from Dentistry, Surgery, Neuro, Ophtho all take part in the on call. The trade off is they don't have to work or be on call on holidays. Limited, for ER Yes for ER and Surgery - currently only Fri afternoon thru Mon AM - during week is voluntary. Yes, ER, it is voluntary to sign up right now

Do you have on-call DVMs? If yes, for what departments? No Oh boy. Yes. Surgery: shared between two surgeons and an ER doc. Neurosurgery: Mostly the Neurologist, one weekend a month covered by a surgeon. Ventilator case: Criticalists rotate through (4 week rotation). Endoscopy: Covered by one Medicine DVM (by choice), other Medicine DVM covered when 1st is

• ut of town.

Advanced Ultrasound: covered by Medicine DVM or Criticalist. Mostly the Medicine DVM. Surgery only plus neurology takes one week a month and will cut backs instead of the surgeon that week Yes, surgery and IM No :( Surgery All specialities (again for Onco and Cardio they mostly just take transfers on the weekends)

How long are the doctors shifts and have they been made shorter over the past few years? Specialty doctors generally receive patients between 8a-6p. Emergency doctors shifts are generally 12 hours. No, they haven't been cut shorter. Location One 7 hours, 10 hours Location Two 10 hours, 14 hours They have not been made shorter, instead we have doubled up on DVMs. We have eight, 10, 12, and 14 hour shifts. Those specific shifts have not changed in length and our DVM’s have not wanted to get rid of the 14 hour overnight. Their manager would like to reduce it but they don’t want to come in for more shifts. We have eight, 10, 12, and 14 hour shifts. Those specific shifts have not changed in length and our DVM’s have not wanted to get rid of the 14 hour

• vernight. Their manager would like to reduce it and we will have to be creative someday to do it

because our day DVM’s do not want to increase to a 12 hour day shift. The downside of shorter shifts in ER is coming in for more shifts a week. It’s a balance between wanting more time away or wanting a shorter shift. Ultimately, I think shorter shifts are better but I don’t know how to reconcile that with keeping the benefit of stretches off in tact for ER. 12 hr. Same for years

How long are the doctors shifts and have they been made shorter over the past few years? 12 hours, no we actually made them longer 12 hr. Same for years Vary based on weekday or weekend - goal is to reduce the length of them to =<12hrs 8-12 hours and yes

Questions?