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Staffing and Scheduling

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									Staffing and Scheduling – Part
II
HCM 540 – Operations
Management
 Primary Objectives

1. Staff scheduling is a difficult, time
     consuming managerial problem
2.   Many flavors of staff scheduling
     problems
3.   Staff scheduling inextricably linked with
     determining total amount of staff
4.   Tactical and operational staff scheduling
5.   Computerized staff scheduling systems
  High Level Staffing Framework
    Budgeting and
      Planning                  Budget, staffing plan, policies
• Annual or as needed
• Planned capacity
                               Operational
• Staffing/scheduling                                                   Staff schedule
  policies                 staffing/scheduling
                        • Every 2-6 weeks
                        • Target staffing levels
                                                                Daily allocation
                        • Create employee
                          schedules for core staff         • Ongoing
 Tactical Staff
  Scheduling                                               • Reacting to staffing
   Analysis
                                                             variances
                               Realized shortages
                                                           • Floating staff,
                                                             overtime, contract
                               and surpluses                 staff, agencies


                                                     Adapted from Abernathy et. al. (1973),
                                                      Hershey et. al. (1981), Warner et. al. (1991)
             The Challenge of Staff Scheduling
              1                  45
                                                                                                                     Postpartum Staffing Needs
                                 40
                                 35
                        Nurses
                                 30
                                 25
                                 20
                                 15
                                 10
                                  5
                                  0




                                                                                                                                                                                                                                                                                      Fri 12 am
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                                      Sun 12 am
                                                  Sun 06 am
                                                              Sun 12 pm
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                                                                                                                                      Tue 12 am
                                                                                                                                                  Tue 06 am
                                                                                                                                                              Tue 12 pm
                                                                                                                                                                          Tue 06 pm




                                                                                                                                                                                                                                      Thu 12 am
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                                                                                                                                                                                                                                                                                                                                      Sat 12 am
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                                                                                                                                                                                                                                                              Thu 12 pm
                                                                                                                                                                                                                                                                          Thu 06 pm
                                                                                      Mon 12 am
                                                                                                  Mon 06 am
                                                                                                              Mon 12 pm
                                                                                                                          Mon 06 pm

      So…, how much staff is needed and how should they by scheduled?
2
    Position     Tour Type                                                FTE Sun Mon Tue                                                                                          Wed                          Thu                           Fri   Sat                                                               Tour Type Tot FTEs                                              3
       1     (8 hrs, 5 days/wk)                                            1.0 O     7a-3p 7a-3p                                                                                   7a-3p                       7a-3p                           O   7a-3p                                                                 (8,5)      30.0
       2            (8,5)                                                  1.0 O 3p-11p 3p-11p                                                                                    3p-11p                      3p-11p                        3p-11p O                                                                     (8,3)       6.6
       3            (8,3)                                                  0.6 O     8a-4p 8a-4p                                                                                   8a-4p                         O                             O     O                                                                  (10,4)       4.0
       4           (10,4)                                                  1.0 O     7a-5p 7a-5p                                                                                     O                         7a-5p                         7a-5p   O                                                                  (12,3)      22.0
       5           (10,4)                                                  1.0 O     7a-5p 8a-6p                                                                                   7a-5p                         O                           8a-6p   O                                                                              62.6
       6           (12,3)                                                  1.0 O       O   7a-7p                                                                                   7a-7p                         O                           7a-7p   O
       7           (12,4)                                                  1.0 7a-7p 7a-7p   O                                                                                     7a-7p                       7a-7p                           O     O


    FTE = Full Time Equivalent (40 hrs/wk = 1.0 FTE)
Staff Scheduling - It’s a Problem
Policies and practices affect total labor cost.
    little “tactical” scheduling analysis done
Overstaffing increases labor costs while understaffing may impact
quality of care or service
Presents difficult combinatorial problems.
Consumes costly managerial time and effort; ad-hoc methods are
the rule.
Bias often to favor employee over institutional needs.
Large impact on employee dissatisfaction and turnover
Not only in healthcare - police, fast food, call centers, airlines
Computerized systems under-utilized and often require inputs
which themselves are the solution to a difficult scheduling
analysis problem.
Elements of Scheduling Environments
  Planning cycle is the number of weeks in the scheduling horizon
      1, 2, 4, 6, 8, etc.
  Each day is composed of planning periods
      15 minutes, half-hours, hours, 8-hr shifts
      staffing or “coverage” requirements by planning period
         where did they come from?
         hard constraints vs. soft constraints (e.g. understaffing costs)
  A shift has a start time, a day of week, and a length (8hr shift,
  starting Mon @ 7:30am)
      allowable start times
  Tour Types: (periods/shift-shifts/week)
      (8-5) is someone who works 5 8-hr shifts per week
      (12-3, 12-3, 12-4) works three 12-hr shifts for two out of three
       weeks and four 12-hr shifts for one of three weeks
      (12-3, 12-3 + 8-1) works three 12-hr shifts every week + one 8-hr
       shift every other week
Elements of Scheduling Environments
     Days-off Patterns                             1=working, 0=off
     Su Mo Tu We Th Fr Sa                 So, how many different patterns are
                                           there for working 5 out of 7 days?
     0 1 1 1 1 1 0
Su   Mo   Tu We    Th Fr   Sa   Su   Mo   Tu We     Th Fr   Sa
 0
 1
      1
      1
          1
          1
             1
             0
                   1
                   1
                      1
                      1
                           0
                           0
                                0
                                 0
                                     1
                                     1
                                          0
                                          1
                                              1
                                              1
                                                    1
                                                    1
                                                       1
                                                       1
                                                             1
                                                             0
                                                                  2-weeks
     A tour is a combination of days worked and shifts worked
         workstretch - # days worked consecutively
         time between consecutive worked shifts – e.g. 16 hours
     The “standard 3-shift nurse scheduling problem”
         day, afternoon, midnight shift
         each shift for each day of the week can have
          unique staffing requirement
         multiple week issues
            covering “off-shifts” (permanent, rotation)
            weekend rotation issues (A out of B weekends off)
            some tour types, e.g. (12-3,12-3,12-4)
 Elements of Scheduling Environments
Employee
preferences
for various
schedule
characteristics

A challenge of
scheduling
problems is to
balance
schedule
quality with
coverage
Tactical vs. Operational
Scheduling
          Tactical                           Operational
Not concerned with specific             Specific employees identified.
employees.
                                        Schedule current staff to meet
Determine minimum staff needed to       TOD/DOW staffing targets
meet TOD/DOW staffing targets           subject to scheduling policies,
subject to various scheduling           staff preferences and
policies.                               availability.

Done periodically as part of planning   Done every two to six weeks.
or a special study.

Done by department staff or             Done by department staff.
operations analyst
Performance of Schedules
 Overall scheduling efficiency
                         Total Hours Required
 Scheduling Efficiency 
                         Total Hours Scheduled

 Distribution of under and overstaffing
    usually more desirable to “spread out”
     under and overstaffing than concentrate it
    costs of understaffing
 Schedule quality / implementability
 Fairness
 Ongoing manageability
Approaches to Solving
Scheduling Problems
 Trial and error + basic scheduling principles
     self-scheduling within management set parameters
     Get a “master cyclic schedule” built and try to follow it making
      modifications as needed
  Various specialized heuristics or algorithms have been
 developed for different versions of scheduling problems
     lower bounds on staff size then build a schedule
     Website devoted to Excel based templates for scheduling
        http://www.shiftschedules.com/
 Mathematical optimization models
 Artificial intelligence based techniques
     suited for finding good solutions for problems with many
      complicated constraints
  Many different commercial scheduling systems exist with widely
 varying capabilities and incorporating one or more of the above
 approaches
Classes of Scheduling Problems
 Days-off scheduling
    staffing specified at daily level (1 or more “standard shifts” per
     day) by DOW
    find min staff size to meet coverage and other constraints on
     weekends worked, workstretch, allowable patterns
    traditional nurse scheduling
 Shift scheduling
    usually posed as a 1-day problem with staffing requirements
     specified by time of day (e.g. hourly)
 Tour scheduling
    basically a combination of days-off and shift scheduling over
     some planning cycle (1 or more weeks)
 Countless industry specific variations on all of
 these problems
  Tactical Staff Scheduling Analysis
      Used periodically as part of planning
      Concerned with capturing the essence of staff scheduling
      problems
          TOD/DOW specific staffing targets
          allowable mix of tour types (shift lengths and # days worked per week)
          allowable shift start times and flexibility
          budget constraints
          days worked constraints (e.g. no 3 consecutive 12hr shifts)
      Determine minimum staff size needed to meet coverage
      requirements subject to scheduling related constraints
      Quantify cost of scheduling policies


Example - Shift Length Flexibility                                  Scenario
                                                               1       2       3
                                                     8 hr      42      28      23
                         All full time     {        10 hr
                                                    12 hr
                                                                       10      10
                                                                               4
                                                 Total FTEs    42      38      37
   Dantzig’s Linear-Integer Programming Based Scheduling Optimization
   Model

          N                                                         c j  cost of shift j
 Minimize å c j x j              (Total staffing cost)
          j1                                                       x j  # of people working shift j
 Subject to:
      N                                 (Staffing coverage in each period (e.g. hourly))
      å Aij x j ³ di    for i  1,2KP
      j1                                             di  demand for staff in period i
                                                             1 if shift j call for work in period i
      x j ³ 0 and integer, for j  1,2,K N             Aij  
                                                                            otherwise


 • Provided basis for 35 years of scheduling research and practice.
 • Many extensions:
     – understaffing costs
     – varying skill levels and productivity
     – breaks and lunches
     – industry specific side constraints


“A Comment on Edie’s Traffic Delays at Toll Booths”, Dantzig, G. (1954)
What is Optimization?
In a business problem context

   Loosely – Finding the “best” solution to a
   problem
   More precise – Finding the answer to a
   problem that minimizes (maximizes) some
   objective or goal of a decision maker while
   taking into account business constraints
   Mathematical version – Finding the values
   of a set of decision variables that minimizes
   (maximizes) some objective function subject
   to constraints (equations or inequalities) on
   the decision variables
Some Optimization Concepts
 A potential solution is feasible if it satisfies all the
 constraints we build in the model
    a model is infeasible if no solution satisfies all the
     constraints
 A potential solution is optimal if it is feasible AND it
 is better than all other feasible solutions in
 minimizing (or maximizing) our objective
    a model is unbounded if we can make the objective as big
     as we want (assume we’re maximizing) and still satisfy the
     constraints
 So, how do we search among the (potentially huge
 number of) feasible solutions to find the optimal
 solution?
    that’s what optimization algorithms such as those built
     into the Excel Solver do
     Linear Programming
         Many useful, important problems can be formulated
         as:

         Maximize     c1x1 + c2x2 + … + cnxn (objective function)

         Subject to   a11x1 + a12x2 + … + a1nxn  b1 (1st constraint)
                       a21x1 + a22x2 + … + a2nxn  b2 (2nd constraint)
LP
                              …
                       am1x1 + am2x2 + … + amnxn  bm (mth constraint)

                              xi ³ 0 , i=1..n, (decision variables)
                     The ci and aij are just numeric coefficients
         that are multiplied by the values of the decision
         variables (x )
LP=linear program i
  Yet Another Observation
     Many useful, important problems can be formulated
     as:

     Maximize     c1x1 + c2x2 + … + cnxn (objective function)

     Subject to   a11x1 + a12x2 + … + a1nxn  b1 (1st constraint)
                   a21x1 + a22x2 + … + a2nxn  b2 (2nd constraint)
                          …
   MIP             am1x1 + am2x2 + … + amnxn  bm (mth constraint)

                         xi ³ 0 , i=1..n, (decision variables)
                         Some of the xi must be integers
MIP=mixed integer-linear program

                                        So, what is different?
Some of the toughest mathematical problems solved
routinely in business today are optimization problems
Example 1: Simple 1 week, days-off problem
•   Formulated model in Excel and we will solve it using Solver
•   Goal 1: give flavor of optimization applied to scheduling
•   Goal 2: illustrate fact that scheduling policies affect staffing needs
•   Goal 3: real scheduling problems can lead to huge optimization problems




                                          SchedulingDSS_Northpark.xls
                                        Scheduling_AdvancedDaysOff1.xls
                                        Scheduling_AdvancedDaysOff2.xls
Example 2: Simple 1 day, shift scheduling problems
•   Formulated model in Excel and we will solve it using Solver
•   Goal 1: see difference between shift and days-off scheduling
•   Goal 2: treat staffing requirements as both hard and soft constraints
•   Goal 3: real scheduling problems can lead to huge optimization problems




                                             ShiftSchedulingModel1.xls
                                             ShiftSchedulingModel2.xls
Example 2-Week Schedule
• Creating a sample schedule is good “test” of whether you’ve come up with an
  implementable solution
• Schedule can be reviewed by staff for undesirable characteristics, errors,
  other ideas for improvement
• Sample schedule helps sell scheduling policy changes because people can
  visualize the end product
Cyclic Schedules
  Idea is to create a set of schedules that employees cycle through.
  Various mathematical methods, computerized and trial and error
 approaches to creating cyclic schedules
  Pros – schedules can be specified well in advance, fair, once
 created relatively easy to manage for stable workforce
 Cons – very rigid, difficult for mix of full/part time staff, difficult
 when varying shift lengths, difficult for 24/7 operations




                                       http://www.shiftschedules.com/
  Coverage Report – Comparison of
  Targeted to Scheduled Staff Levels
                            Sched=Staff scheduled




Target=Min staff requirements
                                  +/- = Over/understaffing
                                  FTE Summary
                                                  # of Shifts              LDR       Postpartum LDR+Postpart      LDRP
                                        Shift     Worked in            2,150 Births 2,150 Births 2,150 Births 2,150 Births
                                       Length     Two Weeks     FTE    Const Flex Const Flex Const Flex Const Flex
     Sample                 Mil
                            Mil
                                  12 hr Full Time
                                  10 hr Full Time
                                                       7
                                                       8
                                                                1.05
                                                                1.00
                                                                        16.8
                                                                         -
                                                                                12.6
                                                                                 3.0
                                                                                      16.8
                                                                                       -
                                                                                             14.7
                                                                                              3.0
                                                                                                  33.6
                                                                                                   -
                                                                                                          27.3
                                                                                                           6.0
                                                                                                               27.3
                                                                                                                -
                                                                                                                       23.1
                                                                                                                        2.0

summary report              Mil
                            Civ
                                  8 hr Full Time       10
                                  12 hr Full Time 6+one 8 hr
                                                                1.00
                                                                1.00
                                                                         -
                                                                         6.9
                                                                                 -
                                                                                 4.9
                                                                                       -
                                                                                       7.8
                                                                                              -
                                                                                              2.9
                                                                                                   -
                                                                                                  14.7
                                                                                                           -
                                                                                                           7.8
                                                                                                                -
                                                                                                               12.0
                                                                                                                        -
                                                                                                                        6.9

 from a tactical
                            Civ   8 hr Full Time       10       1.00     2.0     -     3.0    3.0  5.0     3.0  3.0     3.0
                            Civ   8 hr Part Time       8        0.80     -       0.8   1.6    0.8  1.6     1.6  0.8     3.2

   scheduling
                            Civ   8 hr Part Time       6        0.60     0.6     -     -      0.6  0.6     0.6  0.6     -
                            Civ   8 hr Part Time       4        0.40     0.8     1.2   0.4    0.8  1.2     2.0  -       -
                            Civ   4 hr Part Time       10       0.50     -       1.0   -      0.5  -       1.5  -       0.5
    analysis                Civ
                            Civ
                                  4 hr Part Time
                                  4 hr Part Time
                                                       8
                                                       6
                                                                0.40
                                                                0.30
                                                                         -
                                                                         -
                                                                                 -
                                                                                 0.6
                                                                                       -
                                                                                       -
                                                                                              0.4
                                                                                              0.6
                                                                                                   -
                                                                                                   -
                                                                                                           0.4
                                                                                                           1.2
                                                                                                                -
                                                                                                                -
                                                                                                                        0.4
                                                                                                                        0.6
                                  Number of scheduled FTEs              27.1 24.1 29.6 27.3 56.7 51.4 43.7 39.7

                                  Position Summary
                                                  # of Shifts          LDR       Postpartum LDR+Postpart      LDRP
 FTE implications of                    Shift     Worked in        2,150 Births 2,150 Births 2,150 Births 2,150 Births
 Constrained vs. Flexible              Length     Two Weeks FTE Const Flex Const Flex Const Flex Const Flex
                            Mil
 scheduling policies
                                  12 hr Full Time      7      1.05    16      12   16      14   32      26   26      22
                            Mil   10 hr Full Time      8      1.00   -         3  -         3  -         6  -         2
 Summary of FTEs and #      Mil
                            Civ
                                  8 hr Full Time       10     1.00
                                  12 hr Full Time 6+one 8 hr 1.00
                                                                     -
                                                                       7
                                                                             -
                                                                               5
                                                                                  -
                                                                                    8
                                                                                          -
                                                                                            3
                                                                                               -
                                                                                                15
                                                                                                       -
                                                                                                         8
                                                                                                            -
                                                                                                             12
                                                                                                                    -
                                                                                                                      7
 of positions               Civ   8 hr Full Time       10     1.00     2     -      3       3    5       3     3      3
                            Civ   8 hr Part Time       8      0.80   -         1    2       1    2       2     1      4
 These solutions were       Civ   8 hr Part Time       6      0.60     1     -    -         1    1       1     1    -
 derived from user          Civ   8 hr Part Time       4      0.40     2       3    1       2    3       5  -       -
                            Civ   4 hr Part Time       10     0.50   -         2  -         1  -         3  -         1
 specified scheduling       Civ   4 hr Part Time       8      0.40   -       -    -         1  -         1  -         1
 policies and a             Civ   4 hr Part Time       6      0.30   -         2  -         2  -         4  -         2
                                  Number of scheduled employees       28     28    30     31    58     59    43     42
 scheduling optimization
 model                      Mil Benefit Factor                           ?     ?      ?      ?     ?      ?      ?      ?
                            Civ Benefit Factor     Full time             ?     ?      ?      ?     ?      ?      ?      ?
 Note also the variance     Civ Benefit Factor     Part time             ?     ?      ?      ?     ?      ?      ?      ?
 pooling effect that an
                                  Number of FTEs on Staff                ?     ?      ?      ?     ?      ?      ?      ?
 LDRP gives
 Sample Applications
     Surgical nurses/techs                  How much staff needed?
     Communications operators               Can current staff absorb
     Appointment scheduling clerks          increased demand through
     Short stay unit nurses                 rescheduling?
     Recovery room nurses                   What are the potential savings
     Medical transcriptionists              from increased flexibility in shift
                                            lengths and start times?
     Radiation oncology technicians
                                            By how much can we improve
     Obstetrical nurses
                                            customer service through
                                            scheduling changes?


Isken, M.W. and W.M. Hancock, 1998, “Tactical Staff Scheduling
Analysis for Hospital Ancillary Units”, Journal of the Society for Health
Systems, Vol. 5, No. 4, pp. 11-23.
Comments on Tactical
Scheduling
 How do shift start times and shift lengths match the
 work flow of the department?
     can’t make general statements that certain shift lengths or
      scheduling practices are “good” or “bad”
     look for opportunities to smooth workload to ease the
      scheduling burden
 Pay attention to policies and procedures regarding
 the definition of OT
     >40 hrs/week vs. >80 hrs/pay period
 Schedule desirability can vary widely by employee
     don’t assume what people will and will not like
 Important to involve staff in analysis of scheduling
 policies
     easy for them to undermine
     intangibles not captured by scheduling models
Another Link between staffing and scheduling

      Time of day staffing targets are really decision variables,
      Simultaneous solution of staffing targets and schedules may lead to
      better solutions from cost, service, and schedule quality perspectives.
      Preliminary experimental results are promising.
      Considers workload smoothing, buffering, and scheduling schemes.
      Operational setting drives the model building process (Lab and
      Transcription).
      Challenge is resulting problems more difficult to solve (research
      ongoing)
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Operational Personnel Scheduling
    The ongoing process of creating and
   managing staff schedules
    Balancing system needs with staff availability
   and preferences
    Several methods:
      computerized scheduling systems
      self-scheduling
      manual scheduling done by committee or manager
   A difficult, time consuming process
      it’s like doing a really hard jigsaw puzzle
Nurse Scheduling Challenges
  24/7 coverage needed
  Workload varies by shift by skill level by unit
  Rotation to off-shifts?
  Multiple skill levels (RN, LPN, aide, etc.)
  Covering weekends
  Shortage of personnel
  Dealing with daily fluctuations in supply &
  demand
     OT, agency, part-time, float on/off unit,
      contingent, send home, call-in
  ANSOS
   Typical architecture of Computerized
   Personnel Scheduling Systems
                 Personnel                                   Workload
External Human
                  Module                                      Module            External Service
  Resources
    System                                                                      Delivery Support
                                                                                     System

       HR Data                        Staffing Targets                    Workload Data
                 Personnel                                  Workload


                  Identification
                                                                                          Supports day to
                                     Automated
                  Availability
                  Preferences
                                     Scheduling
                                                         Schedules
                                                                                          day scheduling of
                                                                                          current staff.
                                   Active Schedules            Stored
                                                              Schedules


                                      Schedule
                                                         Schedules
                                                                                    Wide range of system
                                       Editor
                                                                                    capabilities and cost.

                              Schedules and                                         Healthcare, retail, police,
                               Management
                                 Reports                                            fire/EMS, telesales, tech
                                                                                    support, fast food,
                                                                                    banking
  ANSOS – Per Se Technologies
     ANSOS - One Staff
 • Created in 1970s by Warner, tested at UMMC
 • The standard for nurse scheduling software
 • Staffing requirements, scheduling policies, and nurse preferences
      • optimization model based
 • Integrates with 3rd party PCS
 • Numerous add-on modules
                                                              See “Automated nurse
                                                         scheduling” by Warner et al that
                                                             was passed out last time




• Shift centric as opposed to time
  of day centric
• Extent of use varies widely
  among institutions
    • glorified typewriter vs.
      sophisticated auto-scheduler
     A few scheduling packages
ANSOS - http://www.per-se.com/forhospitals/h_onestaff.asp
ActiveStaffer - http://www.api-wi.com/products/activestaffer.asp
AtStaff - http://www.atstaff.com/Products/Products.htm
AcuStaf - http://www.acustaf.com/
Pathways Staff Scheduling - http://www.hboc.com/
Shiftwork Solutions - http://www.shift-schedules.com/
ShiftMaker - http://www.vastech.com/24-7/solutions/vastech24-
7/247modules.htm
ESP eXpert - http://www.total-care.com/
InTime - http://www.intimesoft.com/
VSS Pro - http://www.abs-usa.com/index.epl
Kronos - http://www.kronos.com/
ScheduleSource - http://www.schedulesource.com/content/scheduling/default.asp
ORBIS - http://www.sieda.com/features_e.htm
Various packages - http://www.hr-software.net/pages/217.htm
StaffSchedule.com - http://www.staffscheduling.com/schedule.htm
    web based scheduling
Evaluating Computerized Scheduling Systems
 How are staffing requirements     Can be integrated with 3rd
 specified (TOD or Shift)?         party workload systems?
 Auto-scheduling or just a         Can be integrated with 3rd
 schedule manager?                 party timekeeping, payroll,
 Schedule editing                  and/or HR systems?
 Support for self scheduling?      Cost and licensing
 Single vs. multiple weeks            consulting, installation,
 Easy access to emp. data              training, sofware, hardware,
 Employee requests and                 maintenance, add-on modules
 preferences                       Tech support
 Skeleton rotation patterns        Strong user base
 Archive past schedules            Hardware and software
 Reporting – built in and ad-hoc   requirements
 capabilities                      How applicable to multiple
 Does it handle YOUR scheduling    departments within the
 environment?                      same institution?
Flexible Scheduling Ideas
 Mix of different shift lengths
     >8 hr shift gives more days off per week
     easier to match fluctuating workload
  Increase number of allowable start times
     easier to match fluctuating workload
     more complex to manage; rotation issues
 Mix of full and part-time tour types
     part-timers can provide invaluable flexibility in
      dealing with vacations, odd shifts, absences,
      workload variation by day of week and time of
      day
Flexible Scheduling Ideas
  Float pools (internal agency)
     cross training
     sufficient voluntary “floaters”?
     How big should the pool be? How should the “core”
      staffing levels be set?
  Temp agencies
     pay a premium for staff on demand
     issues with integration with permanent staff
  Contingent
     usually from the employees perspective
  On-call
  Forced TO (time-of) and Forced OT
     not a super staff satisfier
Miscellaneous issues
Circadian rhythms
   researchers study effect of shift work
Shift overlap
   communication improvements
12hr tour types
   334, 3334, 33-1, 2-12 2-8
   cost and scheduling implications
Self scheduling
   need to have a good staffing plan and set
    of scheduling policies
Learning More
Professional association trade journals and
academic journals
   Nursing Management, Medical Laboratory Observer,
    Nursing Times, and numerous other
   Interfaces
   Search Medline for “staff scheduling”
 Google it – “healthcare staff scheduling”
Introduction to Employee Scheduling: Issues,
Problems, Methods – Nanda and Browne

								
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