AT UNITYPOINT HEALTH-MERITER Hospital in Madison, Wis., flexible scheduling allows the group to capitalize on the skill sets and strengths of different physicians.
“Different demographics prefer different shifts and schedules,” points out Dr. Jaskunas. “It’s not just the type of shift, but the days of the week and the hours of the day. Some personalities, skills and strengths match up better with some shifts than with others.”
“Flexibility requires creativity, hard work and openness to change.”
Jeremy Jaskunas, MD
UnityPoint Health-Meriter Hospital
But several factors in the past few years have enhanced what was already a wide assortment of shifts and schedules. For one, the pandemic ushered in a level of patient volume that has stayed predictably high. That volume now makes it much easier to target short shifts to consistent demand.
And two, the group continues to get larger with 41 physicians as well as six dedicated telenocturnists (who can work from home.) The group’s size makes it easier to tailor shifts to individual physician preferences.
What types of shifts are on tap? Dr. Jaskunas points out that the majority of his colleagues work what he calls “an 80/20 split: 80% rounding, with 20% admitting shifts.”
But hospitalists can also work onsite in what’s known as an “access center shift.” During that afternoon shift, doctors triage potential regional transfers within the three-hospital system, which includes UW Health University Hospital, the academic center.
“Hospitalists on that shift handle a large volume of calls,” says Dr. Jaskunas, noting that the afternoon triage shift is eight hours. Or hospitalists can work an evening triage shift from their homes. “They have the same responsibilities but a lower volume of calls.” The access center triage shifts are designed to standardize decisions about where patients are admitted and optimize bed utilization across all three hospitals.
Short shifts
The group now also staffs both morning and evening admitting shifts—shifts that last only five or six hours. “We can easily track when we need that extra help during mornings and early evenings to meet volume surges,” Dr. Jaskunas says. That’s a draw for people who want to work shorter hours but more days, while others prefer longer hours and fewer days.
Group members who want to can work only one type of shift. “We have doctors who just do admitting and don’t do any rounding whatsoever,” he says. “That suits different lifestyles, obligations, skill sets and temperaments.” A hospitalist committee sets each shift’s specific rate, so “we all know exactly what everyone is paid. It’s all fully out in the open.”
Virginia Mason Franciscan Health: Matching shift-start times to work
A group figures out how to best deploy their float physicians. Read more here.
University of New Mexico Hospital: Making the most of scheduling software
Flexible schedules evolve as hospitalists take on new roles. Read more here.
Williamson Medical Center: Seasonal staffing
Learning how to manage low-census days. Read more here.
Phyllis Maguire is Executive Editor of Today’s Hospitalist.
