Six years ago, the Children's Nebraska health system had no single source of truth when it came to scheduling.

THE PROBLEM

Children's Nebraska was growing by 10% per year from a provider standpoint, and at that time, scheduling and on-call generation was done in a myriad of systems across departments – from being written down on paper to being saved in email calendars to being tracked in a spreadsheet. There were many disparate methods, and no one could keep track of them all.

To try and streamline the process, staff would combine all the scheduling details on hand and send it off to the communication center, where someone would manually enter and track scheduling in a Microsoft Word or Excel file.

This meant that if anyone had to make a last-minute schedule change, it wasn't getting sent to the communication center, meaning staff did not have a single place that held the source of truth for scheduling.

It also posed challenges when it came to scheduling appointments on provider calendars. Oftentimes, providers were getting double-booked as division admins would have to cross reference the multiple schedule formats to book an appointment.

"The problem continued to get worse as the number of our providers grew," said Dr. Stephen Dolter, chief medical information officer at Children's Nebraska. "Managing schedules in this manual and disparate way quickly became too much of an administrative burden, and we knew we needed technology to automate these processes.

"We ultimately turned to QGenda for workforce management technology that could quickly and efficiently produce provider and on-call schedules and optimize clinical capacity," he added.

PROPOSAL

QGenda proposed its workforce management technology that would span provider scheduling, on-call, and clinic and exam room management to address the obstacles Children's Nebraska was facing.

"Now, in addition to keeping our patients safer by having a standardized on-call platform that is 100% correct 100% of the time, we enjoy time savings and reducing administrative burden, two of the most important non-clinical benefits we wanted from this type of technology," Dolter explained. 

"Freeing up physician's time allowed them to practice at the top of their license and focus on seeing patients, which also had financial benefits for our organization as providers were able to see more patients and provide quality care, as opposed to working on administrative tasks.

"With that in mind, we aimed to leverage workforce technology to automatically flow schedule creation and changes to our communication center and have last-minute changes automatically updated, so schedules could quickly and efficiently be produced," he continued.

MEETING THE CHALLENGE

All of the provider departments and divisions, the communication center, and anyone on the on-call landing page can look at the workforce management platform. This includes providers, nurses, pharmacists, social workers, case managers, and PT and OT teams – anyone in the hospital.

The vendor's technology integrates with Microsoft Outlook, which the organization uses, so scheduled shifts or time-off appear as appointments for everyone in the system to see.

"This is crucial." Dolter noted. "If someone is looking to book time with a provider, they aren't going to overbook, since it appears blocked and busy when on clinical service. Additionally, QGenda is integrated with Voalte, our secure texting platform, and makes it so you don't have to toggle back and forth between each platform, providing a user-friendly experience."

RESULTS

Before implementing a workforce management platform, Dolter had personally worked eight consecutive Halloween overnight shifts, as there was no source of truth to track staffing trends. That's why he and the rest of Children's Nebraska staff value the new system – the technology is able to identify and correct scheduling like that.

"Now we don't have to worry about getting scheduled for the same holiday over and over again," Dolter explained. "Beyond that, one of the major benefits of the platform has been the visibility into historic data and insights.

"We're able to see who worked what shift and at what times, so moving forward, we can ensure our physicians are working an equal number of shifts and in their area of expertise," he continued. "Before this technology, that wasn't happening. But it goes a long way in terms of workplace satisfaction and work-life balance."

Children's Nebraska hasn't scratched the surface yet of leveraging the data and insights capabilities of the new system, but it is looking forward to using the technology to the fullest potential so the organization can: measure how providers are trending toward contractual obligations; understand time-away trends across departments, sub-specialties, locations and providers; proactively adjust for seasonal demand trends by location; and more.

"Within the next year, we will be able to report specifically on room management improvements," Dolter noted. "While we don't have hard metrics to report on quite yet, we can report on improved operational efficiencies with quicker, automated schedule generation, and we have heard from our staff how satisfied they are with the technology.

"We find the 12-month time frame allows us to draw reliable conclusions, but we know that integrating provider schedules with room management will make it easier to optimize use of available clinic and exam rooms, improving patients' access to care," he said.

ADVICE FOR OTHERS

There are multiple considerations Dolter would offer other healthcare provider organizations looking to leverage similar workforce management technology.

"First, I would recommend integrating it with as many other platforms as possible, including email calendars and secure messaging platforms," he advised. "I'd also make sure you are budgeting 50% more time for installation and implementation than you think you will need as schedule administrators, the ones on your team using this technology, typically need extra time and support to adjust to the change and learn the workflows.

"This flows into the importance of emphasizing change management for teams," he concluded. "While there might be upfront work and a learning curve that comes with implementation of a completely new platform, the outcomes and payoff down the road in terms of time savings and work-life balance will be well worth it."

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