Radiology Scheduling

Radiology Scheduling

Schedulers in radiology groups must cover the varying needs at facilities with radiologists that have unique skill sets or modalities that they can cover. The Lightning Bolt system produces schedules that meet radiologist’s needs for equity in requested vacation days, unrequested days-off, and weekend work while covering tasks that can only be filled by available and skilled sub-specialists.

Radiology groups struggle to cover the sub-specialty needs at multiple facilities with radiologists that have different skills/strengths and different work preferences. Demand at a facility might be different on different days of the week and the availability of the best radiologists to cover the sub-specialty tasks at those facilities also vary from day to day. Consequently, schedulers struggle to map the irregular coverage needs of facilities with the irregular skill set of radiologists that cover them. While radiologists vary in their skill set and work preference, they do share a common need to have commensurate or equal number of vacation days, unrequested days off, and distributions of weekend work. This requirement for equality often conflicts with the unique work profile that includes the skill sets of individual radiologists. An often-seen challenge is that schedulers struggle to distribute the unrequested days off evenly across the radiologists while covering all the modalities at all facilities. Achieving these goals simultaneously requires a deep analysis that overwhelms a human scheduler.

Lightning Bolt NSight is the first product available in the market that thinks deep, making scheduling choices with computational wisdom that effectively thinks several million steps ahead. By adapting novel Artificial Intelligence and Operations Research techniques often used in manufacturing and other industries, the system produces the best schedule possible, often looking deeper into the scheduling permutations than is possible to do by hand alone. In the example above, the system would consider the impact on the balance of unrequested days off even as it thinks deeply on how best to cover all the required sub-specialty tasks at various facilities.

 

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Radiology Scheduling Sample Schedules

Check out sample schedules by clicking on the image.

 

 

Sample Radiology Schedule
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Radiology Scheduling Sample Rules/Requirements

Rule #
Description
Priority

1

When scheduled for OPDC-fluoro AM, schedule for assignment OPDC-fluoro PM in the afternoon. This doesn't apply to Dr. Jerne or Dr. Lewis, who often work half days.

High
2

Equalize number of times providers are scheduled for Diagnostic Weekend Day Call.

Maximum
3

Equalize number of times providers are scheduled for Diagnostic Weekend Night Call.

Maximum
4

Equalize number of times that providers are on Specials Call. There should be separate tallies for weekend days on call, Fridays on call, and Mon thru Thurs on call.

Maximum
5

Equalize number of times that providers are scheduled for Diagnostic Week Day Call. This should include equalizing specific days on call, i.e. everyone should have same number of Thursday nights on call.

Maximum
6

Day Off Post Call rotation always follows Diagnostic Week Day Call rotation or Sunday Diagnostic Weekend Night Call.

Maximum
7

Equalize number of times providers are scheduled for Wednesday Day Off (Specials), with each of two providers alternating when possible

Very High
8

Weekend Day Call rotation should alternate with Weekend Night Call rotation for each provider, but should not be scheduled within 2 weeks of each other. For example the closest together should be: Week 1, Weekend Day Call; Week 2, Off; Week 3, Off; Week 4, Weekend Night Call Rotation. There should be no more than 5 weekends off between these rotations.

Very High
9

The same provider should not be scheduled for Special Weekend Call rotation two weekends in a row.

High
10

The same provider should not be scheduled for Diagnostic Week Day Call rotation more that one day each week.

High
11

The same provider should not be scheduled for the same weekday rotation, excluding Specials and Neuro rotations, and OPDC rotations for Jerne, Lewis, more that once each week.

Medium
12

Dr. Barry and Brenner should preferentially be scheduled for Neuro AM and Neuro PM rotations over other radiologists.

Medium
13

Drs. Entel and Black should preferentially be scheduled for Special Procedures rotation, with Drs. Barry and Cohen each being assigned to Specials Procedure rotation once each week.

Medium High
14

ER, extras rotation should not be followed by Main Department rotation.

Medium
15

Drs. Blobel, Fisher, Brenner, Brown, Cohen should not be scheduled for Diagnostic Week night Call or ER, Extras rotation on the fourth Tuesday of the Month (for executive committee meeting).

Medium High
16

Thyroid AM rotation should be followed by Neuro PM, OPDC-fluoro PM, OPDC-US PM, or ER,extras PM rotation in the afternoon.

Very High
17

Thyroid AM rotation should be scheduled on Thursday mornings when Dr. Fisher is available, otherwise Tuesday mornings. It should occur no more that once per week. There is no Thyroid AM rotation when Dr. Fisher is on vacation. There will be no Neuro AM rotation in the mornings when there is Thyroid AM rotation.

Maximum
18

The provider assigned to Special Weekend Call shall be assigned to both Saturday and Sunday call. They should also always be scheduled for Friday Night Specials Weekday call as well, but should not be assigned to any other Specials Week Day call the preceding week when possible.

Medium
19

In the months of March, June, September, and December, only non-partners (Hartwell, Murray) should be scheduled for Diagnostic Weekday Call and ER, extras rotation on the fourth Tuesday of the month (group meeting).

Medium Low
20

Dr. Jerne and Lewis usually work half days. Dr. Jerne only works on OPDC-fluoro and OPDC-US rotations, which should alternate for him, when possible. Dr. Jerne generally works all morning rotations for one week, followed by all afternoon rotations for one week.

Medium Low
21

On the days when Dr Jerne works mornings, Dr. Lewis works afternoons, and vice versa. Dr. Lewis generally works OPDC-fluoro or OPDC-US rotation two or three days and week, and Neuro-AM, Neuro-PM, ER extras-AM, ER extras-PM the other days.

Medium Low
22

A provider should not be scheduled for the OPDC-bx rotation more than once a week when possible.

Medium Low
23

Avoid placing a provider on Friday night Diagnostic week day call or Specials week day call on the Friday before a vacation week off.

Very High
24

Avoid placing a provider on Thursday or Friday night Diagnostic Week Day Call on the Thursday or Friday before they are assigned to Diagnostic Weekend Day Call or Diagnostic Weekend Night Call.

Maximum
25

Dr. Barry should never be scheduled for Diagnostic Week Day Call on Friday night.

High
More Rules

Radiology Scheduling Challenges

Is the schedule simply not possible mathematically?

Is the schedule the way it is because I can’t find a good schedule or is it simply not possible mathematically? How many vacation days can each provider take per year? Can each provider work only two weekends per month? Do we have enough providers to cover all the outreaches and sites? How many locums do we need to cover shifts given the work preferences of regular staff? What’s the impact on the work schedule of existing providers if we add a certain sub-specialist? These are simple questions but the answers are not so simple because of the interaction of rules and how a small change brings large changes to schedules in chaotic systems.
Lightning Bolt NSight lets you explore the precise edge of what is possible. A schedule draws a line between individual needs and institutional need; between patient volume/quality of care and provider needs; between individual needs and collective needs. Lightning Bolt NSight helps you analyze and explore the boundaries unique to your group. Can each provider be limited to two weekends per month? If yes, the system will produce a schedule with that limit. If not, it will let you know. Can the work shifts be covered by available staff? If yes, the system will produce a schedule covering all work shifts. If not, it will help you determine how many additional staff you will need. These are examples of questions and answers at the edge of what is mathematically possible, an edge that you can explore with Lightning Bolt NSight.

Only thing constant in our group is change

Only thing constant in our group is change – changes due to changes in staffing levels and/or work demand. Schedules often need to adapt to changing events whether that event is due to a provider being unavailable due to illness, taking a leave of absence, or new providers joining the group. Just when the group is adapting to a period of change, a new schedule needs to be generated that takes the new events into account. Often, even a small change has large impact on the overall schedule.
Lightning Bolt NSight adapts. With Lightning Bolt NSight, any portion of the schedule can be revised with the click of a button whether the portion needing revision is a day, a week, month or a year. When a new event occurs, you simply re-schedule the remaining period or a period specified by a start and a stop date.

Why is the schedule the way it is?

Why is the schedule the way it is? Physicians who live the schedule often seek an explanation as to why they are or are not scheduled on a particular day. Not knowing the collective rules and constraints, the choice of a particular schedule or a scheduling decision may seem random or biased.
Lightning Bolt NSight explains. The rationale behind a scheduling decision is particularly important when the schedule is automatically generated. Lightning Bolt NSight offers detailed explanations of its decisions and displays violations of rules when they are unavoidable because of conflicts.

Time-off requests cause coverage problems.

Time-off requests cause coverage problems. Schedulers would like to accommodate individual time-off needs to the extent possible. However when individual requests are unchecked, the collective requests causes coverage problems when too many providers are unavailable on the same day. When the group consists of sub-specialists that are not interchangeable, determining potential coverage requires a complicated calculation based not only on the number of absent providers but which combination of sub-specialists are absent. Not knowing which combination causes problems, the administrator faces a difficult choice in being overly conservative by denying requests that could be honored or being overly aggressive and face coverage problems when creating schedules later.
Request Manager ensures coverage. With the optional Request Manager, users enter absence and other requests online, and the Request Manager approves or denies requests based on potential coverage problems and other user defined rules. Request Manager uses a sophisticated algorithm that determines whether a given sub-specialist can be absent based on the number of sub-specialists required and the current list of providers who have already been approved for absence on that day. This allows the maximum number of providers to be off on a given day while ensuring that there will be no coverage problems.

Our Scheduler is no longer available

The scheduler who has been doing our schedule for 15 years is no longer available. What do we do now? Because of the complexity of schedules, schedulers have often acquired much domain knowledge on the logic required to create a good schedule. They may have picked up many tricks, which might involve a sequence of complex steps in producing schedules. Often, schedulers would create schedules in layers. If the scheduler is suddenly no longer able to do the schedule, this poses an operational risk to the group especially if there was no time to plan the transition.
Lightning Bolt NSight offers a medium of transferring scheduling know-how. With Lightning Bolt NSight, since the system is already configured to produce schedules automatically, a new scheduler only needs to learn to click the button to produce the schedule!!! As a result, the system continues to produce good schedules across this transitional period for the group.

Equitable distribution of work is not so easy

Vacation requests, the need to cover sub-specialty tasks, and work preferences of individual providers make it difficult to distribute work evenly across providers with unique scheduling profiles.
Lightning Bolt NSight schedules fairly. Lightning Bolt NSight allows you to specify your group’s definition of equality based on FTE values or specific target numbers for each provider. It keeps separate counters internally for each area that you want to track. For example, you could specify that weekends and holidays need to be tracked separately. The system can be configured to produces schedules that converge to desired tallies over the long run based on past periods.

Schedule creation and maintenance is time consuming.

Generating schedules takes several hours to several days. Even creating one week of schedule for a small group of physicians can take anywhere from several hours to several days. The difficulty increases dramatically with more physicians and/or more tasks to be scheduled.
Lightning Bolt NSight saves time. After defining the scheduling policies in the initial setup, Lightning Bolt NSight generates a new schedule on the click of a button. Once the system generates a schedule, users can modify it if desired. Lightning Bolt NSight typically reduces the time to create and maintain schedules by approximately 90%. The software typically pays for itself within the first year by saving time on producing schedules.

Schedules can be misplaced or outdated.

Schedules can be misplaced or outdated. Where is the latest schedule? Modifications often need to be made after the distribution of the initial schedule. For example, physicians may need to swap shifts with each other. Maintaining the current and latest schedule can be difficult if it's on a static piece of paper or on a spreadsheet on someone's computer.
Lightning Bolt NSight has the latest schedule. With Lightning Bolt NSight, there is a central place for the latest schedule. The schedule can also be published on a password protected website which can be viewed from anywhere you have internet connection. Users having sufficient access privileges can also swap shifts online, keeping the schedule current. These changes are not only reflected on the central website but also on any mobile device via calendar subscriptions which allows users to automatically sync their mobile device with the information on the Lightning Bolt web application.

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Noam Littman, M.D., Scheduling Physician

"This is, hands down, THE most service-oriented company I have ever dealt with."

Radiology Associates of Fox Valley, Neenah, WI
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