A checklist for healthcare scheduling: you can have your cake and eat it too

The first industrial revolution began in 1760 and lasted for about a hundred years, a by-product of which has been the well familiar 9 to 5 lifestyle. To much surprise, this has survived changes of the ages for the most part well into the fourth industrial revolution we are in.

Photo by Hush Naidoo

The first industrial revolution changed life on the planet where people in many communities moved from farms and household operations to work on production lines and factory businesses. To do the work, we needed to be together at the same place at the same time. Does that hold true for your job today? Do we all need to follow the same style of work? Today’s gig economy has shown us that when planned well, remote work and non-traditional ways of forming teams and working together can actually be more productive and can also create more happiness for us.

In many professions, like healthcare, remote work is mostly not a possibility. Although there are a number of platforms and tools created to enable telemedicine, face to face patient work is still a large component of the diagnosis and care processes. This is not to say that we cannot benefit from the flexibility, efficiency, and connectivity afforded through software and the Internet grid. The online psychotherapy tool (OPTT.ca) is a good example where technology overcomes the barriers of geography, time, culture, language, and stigma to deliver electronic cognitive behavioural therapy (e-CBT) for depression and anxiety disorders at times better than a face to face alternative.

Still for a patient on an ICU (intensive care unit) bed after an open heart surgery, the frontline providers of care are nurses and physicians who play God. They make the difference.

Photo by Hush Naidoo

Working conditions for these professionals have proved challenging for a variety of reasons. They work with distraught, stressed, and hurting patients and their families seeing them at their lowest lows. This at times requires the mental capacity and patience of buddhist monks. Their jobs are also physically demanding. From working many long hours and inhumane shifts to having to move heavy diagnosis and care equipment, to moving patients from a stretcher to a bed, they literally break their backs doing what they love to do.

Engineers and technologists are working hard to help. Scientists at the Toronto Rehab Institute are building tools and apparati to allow nurses to more easily move patients in their hospital beds without having to exert unsafe pressure to their bodies.

With an ever-shrinking tight healthcare budget, there is an increasing urgency to do more with less. Just how simple machines like levers and gears helped improve work in the first industrial revolution, now software, cloud-based tools, algorithms, and artificial intelligence (AI) are here to do the same for the fourth industrial revolution. After all, this is a revolution ushered by digital tools, Internet of Things (IoT) devices, and advance technologies.

One particular application of algorithms and AI is to help reduce the stress of the healthcare providers lives. Nurses’ number one complaint about their work is in fact their hours of work and their shifts. For physicians, the situation is a national catastrophe. Every day a doctor commits suicide due to stress and burnout. Hours of work are a major contributor of this very unfortunate reality. Certain specialties like emergency and intensive care suffer more than some others based on the US and Canadian data available. Burnout in this case is really what some refer to as moral injury. Our conscientious doctors are doubly suffering from the limitations around them where they cannot do what they worked so hard to do: to save lives and improve their patients’ conditions and outcomes. On the one hand, they have to do more paperwork, more administrative work, all while on the other hand, their longer hours of work are creating many work-life conflicts they simply cannot resolve on their own.

Technology promises to help but data shows bad designs have made platforms like electronic health/medical records (EHR/EMR) more of a problem than a solution.

Photo by Markus Spiske

One particular product is here to do good. MESHAI designed by MESH Scheduling Inc., a Kingston-Ontario-based tech company, has been called the first tool for Socially Intelligent Staff Scheduling (SISS) in healthcare. Designed by healthcare professionals, scientists, and world-renowned engineers, MESHAI gives some control back to healthcare professionals when it comes to when they work, how they do it, and with whom they team up to take care of their patients.

With MESHAI, medical staff provide their vacations, clinical, research, and teaching times to the platform. They then add their personal preferences. A single mother might need to be home by a certain hour to take care of her children no matter how frenetic things are in the ward. A physician with better nocturnal abilities might prefer evening shifts to open up 3- to 4-day weekends for other activities. We know they exist: some people actually prefer night shifts and we assume all people are treated the same when we do scheduling and shift planning. This is not efficient; it is just wrong. This is where you can have your cake and eat it too! If a nurse prefers a yoga class on Monday mornings with his favorite yogini or a doctor has started taking waltz classes with his husband, why not allow them to enjoy these if we can. We have heard c-level officers and administrators in hospitals tell us they can hardly work with the vacation requests from people, how can they even imagine allowing these individuals to add preferences. Well, “any sufficiently advanced technology is indistinguishable from magic” as Arthur C. Clarke said. Today this is a reality! If you asked a rider in New York city looking for a cab in 2001 if she would use her cell-phone to click a button and have a car pick her up in minutes, she would have a similar reaction to many of the health tech resistors we meet today.

It is time we thought differently. It is time we took good care of our frontline soldiers of healthcare. When we take care of our nurses and physicians, we are also taking care of our patients. Patient outcomes improve when medical teams work better together and are not stressed or exhausted.

MESHAI is a lot more than a scheduler. It is designed to detect productive patterns, antagonisms, and resource allocation strategies. Managers, administrators, and schedulers are ultimately always in control of when people do what. Yet, the algorithms and augmented intelligence (this is the AI of MESH AI) disguised behind its easy-to-use and beautiful user interfaces on the web, iOS and Android apps, allow them to save tremendous amounts of time in scheduling and the back and forth communications for it, reduce errors in scheduling and staffing, and they save money too.

MESHAI helps improve employee satisfaction and reduce nurse/hospitalist turnover. Hospitals and clinics are using it to recruit. “If they use MESHAI, it means they care for the health and well-being of their employees”, says a nurse applying for an open position in an Ontario hospital about her potential employers. A chief of staff at another hospital in Canada said: “MESH AI makes me and the hospital executive look great in front of our physicians.”

To make the most of your MESHAI and reap the maximum benefits, like all other software, you need to use it correctly. Our research over the past 5 years in Canada and the US has shown that the methods and processes used to schedule medical staff are as diverse of hays in a haystack. Almost no two units are scheduled entirely identically, even in the same hospital.

This is our 10-step checklist to get the most out of MESHAI:

  1. While your success with MESHAI is not dependent on buy-in or adoption rates among your staff, to maximize your benefits you want as many of your staff to be on the platform and using the MESHAI web, iOS, or Android apps as possible. Urge them to accept the system invitation and log in to join. Given them incentives and deadlines to join. One incentive can be that they can only add “preferences” if they use the MESHAI app.
  2. Schedules in healthcare can be created weekly, monthly, or even yearly. No matter how long your scheduling block is, plan a few weeks in advance and give your staff a deadline to enter in their approved, as well as to-be-approved vacation, on/off, and preference requests. They can even say whom they prefer to work with and not anonymously. The request types and the process to approve them are fully at the discretion of the admins and chiefs.
  3. If you plan to manually schedule your team, you are ready. Approve or reject the requests that have come in so that you can go to the next step. Do not worry about soft requests. Hard requests like approved vacations are not to be broken unless you are ready for some angry people at your door or a union grievance case. Soft requests like “I like to be off Monday mornings to do my favorite yoga class” are only accommodated if all other needs and requirements are satisfied fully. If so, then why not! It’s good karma for sure.
  4. If you also plan to use the MESH Auto-scheduler, the state-of-the-art proprietary AI-enabled engine, make sure you have the right “rules” and scheduling constraints added to your team. These can be picked from a rule menu with a few clicks by the team admin. You can also contact the MESHAI Concierge service to do this for you at no extra cost. They are always there to help. If you have a rule that is not listed, don’t be sad or surprised. Like we said before, no two healthcare units are created the same. Ask the MESHAI concierge and they would develop and add the rule for you. This is done at no cost or depending on the level of complexity for a small one-time fee ($100-$500).
  5. You can now press the MESH Auto-scheduler button and leave to go for a walk or a cup of coffee. Come back and see the magic of MESHAI with your own eyes! Viola! Remember you can manually set some shifts before auto-scheduling or manually make changes after or like we note before do all of your shifts manually. The choice is all yours.
  6. We do urge you to use the MESH Auto-scheduler to benefit the most. Some teams with simpler schedule structure still use the automation provided to save time on having to pick people for each shift one by one. They let the system to randomly place people in shifts. Imagine the fairness this brings to your team. Bye bye favoritism! Make sure your staff know this is how you do the shifts. No more angry people knocking on your door.
  7. Check the schedule quality page to gain insights about your current scheduling period. Here you can see the distribution of shifts and hours among people, days of the week, weekends, special days, etc. This provides one more opportunity to find anomalies and make manual changes before you finalize the schedule.
  8. When all the checks and edits are done, you should be ready to show off your new MESHed Schedule. Go ahead and publish the schedule to your staff. The schedule is now available on an anytime-anywhere basis to all. No lags, no errors via MESHAI apps.
  9. MESHAI also allows staff to connect their favorite calendars to the tool. As such, shifts will also appear on Outlook, Google, or Apple calendars seamlessly. Make sure you remind your staff of this function and that changes after schedule publication such as swaps are still handled easily via the MESHAI apps.
  10. Life does not happen on a schedule. Transparency and ease of schedule management are the other key benefits of MESHAI. Show your staff how they can use the schedule analytics page to see the quality and quantity metrics for the schedule they are a part of. They can see how many weekends they do in relation to others for example. If they have a change of heart for the time of their vacation in Hawaii or get stuck at home with a nasty flu, then use the MESH Bazaar tool to let the team and managers to know in time. The entire process, be it asking the team to help out or swapping with a colleague is handled seamlessly on the MESHAI apps. Never to worry about a thing as managers are still in full view and can decide what to control or approve. And by the way, absolutely every action on the platform is logged for future reference and reporting needs.

MESHAI is in a busy market of many scheduling apps. What sets it apart from others, in addition to its secret scheduling algorithms and engine as well as simple under interface, is it’s approach and mission. It does not do scheduling better. It just does it “differently”. The venture is on a mission to change the way people think about shift work in healthcare on both sides of the isle: employees as well as employers and admins.

A 2019 scheduler is not just about scheduling people into shifts; we have done this for more than a hundred years. It is time we got to know who our colleagues are and what they need: what their work-life conflicts demand from them. A socially intelligent staff scheduling tool creates a culture of team-work, it democratizes the time planning process, and it sends good karma all around. MESHAI is a creator of better culture — a sustainable and harmonious culture. Let’s engineer a better healthcare system together.