Date Published: March 22, 2017
Publisher: Public Library of Science
Author(s): Rodrigo Octávio Deliberato, Leonardo Lima Rocha, Alex Heitor Lima, Caroline Reis Maia Santiago, Jose Cláudio Cyrineu Terra, Alon Dagan, Leo Anthony Celi, Luís A. Nunes Amaral.
Physician shift schedules are regularly created manually, using paper or a shared online spreadsheet. Mistakes are not unusual, leading to last minute scrambles to cover a shift. We developed a web-based shift scheduling system and a mobile application tool to facilitate both the monthly scheduling and shift exchanges between physicians. The primary objective was to compare physician satisfaction before and after the mobile application implementation.
Over a 9-month period, three surveys, using the 4-point Likert type scale were performed to assess the physician satisfaction. The first survey was conducted three months prior mobile application release, a second survey three months after implementation and the last survey six months after.
51 (77%) of the physicians answered the baseline survey. Of those, 32 (63%) were males with a mean age of 37.8 ± 5.5 years. Prior to the mobile application implementation, 36 (70%) of the responders were using more than one method to carry out shift exchanges and only 20 (40%) were using the official department report sheet to document shift exchanges. The second and third survey were answered by 48 (73%) physicians. Forty-eight (98%) of them found the mobile application easy or very easy to install and 47 (96%) did not want to go back to the previous method. Regarding physician satisfaction, at baseline 37% of the physicians were unsatisfied or very unsatisfied with shift scheduling. After the mobile application was implementation, only 4% reported being unsatisfied (OR = 0.11, p < 0.001). The satisfaction level improved from 63% to 96% between the first and the last survey. Satisfaction levels significantly increased between the three time points (OR = 13.33, p < 0.001). Our web and mobile phone-based scheduling system resulted in better physician satisfaction.
One of the major challenges facing medical centers around the world is the ever more complicated task of physician scheduling . Every day physicians are dealing with multiple schedules: their personal appointments, their research responsibilities, and their clinical shifts. Often these professionals work in multiple clinical settings over different periods of time. Still, it is very common for shift schedules to be under the jurisdiction of a person, often using some calendar on paper or as a “gatekeeper” of an online spreadsheet. The process of constructing a schedule or accepting a shift exchange, is complex, time consuming and requires the physicians to use multiple communication tools including emails, phone calls and messages.
A total of 51 (77%) physicians completed the baseline survey, 50 (98%) of them owned a smartphone, 32 (63%) were male, with a mean age of 37.8 ± 5.5 years (ranging from 29 to 57 years). The average time since medical school graduation was 13.6 ± 5.6 years with 10.1 ± 6.0 years dedicated to the practice of critical care specialty. Thirty-six (70%) physicians were using several routes for shift exchanges. Fifty-one (100%) of the responders were using WhatsApp, 30 (59%) regular phone call, 21 (41%) regular SMS and 8 (16%) email. Regarding the usage of the current shift exchange method(s), before the digital scheduling system implementation, close to 23 (45%) reported that they used it at least once per week, 12 (24%) fortnightly and 16 (31%) monthly.
Our study showed that a mobile application with a web interface improved and sustained physician satisfaction with shift exchanges that were done faster, more easily and more reliably. Factors that contributed to the success of the project include dissatisfaction with the previous system, the ubiquity and physician familiarity with smartphone technology, and the involvement of clinicians throughout the software development process.
Creating a shift schedule that accommodates the departmental requirements, labor work hour regulations and physician preferences and requests has been challenging. In this study we demonstrate that a multi-platform digital system designed by a cross-disciplinary development team significantly improved the physician experience with the complex task of scheduling. The success of this project is a testament to the value of collaborative innovation between clinicians and IT experts.