SPINFUSION. Software powering medicine TM

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1 At A Glance Group Name: Anesthesia Consultants, Incorporated Web Address: Group Location: Columbus, OH Group Size: 20 MDs, 19 CRNAs, 5+ Locums, 25+ SRNAs Momentia Since: June 2003 Hospital Culture 640 bed Level I trauma center serving Central Ohio Leadership strived to implement equitable scheduling algorithm for both MDs and CRNAs Came to SPINFUSION to replace aging standalone system which couldn t even handle addition of new personnel MD Call Schedule 1 st, 2 nd, 3 rd, Heart, Night call, 30+ rules MD Vacation Schedule Request-based, PTO bank CRNA Vacation Schedule Request-based, shared with MDs CRNA Shifts Manual entry by Chief CRNA SRNA Schedule Generated by SRNA program director Reporting 5 different daily reports Before & After Prior to contacting SPINFUSION, group was using standalone scheduling software for 3 years to handle complicated rule-based call schedule generation. Software required 80% correction for all schedules made. Other problems included: Vacation was granted on first-come first serve basis one year in advance; lead to line forming for holiday vacation at 12:01am Vacation acceptance turn around time of 2 weeks Call Schedule generation was exceptionally time consuming, schedule was never released more than 1 month in advance, MDs couldn t make plans ahead of time Reports created done by hand, extremely time-consuming No central repository of schedules, various copies that weren t dynamically updated Master vacation book stored in office, unavailable offsite or after hours MOMENTIA was able to effectively generate department schedules exactly as the department leadership wanted. In particular: MD/CRNA Vacation Book All stats updated automatically, requests approved automatically, lottery implemented to fairly grant holiday vacations Department Accessibility All MDs, CRNAs, SRNAs, spouses of department members can view all schedules both inside hospital and outside hospital; anywhere Internet is available Automation of MD Call Schedule MD Call Schedule generated automatically in 5 minutes, implementing 30+ rules, schedule was created/released for 6 months in advance Complex Reporting Daily reports with same format generated automatically to track daily assignments, offsite assignments, and rule-based recursive MD outlist MOMENTIA SCHEDULING Simple. Powerful. Optimal. TM

2 Scheduling Paradigm Vacation Book online: Momentia uses the following algorithm (as define by ACI) to approve or deny vacation requests 1. Physicians/CRNAs may request vacation that will be accepted/rejected based on following rules (in order of precedence): a. Can not request weekend, automatically determined b. Vacation must be for > 24 hours from time of request c. Vacation may not be requested > 12 months in advance i. 12 months is determined using date of first Saturday requested for vacation ii. Must be past the date in current year to request d. Must have been working > 90 days e. Must not be a blocked day (see Holiday pre assignment below) f. Must not be on physician call any of requested days g. Can not request more than 2 consecutive weeks (without administrative approval) h. Must be open slot for days requested i. Slots defined as follows: 1. 6 in June/July/August/last two weeks of March/first two weeks of April/Thanksgiving/Christmas/New Years a. Thanksgiving/Christmas/NY 4 docs/2 CRNAs 2. 5 rest of year ii. If some one requests an entire week, can bump person who has requested partial week i. Must have PTO time available in bank i. CRNAs administrator can enter sick days in vacation book which will generate for unpaid vacation ii. Physicians Partners will have an generated to them and administrator on anniversary date indicating additional vacation that they need to pay for j. If above criteria are satisfied, vacation is granted 2. Cancellations a. Cancellations will be accepted unconditionally b. If < one month away, PTO time will not be returned 3. Weekend vacation a. Weekend vacations are automatically granted as follows: i. Full week Weekend before/after ii. Mon/Tue Weekend before iii. Thu/Fri Weekend after 4. PTO Bank a. Receive PTO based on Anniversary Date and employment b. Year for PTO is from anniversary one year to the next c. Holidays are not deducted from PTO d. No rollover of PTO Bank e. Anniversary Date information supplied (see #4 example packet) 5. Barter system a. Two employees may trade vacations if both parties agree b. One employee may give up his vacation to another if both parties agree

3 Call Schedule: c. Change or switch will only be accepted if above rules for acceptance are satisfied 6. Holiday pre assignment a. Some holidays may be assigned in future based on rotating schedule or lottery 7. Wait list There is NO wait list or standby list Momentia uses over 30 different rules in a complex process to implement the following call schedule generation algorithm (again, as defined by ACI). General: Overview 1. Vacation supercedes any call, vacation changes made after call schedule must be approved by an administrator (to ensure that call is covered) 2. Can t be on call 2 days/nights in a row 3. Call schedule should be created six months in advance 4. Some doctors excluded from Heart Call (see example packet pg 5) 1. Need to fill the following slots Mon through Sun: 1 st, 2 nd, 3 rd, night call. 2. Need to fill the following slots Mon through Fri: Heart Call. 3. Rough rule of thumb: if not on vacation, during average 4 week month, will have 2 calls for 3 weeks and 1 call for 1 week Process 1. Vacation examined, exclude anyone on vacation from call for all type of calls 2. Use Holiday Call Schedule (see example packet, pg 1/2) to fill any calls in time period that occur on holidays a. Only assign 1 st, 2 nd, night call on holiday (based on rotation list) 3. Fill weekend night call (Sat/Sun night) and Thur 1 st Call (3 Physicians) a. One call physician for Sat/Sun b. Based on rotation (see example packet, pg 3) c. If person who is on rotating schedule is on vacation, then they are skipped until they are available again d. Thur 1 st call is same individual 4. Fill weekend call (3 Physicians) a. Can not be on vacation for weekend night call to be available b. Only 3 physicians needed for 2 days because: i. 1 st Call Sat 3 rd Call Sun ii. 2 nd Call Sat 2 nd Call Sun iii. 3rd Call Sat 1 st Call Sun c. To determine available use following algorithm i. Exclude anyone on weekend call in last 15 days ii. Make list of remaining physicians, rank ordering by most recently to most remotely covering call iii. Take 3 physicians on the bottom of the list (i.e. most remotely) iv. If you don t have enough then list last 15 days call individuals (start with most remote) v. Never put on more than 2 weekends in a row

4 vi. If still not enough, error out d. Once 3 physicians are selected, assign to 1 st, 2 nd, 3 rd call based on statistics of past assignments 5. Fill Night Call on Thursday (1 Physican) a. Make list of physicians on vacation following week b. Choose physician most remotely on Thursday call 6. Fill 2 nd, 3 rd, Heart Call on Thursday (3 Physicians) a. Take list from 5a. b. Fill calls in order (2 nd, 3 rd, Heart) c. If > 3 then pick based on stats, if < than 3 than pick from available based on stats 7. Fill rest of calls ( = 19 Physicians) a. Fill Friday Call (1 st, 2 nd, 3 rd, Heart, Night) b. Fill M W Nights i. Exclude Friday call from Monday (2 day rule) c. Fill 1 st /2 nd /3 rd /Heart M W (statistics only) i. Exclude Friday call from Monday (2 day rule) d. All are filled in above order based on: i. 15 day rule ii. Statistics 8. All vacations requests will be logged. Reporting ACI uses the gear functionality of Momentia (as explained in the product overview) to generate the following reports: Surgical Schedule Assignment Worksheet Per sample given, sheet will have check marks next to employees who are available, on call, and on vacation. This sheet will also total the number of employees available at the bottom, per example. TSSC Per sample given, will have date and the TSSC CRNAs who are available and who are on vacation. Daily Out List The daily out list will be generated as follows: 1. Number of slots to fill will be determined by physician available from Surgical Schedule Assignment worksheet 2. Last 4 slots will be filled with 1 st call, 2 nd call, 3 rd call, Heart Call a. On T F slot previous to this is the 5 th call slot 3. First 5 slots will be filled as follows: a. 1 st, 2 nd, 3 rd from previous day (including weekends) b. If M:

5 i. Previous Fri night call ii. Previous Fri 1 st call (unless already on the list) c. If T F: i. Previous day Heart Call ii. Previous Day 5 th Call 4. Fill slots in between as follows: a. Starting listing all call next day and forward until slots are filled (including weekends).