4 Reasons Why Emergency Department Scheduling is So Complex

The trends are clear: emergency department scheduling is one of the most complex of all physician scheduling, and is getting ever more complicated. Because there are more groups to juggle, emergency department schedules are more complex than OB-GYN schedules, pulmonology schedules, and anesthesiology schedules. A confluence of factors contribute to emergency medicine scheduling complexity, including:

1. Use of Locum Tenens Physicians

A 2022 AMN Healthcare survey on temporary physician staffing trends revealed that 88 percent of healthcare organizations utilized locum tenens providers in the previous year, a slight increase from 84 percent in 2019. Emergency medicine physicians continued to be in high demand, ranking among the most requested types of locum tenens doctors. Notably, 47 percent of healthcare facility managers reported actively seeking temporary emergency physicians, a significant rise from just 8 percent in 2014. The survey highlighted that 70 percent of facilities relied on locum tenens primarily to fill gaps until permanent staff could be hired, reflecting ongoing challenges in maintaining adequate staffing levels amid rising patient needs.

Locum tenens physicians may fill in for regularly scheduled emergency department physicians, or – more often – may be used to supplement employed physicians in order to meet the fluctuating demands of the department. These temporary physician shifts must be incorporated into an already complex schedule.

2. Emergency Departments Open 24/7

Unlike medical clinics, which have limited hours of operation, emergency departments are open 24 hours per day, 7 days per week, 365 days per year. That requires 8,760 hours of physician staffing. Emergency medicine scheduling has to take a number of factors into account, including cost-effective care, the historical patient census, patient safety, patient satisfaction, and physician satisfaction. The ebb and flow of emergency department usage may have a predictable pattern throughout a given day or over the course of a week, but it keeps the schedule in flux. As a result, the schedule must be adaptable to required changes and accessible to all staff members.

3. Cost-Effective Scheduling

Hospitals are increasingly aware of budgetary constraints and the need to do more with less. In other words, they must balance the needs of the patient with the economic drivers of the facility. As a result, family practice or internal medicine physicians with emergency medicine experience may outnumber board-certified emergency medicine physicians during a given shift. Similarly, additional physician assistants might be scheduled prior to scheduling a second or third emergency medicine physician. Juggling economic priorities along with the needs of individual physicians can be challenging and further complicate the schedule.

4. Increased Awareness of Shift Work

While emergency departments are open 24/7, the human body isn’t designed to work 24/7. Indeed, the American College of Emergency Physicians has staked out a position against scheduling rotating shifts that interfere with circadian rhythms. ACEP advocates for shifts that are 12 hours or less and that rotate in a clockwise manner. The organization encourages schedulers to consider time off between shifts and the total number of hours worked by emergency room physicians when creating schedules. These considerations further complicate emergency medicine scheduling.

Designing an effective emergency medicine schedule requires serving many stakeholders. MDsyncNET’s cloud-based emergency medicine scheduling platform enables flexible scheduling and real-time access by authorized users within or outside of the emergency department.