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Hospitalist Shift Scheduling: Finding the Work-Life Balance

According to the American Hospital Association, more than 5,500 U.S. hospitals serve 35 million admitted patients each year. The vast majority of those patients are cared for by more than 57,000 hospitalists – physicians (typically internists) who work exclusively with hospital patients. The unique nature of hospitalist shift scheduling creates a tension between the need for continuity of care and the need for the provider to achieve a reasonable work-life balance.

Typical Hospitalist Shift Scheduling

Three out of four hospitalist groups use shift scheduling to develop work calendars. It’s most common to use block schedules of seven days of 12-hour shifts, followed by seven days off, although five-day block schedules are also utilized. The idea behind block schedules is that the continuity of care provided by hospitalists improves patient outcomes and reduces readmissions, which both increases patient satisfaction and lowers costs.

Approximately 35 percent of hospitalists report working mostly daytime shifts with occasional night shifts, although one in five says they only work day shifts. In recent years, there has been a marked increase in – and demand for – nocturnists, hospitalists who exclusively work night shifts. Nocturnists provide complete nighttime coverage for 38 percent of hospitalist adult practices.

The Impact on Work-Life Balance

Hospitalist shift scheduling has been treated as a one-size-fits-all solution, but hospitalists are sounding the alarm that schedule rigidity results in poor work-life balance and increased physician burnout. While hospitalists are often forced to put their lives on hold during their work blocks, some hospitalist practices are opting for more flexibility. For example, a hospitalist group may pair hospitalists who seek similar schedules, so that one pair could work seven days on/seven days off, another pair could work 14 days on/14 days off, and a third pair could work five days on/five days off. This model can also enable physicians who want to earn more to work more, and those who want to work fewer days to do so.

Nocturnists are becoming more vocal about the necessity of hospitalist shift scheduling that adapts to their needs. Taking a page from research on shift work in other occupations, nocturnists suggest that it is more appropriate to work fewer shifts – such as three on/three off – as well as shorter 10-hour shifts. They also advocate adjustments to how shift change communications occur and how nocturnists can participate in the larger hospital culture.

Hospitalists Bridge the Gaps

The role of hospitalists encompasses more than doing rounds to check on admitted patients. Researchers have found that hospitalists touch virtually every part of the hospital, including the recovery room, the emergency department, and labor and delivery. They are the hub of communications among hospital staff, surgeons and primary care physicians, as well as patients and their families. They develop treatment plans and perform medical procedures. And, at teaching hospitals, they supervise interns and residents.

In order to prevent physician burnout and improve work-life balance, hospitalists deserve to have a voice in how their schedules are structured. With MDsyncNET, hospitalist shift scheduling can be streamlined. The system is designed to be flexible in order to meet the scheduling needs and demands of hospitalists and nocturnists, schedule changes can be made quickly, and up-to-the-minute schedules are available on any connected desktop or mobile device.

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