6 pitfalls in hospital workforce planning and how you can avoid them

A hospital’s duty roster plays a key role in determining long-term economic success, attractiveness for employees and high quality of care. We show the most common pitfalls in duty scheduling and how you can avoid them.

1. Stumbling block: needs-based and employee-friendly planning are seen as a contradiction in terms

An apparent conflict of interest between the employer and employees can quickly lead to conflicts. Hospitals should guarantee high-quality, patient-specific and needs-based care for the population (Hospital Financing Act, Section 1, Paragraph 1). Employee-friendly planning is desirable for the workforce. In the absence of communication, these different goals can lead to the fallacy of an apparent conflict of goals.

Example: The patient traffic in the emergency room follows a certain pattern with a peak in the morning, a peak in the afternoon and a reduced volume overnight. In practice, good compromises can usually be found between attractive working hours and needs-based care.

Our tip: Do not regard needs-based and employee-friendly planning as a contradiction, but as mutually dependent factors! Employee-friendly planning strengthens employee loyalty and thus economic success. Efficient and well-structured planning, in turn, leads to higher employee satisfaction!

2. Stumbling block: Inadequate communication between those responsible for the duty roster and those to be planned

In order to avoid stumbling block 1, good communication between employees and those responsible for the duty roster is a basic requirement.

Example: As a rule, late shifts are rather unpopular. Therefore, the planner pursues the goal of distributing this as fair and evenly as possible among the workforce. In fact, an employee likes to work the late shift due to his or her personal circumstances.

In this example, due to a lack of communication, the planner overlooks a solution that would be much more pleasant for everyone involved.

Our tip: Make it as easy as possible for your employees to communicate with you! A good software solution can significantly support this communication. This enables planners to take into account the wishes of all employees and to create the plan that best suits everyone with little effort. For the employees, on the other hand, it not only becomes easier to communicate wishes, but they also gain insight into the basis of decision-making and can thus better understand the process.

3. Stumbling block: Qualification concepts are not adequately illustrated

The clinical pictures of patients are diverse – employees have different skills. The task of duty scheduling is to assign the right tasks to the right employees at the right time. To make this possible, a differentiated qualification concept is required.

Example: A service called “specialist on-call service” is to be filled.

  • Due to the required experience, this must be filled by a specialist.
  • Alternatively, an experienced assistant doctor is also possible shortly before the end of the training.
  • In the second preference, the service can also be manned by a senior doctor.
  • The on-call service cannot be manned by a person who carries out their consultation hour on the following day.
  • The service should not be occupied at the weekend by employees who are part-time during parental leave, as they only have limited opportunities to compensate for overtime.
  • When staffing the service, it must be ensured that not both doctors assigned to a ward are absent on the following day.

In practice, seemingly simple requirements such as “specialist” hide many nuances that need to be addressed. Experienced duty roster managers can usually assign a large part of these nuances to the employees from their heads. Since, depending on the collective agreement, the duty roster has to be made well in advance of up to two months, it is extremely difficult to keep all the details in mind at the same time.

Our tip: The qualification concept on which the duty roster is based must make it possible to define qualifications that are not free of overlaps as well as multi-layered qualifications. Ideally, this multilayeredness is supported by software. The PLANFOX personnel deployment planning software, which was specially developed for the hospital environment, integrates a multi-layered, differentiated qualification concept so that all information is always available at a glance.

4. Stumbling block: duty roster is structured from the wrong end

The ultimate goal of duty scheduling is to assign employees to tasks. The mistake is often made here of structuring planning steps based on their chronological order. If only one or a few people have the expertise and there is also no transparent documentation, this can have negative effects in several ways. On the one hand, the cognitive and manual effort for the duty roster managers is extremely high, which can impair the quality of planning due to careless mistakes or lack of clarity. On the other hand, dissatisfaction can arise among employees because decision-making processes are not transparent or because there is an unfair distribution because historical assignments are not taken into account. In addition, sickness, vacation or departure of the duty roster are associated with a great loss of information, which cannot always be completely compensated by a substitute or a successor.

Example: The restructuring of the roster of a hospital fails.

  • In order to ensure that enough staff is available throughout the year, an estimate should be made based on past experience of how many people can take vacation at the same time without chaos breaking out.
  • The process of creating the roster is structured in such a way that the duties are distributed to all available employees in the best possible way.
  • At the end of the day, not all tasks can be filled in the daily planning. What went wrong?

Our tip: think from the goal! You get the best structure if you think from the actual goal, the assignment of employees to tasks:

  • Which tasks have to be filled in the end and which qualifications are required for them?
  • Which services result from these tasks and must therefore be assigned via the duty roster?
  • How many employees are required when and with what qualifications to fill the services and tasks (annual vacation planning)?

This principle of backward induction has been known for a long time and is used, among other things, in route planning. A particular challenge in the hospital environment takes place between the lines:

  • In what percentage of cases is it justifiable that a certain task remains vacant (administrative tasks vs. emergency doctor service)?
  • Which buffers have to be included for short-term absences (e.g. illness)?
  • Which buffers have to be taken into account for medium-term absences (e.g. parental leave, fluctuation balance)?

By consistently carrying out these steps, you will achieve objective planning, which will allow you to have your service level and your efficiency completely in your own hands!

You can find further information on the subject of structuring in our video contribution “Duty planning well solved – How structures and rules improve the quality of your planning” .

5. Stumbling block: Lack of or inadequate absence planning

Early vacation and absence planning based on the needs and wishes of employees is essential for robust duty planning. If the planning is too short-term or too rough, there may be bottlenecks in the coverage of requirements. The necessary rescheduling results in enormous effort and inconvenience.

Example: Before the duty roster is created, five employees are absent in the first week of a month if the needs are the same, while only three employees are absent in two weeks and only one employee in one week.

In order to be able to complete all tasks in the event of underfunding, improvisation has to be carried out under high stress on the employees and a high communication effort. This leads to dissatisfaction among staff and increased planning effort. Even the case of a significant surplus of requirements only appears to be unproblematic at first glance: The supposedly comfortable buffer at this point leads to accumulating vacation entitlements and high overtime accounts if the supply is efficient.

Our tip: In the long term, this problem should be countered by absence planning that provides a buffer for absences due to parental leave, illness, etc. for each qualification. In the short term, in the event of excess coverage, employees should be given the opportunity to reduce overtime or take additional vacation.

The PLANFOX personnel deployment planning software addresses these requirements by means of the innovative concept of multi-layered, overlapping qualifications in absence planning: Requirements and offers are automatically coordinated with one another on the basis of a multi-layered qualification logic, so that sufficient staff with the right qualifications is always available.

6. Stumbling block: The complexity of duty scheduling is underestimated

Anyone can assign tasks to employees? In principle yes, but the decisive factor is the quality of the duty roster.

Example: Often, two types of duty roster can be found in practice: The first type spends any amount of time to create a duty roster that does justice to all employees down to the last detail. The second type creates a roster in much less time, but not all of them Employee wishes taken into account.

The creation of duty rosters is highly complex and includes needs, qualifications, legal requirements, training aspects and employee wishes as well as many other aspects. If planning is carried out manually, experts plan on the basis of knowledge and rules that they have acquired over several years. This requires high cognitive performance and a considerable investment of time. To master the complexity, structures are created intuitively that only exist in the minds of the planners and are not documented.

Our tip: Become the third type of duty planner! By automating the duty roster, you can quickly create a duty roster that meets the needs of all employees. Non-transparent planning, careless mistakes and challenges when handing over the planning task are a thing of the past.

Do not you believe? Let our experts convince you!

Author and contact person

As a Senior Consultant at XITASO Healthcare, Dr. Sebastian McRae Expert for optimization solutions with a mathematical-scientific background in the hospital environment.


Share this post
Other relevant posts