Ensuring fairness in duty scheduling in hospitals and clinics does not seem to be an easy task. Not only since the changes in the collective agreement for doctors at municipal hospitals in May 2019, the Amendment of the TV Doctors TdL , which was decided in March 2020 by the Marburger Bund and the collective bargaining association of German states, and the Changes to the guidelines for employment contracts in the facilities of the German Caritas Association (AVR-Caritas) from June 2020 , duty scheduling in hospitals has proven to be a particular challenge, especially in the area of weekend work and on-call duty. With the new versions of these collective agreements, an adjustment of the remuneration and limitations of weekend and on-call duties are connected, which again increases the complexity of the design of duty rosters significantly. But the question of fairness in duty roster planning in hospitals is as old as the creation of duty roster itself.
Nevertheless, the topic is currently more explosive than ever. The topicality of the topic of “fairness in duty scheduling” is also in the context of a changing world of work, mostly summarized under the catchphrase “New Work”, in which the medical profession also expresses the need for flexibility in working hours or the compatibility of family and work . The fact that family and private life usually take place on the weekend may explain the unpopularity of weekend services.
But even if weekend shifts are often a major factor in the doctors’ satisfaction with their duty roster, it is not enough to focus solely on this. Night and on-call duty must also be included when considering fair duty rosters. Because it is not the specific services that affect medical staff in their work and leisure activities and occasionally cause frustration, but primarily any kind of undesirable work outside of normal working hours. By minimizing their number and taking into account the staff’s requests for duty, you can create fairness in duty scheduling.
That this seems to contradict the shift models in hospitals and clinics is only the case at first glance. Because with the right duty scheduling, in addition to legal rules and regulations, aspects such as fairness, flexibility and duty requests can also be agreed.
How to create fair duty rosters
- Define the term fairness for yourself and your employees, e.g. whether an equal distribution of services is more important to you or a higher rate of fulfillment of service requests.
- Together with your employees, identify which services and combinations are perceived as unpopular or exhausting.
- Make sure that at least these services and combinations are distributed fairly among your employees.
- Define periods in which you want to implement your definition of fairness, e.g. quarterly, and evaluate the implementation.
- Bring your definition of fairness in line with other planning goals such as legal frameworks or collective agreements.
- Obtain individual service requests from your employees.
- Ensure transparency when entering your employees’ service requests and thereby support self-scheduling.
- Create opportunities for interaction between your employees, e.g. an exchange platform for services, with which you improve communication channels and relieve your planning.
What does fairness mean in duty roster?
This raises the question of what fairness actually means in relation to hospital services outside of the norm. There is no generally applicable definition of fairness in practice. In research there are various approaches and recommendations for integrating aspects of fairness into the design of the duty roster. Which of these are implemented in practice is individually defined by the respective clinic or specialist department. And how “fair” or “unfair” these plans are then judged by the medical profession also differs from person to person.
Some employees may perceive it as fair if weekend and on-call duties are shared equally among the workforce. On the other hand, depending on the personal situation, it may even be advantageous for the staff to complete more duties than a duty roster based on an equal distribution would allow, be it for financial or other reasons. In the vast majority of cases, however, it will be perceived as fair if the individual service requests of the workforce as a whole are taken into account as well as possible.
The first thing to do here is to define the term fairness for yourself, your clinic and its employees, so that it can be incorporated into the creation of the duty roster.
PLANFOX not only focuses on automated personnel deployment planning and precise determination of personnel requirements, but also on guaranteeing the respective definition of fairness in duty scheduling, such as taking individual wishes into account. Practical experience from clinics such as the Clinic for Anesthesiology at Klinikum rechts der Isar (MRI) and current research results from the Chair for Health Care Operations / Health Information Management at the Faculty of Economics at the University of Augsburg have been incorporated into the development. With this expertise, the PLANFOX personnel deployment planning can map the respective definition of fairness in the software.
