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Schedules 2016-2017

Page history last edited by Rachel Dahms 4 years, 8 months ago

Chiefs,

Here you are., 10 pages of scheduling considerations.  Yay!!  It may seem overwhelming, but I think it is better to have all the details collected in one place with some form of organization.  There are lots of concrete things here, and some decisions yet to be made.  Hopefully this will get your creative thoughts twirling in a good way.  If it makes you sob and consider quitting, call me and we’ll go out for a beer or coffee.    Please ask about anything that does not make perfect sense, or if there is anything you disagree with. 

 

Here are the known changes/issues for 2018-2019

 

Changing intern class to 11 blocks

MICU for G1s and G2 moving to overlap, left extra vacation space in mid-year (aks holidays)

Moving G1 EMS to 3 1-week mini-blocks

???moving Ultrasthesia to 3 1-week blocks??? (Peter said meh, Mike said sounds great)

? Have additional person for G2 teaching on days when there is sim session 

Baker needs elective 3rd block, has a wedding in July

Priya has wedding in July

Boys maternity leave block 1+

Wellborn needs elective in July

Andrea W wants to swap elective and community (will mess with backup/pull) Jan of G2 year

Need extra coverage for the evening AFTER the wellness retreat

Wellness retreat

Need to set PA dinner date (don’t have it the second Tuesday since it interferes with procedure lab

Adding q Tuesday C pod shift for (interns vs everyone?) with additional resident staffing from additional resident

Decide on continuing G3 nighthawk, whether to do G2?

C Pods are always 12noon....

Decide whether to have different coverage the day AFTER graduation

G3 and Wendy Woster question....make Hudson shifts DRIP?  

Consider fixing split block schedules—-SPK, SICU.  

Move 2019 graduation to a NON-Thursday to help PA coverage.  (Non Wednesday too)

Consider coverage changes for G3 dinner, ??make G2 dinner

Nighthawk Chief should prob not be admin call

Priya...was 3 SICU blocks as G2 but gave one to Tyler...?what to do with her blocks G3 year? 

Consider giving people their birthday off?  

Keep special bonus Friday, could stay intern or be anyone

Pre-set conference presenters vs do schedule first?  

Pre-set IPL vs do schedule first

Set ITE exam date

Get vacation requests, they really cant overlap much....

Set a chief for all interview dates, two for UMN day?  

Is intern ATLS all in one group?  

SPK—keep shifts 3-11.  ADD sim to schedule?  Keep PULL G2 overlap (SPK is never backup)

Decide whether to keep shiftadmin, hand schedule, self-scheduling?  

 

 

Tasks for the chief(s) making the schedule:

 

1.
READ the ACGME/RRC-EM duty hours rules online.  These are your main rules. 
2. READ the residency policies on scheduling, vacations, leaves, backup/pull, moonlighting. These are your corollary rules.  Actually all the chiefs should take a moment to read all the policies on the residency website, plus find the contact information there for us and for off-service liaisons and such…)
3.   Set and double check block schedule dates—see all the complexities below about transition dates.  Schedules are kept on the EMD W drive under SCHEDULE/Residents.  Lori can help map you to the W drive if needed. 
4.   Rachel/lori/amy/cullen to review block schedules 
5.   Send out block schedule requests to residents, with deadline 
6.   Confirm which G3s have specific elective plans that would affect the schedule.  
7.  Assign and tweak block schedules for specific residents based on electives, extra SICU, other variables.
8. Get vacation requests and leave guesses from the residents, with deadline
9. Assign vacations within the blocks
10. Set and confirm special dates throughout the year (see below)
11.   Finalize block schedules 
12.

Discuss and finalize changes to the ER schedules (Cullen/rachel/kurt/joe u/lori/chiefs)—start and end times, c pod shifts, bonus Fridays, who works swing when, others….

13. Confirm preferred days of the week with US and EMS folks
14.  Check on G2 HCMC swap interest
15.  Get community site preferences, assign 
16.  Decide on hand-scheduling vs ShiftAdmin
17.

ED schedule creation—ONE block only at first

18. 

Rachel to review and amend July Block 1 schedule

19.  Publish block 1
20. ED schedule creation review and revisions for remaining blocks
21.  Publish blocks 2-10
22.  PRINT COPIES of schedule on the day you publish it.  Mistakes get made and this is the “original” record. 

 

Goals and clinical data:

  • Clinical goal for all residents is 40-45 hours per week when in the emergency department, with total hours goal 45-50.  This does not include ROD shifts, pull.  It does include backup from the ED.  JFacs count as clinical shifts. 
  • One could argue that EMS shifts for the interns are not clinical shifts either, but we currently count them as such. Ultrasthesia is clinical too. 
  • We count Children's Hospital shifts as the same length as Regions Hospital shifts (9 hrs).
  • In the past we had said residents wouldn’t be scheduled for more than 5 shifts in a row, last year it went to 6 in some cases. I’d personally advocate that it go back to max of 5. 
  • It is worth it for you to look up/read the ACGME/RRC-EM duty hour restrictions and review the residency policies on scheduling things.  (google ACGME emergency medicine duty hours).
  • In 2015 we changed the shift start and stop times to reflect 8 hr shifts, continuing to count each shift as 9 hours towards duty hours.

 

Block schedules:

  • Now is the right time to look at the block schedules and reassign dates of block beginnings and endings.  Blocks are ~36.5 days but this is a little flexible.  We had switched in 2013 so that the blocks did not transition on weekends for most services (too hard to orient, staffing is often minimal). Thursday transitions are bad because of conference.  Holiday transitions are not great either (any bank holiday).  MICU block changes should not happen on Mondays because the attending changes that day.  SICU transitions should not happen onto evening/night shifts for the G2, as they have to start on a day shift.
  • The block schedules and templates are on the W drive, under SCHEDULE, Residents.  If you don’t have W access Lori can help map you to it. 
  • Several block schedules are already set--specifically for the 3rd years.  Pre-arranged electives (see below) and the no-SICU blocks are already set. Blocks may be set or limited for people expecting babies.
  • Procedure labs have set dates and need to be worked into the schedule. (2nd Tuesday of the month, running August through May.  July is PA residents, June is PEM Fellows—but you don’t schedule those other guys).  So we schedule for Aug-May.  Usually G1-G2-G3.  The lab during SAEM works better if it is G2-G2-G3, and make some other lab in the year G1-G1-G3 (earlier in the year is better since interns need the experience the most).  Days for the lab can come from ED, other blocks.  Can’t have backup or pull get in the way of a procedure lab.
  • We avoided taking backup/pull from certain rotations last year.  We can readdress the specifics of this.
  • We make sure that the 2nd year on the MICU does not take vacation until the end of the block, as leaving earlier may leave the intern with less support and create badness.
  • G2 SICU needs to be split into 2 half-blocks.  Transitions absolutely CAN NOT happen with the G2 doing the first shift on nights. 
  • Should we keep TWO G2s working an extra SICU block, or is it the right thing to transition this year to only covering the last half-block? 
  • G2 SPKids was split into 2 half-blocks in 2015.  Transitions can happen whenever.  You may want to consider holiday coverage overall (thanksgiving, Xmas, New Year’s) if one day in either direction matters at all.   
  • Block schedules can be tweaked before sending out to meet specific needs—We try to take leaves from rotations that are not the ED or ICUs. 
  • Vacations---cannot happen during ITE unless the resident arranges to take the test at another site with another residency on the same day.
  • Maria and Mark got the vacation shaft last year because they turned their requests in after the deadline.  They should get 2 blocks of vacation together this year, assuming they get their requests in on time. 
  • Noah is doing Community in Block 1, BBrindle is working his ER block for him—so he needs to start on an ER block. 
  • Block 2 BBrindle wants to work Lakeview shifts.  She will do these in block 2 as she is extending through 8/18/16.
  • Brian Hahn and Maria did extra SICU blocks G3 so will work fewer blocks in 2016-2017.

 

ED rotation considerations:

  •  Decide about Shift Admin versus hand-scheduling templates.
  •  The residents tend to change from year to year in what they want in regards to schedule.  Residents have rejected circadian scheduling in the past, even though there is evidence to show that improves lifestyle and resilience.  You and I can discuss number of days on in a row versus off in a row.  In the past we have also discussed whether residents prefer a block progression of day-day-day shifts or day-evening-night shifts in a row. Everyone has a different opinion.
  •  The last several years, residents have generally had one full weekend off per block. But a golden weekend is not a promise or part of policy. 
  •  In 2014 we added an extra week of vacation to the G3s. 
  • Interns need time off for SAEM, from whatever rotation. 
  • There was again discussion this year (okay, grumbling) about how the template overlapped the winter holidays.  In the past we have not given promises of days off around the holidays. Do we want to change this? Splitting SPK and SICU in 2015 helped.
  • If there is not much to do on the ROD shifts on Mondays, should we look at doing something different?? Should the G2s have these Mondays to maximize time to do research and quality projects?  Or the G3s?  Set ROD days work best in a templated schedule. 
  • In the past the scheduling chief has made sure that no G3 works the night shift on last day of the year.
  • In the past we have discussed the possibility of Nighthawk month or blocks when working in the emergency department.  This adds a layer of complexity with a template schedule. Is it an opt-in, or is it mandated?  There is literature to suggest that blocking nights makes for more sanity. If we do shift admin this would be workable as a trial if we want.   
  • We have listed Wednesday evening shifts at Regions and SPK as ending at 1130PM to avoid conflicts with conference. 
  • Don’t forget to work in the chief shift differential.  And consider where that differential comes from—is it fewer clinical shifts, fewer JFACs? 
  • The rotator schedule in general is something we can discuss.  The good news is that you are not in charge of it! 
  • We have lots of dates that require extra tweaks—night before and day of inservice , PA spring social event, graduation for G3s, last night of the year, SAEM.  We have a G3 dinner yearly which could be scheduled in, and have talked about a G2 social event too.  The Thursday AFTER in-service needs day coverage and no conf call coverage.  Retreat, applicant interviews too. 
  • Remember the “Bonus Friday” shift, A eves q 3 weeks, continued throughout the year, covered by G2s and G3s in some mix. Continue the q3 from whatever it is now.  This was in exchange for the extra PA hours needed to abolish the Thursday Princess shifts. 
  • We do NOT EVER schedule residents to double back (have only 8 hrs off after a shift).  We do allow them to trade into this if they want. 
  • We have talked about having the PEM Fellow or other rotators work the night shift before conference.  I am not sure how to make this work in the schedule.  I’m open to ideas.
  • The actual scheduling for shifts needs to take into account the transitions between blocks….interns have issues with evening or night shifts before off-service rotations.  SICU transitions are known.  The move between MICU and Mpls Kids was a problem last year. Lots of other considerations about the first and last days of blocks. 
  • Sliver shifts were nor used at all in 2015.  There are a few days at the ends of some blocks (4 week rotation plus 1 week vaca leaves you 0.2 weeks leftover from the 5.2 week block)  Consider using these again, if only for Backup/Pull
  • We must maintain 1 day off in 7
  • In 2015 we just kept the 2014 Day shift scheduled as conference code coverage on Thursdays
  • What to do if we are short-staffed in the evening?  I call this the  “A-hole” protocol—you should know the details of this.  We should discuss if it is always the intern who moves to A if needed, as opposed to the PA.   
  • Add CONF to the actual schedule so we can see 1 day off in 7 better….
  • Some Thurs there is no conference….Thanksgiving this 2016.  Some years Xmas, New Years, July 4th are on Thursdays.  In-service, retreat, oral boards, more….
  • What are we doing with C pod and split flow?    HUUUUGE question. 
  • People overall wanted >24 hours off after a night shift when we did the discussion. 
  • For any of the transitions between off-svc and ED blocks, we can use the “sliver shifts” at the beginning and end of the rotation creatively to ensure transitions happen more easily. 
  • Steve Palm and Noah Maddy are in the National Guard and have required weekends for training.    It is worth checking with them for the specifics.   

 

Swing

  • Swing shift was a little different in 2014, with residents of different levels working swing shift on set days of the week.  Specifically, Interns were working the Saturday night shift.  We got feedback from some staff that having them on a weekend shift in the 1st half of the year is somewhat stressful.  It is probably best to have interns be the set Wednesday swing since they classically have the best ability to attend conference throughout the year.  We can discuss changing the set days—the set days work better in the templated schedule, but if we do shift admin it could go back to being flexible. Or not.  Swing, Flex, and RODs are where most of our schedule flexibility lies. Oh, and backups too…

 

ROD

  • Since 2013, ROD has been a set level resident on a set day.  This could change if we want.  In 2014 the 3rd year on the Friday ROD was always the person presenting critical case the next week.  In 2015 that uncoupled a little, and for a few weeks, the presenting resident was actually post-nights going into Thursday morning.  This should not happen again this year as we would like the presenters to be at their best, or at least coherent. In 2013 it was Monday ROD = Thurs crit case presenter, but I think people overall liked having a little bit more time to prepare their case, plus the added benefit of going out to lunch on Fridays. So I’d vote to keep Friday G3 ROD does next Thurs conference.  Your EDUCATIONAL CHIEF colleague should make sure that the trauma talks and other special presentations are not done by post-nights people. 
  • We sometimes double up the 2nd and 3rd year ROD shifts on Wednesdays because of the student workshops and super-exciting meetings. Lori can get you the few dates that ABSOLUTELY need to have a double ROD (double sim workshop days).  On days with no MS workshops, double ROD is not needed. 
  • The Chiefs may benefit from set ROD days so that they can attend meetings like Operations and Quality and GMEC and such.  Or not.  Front-load your shifts off since you transition around April-May to the next crop. 
  • Cullen has discussed scheduling a chief to be present at all interviews…
  • No RODS on holidays, or between big holidays and weekends.  Basically, if there is nothing going on in the ED offices administratively, don’t make a ROD come in. 
  • Consider scheduling upper-level resident ROD on Tuesdays to go to ultrasounds with the intern?
  • Since Friday G3 ROD does next week’s conference presentation, try to spread these out.  G3s end up giving ~5 critical cases each. But remember the weeks we don’t have conference—In-service, Thanksgiving, other Thursday conferences like TETNG, Retreat, Oral Boards….
  • Consider scheduling extra chief RODs for presence at applicant interview days, especially the Combined UMN interview day. 

 

Flex shift--AKA JFAC and C Pod,

  • We call the Jfac and C shifts “Flex shifts”.  These will be evening shifts, somewhere 3-11 or 2p-130a.  But with all the split flow discussions the details about the timing and clinical specifics are still in flux. 
  • We arbitrarily picked Tuesday for C pod shifts in 2014, and switched to Monday in 2015.  Monday made more sense because there is another MD in Pod D to help with staffing if we do continue to experiment with split flow.  Wednesday does not work because of conference, same thing for Thursday since the shifts are 5 PM to 1 AM.  Friday is also an option, but who wants to work even more Fridays? 
  • Until 2014, residents did flex shifts in the C pod for the 1st half of the year, and as junior faculty for the 2nd half of the year.  In 2014 we moved to a much higher proportion of junior faculty shifts. 

 

Backup/pull (BU/P)

  • In the past (pre-2013) we have had backup and pull start at different times during the day.  We can talk about the good versus bad of changing the start time.  Currently, with a 7 AM start, it means that the resident essentially needs either a day shift or a day off prior to a backup shift (for scheduling purposes….since we don’t schedule double-backs…..but residents can trade into a Backup/pull shift after an evening shift if they want). Current backup/pull covers D-E-N shifts.   A few years ago we had the shifts start with the night shift at 10-11 PM, so it covered N-D-E shifts. The benefit of this is that the backup day could come after a night shift. We can discuss.    It makes it easier to tag a backup/pull shift at the end of a string of nights and usually allow for an extra day off (unless activated)….
  • No strings of greater than 6 can be scheduled. 
  • We have historically not taken backup or pull from elective, given that some residents do electives away.
  • Years ago (~2010), residents on some lighter off-services, usually interns, were scheduled to work a weekend in the ED (as in a weekend on tox that would otherwise be “off”).  It is a potential way to add flexibility to the schedule, though it decreases the exposure to the off service rotation depending on how it is carried out.  Just for consideration. But backup and pull already eat up many of the weekends they would have off. 
  • We should take less backup from St. Paul children’s in the winter as last-minute calls can be a pain for them in RSV/flu season. 
  • We have not scheduled backup/pull during Peds Anesth
  • Keep in mind that weekends of off-svc rotations may be obliterated by backup/pull since we rarely take the actual off-svc schedule into account when scheduling our BU/P. 
  • Can’t have backup/pull from Hudson over the weekends when the resident is working the weekend (F-Su, so NO backup/pull Th-Mon)

 

EMS

  • Anesthesia and EMS on formal holidays is a fairly big waste of time, as are ROD shifts on formal holidays (Christmas, New Year's, Memorial Day, Fourth of July, etc.). No elective OR cases, and no meetings.  The week between Xmas and New Year’s is pretty sparse too.  Same applies to Peds Anesthesia. 
  • Check with EMS folks about scheduling  prefs
  • No holidays

 

Ultrasthesia

  • Check w Mike and Kuma about preferred days.  For the past several years they have chosen to have these centered on Tuesdays, and have arranged their schedules to maintain a presence.
  • 2 years ago we gave the interns all several days of anesthesia blocked together as their 1st exposure, just so they could get the hang of it.  This did not happen last year it was harder to work into the templated schedule.  I support giving them 2-3 days in a row if possible, but understand that it is not easy to do. 
  • Anesthesia and EMS on formal holidays is a fairly big waste of time, as are ROD shifts on formal holidays (Christmas, New Year's, Memorial Day, Fourth of July, etc.). No elective OR cases, and no meetings.  The week between xmas and new year’s is pretty sparse too.  Same applies to Peds Anesthesia
  • Check with Mike Z—there is going to be an US person in the ER still on M, Tu?  Ultrasthesia days should be on the days that person is here

 

Bonus Fridays

  • Q 3 week Fridays were added to balance the hours from abolishing the princess shift in 2015.  Just keep the q3 week schedule moving forward from whatever it is this year. 

 

Off Services:

 

HCMC Swap

  • The HCMC swap has not been variably received. It is worth asking the upcoming G2 class who is interested in the swap.  Most are not interested for the 2016 year. 

 

SICU G1/G2/G3

  • Some SICU shifts continue to be 24 hours for the 2nd and 3rd years.  The upper-level residents have historically voted to continue this--even though it is grueling, it makes for fewer days worked and prevents the disconnection of a night-float system.  One could argue that 12 hour shifts are better in some ways. But we will probably keep as-is. 
  • Split SICU blocks for the G2 will continue
  • The G2 should never, never, never start on a night shift as they do not know the service.  This affects the block schedule dates.
  • SICU transitions also should not be on Thursdays or on weekends. 
  • Anyone leaving the SICU to the ED should have 24 hours off between shifts. 
  • We enter the SICU schedule onto amion so that we can schedule around it. 

 

Ortho

 

MICU G1/G2

  • For block 1 and 2, the G2 on MICU should not take vacation at the beginning of the block as it leaves the intern there alone and with less support.
  • Do not have the block change dates on Mondays because staff also changes that day
  • Do not have the G1 and the G2 change on the same day if able. 
  • We had several issues in 2015 with transitions and the MICU.  Residents should only work a day shift if moving from the ED to the MICU (plan on worst case—long call on the first day).  You also should assume that they end on a long call day on the last day of the MICU block.  So they can either have the first 24hrs off in the ER, or start on a night shift. 
  • If the G1 is starting in the MICU alone, they should not have block transitions on a weekend. 

 

Mpls Kids

  • We are probably going to schedule Peds Metro conference onto the schedule this year too—the G1 on Mpls Kids and the ROD. 

Tox

  • Tox had asked about the intern on Tox going to their big  tox meeting, whenever it is.  If we allow this, it will affect the backup and pull schedules. 

 

Cards/Hosp

  • Specific question about schedule for block one 2016-  Normally the interns do Cards then Hospital Medicine.  In July 2016 Colin Turner requested that that they START on Hospital Medicine.  I don’t think we care either way but I am including it here for completeness sake. 

 

OBGYN

 

SSS

  • SICU to SSS transition is known and may affect the actual SSS rotation dates within the blocks. 

 

SPKids G2

  • SPK wants the shifts there to be 4-midnight.  We’ll keep that, though the Wed evening shift will be over at 1130. Yeah, I know it is changing the time on paper mostly, and not in practice.  We can readdress the shift start/stop times with them since we changed in 2015 to our Regions evening shifts being 3-11. 
  • SPKids for the G2 does not have to be M-F. It can stay that way if we want.  It is probably worth looking at holidays and deciding whether to have a G3 work a shift or two around the winter holidays.  Consider changing the schedule from the standard Monday-Friday over vacations/holidays?
  • Keep 2015 G2 SPK split into 2 blocks. Great move.    
  • Less backup from St. Paul children’s over the winter
  • We manage all SPK shifts on the amion schedule

 

SPKids G3 integrated

  • Consider changes as above with the G2 rotation. 
  • G3s currently work ~10-11 weekend shifts at SPK.  5 days a week x 52 weeks covered by the G2s, split the rest among the G3s.

 

Community G2

  • It will soon be time to get community site requests from the residents.  In the past we have guaranteed each community site at least one resident.  The past 2 years we have left the maximum number open to the free market.  Fairview has months during which they prefer not to have one of our residents.  There were concerns that the Methodist rotation should possibly be arranged when there is not a family medicine resident there.
  • United, St. Johns, St. Joes, Abbott NW, Univ of MN Med Cntr, North Memorial, and Methodist are the sites.
  • Methodist is great but there is a family medicine resident there for half of the year.  Better to schedule around them
  • Nobody has chosen Fairview-University last 2 years.

 

G3 Hudson

  • The Peds anesthesia rotation is currently set as the last week of the Hudson block—except that it might not work out over the winter holidays or other holidays.  So blocks may be  different.  Ped Anesth is usually M-F. 
  • There are always issues with Hudson and the summer holidays. We need to let Carol Lennartson know the vacation for the G3 working on July 4, Labor Day blocks ASAP. She has to know when our resident will be there and when he/she won’t. 
  • Can’t have backup/pull from Hudson over the weekends when the resident is working the weekend (F-Su, so NO backup/pull Th-Mon)

 

Elective

  • There are several other people making plans…..this can affect the block schedule assignments.  Baby leave is often best taken over elective time too, along with community….But we can get creative.
  • Electives have been spared from backup/pull because this allows for travel. 
  • David is rotating in Zambia in June, Alan was looking at doing the teaching Fellowship, Brian was considering a rotation in Mexico.  Not sure about others. Send out an email to check. 

 

IPL

  • Procedure labs are on the 2nd Tuesday of every month.  June is reserved for the EM-Peds residents.  July is reserved for the PA residents.
  • For every other month of the year, there should be a G1, G2, and G3 assigned.  Assignments can come from the emergency department or from off service.
  • Need to make sure that the IPL is protected from the backup/pull schedule. 
  • See additional notes in the ED schedule section above. 

 

Vacations/leaves:

  • It is a good idea to ask about  potential major life-events such as babies and weddings when asking about vacation requests.  Vacation dates are somewhat open, but if there are too many residents on vacation on a certain overlapping day it can make backup and pull impossible
  • Some people have requests relating to religious holidays.  We try to be accommodating within reason. (24 hour SICU shifts while fasting might be a suboptimal thing….) Sakib was the only person with needs faith-based requests year
  • For the G3, the 4th week of vacation from the emergency department can technically come anytime.  However, making sure that it is not during SAEM
  • David  rotating in Zambia block 1, so needs to start on elective.
  • Alan was looking at doing the teaching Fellowship, which may mean a split elective.
  • Brian was considering a rotation in Mexico.  I don’t know about other specific elective plans, but we should re-ask. 
  • We have not guaranteed any holidays off in the past.  Should we start a holiday system?  If so, what services should it cover, and how should we run it? 
  • Keep a list of all the vacations and special dates people request…and share this with Lori/rachel/amy/cullen once you have them all. 

 

Intern SAEM

  • Check the website for dates.
  • No intern backup/pull needed when the interns aren’t working.  But G2/3 BU/P gets tight. 
  • If SAEM starts on a Wednesday, we have the procedure lab that month with someone else in the G1s place

 

What Rachel looks at when she evaluates/approves the schedule (use this as a double-check when you make the schedule):

  • number of shifts on in a row, ideally no more than 5.  Definitely no more than one 6 in a block? 
  • one day off in 7, for any given 7 day period
  • rotation of shifts–adhere to duty hour restrictions, no double-backs
  • breakdown of day/evening/night shifts
  • transition onto the block (esp MICU, PEDS, SICU)
  • transition off of the block (esp MICU, PEDS, SICU)
  • 24 hours off after SICU
  • backup/pull shifts from the ER—number and distribution
  • backup/pull shifts from off services—number and distribution (NMT 6 in a row, look at affected services)
  • procedure lab scheduling, free of backup/pull before or during
  • vacations honored
  • ??  1 weekend off during ED block
  • ROD and double-ROD days
  • C Pod vs JFACs
  • Bonus shifts
  • US Tuesdays
  • Sliver shifts
  • Hudson weekends free of Bu/P
  • No nonclinical shifts on holidays

 

Jackie’s sanity:

  • Meet with Jill, and ask her for advice. She is the most recent guru of this. She can give you lots more info. 
  • We can talk about Shift Admin goods vs bads.  Kristi has experience with this.  We can use it this year if we want to. Or not. 
  • Starting after the chief transition, the three chiefs share admin call.  While you are making the schedule you should not be on admin call. 
  • We will talk in 2016 about having the outgoing chiefs each cover some shifts for you and perhaps the incoming chiefs also.  This would free up dedicated time.  It would start a new precedent, but I think it is a good one to set. 
  • Year to year, a ton of experience is lost during the chief handoffs.  I know that Jill has a lot of detailed information that she’ll be able to share with you—what do you guys think about setting up some central repository for some of this?  Maybe a scheduling wiki, with a list of things to do, consider, and a way to track things that come up during the year that we may want to consider changing for next year?  I welcome ideas about this. I made this schedule “brain dump” to serve as the repository for now.  Sorry if I made you cry. 
  • Meet with me to ask questions—I am not the one who creates the actual schedule, but there are a lot of subtle bits and rules that I know.  I tried to put them all down here.  You will get a lot of flexibility to try new things if you want, and to make the schedule your own. However, don’t do the entire year schedule for every resident before asking me to look at it—there are usually one or two (or more) tweaks that need to happen. 
  • If continuing with amoin--Get your P- drive access from Lori and do a few of the amion website tutorials—in conjunction with getting tips from Jill.  Never publish a schedule to the residents before it is completely approved and perfect, or your classmates will go insane and enter a work-in-progress into their calendars and ignore any explanations that it is not final (aaah, 2012, the fond memories…). 
  • If switching to shiftadmin, we will have to figure out the info they want in the spreadsheet so they can set up the database for us. If we move to shiftadmin, then there are options to incorporate the Hudson, SPK, MplsK, SICU, and rotator schedules into what we do. 
  • Feel free to hound me for input and scheduling reviews. 
  • Set deadlines for requests with your colleagues (requests due by midnight on Tuesday….).  Stick to them.  Those who fail to meet deadlines “take what they get and don’t throw a fit”. 
  • Sometime in June, mail a reminder about duty hour rules out to the residents….MUST have 8, should have 10 off.  BTW you (as residents, not necessarily as the scheduler) can split shifts on amion if you want, which opens up possibilities for trades.  They should know the basic rules and it will save you wasting time looking at a trade request that is obviously not going to work.
  • When you send out the schedule for any given block, tell the residents to review their own schedule with special attention to days on in a row, backup/pull, and transitions on and off the block.  If there are problems they need to identify them by whatever reasonable deadlines you set….or else they have to fix the problem themselves.  Anything not identified is not our problem to fix.  Or so we say. 

 

Hmmm.  I think that is all for now.  Questions????

 

 

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