1. AUTOMATED
ON-CALL SCHEDULING:
SMALL STEP, BIG GAINS
Tackling administrative challenges in healthcare enterprises often
means big resource commitments that take years to pay off. But on-call
scheduling technology can reverse that equation, delivering impressive
ROI from a relatively modest investment of time and money.
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2. | 2
Hospital administrators face a long list of
seemingly unrelated challenges, including
bolstering physician-hospital relations; personnel
shortages and retention; patient safety, quality,
and satisfaction; absorbing acquisitions; and,
above all, finances, especially as the migration to
value-based care proceeds.1
Faced with such big organizational challenges,
it’s natural to assume equally big initiatives and
investments are needed to address them. But
sometimes a major leap forward can be made with
a relatively small change. An everyday inefficiency
that seems to impact only a few may actually have
ripple effects throughout an organization. Finding
and fixing this type of problem can quickly deliver
disproportionate bang-for-the-buck.
The physician call schedule is often one such
area. Call scheduling can be a source of persistent
frustration to doctors — but the negative effects
of inefficient scheduling can go far beyond
the physician team. The hassles, errors, and
miscommunications inefficient scheduling creates
reverberate through almost every area of the
organization.
Intelligent automation can solve many of the
challenges of on-call scheduling — including many
that are less visible on the surface. Automating
call scheduling can quickly make it easier, more
reliable, and less likely to cause conflicts. And
just as the pain caused by inefficient scheduling
echoes beyond the physician team, the benefits of
improving it can radiate through an entire hospital
system.
Real-time schedule updates mean
improved efficiency and reduced risk
Reliably knowing who’s scheduled on call from a
department or practice is critical not just for the
members of that team. Colleagues throughout
the system, from the hospital switchboard to the
ED to the OR, have to know which clinicians are
available, and how to reach them.
The old-school approach to scheduling — whether
by white board, spreadsheet, sticky notes, or some
combination of all three — makes quickly and
accurately communicating this crucial information
very difficult.
1 For example, in its 2015 survey of hospital CEOs, published in February, 2016, the American College of Healthcare Executives (ACHE) found that the top ten
issues confronting hospitals include financial challenges (#1), patient safety and quality (#2), personnel shortages (#4), patient satisfaction (#5), physician
relations (#6), and reorganization (#10).
Automated
On-call Scheduling:
Small Step, Big Gains

3. | 3
Consider the dozens of on-call schedules that
are typically created either within a hospital or
in the practices of physicians on staff. When
each of these schedules is created on paper or a
spreadsheet, someone in the hospital must gather
and assemble the information for everyone to
use. That usually means a lot of calling, collating,
and distributing of information. And what happens
when — as happens so often — someone’s schedule
changes? The entire labor-intensive process must
begin all over again. All of this manual constructing,
collecting, updating, and distributing of schedules is
not just inefficient, it creates more opportunities for
human error.
The consequences of out-of-date call information
can range from annoying to tragic. An error might
mean that the wrong physician is awakened at
3:00 a.m. Or it might mean a significant delay in
patient care because no one could figure out how
to reach the right physician in time.
Commonplace events like doctors swapping call
on their own or a clinician getting a new phone
number can have severe consequences if there’s
no way to be sure everyone is aware of the change.
As healthcare organizations grow, and physicians
frequently practice at multiple locations, these
communication challenges — and the possibility of
errors — multiply even faster.
Technology can address
this problem in an elegantly
simple, intuitive way: by
ensuring that there is one,
and only one, source of
schedule information.
A thorny data problem with a
straightforward solution
Healthcare is not the first industry to grapple
with information siloed in multiple systems that
don’t automatically update each other. In other
business settings, database systems have evolved
to address this problem by maintaining a “single
source of truth.” A single source of truth means
that while data can be published and used in
many systems, each important bit of information is
actually stored and managed in just one place.
Today’s automated on-call scheduling solutions take
advantage of this powerful idea to simplify commu-
nication and ensure accuracy. With just one data
source for any element of the schedule, a single up-
date will make accurate data available to the entire
organization. The chances of obsolete or erroneous
schedules circulating the hospital, causing problems
and extra work, are greatly reduced.
Normally, establishing a single source of truth from
legacy data can be daunting. But call scheduling
offers a rare chance to automate where no legacy
system likely exists. It’s a project that can be a
breath of fresh air to hospital technology teams
beleaguered by difficult integrations. The upside
for everyone who relies on the schedule is large
and undeniable. And with no legacy system to
convert, there are fewer reasons to resist the move
to a new solution.
A successful transition to technology that makes
everyone’s work lives easier is an excellent way
to demonstrate that technology can add a lot of
value. As such, it’s an excellent way to gain buy-in

4. | 4
(and a bit of patience) for the larger, more difficult
implementations that may be on the way.
A not-so-small task with significant
hidden costs
At first blush, automating the physician on-call
schedule may not seem like a significant cost-
cutting opportunity. On the surface, it seems like a
relatively small, specialized job. And in some ways
it is: even in large teams, call scheduling may be
handled by just a few people who take care of it
alongside their “day jobs.”
But because the clinical rules that drive schedul-
ing are complex and critical, one or more of those
people will likely be a senior physician. This means
that scarce, precious physician time is diverted from
patient care — a significant hidden cost.
Besides clinical rules, there are always other
dependencies that accumulate over time —
constraints due to physicians’ obligations at other
facilities, and, of course, personal preferences. Ad
hoc constraints like vacations, parental leave, and
other absences must also be worked into the mix.
Documenting all these rules
for automation can seem
daunting. Over time, the
employees who work the
schedule internalize the
patchwork of constraints that
must be accommodated.
It may seem easier, and
even less costly, to let these
reluctant experts keep preparing and distributing
the schedule manually.
But the picture looks different when you consider
the time devoted by your experts to scheduling
over not just a single month, but a period of
months or years. It doesn’t take long before the
hours invested in scheduling add up to significant
drain on important resources. What’s more, in
any given scheduling period, the amount of time
devoted to the task can balloon when unexpected
changes are needed.
The difficulty of on-call scheduling has also
crept upward in recent years. The number of
subspecialties has proliferated, increasing the
complexity of assigning call. This makes the
process more time-consuming, and mistakes
harder to avoid.
Scheduling software, on the other hand, has
evolved to become much easier to implement.
Even complicated scheduling rules can usually
be automated. By automating the schedule, you’ll
recapture the clinician time currently spent on it for
months and years ahead — quickly paying back your
investment.
Hard to quantify, yet priceless:
engagement and morale
Besides reducing errors, making managing
the schedule much easier, and simplifying
communication, automated call scheduling offers
another benefit hand-crafted scheduling sorely
lacks: transparency.

5. | 5
The traditional, manual way of scheduling can
feel like a “black box.” Physicians may submit
scheduling preferences, but have little sense of
how they’re evaluated against other requests and
department needs. When requests are denied
and the decision-making process seems opaque,
physicians may feel unsure that the process is fair
— especially in a larger organization, where it might
not be easy to ask about it.
Such qualms may seem like minor problems — the
sort of irritations we all bear in organizations. But
any erosion of trust can make engaging physicians
harder. As hospitals and healthcare systems
grow larger, their challenges are growing apace.
Healthcare enterprises need physicians to lead
diverse teams and tackle big, complex problems in
care delivery. Establishing and maintaining trust is
critical to keeping physicians focused and working
together on issues that can’t be solved without their
brainpower.
When physician morale suffers, the employees
they work with feel the pain, too. The hassles of
scheduling the old-fashioned way have long been
a predictable source of conflicts between people
who need to work closely together. Automating
the schedule is a relatively small and easy step
that can improve the esprit de corps of the entire
clinical team.
An automation opportunity with
unusually powerful benefits
It is hard to imagine an administrative task in
healthcare that has more potential to be improved
by automation than on-call scheduling.
Planning the schedule is a
focused activity, normally
managed by just a few, even
though entire hospitals
depend on its execution. And
as healthcare enterprises
have grown more complex,
the time required to prepare schedules in
traditional ways has mushroomed, as has the
stress the process causes.
Automating scheduling reduces costly manual
work (and re-work), errors, liability, and stress on
the team. By boosting transparency, it can even
improve team morale. Few technology solutions
have the potential to deliver such immediate
and profound payoffs. And for organizations that
are burdened with inefficient scheduling using
whiteboards or spreadsheets, the process of
conversion may even be easier than expected, with
no existing data stores to integrate.
ABOUT THE AUTHOR
Laurie Morgan of Capko & Morgan is a medical
practice management consultant, speaker,
and author. Her consulting work focuses on
helping practices generate and capture more
revenue, optimize their workflows, and use
technology to improve profitability.
Laurie is a frequent contributor to
healthcare publications and blogs such as
Repertoire, PracticeLink, and Physicians
Practice. She is also the creator of the
popular “ManagementRx” series of practice
management ebooks.
Laurie is a graduate of Brown University and
Stanford University.

6. ABOUT THE SPONSOR
Across the continuum of care, Kronos® for Healthcare helps providers of all sizes
develop their workforce into a competitive advantage to support the delivery of value-
based healthcare. Kronos EZCall™ is a leading automated clinician scheduling solution
that creates flexible, fair, and equitable call and shift schedules helping organizations
staff smarter and faster. Kronos EZCall, integrated with Kronos timekeeping, HR, and
payroll solutions, provides a unified and seamless workforce management platform
enabling practices, hospitals, and health systems to reduce administrative burdens,
gain a holistic view into the entire organization’s workforce, and improve compliance by
adhering to one standard across the organization.
For more information, please visit www.ezcall.com/demo