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Devise a scheduling system that works for your employees

Patient Access Weekly Advisor, January 9, 2008

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How do managers keep their staff members happy? Their schedules are a good place to start.

Some access departments use a flex-hours system that allows a staff member to schedule his or her own hours, such as four 10-hour days. The key, managers say, is to balance schedules to ensure adequate coverage in the facility.

Donald Brown, manager of access services for Mercy Iowa City (IA) Hospital, had a flexible, 10-hour-days schedule at his previous facility, a 120-bed hospital in Northern California. It didn't work, he says.

Billers who wanted to be part of the program signed an agreement, he says. The agreement stated this was to be the employee's choice and was for an initial period of 30 days. Then the employee decided whether he or she liked it, and management had to evaluate whether the hospital was unharmed.

"After the initial period, the idea was that [the program] would either stop or continue indefinitely until the employee decided [he or she] did not want to be a part of it or the hospital decided it was not working," Brown says. "As I recall, I had about six out of eight billers who wanted to do it at the start. Within 18 months we were down to two. It went up and down, but within three years had disappeared. I think it probably has more to do with the unity, or disunity, of the group and the personal needs."

At Brown's current hospital-Mercy Iowa City, a 233-bed facility-it is five-day weeks. As for time off, it's all about how the team is affected.

"I try to set an attitude that [staff members] do not get permission from me to take the afternoon or week off," Brown says. "They look at what else is going on and determine if the team can absorb their being gone. They decide they can't take off because too many others are already off or that if they leave there would be only one person to answer the phones from 3:30 until 4:30, and they wouldn't want to be left with that. Then they mark the calendar [based on the staff's needs]. Of course I review it, but so far I haven't had to refuse to let someone take time off. I have people who cancel their scheduled vacation when another gets sick or a special problem arises."

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