Provider and Staff Scheduling in a Pediatric Practice Setting

Appropriate staffing can help a practice run efficiently, increase patient satisfaction and assist with workload. Review provider and staff scheduling tips below.

Provider Scheduling  

Provider scheduling should be done by a non-physician, as it can be very difficult to be completely unbiased if a person is in control of their own schedule. While it is best to try and offer providers a set day off during the week, it is best not to guarantee this as things can change at a moment’s notice. The goal is to always have enough providers to provide care to patients, because canceling patients can erode a patient/family’s trust in the practice. 

Provider schedules should be finalized at least 2 but preferably 3 months in advance so parents can schedule follow-up visits before they leave the office. Once the schedule is posted, it should be understood by all that it will not be modified except for extreme emergencies.

To create a customized base schedule template, the following characteristics should be considered: 

1. An understanding of the practice's seasonal variations in demand for certain types of visits. For example, each schedule may be customized with additional slots assigned for well visits in the summer season and more acute care visits assigned during the winter season. 
2. An understanding of how each provider works. There are clear differences in provider styles, which may not allow them to all have the same schedule. Some work very quickly, some less so. Some take on more complex specialized patients and need a schedule that reflects this. If there are multiple locations, they may have different characteristics. All of this must be meshed with your productivity schema so that everyone has the opportunity to be rewarded for their own productivity.  
3. The time and compensation to monitor how the practice is booking on a daily basis and to make requisite modifications to the system on an ongoing basis. There must be extra salary for the person who handles scheduling, over and above their base salary.
4. The authority to make decisions about the provider schedules. If other providers would like to make changes, these changes must be authorized by the scheduler prior to implementation.
5. The data systems needed to figure all of this out and the ability to try to get patients to move their well visits to low-demand periods such as April and May to even out the summer crunch of such visits. This may require active calls to patients to solicit such visit times. 
6. The ability to customize the schedule with certain types of visits at certain times, with rules about changing such job stream templates for appointment staff to follow. These job streams may vary by season, office, and individual provider.  

As is obvious, this type of system is not for everyone. However, if fully implemented, this type of schedule can earn a practice far more revenue than nearly any other single management technique of handling patient care.  

Staff Scheduling  

Staff scheduling can be done by an office manager/administrator and should be done minimally on a monthly basis and presented to the staff at least 2 weeks before the start of the new month.  

If the practice employs part-time staff, it is helpful to schedule a blend of both full-time and part-time staff. Part-time employees might have a fixed schedule with little flexibility.  

Full-time staff generally offer more flexibility because they are there for 4 or 5 days a week to work as needed. Most states require employers to pay overtime if an employee works more than 40 hours in any week; therefore, it may be helpful to set full-time employees' schedules to 36 or 37.5 hours a week, which gives the practice flexibility. If employees need to stay late 1 or 2 days, the practice will not be required to pay overtime.  

It is important to have very clear guidelines for vacation and requested days off. A lack of clear expectations in this area will result in the person responsible for scheduling having to address staffing situations daily, which is very time consuming. Remember, the rules established for one person will set precedence for the entire staff. Do not allow one person to do something that would not be desirable for all staff to do.   

Decrease in Patient Census  

As long as practice employees are not contracted, they can be sent home at any time because of decreased patient volume. The first staff to be sent home should be overtime staff, per diem staff, part-time staff, then full-time staff. Be sure to send home a different person each time and not pick on any one individual unless it is a per diem or someone who has volunteered to go home early.

If a practice staff person is contracted for a certain number of hours or is salaried, avoid sending them home early as they are being paid regardless. Use the extra time to cross-train them for other roles or to catch up on other tasks, which will be to the practice’s advantage.