Scheduling Physicians in the Neonatal Unit at the University of Tennessee Medical Center

What is it about?

Neonatal Physician Scheduling at the University of Tennessee Medical Center Abstract A common issue faced by contracted physician groups is how to schedule 7x24 coverage for hospital units such as an emergency department. The first step is to determine the shifts that must be regularly covered. The second step, typically referred to as the rostering problem, is to assign the physicians to specific shifts. The task of rostering is complicated by a variety of constraints and the fact that the shifts vary with respect to duration, day of week, time of day, and desirability. In many physician groups, fairness of workload is insured by evenly dividing the shifts, by type, among the physicians. For example, each physician would be assigned to work the same number of weekend overnight shifts within a given scheduling horizon. Such a problem can be readily modeled and solved via optimization, and we refer to its solution as an “equality” schedule since each physician is working an equal number of each type of shift. The focus of this paper is an approach that incorporates individual shift preference and seeks for each physician a schedule that is superior to his or her equality schedule. This new approach utilizes additional constraints and requires inputs specifying workload values and individual relative preference values by shift type. Lifestyle, physical endurance, and stage of career are some of the reasons for differences among individual physician shift preferences. We formulate and solve the problem as a binary, mixed-integer program with work requirement constraints and an objective that measures and maximizes relative gains in individual preference. We describe the methodology and its real-world implementation within a physician group that provides neonatal intensive care services. The overall concepts, however, can be generalized to many other rostering situations.

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