* Excessive time was being spent by the emergency department (ED) staff, head nurse, and unit secretary on a complex 6-week manual self-scheduling system. This issue, plus inevitable errors and staff dissatisfaction, resulted in a manager-lead initiative to automate elements of the scheduling process using Microsoft Excel.
* The implementation of this initiative included: common coding of all 8-hour and 12-hour shifts, with each 4-hour period represented by a cell; the creation of a 6-week master schedule using the "count-if" function of Excel based on current staffing guidelines; staff time-off requests then entered by the department secretary; the head nurse, with staff input, then fine-tuned the schedule to provide even unit coverage.
* Outcomes of these changes included an increase in staff satisfaction, time saved by the head nurse, and staff work time saved because there was less arguing about the schedule. Ultimately, the automated self-scheduling method was expanded to the entire 700-bed hospital.
SELF SCHEDULING is a key ingredient of professional, practice. Self-scheduling has been shown to improve staff retention (Bischof, 1992; Gaydos & Ritter, 1994; Griesmer, 1993; Hawkins & Sutton, 1991; Miller, 1984; Miller, 1992; Tully, 1992; Vernengo, 1996) and staff recruitment (Hensinger, Harkins, & Bruce, 1993; Tully, 1992; Vernengo, 1996). Further, unit productivity increases (Gaydos & Ritter, 1994; Ringl & Dotson, 1989), often as a result of a decrease in absenteeism (Bischof, 1992; Miller, 1992; Tully, 1992), and an increase in organizational loyalty (Gaydos & Ritter, 1994). Self-scheduling promotes professionalism (Belanger, Snell, & Fortier, 1991; Beltzhoover, 1994; Griesmer, 1993), autonomy (Belanger et al., 1991; Griesmer, 1993; Hensinger et al., 1993; Miller, 1984), and the ability to meet personal needs (Belanger et al., 1991; Vernengo, 1996). The ability to have input into one's personal schedule improves shift-to-shift cooperation (Miller, 1984; Miller, 1992; Tully, 1992) and collaboration (Bischof, 1992), positively affecting team spirit and morale (Bischof, 1992; Miller, 1984; Ringl & Dotson, 1989). Benefits to organizational leadership include decreased time managers spend on scheduling (Bischof, 1992; Tully, 1992) and an improvement in cooperation between staff and management (Miller, 1984).
A major disadvantage of self-scheduling is inequitable distribution of desirable shifts among staff. To overcome this problem, many units have created guidelines for the order in which staff or groups of staff are allowed to sign up for shifts (Bischof, 1992; McCoy, 1992; Zimmermann, 1995), formed of staffing committees (Manchester, 1987; McCoy, 1992; Zimmermann, 1995), and/or appointed staffing liaisons (Belanger et al., 1991; Griesmer, 1993; McCoy, 1992; Miller, 1992) to supervise the completion of the schedule. Another reported problem of self-scheduling is that some staff put personal desires ahead of unit needs (Griesmer, 1993; Tully, 1992), often signing up for midweek shifts, leaving weekends and Fridays understaffed.
Self-scheduling in large emergency departments (EDs) with many employees and overlapping shifts has become increasingly complex. In our ED, with 100 employees and nine overlapping shifts, the responsibility of ensuring unit coverage fell to the head nurse, who manually tallied staffing numbers for nine overlapping shifts, a very time-consuming process. Further, some staff interpreted...
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