IT Consulting from the Trenches

SHIFT PATTERNS

Scheduling work shifts is one of the most common and underestimated problems of modern organizations. It’s a vexing problem that can torpedo a system’s effectiveness. These are lessons learned from a recent project that needed a scheduling solution in order to be considered a success.

A department’s workload determines the shift patterns that it can adopt. Any scheduling decisions need to start with a clear understanding of the workload.

The workload needs to be converted into a number. This is the number of staff members that are needed to perform the workload. A level workload is easier to schedule than a seasonal or variable workload.

AREAS OF CONCERN

Scheduling difficulties always occur around holidays. After holidays the second most common area of concern is absences. The two remaining areas of concern are events that disrupt the staff from meeting the workload. These are training and breaks. Team training can be especially challenging. Breaks that occur due to staff fatigue will occur frequently in environments that have two or three shifts.

A significant difference exists between anticipated and unanticipated events. For example, many problems associated with training can be avoided by furnishing advance notice to the concerned staff. People generally dislike workplace surprises and they will appreciate any advance notice. Notification must be significant however. Being notified one, two, or three days is frequently inadequate. These notices are especially inadequate if the days span a weekend. Staff members will usually perceive this type of notice as last-minute maneuvers instead of advance notice.

HEALTHCARE-SPECIFIC CONCERNS

Horror stories abound about wrong limbs being amputated or procedures being performed on the wrong patients. When these cases of mistaken limbs or mistaken identities are investigated, a contributing factor is frequently miscommunication, or missed communication, between physicians or nurses who work in different shifts. The handover from one shift to the next is typically transmitted through written notes. Verbal information happens too infrequently, too randomly, and too incompletely to be considered unreliable.

The problem is exacerbated by two things. First is the mental and physical condition of the incoming shift worker. And second is the number and type of the incoming shift worker. Second- and third-shifts are usually populated with the more junior staff members. Among doctors these would be the new residents. Among nurses these would be the recent graduates. This situation means that the organization has less experience and less training at night. It’s a fair statement to make that from 5 pm to 7 am, most organizations have less of everything: less experienced and less trained workers and fewer of them at that. Conversely, it’s also fair to state that patients face more risk between those hours.

What can be done about this? Not much realistically. Statistics show that mortality rates are much higher during these hours. Patients can do their part by speaking up but too often patients are unable or unwilling to do that.

IMPLEMENTATION

After shift patterns have been created, the next step may either have the most problems or none at all. These extremes—problem-ridden or smooth sailing—will depend upon the terms and conditions of employment and the current state of labor relations. At many organizations, the terms and conditions of employment were written by people who are unfamiliar with the nuances of second- and third-shift conditions. Lawyers may work late into their evenings but I don’t know of any who work at 24 x 7 law firms. At many organizations, the current state of relations between management and rank-and-file dictates the ease or even possibility of implementing shift pattern problems. One can be repeatedly frustrated by these two issues. For example, common definitions may prevent any agreement. Days and weeks tend to have different connotations for second- and third-shift workers. Fortunately, or unfortunately, the prevalence of part-time workers sidesteps these two issues.

GENUINE CONSIDERATION LEADS TO EFFECTIVE SOLUTIONS

With all these said, the most important factor in solving shift-related problems is consideration. Shift patterns affect people’s lives. Genuine consideration for the impact that abrupt or excessive changes make to people’s lives goes a long way in creating suitable shift patterns.