Scheduling management: a step towards modernity

While cutting-edge medicine is developing, hospital schedules are often still created manually using spreadsheets. This absurdity is what Petal Santé’s solution aims to correct. Here are three examples from hospitals that use it.

Freeing up time for doctors

For Petal Santé, the observation was simple. In a world where doctors are highly specialized and machines are ultra-sophisticated, scheduling management hasn’t kept pace. “With our team of computer engineers and mathematicians, we sought to optimize the allocation rules so that doctors no longer spend entire days on this task,” explains Patrice Gilbert, founder and CEO of Petal Santé.

However, the mission is extremely complex. First, because of the sheer number of tasks to be handled each day. At Amiens-Picardie University Hospital, 12 to 13 care activities must be provided during the day, and 6 to 7 night shifts within the Emergency Medicine Department. Furthermore, medical staffing levels vary considerably, as Dr. Christophe Boyer, Head of the Emergency Medical Service (SAMU/SMUR) and Head of the Emergency Medicine Unit, explains: “The new generation of doctors often works across multiple sites. Some are present on part-time schedules ranging from 20% to 80%. In addition, requests for working hours can be expressed in different ways: 24-hour shifts, alternating weeks, days off (avoiding Thursdays, for example), or a desire to be assigned exclusively to emergency care positions in the hospital or outside the hospital.”

It is therefore necessary to juggle all this information to create the schedule, which will often be modified by the healthcare professionals themselves. In another facility where Petal Santé’s scheduling solutions are deployed, Thierry Klein, head of medical information at the CHR de Haute-Senne (Belgium), notes this point. “Previously, it was very difficult to track the schedule in real time because doctors made arrangements amongst themselves through unofficial channels. As a result, the on-call schedule wasn’t always fully up-to-date.”

A step-by-step deployment

Before any implementation, the solution aims to understand and model the practices of each facility. A map is created for each department, detailing tasks to be performed, necessary resources (staff and equipment), contact numbers, and available time slots. Once this framework is complete, the application can be deployed (as a fully web-based application), and the teams are trained to manage the schedules. “The idea isn’t to do it for them,” explains Patrice Gilbert. “We help them, but we allow them that necessary degree of subjectivity inherent to the workings of a medical department.” “

At the Nancy University Hospital (CHRU), 47 staff members (anesthesiologists and secretaries) are registered in the scheduling system, along with three “substitute” profiles. Schedules are created two months in advance. In the first phase, “everyone’s preferences are gathered,” explains Professor Philippe Guérini, head of the anesthesiology department. “An automatic notification reminds each person on their smartphone that they can then express their wishes (days or activities).” Next, on-call shifts and days off are assigned.

To achieve this, Petal Santé combines combinatorial logic and machine learning. The tool takes into account individual preferences, statutory rules (mandatory on-call duty at least once a week and at least one Sunday per month, etc.), and the specific rules of the different departments. For example, it incorporates the fact that some departments systematically try to offer three days between on-call shifts.” “To achieve this, the experts at Petal Santé analyzed our last three schedules to identify underlying rules,” recalls Dr. Christophe Boyer. “This established a set of rules. And we retain control over certain rules to adjust them as needed.”

Once the schedule is published, healthcare staff still have the option to adjust their assignments. A feature allows them to offer unwanted days on a kind of “on-call exchange,” swapping them if they find takers.

Benefits on multiple levels

“The result is a real success story,” summarizes Thierry Klein. In his facility, it’s not just the on-call shifts of healthcare professionals that are planned this way, but all “institutional on-call shifts.” Logistics, IT, patient care… Numerous departments are involved, representing nearly 1,000 employees.

“Thanks to this method, we anticipate all problems. And it’s also a way to decentralize responsibility.” All stakeholders are responsible for creating the schedule, whether at the individual, departmental, or site level.

Fewer conflicts, but also greater fairness. “The system analyzes previous periods to see if some may have been favored or, conversely, disadvantaged,” emphasizes Patrice Gilbert. “Then it restores the balance for the upcoming period. Similarly, at the end of the year, a review of weekends is conducted to harmonize on-call shifts.”

Ultimately, for the schedulers, the tool is extremely beneficial. No more anomalies, no major discrepancies between professionals, allowing them to be more at ease and “free up time in the operating room or in patient care,” notes Professor Philippe Guerici. “It’s a game-changer for us. The doctors, for their part, initially saw the tool as a constraint. But, after an adjustment period, they perceived the benefits and are very satisfied.”

And the applications are vast. Petal Santé has developed care protocols to direct patient flow to pharmacies, nurses, general practitioners, etc. This approach significantly reduces pressure on emergency rooms. But that’s another story… To learn more, visit petal-sante.com