Setting quotas based on theatre sessions
December 04, 2017bestpractice
At HosPortal it is self-roster season, with many hospitals getting ready for anesthetic on-call rosters starting in February and March next year.
All of our private hospitals currently underway are setting self-roster quotas based on the amount of activity done by each doctor: doctors with higher activity are given a higher requirement of on-call shifts.
The challenge is: what is the measure of that activity?
Typically, there are two ways to measure activity:
- How much operating theatre and clinic activity is each doctor scheduled to do each cycle (the schedule), or
- How much activity did each doctor actually do over some period (actuals).
The distinction, although subtle, is important, and the method of gathering the data may be different.
In some hospitals, the schedule is defined in terms of the surgeons doing a list, but may not routinely include the name of the anaesthetist attached to the surgeon. We have heard of hospitals where anaesthetists will claim that they should be exempt from the roster because they do not have any scheduled activity, and have only been doing only ad-hoc work...it just happens to be alongside the same surgeon every Wednesday and Friday for the last 12 months!
Actuals are more volatile but are likely to be fairer. A doctor may in fact have no regular work, but regularly fills in for a half-dozen other colleagues at that hospital when they go on leave. Conversely, an active doctor may be on leave in the month the data is extracted, So you cannot look at just a single month or cycle: in most cases the most recent six months is a fair indicator of activity.