By Dr Chris Jones, Anaesthetist and Founder of HosPortal
As the founder of HosPortal, it’s common for me to see large hospitals still using Excel spreadsheets and fragmented communication processes to build their rosters.
Don’t get me wrong. These systems can still produce workable rosters.
However, as workforce demands and operational complexity increase, the effort required to sustain them grows — placing pressure on the clinicians and administrators that carry the day-to-day responsibility for hospital rostering.
When I built rosters as an anaesthetist 25 years ago, the primary goal was fairness — ensuring clinicians worked a balanced distribution of shifts.
Today, fairness is only one part of a much more complex system.
Modern hospital rostering systems must now account for fatigue management, wellbeing, clinical supervision, and training requirements — while ensuring the right people are in the right roles, in the right place, at the right time.
These are not administrative considerations. They directly influence patient safety, training quality, clinical supervision, and team performance.
The number of factors that must now be balanced in hospital rostering has increased significantly, including:
Each factor is manageable in isolation. However, the challenge is navigating the layering of requirements, constraints, and competing priorities across large, interdependent teams.
This level of complexity is increasingly difficult to manage within manual rostering processes, particularly at scale.
These manual rostering approaches depend heavily on experienced individuals to coordinate inputs, manage changes, and resolve conflicts.
In many hospitals, the system continues to function because people compensate for its limitations — manually adjusting around constraints, resolving issues as they arise, and continually reworking rosters to keep services operating.
And even with significant manual effort, constraints can still be missed, roster quality can vary, and clinicians can still be dissatisfied with the outcome.
Clinical time spent coordinating rosters is time not spent:
What previously worked as a manual rostering process is now being stretched beyond its design limits.
Drawing on insights gained from working with emergency department leaders over many years, HoIn many workplaces, rostering teams are still forced to work across spreadsheets, uploads, disconnected systems, and manual reconciliation processes to keep rosters functioning day to day.
However other hospitals are addressing these challenges head-on – moving away from spreadsheet-based rostering and fragmented manual workflows towards software-driven systems that manage complexity more effectively at scale.
Their adopting automated and AI-supported rostering approaches that reduce reliance on individual oversight and improve consistency across teams.
The shift is not simply about replacing spreadsheets. It’s about moving to a different operating model for how rostering is managed.
For hospitals exploring more structured or automated rostering approaches, the first step is understanding how the current model operates in practice.
The key question is whether the current approach remains sustainable.
Through HosPortal’s work with hospitals such as Royal Hobart, Maitland, and Toowoomba, a consistent pattern is emerging where more structured, system-supported rostering approaches have been introduced.
At Royal Hobart Hospital, rostering processes have become more consistent and less dependent on manual reconciliation.
At Maitland Hospital’s Emergency Department, administrative coordination has been reduced, with greater transparency in how rostering decisions are made.
At Toowoomba Hospital, the complexity of large-scale junior doctor rotations is being managed with less manual intervention, supporting both efficiency and clinical supervision.
While each hospital is different, the shift is similar: rostering moves from a manual coordination task to a system-supported function.
Across these environments, the direction of change is similar: rostering is moving from a manual coordination task towards a more structured, system-supported function designed to manage complexity at scale.
At HosPortal, we work with hospitals to assess current rostering processes and explore how AI-enabled rostering systems can better support clinical, operational, and workforce needs.
You can learn more about HosPortal and our automated hospital rostering software at hosportal.com or speak with our team about assessing your current roster process, needs, and options.
Dr Chris Jones is a senior anaesthetist and the founder of HosPortal, an Australian hospital rostering software company designed for complex clinical environments. Having managed rostering firsthand, Chris established HosPortal to address the growing gap between the needs of modern hospitals and traditional rostering tools.