Can we solve the problem of scheduled cases on the weekends?
I’ve been to a lot of hospitals, and listened to a lot of people talking. What are they talking about? Scheduled cases on the weekends. The “Since-you-was-here” cases. Can anything be done about it? Do we want to do anything about it?
First, why is it happening? For some reason, doctors want to do more cases; more difficult and involved cases, lasting longer and longer. But the big thing is, they are doing more cases. They are doing them in and around their office time. In the past, they doctors had a day or two in the lab and a couple of days in the office. Now? They seem to be trying to do it all. But I don’t think we can stop that trend. Unless, of course, we can do something about Medicare and Insurance reimbursements. (I don’t think so).
But what can we do? We do need to have our lives outside the hospital. We need a break. It is as dangerous for us to work massive amounts of overtime as it is for any pilot or driver. As a matter of fact, since our work is done in a radiation environment, the more hours we work, the more radiation exposure we receive. That can be a problem in itself, since we work with all doctors, not just one.
So…is there an answer?
As a traveler, I was thinking about this. I would not be averse to working 3 12-hour shifts; Friday, Saturday and Sunday. Or even, Friday 1 – 7 pm; Saturday and Sunday 7 – 7 and Monday 7 – 1. I would agree to a Thursday-Friday-Saturday-Sunday shift 10-hour shift. Do you think the hospital managements would agree to add Saturday as a normal work day? Of course, they would have to agree NOT to allow the call team to do scheduled cases on Saturday/Sunday. If, of course, the doctor can work knowing there is another team “available”.
Times are changing, and we have to go outside the box to adapt. Opinions?
If your hospital has the volume to steadily keep the lab busy on the weekends…staff it!! If the docs knew they had a normal shift to cath on Sat. & Sun. you would not have trouble filling cath slots.
This is NOT cases for the call team!!! These are scheduled cases and over flow. True emergencies would be covered by the call team and they will leave when their case is done. The call case will be immediately sent to the unit as normal and NOT held in the lab…since its staffed. There will be a STRICT number of cases scheduled and these cases will NOT BE complex PCI that require resources available during the week, when the lab is fully staffed.
A contract WILL BE SIGNED by the physicians and there will be no arguments about how many cases and type will be scheduled on the weekend!
IF…this can be done…I’d be signing up tomorrow to work weekends!
The docs would love it and the board wouldn’t be loaded up on Monday and Friday trying to accomodate the need to get folks done to satisfy the insurance nazis! Over time pay would be DRASTICALLY reduced, stress levels reduced , and dept morale would significantly improve!! The entire dept. wins and patient safety would never be compromised!!
In our facility we run 24/7 in house staff. Call team is on 2030 to 630 weekdays, and all weekend. We have seen any scenario you can imagine, scheduled cases, add ons, emergent, urgent. Cold feet, AAA, disected Ao, PNB, plain old chest pain to TAVR. Scheduled staff or call team, really doesn’t matter. Boils down to they Never Say No to the Dr.