Achieving Medical Rostering Fairness and Doctor Satisfaction


University Hospital Galway (UHG) is one of Ireland’s major academic teaching hospitals with over 640 beds providing 24/7 acute surgery, acute medicine, and critical care. The hospital includes 19 medical specialties and 15 surgical specialties.


Unfair Medical rosters and basic rule breaches

In manually producing the Medical Junior Doctor roster, the medical workforce team try to ensure that all doctors get an even number of shift allocations; in total and by allocation type – nights, weekends, bank holidays, etc. Allocations also need to be spaced out, ensuring doctors get sufficient rest periods and do not work consecutive weekends for example. Trying to achieve all this is a very difficult task and becomes humanly impossible when also attempting to consider leave requests and avoid assigning doctors from the same team to call together. The problem worsens when last minute changes to staff lists such as a doctors becoming unavailable for the beginning of the period due to sickness, or dropping out altogether. With limited time to make appropriate changes, a manually produced roster will result in unfairness and basic rule breaches.


    roster optimisation logic to ensure fairness

    Our roster optimsation application uses an advanced mathematical optimisation model to produce the fairest roster possible. This means all doctors will get an even allocation of shifts – not just within the current rostering period, but over previous periods too – meaning nights, weekends, bank holidays, etc. will be evened out throughout the year. This is achieved while also ensuring all other objectives are met and leave requests are fulfilled.

    As our solution is an automated process, last minute changes or requests are no longer a problem. New rosters can be produced in minutes, meeting all roster objectives and ensuring the same level of fairness – an optimal solution is always achieved.


    In addition to increased levels of fairness, the table below illustrates the elimination of breaches which previously caused doctor dissatisfaction and, in some cases, European Working Time Directive (EWTD) breaches. Instances of fairness breaches were reduced from 76 over the roster period studied to zero. The approach to leave requests was also improved, with doctors encouraged to request all leave before a 3-month roster is produced. This means leave requests are fulfilled in the original roster, reducing subsequent shift swaps. Avoiding swaps also improved fairness and avoided rule breaches.


    Ensuring medical roster fairness was very challenging for UHG because of the number of rules that must be considered, and the manual processes used. MedModus’ roster optimisation service ensures that fairness, and allowed us to improve the way leave requests are handled for doctors

    University Hospital Galway, Medical Workforce Manager

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