Workforce & Rostering — Roster Optimisation

Transforming junior doctor call roster design with a 98% improvement in fairness and availability

Replacing 12 person weeks a year of manual spreadsheet rostering with automated optimisation across three grades of junior doctor — producing fairer rosters in under five minutes.

fall in unavailability from specialty clashes: 98%
to produce a roster, down from weeks: <5 min
of annual productivity released: 12 person weeks

The challenge

Tallaght University Hospital is one of Ireland's major academic teaching hospitals — 562 beds, 16 theatres and 20 critical care beds, with 3,000 staff treating over 410,000 patients per year.

TUH's medical workforce team produced medical on-call rosters for almost 90 junior doctors. The manual quarterly process was complex and time-consuming, requiring at least 12 person weeks per year, and the difficulty of ensuring fairness generated complaints from doctors. Three rosters were needed — 30 registrars, 30 SHOs and 26 interns — four times a year.

Requirements included even distribution of day, night and weekend call shifts, plus over 20 constraints: avoiding consecutive weekends, maintaining EWTD rest-day gaps between call, keeping doctors from the same specialty off call on the same or adjacent days, and further specialty and consultant-specific restrictions.

Our approach

TUH replaced the manual spreadsheet process with MedModus' automated Roster Optimisation application, which uses an advanced mathematical optimisation model to achieve every rostering objective while adhering to all constraints.

Rosters for all grades of doctor are produced simultaneously rather than sequentially, so specialty clashes are avoided across grades and doctor availability improves. The model also accounts for annual leave and previous roster allocations, testing thousands of permutations in minutes to reach an optimal result.

The solution

Fairness improved dramatically: instances of rest-day rule breaches — such as doctors working more than one bank holiday — fell to zero, and each roster is now produced in under five minutes instead of weeks.

Availability improved in parallel, with unavailability caused by specialty clashes falling by 98%, so more doctors were on hand within their specialties to provide care. Last-minute roster changes are turned around quickly, and the approach was extended to surgery, covering 160 doctors in total.

MedModus also provides a responsive managed service to support TUH through busy roster seasons.

“Producing these rosters was a real headache for our department. The number of factors to consider made it time-consuming and prone to error. The automation of this process has resulted in fairer rosters with less errors and saved valuable HR time.”

Human Resources Director, Tallaght University Hospital

Outcomes

What changed for the organisation once the platform was live.

98%
reduction in specialty-clash unavailability
Zero
rest-day rule breaches
Weeks → minutes
to produce each roster
12 person weeks
of productivity gained per year
Improved EWTD
compliance across grades
160 doctors
covered after expansion to surgery
Fast turnaround
of last-minute roster changes
Managed service
support in busy roster seasons

Facing a similar challenge?

We will walk you through how this engagement was delivered and what the equivalent first phase would look like for your organisation.

More case studies