Workforce & Rostering — Roster Optimisation

Achieving medical roster fairness and doctor satisfaction

Using mathematical optimisation to eliminate fairness breaches in junior doctor rosters — from 76 breaches over the period studied to zero.

fairness breaches over the period studied: 76 → 0
consecutive weekends of call: 0
to produce a new optimised roster: Minutes

The challenge

University Hospital Galway is one of Ireland's major academic teaching hospitals, with over 640 beds providing 24/7 acute surgery, acute medicine and critical care across 19 medical and 15 surgical specialties.

In manually producing the junior doctor roster, the medical workforce team tried to give every doctor an even number of allocations — in total and by type: nights, weekends, bank holidays. Allocations also had to be spaced out to provide sufficient rest and avoid consecutive weekends.

Achieving all of that becomes humanly impossible once leave requests and same-team call clashes are also in scope — and worse again when staff lists change at the last minute through sickness or drop-outs. With limited time to rework the roster, the manual result was unfairness and basic rule breaches, including European Working Time Directive breaches.

Our approach

MedModus applied its roster optimisation application, built on an advanced mathematical optimisation model, to produce the fairest roster possible for the medical workforce team.

Fairness is balanced not only within the current rostering period but across previous periods too, so nights, weekends and bank holidays even out over the year rather than within a single quarter — all while other rostering objectives are met and leave requests fulfilled.

The approach to leave was improved alongside the optimisation: doctors are encouraged to submit all leave requests before a three-month roster is produced, so leave is built into the original roster rather than fixed afterwards.

The solution

Because the process is automated, last-minute changes and requests are no longer a problem. New rosters are produced in minutes, meeting every roster objective and maintaining the same level of fairness — an optimal solution is always achieved.

Instances of fairness breaches fell from 76 over the roster period studied to zero, removing the breaches that had previously driven doctor dissatisfaction and, in some cases, EWTD non-compliance. Fulfilling leave in the original roster also reduced subsequent shift swaps, which in turn preserved fairness and avoided further 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.”

Medical Workforce Manager, University Hospital Galway

Outcomes

What changed for the organisation once the platform was live.

Zero
fairness breaches, down from 76
Even allocation
of nights, weekends and bank holidays
Year-round fairness
balanced across previous periods
Minutes
to reproduce a roster after changes
Leave fulfilled
within the original roster
Fewer shift swaps
protecting fairness and rules
EWTD compliance
breaches removed
Improved satisfaction
for junior doctors

Facing a similar challenge?

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