A quality improvement project to identify the challenges in call scheduling and validating a custom digital tool to optimize call schedule generation.

This quality improvement study aims to reduce the time to produce an accurate call schedule by 40% in 12 months at an adult neurology residency program. Secondary measures include reduction of revisions by 50% and subjective difficulty by 30% on a 10 point Likert Scale. Alongside a senior software engineer, the author has developed a custom program (“CRONUS”) that utilizes constraint algorithms to instantaneously apply desired features. Plan-Do-Study-Act (PDSA) cycles will apply additional features as directed by feedback every four weeks to determine the factors that optimize call schedule production.

Initial surveys described difficulties with visualization and desire for automation to provide a preliminary schedule. Across five hospitals, a mean of 4.6 hours was required to complete a schedule with 3.1 revisions and a difficulty rating of 5.9 (out of 10). Thus far, preliminary data using “CRONUS” has shown a 25% reduction in total number of hours required, 33% reduction in average revisions required and 27% reduction in subjective difficulty. Additional data are being collected and will be presented at the time of the conference.

There is a significant reduction in overall time required, number of revisions and perceived difficulty when using the program. Additional PDSA cycles will be required to confirm its efficacy, identify additional factors and implement new features to optimize them.  Future directions include use in other residency programs as well as application to clinical informatics to optimize outpatient clinic scheduling.