Need for work style reform: Doctors’ long working hours have become a serious social problem. This is especially true of anesthesiologists, which are experiencing an alarming amount of overtime work, and a concerning shortage of manpower leading to a serious medical systematic problem.

Additionally, advances in medical technology have led to an increase in surgical procedures, and the demand for anesthesiologists has increased accordingly. In response to this issue, hospitals are considering various measures in 2024 to benefit doctors’ work/life balance and wellbeing in the workplace. The Ministry of Health, Labor and Welfare’s overview of “work style reform for doctors” states as follows:

Factors contributing to long working hours

1. The need to improve doctors’ skills: Anesthesiologists are required to have advanced skills in a wide variety of tasks, including assessing patients before surgery, formulating anesthesia plans, monitoring during surgery, and checking recovery status after surgery. Improving doctors’ skills will reduce the overall work burden on anesthesiologists. For this reason, it is extremely important to secure time that can be dedicated to human resource development.
2. Manual administrative tasks: Anesthesiologists must coordinate not only with other physicians and staff but also surgical schedules. Operating room situations, emergency surgeries, and schedule changes occur frequently, and solving these administrative tasks results in long working hours.

Assignment

Securing time for regular work as a doctor and reducing administrative work In order to reduce doctors’ overtime work, it is important to first reduce clerical work, including shift schedule creation for doctors. When managing a doctor’s schedule, it is necessary to take into account not only whether or not the doctor attends work, but also the hospital’s unique shift rules and the doctor’s skill level and growth (experience). Even in the best case scenario, in addition to in-hospital shifts, outside duties are also common. As a result, this extremely complex shift creation needs to allow unavoidable overtime work.

Solution

YoteiPLUS+ (Introduction of monthly/daily doctor shift scheduling)
In order to reduce the administrative work involved in assigning shifts for anesthesiologists, we introduced YoteiPLUS+, the monthly and daily schedule management system by Aquila Systems. Once the monthly availability of doctors is confirmed, the AI engine will automatically assign their daily shifts to the surgeries scheduled a week in advance.

Assignment is done as follows:

1. As the first step, each doctor fills in their own preferences
2. Then, the AI engine creates an optimal monthly assignment according to the constraints
3. As the last step, the AI engine matches each elective surgery with the appropriate anesthesiologist

Surgical schedule changes occur frequently, but optimization can be repeated as many times as required. From collecting requests to assigning shifts, we can use a seamless system which ensures fairness, equity and optimality within the given constraints. The AI engine takes into account the difficulty of the surgery and recommends assignments based on the skills and future growth of the anesthesia doctors.

Integration with external systems
The management of anesthesiologists performing outpatient care at affiliated hospitals is recorded in a separate system. Previously, shifts at affiliated hospitals were recorded manually. However, with the introduction of YoteiPLUS+, it is possible to link with the outside work record system, automatically updating shift assignments and creating schedules that take outpatient work into consideration. This reduces manual work, improves operational efficiency, and enables more effective use of time and resources.

Results

“Until now, physician work management at our hospital had been mainly done manually using Excel and other tools. This administrative work required knowledge of each doctor’s skills and capabilities and it was highly dependent on one doctor responsible for the schedule. However, after introducing YoteiPLUS+, manual work and individual dependency has been significantly reduced, making it possible to assign shifts and tasks faster and equitable. The system was easily adaptable to our hospital’s needs and requests, and in this process I felt that we were evolving together.”

Feedback from schedule administrators

“The scheduling of anesthesiologists is complicated by various factors such as irregular field assignments, increased surgical caseloads, disparities between requested and actual surgical times, the presence of anesthesiologists with different work patterns (variations in workdays and night shifts), management of the required number of cases for specialty certification, and coordination of requests to avoid certain assignments.

Previously, we relied on intuition to create schedules, which consumed significant time in preparation, post-schedule adjustments, and error checking. With the implementation of this system, the preparation time for schedule creation has been drastically reduced. Information regarding task avoidance and work patterns is already input and summarized, allowing for efficient allocation of internal assignments by AI, taking into account travel time for field assignments. Moreover, the system offers flexibility, allowing us to pre-designate specific anesthesiologists for specialized procedures using features such as PIN locking.

As we continue to use these systems, they evolve and improve, enabling even more efficient operations. We believe this solution not only facilitates work-style reform but also contributes to the overall improvement of hospital management.”

Conclusion

With the introduction of the cloud-based, AI-powered anesthesiologist shift allocation system, the anesthesia department has achieved remarkable results:

• Streamlining administrative work, freeing up time for doctors to focus on their core responsibilities
• Adding flexibility to scheduling, allowing more time for personal development
• Reducing overtime work, leading to a better work-life balance, and ultimately provision of higher-quality medical care for patients

“Our hospital has achieved remarkable results in transforming the way doctors work with the introduction of cloud-based anesthesiologist shift allocation powered by an AI engine. Positive changes are being seen in a variety of areas, including reducing long working hours, streamlining administrative work, and freeing up time for doctors to focus on their core work. By streamlining shift creation, doctors are able to manage their schedules more flexibly, and by securing time for human resource development, they are able to improve their overall skills and improve the performance of the entire organization. Additionally, by reducing overtime work, you can secure more private time. This is expected to make it easier for doctors to balance work and life, reducing fatigue and improving mental health. We believe that if doctors can work with a more refreshed and rewarding feeling, this will ultimately lead to the provision of high-quality medical care to patients.”

About Ehime University Hospital

Ehime University School of Medicine was established in 1973 as the only medical education facility in the prefecture, and Ehime University Hospital opened in 1976, and has been the leading hospital in Ehime Prefecture since then. It functions as a general hospital that protects the area.

The University Hospital currently has 24 departments, 47 central medical facilities, 644 hospital beds, and a total staff of approximately 2000 people, with around 550 doctors and 740 nurses, pharmacists and radiologists, and other healthcare professionals and administrative staff, all working hard to provide a perfect system of medical care.