Introduction
With increasing technology development, many hospitals, healthcare facilities and aged care facilities are choosing to replace manual, paper-based rostering with commercial electronic rostering software that is often inclusive of artificial intelligence (AI) technology. The QNMU supports organisations developing an electronic rostering and AI strategy that covers the intended adoption purpose and adherence to best practice rostering principles.
Inherent in this shift in the use of electronic rostering is the balance between flexibility, predictability, and ensuring individual staff needs are met while ensuring appropriate skill mix and compliance to the Business Planning Framework (BPF) if applicable (Queensland Government, 2021.
Purpose
The purpose of this position statement is to outline the QNMU’s position regarding the use of electronic rostering systems by hospitals and healthcare facilities.
Definition
Rostering is the process which ensures staff are allocated appropriately to match patient care demands (New South Wales Government, 2018). Effective rostering enables the delivery of safe and quality care and appropriately manages the wellbeing and fatigue of staff. It also allows for patient dependency, activity patterns, staff requests and other variables to be factored into the development of a work roster (Royal College of Nurses, 2019).
Background
Electronic nursing and midwifery rostering has seen significant growth in the last decade and is increasingly seen as the solution to producing cost effective, safe, equitable work schedules (Drake, 2019). Effective rostering requires collaboration between employees and management and incorporates flexible working requests of staff, while meeting organisational needs (Barrett & Holme, 2019).
The QNMU is aware of an increasing trend to implement information technology (IT) into rostering processes. The introduction of these systems may be seen as advances in time management, reallocation of resources and interface user compatibility. However, the requirement for work-life balance must not be underestimated as it is essential for work groups. The adoption of IT processes must not remove the ‘human element’ of compassion, empathy, understanding of work-life balance.
Principles
Key electronic rostering principles and concepts are:
- Consultation and collaboration with nurses and midwives prior to implementation, with an appropriate process for feedback.
- Delivering a service which aims to achieve a balance between service demand and supply of resources.
- Support where necessary, appropriate adjustments to the roster to minimise and correct emergent imbalances to ensure safe, high-quality nursing/midwifery services.
- Sufficient, skilled staff and appropriate skill mix ensuring nurses and midwives are rostered to provide a suitable skill mix to meet identified service demand and maintain patient safety.
- Regulations and policies are conformed to include the BPF (2021) and legislated minimum nurse to patient ratios (where applicable), industrial awards and agreements, workplace health and safety legislation, anti-discrimination legislation and policies/procedures.
- Fairness and equity in the treatment of staff in roster development through transparency, collaboration, co-operation and consultation between management and staff. This promotes fairness, equity and work-life balance, whilst still providing appropriate flexibility to facilitate organisational staffing needs.
- Supervision, training and handover for staff be considered in rostering ensuring nursing and midwifery resources are appropriately allocated.
- Governance and negotiation processes for developing rosters that promote accountability, consultation, collaboration and transparent decision-making in the creation, approval, posting, monitoring, security of data, changing and reporting of rosters.
- Co-operation between rostering managers and staff, to promote fairness in the rostering process.
- Health and safety requirements designed to mitigate fatigue and consider the health and safety needs of nurses and midwives for the provision of safe workplaces, optimal patient care and work/life balance (New South Wales Government, 2021 & Queensland Government, 2018).
- Support for work-life balance for staff as it generates organisational and personal benefits including improved recruitment and retention, attendance and higher staff productivity. Electronic rostering that recognises work and family conflict, influences the work-life balance of nurses and midwives strengthens work-life balance (Skinner & Chapman, 2013).
- Flexibility and capability to facilitate individual flexible working arrangements.
- Visibility/transparency/accessibility of the roster must not be used as a mechanism to hide roster information from staff under the guise of staff privacy. The ability for staff to see roster requests provides collegial discussion to assist with roster formation and needs.
- Surveillance of staff using electronic rostering must not be used, nor must it be used as a mechanism for employee surveillance, time-management oversight or for punitive purposes.
Best practice considerations
In the implementation phase of using an electronic roster, consideration must be given to:
- Technical support.
- Communication and training.
- Clear goals and objectives.
- Having evidence of the advantages and disadvantages of the new system.
- Ease of use.
- Capacity for requests or changing of shifts.
- Publication of the roster.
- Security of published roster (e.g. not shared on Facebook).
- Committed leadership.
- Monitoring, follow up and reporting.
- Gradual implementation through a trial and evaluation process.
- Feedback addressing concerns and issues.
Once in operation, electronic rostering must:
- Be award/agreement compliant.
- Comply with the BPF, if applicable (Queensland Government, 2021).
- Ensure protected time for those who are required to produce the roster.
- Have developed, local conventions or guidelines in collaboration and consultation with unit employees that may include criteria for:
- Shift swapping / changes to a roster.
- Roster requests/roster preferences.
- Allocation of night duty as per unit-based rostering policies and/or the Best practice rostering guidelines (2018).
- Allocation of days-off following completion of night duty in accordance with work health safety regulations.
- Industrial entitlements and/or the Best practice rostering guidelines Queensland Government, 2018).
- The consideration for flexibility with people’s changing lives/circumstances to enable not just an equitable rostering system but one that considers the human aspect of shift work and work-life balance.
- Have the ability for feedback and re-evaluation, including the interface and whether this is appropriate for nursing and midwifery contexts.
- Demonstrably interface with the payroll system, which accurately reflects worked rosters.
The next review of the Best Practice Rostering Guidelines must include the validation from this position statement.
References
Barrett, R. & Holme, A. (2018). Self-rostering can improve work-life balance and staff retention in the NHS. British Journal of Nursing, 27(5), 264-265.
Drake, R. (2019). e-Roster policy: Insights and implications of codifying nurse scheduling. Health Informatics Journal, 25(3), 844-857.
New South Wales Government. (2018). Framework for rostering in NSW Health 2018-2023. Right people, right skills, right place. Retrieved from https://www.health.nsw.gov.au/Rostering/Publications/framework-for-rostering.pdf
New South Wales Government. (2021). Key rostering principles and concepts. Tips for roster managers. Retrieved from https://www.health.nsw.gov.au/Rostering/Documents/key-principles-concepts.pdf
Queensland Government. (2018). Best practice rostering guidelines. Queensland Health nurses and midwives.
Queensland Government. (2021). Business planning framework. The methodology for nursing and midwifery workload management (6th ed.). Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0022/1103773/bpf-2021.pdf
Royal College of Nurses. (2019). Getting staffing levels right. Retrieved from https://www.rcn.org.uk/magazines/bulletin/2019/february/e-rostering
Skinner, N. & Chapman, J. (2013). Work-life balance and family friendly policies. Evidence Base 4, 1-17.