University of Iowa, Iowa City, USA.
Department of Anesthesia, University of Iowa, Iowa City, USA.
J Clin Anesth. 2023 Sep;88:111142. doi: 10.1016/j.jclinane.2023.111142. Epub 2023 May 6.
We performed a narrative review of articles applicable to anesthesiologists' and nurse anesthetists' choices of who works each statutory holiday for operating room and non-operating room anesthesia. We include search protocols and detailed supplementary annotated comments. Studies showed that holiday staff scheduling is emotional. Working on holidays often is more stressful and undesirable than comparable workdays. Intrinsic motivation may overall, among practitioners, be greater by preferentially scheduling practitioners who choose to work on holidays, for compensation, before mandating that practitioners who would prefer to be off must work on holidays. Granting each practitioner (who so desires) at least one major holiday off can depend on identifying and scheduling other clinicians who want to work holidays for monetary compensation or extra compensatory time off. Scheduling holidays by random priority (i.e., a lottery choosing who gets to pick their holiday[s] first, second, etc.) is inefficient, resulting in fewer practitioners having their preferences satisfied, especially for small departments or divisions (e.g., cardiac anesthesia). No article that we reviewed implemented a random priority mechanism for staff scheduling. The selection of practitioners to take turns in choosing their holidays is perceived to have less fairness than a selection process that collects each participants' preferences. Although holidays often are scheduled separately from regular workdays and weekends, doing so will not increase efficiency or fairness. Holidays can, in practice, be scheduled simultaneously with non-holidays. Models can explicitly include fairness as an objective. For example, fairness can be based on the difference between the maximum and minimum number of holidays for which practitioners of the same division are scheduled. Holidays can be given greater weights than other shifts when estimating fairness. Staff scheduling for holidays, when done simultaneously with regular workdays, nights, and weekends, can also use personalized weights, specifying practitioners' preferences to be satisfied if possible.
我们对适用于麻醉师和护士麻醉师选择谁在每个法定假日为手术室和非手术室麻醉工作的文章进行了叙述性综述。我们包括搜索协议和详细的补充注释。研究表明,假日员工排班是情绪化的。在假期工作通常比可比工作日更有压力和不令人向往。在实践中,从业者的内在动机可能更大,通过优先安排选择在假期工作的从业者,给予补偿,而不是强制那些宁愿休假的从业者在假期工作。允许每个从业者(如有需要)至少休一个主要假期,可以通过确定和安排其他愿意在假期工作以获得金钱补偿或额外补偿休假的临床医生来实现。通过随机优先级(即,选择谁首先选择假期,其次等的彩票选择)来安排假期是低效的,导致较少的从业者满足他们的偏好,特别是对于小部门或科室(例如,心脏麻醉)。我们审查的没有一篇文章为员工排班实施了随机优先级机制。选择从业者轮流选择假期的做法被认为不如收集每个参与者偏好的选择过程公平。尽管假期通常与正常工作日和周末分开安排,但这样做不会提高效率或公平性。假期实际上可以与非假期同时安排。模型可以明确将公平性作为目标。例如,公平性可以基于同一部门的从业者被安排的假期数量的最大值和最小值之间的差异。在评估公平性时,可以给假期比其他班次更大的权重。当与正常工作日、夜班和周末同时安排假期时,员工排班也可以使用个性化权重,如果可能的话,指定满足从业者的偏好。