Hospitals & Health Systems Archives - Lightning Bolt Solutions https://www.lightning-bolt.com/case-study-category/hospitals-and-health-systems/ Fri, 13 Feb 2026 16:33:07 +0000 en-US hourly 1 https://wordpress.org/?v=6.9 https://www.lightning-bolt.com/wp-content/uploads/2024/08/favicon.png Hospitals & Health Systems Archives - Lightning Bolt Solutions https://www.lightning-bolt.com/case-study-category/hospitals-and-health-systems/ 32 32 How To Cut Call Volume By Integrating Physician Schedules https://www.lightning-bolt.com/case-study/hospital-pager-replacement/ Fri, 13 Feb 2026 16:32:16 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=27463 Executive Summary Improved Efficiency with Lower Costs 50%savings The changes improved reliability, visibility, and communication efficiency for operators, clinicians, and patients alike, and Munson’s monthly costs related to pagers dropped by 50%. A System Stuck in the Pager Era Munson’s call center was built on a legacy vendor’s on-prem technology that was no longer a...

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Executive Summary

  • Munson Healthcare’s 7-hospital system in northern Michigan was ready to retire its aging call center infrastructure, which relied heavily on pagers and an unreliable mobile messaging app.
  • The on-prem system was difficult to maintain, tethered the organization to nearly 1,500 physical pagers, and created heavy call volumes for operators.
  • Clinicians lacked a dependable way to connect directly with colleagues, and schedules were difficult to keep current.
  • As part of a larger modernization effort, Munson replaced the legacy platform with PerfectServe, including its Operator Console, Clinical Collaboration, and Lightning Bolt Scheduling solutions.
  • Over the next 13 months, Munson saw call volume to the call center decrease by 56,000. The health system also retired 600 hard pagers (40% of the total) and transitioned more than 2,000 clinicians to PerfectServe’s secure mobile and web messaging platform.

Improved Efficiency with Lower Costs

50%savings

The changes improved reliability, visibility, and communication efficiency for operators, clinicians, and patients alike, and Munson’s monthly costs related to pagers dropped by 50%.

Clinicians relied on pagers and the vendor’s mobile app for communication—tools that worked in theory, but not always in practice.

Although the mobile app technically supported secure paging, its reliability issues led to frequent missed messages and delayed responses, creating risk and frustration for clinicians.

Operators, meanwhile, had little visibility into whether messages were received or acted upon.

How PerfectServe Streamlined Call Routing and Messaging

After an extensive evaluation process, Munson partnered with PerfectServe to address not just communication weaknesses, but scheduling shortcomings as well. Though the call center was a focal point, the vision PerfectServe outlined, with multichannel communication and integrated provider scheduling across their entire health system, yielded a broader project scope with greater potential for impact.

PerfectServe replaced Munson’s on-prem communication system with a multi-solution, cloud-based platform designed for reliability and flexibility. The implementation included:

Operator Console
A modern switchboard that gives operators instant access to clinicians, customizable scripts, and quickaction buttons for tasks like clinical codes. One particular area of improvement has been the upload process from Active Directory, which helps ensure clinician data stays current across the system.

Clinical Collaboration
Secure mobile and web messaging that lets clinicians reach colleagues directly without routing through the switchboard.

Lightning Bolt Scheduling
Integrated provider schedules that ensure all users—from operators to clinicians—can easily tell who’s covering each role.

Emergency Alerting
Mass notification capability that allows Munson to page up to 10,000 users at once for weather emergencies and other critical events—and in the same platform where all other critical communications happen.

56,000 Fewer Calls—and a More Connected Care Team

The impact of Munson Healthcare’s move to PerfectServe was far-reaching. By consolidating communication and scheduling into one platform, Munson achieved results that touched almost every corner of the organization

The shift to PerfectServe has transformed how calls flow through Munson’s switchboard. Instead of relying on operators for every connection, clinicians can now reach one another directly and securely.

  • Uptick in secure messaging adoption: In January 2024, 1,895 clinicians used the previous vendor’s mobile application. By September 2025, 2,097 were using PerfectServe’s mobile and web app. Clinicians sent 64,622 secure messages in PerfectServe in July 2025, a 32% increase from the 49,035 sent the prior August. These are clear signs of growth and confidence in the new platform.
  • Internal calls down 34%: Calls to the switchboard from the internal queue dropped from 12,230 in August 2024 to 8,090 in July 2025.
  • Operator-initiated pages down almost 30%: Paging activity from the switchboard fell from 3,627 in August 2024 to 2,568 in July 2025, allowing operators to focus more on urgent or complex cases.
  • Code phones remain for critical alerts: While emergency code phone calls—used for scenarios like STEMI or code blue—still represent a small but important share of traffic, operators can now use quick-action buttons in Operator Console to quickly send predefined alerts to the correct response teams.

These trends, combined with the introduction of an IVR phone tree that now handles a large share of routine calls, resulted in a reduction of 56,000 total calls to the call center over 13 months. Fewer routine calls mean operators can focus on high-stakes situations while clinicians enjoy faster, more reliable communication through secure messaging.

32%

increase in messages sent after implementing PerfectServe.

34%

drop in internal calls to the switchboard.

30%

drop in operator-initiated pages.

Fewer Pagers, 50% Reduction in Monthly Costs, and More Reliable Communication

Since implementing PerfectServe, Munson has retired about 40% of its hard pagers (600 out of 1,497). The resulting benefits have been twofold:

1

First, these pagers come with monthly service and maintenance costs, which end up accounting for most of the lifetime revenue derived by vendors who use them. In this instance, Munson’s average monthly spend for pager fees was about $20,000. After the PerfectServe deployment, that number has been reduced to $10,000— a significant 50% drop.

2

Second, the transition to PerfectServe-enabled secure mobile and web messaging gives clinicians a more modern and reliable way to connect that pagers can’t replicate. Enabling realtime communication has improved both clinician response times and the speed of care coordination.

Operators Are Working Smarter, Not Harder

With fewer calls and advanced scripting at their fingertips, operators can handle complex scenarios with speed and confidence. Quickaction buttons, searchable directories, and pre-built clinical code scripts mean that even new staff who don’t have every department memorized can efficiently manage high-stakes alerts like STEMI or code blue.

PerfectServe gives operators visibility into message delivery and read receipts, and the platform also indicates when a message has been auto-escalated to another recipient if it hasn’t been actioned within a certain time frame. This prevents operators from having to spend additional time following up or repeating actions, and it gives them peace of mind that important communications are reaching someone who can respond appropriately.

System-Wide Scheduling Drives Clinical Efficiency

Because Lightning Bolt schedules are fully integrated with Operator Console and Clinical Collaboration, operators always know who’s on call and how to reach them. This real-time connection between scheduling and communication reduces errors, prevents delays, and removes potentially dangerous roadblocks from daily care coordination.

These combined gains translate into a more efficient call center, lower costs, and a better communication experience for every member of the care team. It’s a good indication that retiring outdated technology can quickly unlock measurable, system-wide value.

A Vendor That Feels Like a Proactive Partner

Munson was also thoroughly impressed with PerfectServe’s proactive and customer-centric approach. These projects impact and require input from a lot of people, and the details tend to evolve quite a bit from start to finish, so success almost always hinges on close cooperation between the healthcare organization and the vendor.

That’s exactly what Munson has experienced with PerfectServe, noting in particular that the PerfectServe project team:

  • Takes time to listen and understand their needs
  • Translates those needs into creative solutions
  • Hosts productive project check-ins on a regular basis
  • Asks for feedback and follows through with actionable changes to improve workflows
  • Presents proactive solutions and enhancements that they may not even be asking for

This kind of close partnership can be the difference between a big deployment whose impact diminishes over time and a game-changing upgrade that permanently alters the way care is coordinated.

Replacing a Legacy Vendor to Build a More Connected Care Team

Munson Healthcare’s journey underscores a simple truth: Retiring outdated technology is a worthy goal if it’s no longer meeting your needs, but it’s also only half the battle. Long-term success with this kind of project required a partner who:

  • Had the right scheduling technology with Lightning Bolt
  • Gave them a chance to consolidate important scheduling and communication workflows with one vendor
  • Had the right mix of clinical experience and proactive customer support to help them execute a transformative upgrade with tangible results

With PerfectServe, Munson replaced a legacy vendor while building a foundation for faster communication, lower costs, and a more connected care team.

Exploring New Ways to Scale with PerfectServe

With the core switchboard already seeing strong results, Munson is exploring other ways to leverage the PerfectServe platform, including expanded scripting features that could further streamline critical communication.

Whatever the future holds, working with PerfectServe’s more scalable technology has given Munson the flexibility to add functionality on its own terms and as needs arise.

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Finding a Better CRNA Scheduling Solution https://www.lightning-bolt.com/case-study/crna-scheduling-case-study/ Thu, 18 Dec 2025 20:53:21 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=27382 For John Krall, Chief CRNA at Midwest Physician Anesthesia Services, scheduling used to be his biggest headache. He spent at least an hour each week managing time-off requests and piecing shifts together by hand. Since the MDs built their daily schedules around his weekly plan, John felt a lot of pressure to get it right....

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For John Krall, Chief CRNA at Midwest Physician Anesthesia Services, scheduling used to be his biggest headache. He spent at least an hour each week managing time-off requests and piecing shifts together by hand. Since the MDs built their daily schedules around his weekly plan, John felt a lot of pressure to get it right.

Still, providers weren’t always happy.

With most of his team covering 3 hospitals and 5 surgery centers, the schedule was already complex. Add the inevitable last-minute changes and necessary blocks for travel time, and it felt less like scheduling and more like untangling a knot.

John built schedules manually in Excel before exporting the PDF into a basic web-based tool that didn’t offer much help. It didn’t support real-time updates—meaning changes weren’t immediately visible to others—and schedules could only be built one week at a time. Before one week even wrapped up, he was already starting the next.

John wanted automation, actual real-time visibility, and a way to plan ahead without sacrificing provider requests. After switching to PerfectServe’s Lightning Bolt Scheduling, “90% of the work” came off his plate. For the first time, every provider across every location was on the same platform.

Benefits of Better Healthcare
Scheduling Software

Time Saved Building Schedules

Transitioning to anesthesia scheduling software was a smooth process thanks to Paje Bishop, one of Lightning Bolt’s many dedicated technical consultants. With her help, John was able to create custom rules, which act like a blueprint as the algorithm pieces the best schedule together. This meant he could ditch the painful Excel process.

Improved Vacation Management

Before, all time-off requests had to be submitted on a one-off basis, and they weren’t managed inside the scheduling interface. That meant John had to keep track of all requests to make sure they were reflected in the appropriate schedule. When scheduling isn’t even your primary job, little annoyances like this can add up fast.

Now, John can manage vacation time in Lightning Bolt with a much simpler and more reliable workflow. Almost all users submit their time-off requests in the platform, and John can approve them in just a few clicks. Once requests are “on the books,” schedules are automatically built around them.

Mobile Device Schedule Management

Lightning Bolt has both desktop and mobile apps, so John can manage the schedule anywhere, anytime—even from his phone. The real-time schedule is also available via a public link, which gives providers—and anyone else who needs to know the group’s schedule—easy access from any device.

Extended Schedule Horizon

Because Lightning Bolt uses an intelligent healthcare scheduling algorithm, John can build schedules 6 months in advance instead of sprinting through the old weekly scramble. This saves him time and gives providers a longer view of their schedules, which allows them to more easily plan their lives inside and outside of work. It also gives patients the chance to schedule appointments further in advance.

Supporting Group Growth

As Midwest Physician Anesthesia Services continues to grow, Lightning Bolt easily integrates new CRNAs and MDs into the scheduling process. New team members can be added without disrupting previously published schedules—even those completed months in advance.

A CRNA Scheduling Solution That Saves Time and Reduces Stress

Switching to a scheduling platform built specifically for the complex needs of a group like Midwest Physician Anesthesia Services has transformed scheduling for John Krall and his team. Time-off requests are easier to manage, schedules can be planned months in advance, and what once required hours of manual work now takes minutes.

Providers across all locations now work from a single scheduling platform, creating better visibility across the group and allowing schedules to be built months in advance. That long-range view helps promote balance and predictability for providers, while Lightning Bolt ensures scheduling remains accurate and effortless as the organization continues to grow—freeing John and his team to focus on what matters most: patient care.

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Solving Complex Radiology Scheduling https://www.lightning-bolt.com/case-study/solving-complex-radiology-scheduling/ Tue, 16 Sep 2025 17:57:24 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=27206 75% Decreased time spent creating schedules by 75% 130+ Successfully implemented over 130 rules to efficiently manage provider requests 5 to 4 Transitioned from five-day to four-day work week with optimized schedules 2 Improved clarity and efficiency by generating schedules once every two months = Maintained critical coverage while supporting work-life balance “If I didn’t...

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75%

Decreased time spent creating schedules by 75%

130+

Successfully implemented over 130 rules to efficiently manage provider requests

5 to 4

Transitioned from five-day to four-day work week with optimized schedules

2

Improved clarity and efficiency by generating schedules once every two months

=

Maintained critical coverage while supporting work-life balance

From Spreadsheet Struggles to Scheduling Success

Today, this radiology department operates more smoothly and transparently than ever before. Physicians work four-day weeks with balanced rotations, vacation requests are handled effortlessly, and the scheduling physician spends 75% less time wrestling with scheduling challenges.

But the journey to this point wasn’t simple.

Challenges

The Breaking Point of Manual Scheduling

For years, this radiology group’s scheduling physician carefully built intricate Excel spreadsheets, painstakingly balancing provider preferences, rotation requirements, and call shifts. The manual process took up valuable time that could have been spent on patient care.

The manual process of creating schedules for 40+ providers divided between diagnostic and interventional teams, each with their own subspecialty rotations and preferences, had become too complex and time-consuming.

The Four-Day Week Vision

In 2016, the department envisioned a bold change: transitioning from the traditional five-day work week to a four-day schedule while maintaining comprehensive patient care. This vision would enhance physician work-life balance but presented some scheduling hurdles:

  • Physicians would work 10-hour days instead of 8-hour days
  • All subspecialty rotations needed full coverage despite fewer working days
  • Call shifts required equitable distribution across fewer available days
  • Fair distribution of off days became crucial for team morale

Evolving Practice Needs

As with many healthcare organizations, the department faced ongoing changes:

  • Provider turnover through retirements and new hires
  • Growing complexity in workflows requiring specialized coverage
  • Increasing need for coordination between diagnostic and interventional teams
  • Managing vacation requests while ensuring critical subspecialty coverage

Solution & Implementation

When the department reached its breaking point with manual scheduling, they started looking in earnest for a new radiology scheduling solution that could reliably handle these legitimate challenges. Lightning Bolt had the optimization capabilities to handle the complexity and the team full of experts the group needed to get a leg up.

Partnership Approach

From the beginning, the department worked closely with a Lightning Bolt technical consultant who understood their specific challenges. This relationship proved crucial to success because the consultant:

  • Translated the department’s complex needs into a customized scheduling framework
  • Designed and implemented 130+ rules to reflect both provider preferences and requirements
  • Provided ongoing support as practice needs changed
  • Met regularly to check out schedule results and make adjustments as needed

And with respect to rules, that’s one area where the Lightning Bolt team’s expertise and longevity is really evident. 130 rules may sound like a lot, but in the scope of what Lightning Bolt can handle—both the team and the technology—it’s very normal. The team draws from years of experience with many kinds of implementations, so this level of granularity is not unexpected and can easily be folded into an efficient deployment.

Rules-Based Optimization

Each rule in Lightning Bolt is assigned a numerical priority, which guides the system’s algorithm—powered by combinatorial optimization—when it builds schedules. Designed by a dedicated consultant who works closely with each group to reflect their unique preferences, these rules ensure the schedule aligns with physician needs.

The algorithm’s goal is always to break zero rules if possible, but sometimes it has to break the “right” rules. In these instances, the lowest priority rules are broken (and flagged for review) to build the best, most complete schedule.

Part of Lightning Bolt’s inherent flexibility is that no two rules have the same priority level, which allows the algorithm to create a complete schedule that covers even the hard-to-fill shifts. With this more nuanced approach, Lightning Bolt can satisfy the most scheduling rules possible with the fewest gaps. And best of all, rules only need to be configured once and are applied automatically moving forward.

With more basic scheduling solutions, rules may only have high, medium, and low priority designations, which creates problems when two rules with the same priority level are being compared. The system won’t be able to make an independent decision about which rule should be broken, which results in a schedule gap. Lightning Bolt’s rule-based scheduling easily accounts for more granular levels of importance to avoid this scenario.

Smart Vacation Management

The scheduling physician partners with their Lightning Bolt consultant to set the number of physicians who can take PTO each week, with limits assigned to each radiology subspecialty.

“HOT PTO” requests submitted by the radiologists are auto-approved on a first-come, first-served basis until the weekly limit is met. Once the limit is reached, the system automatically blocks additional requests for that time period, helping to maintain balanced provider coverage.

Four-Day Work Week Success

The department successfully implemented their vision of a four-day work week with:

  • Optimized 10-hour shift designs
  • Automated rules ensuring fair distribution of off days
  • Priority coverage for critical rotations when short-staffed
  • Balanced call responsibilities across fewer working days

Results: A Department Transformed

From Time Drain to Efficiency

The most dramatic improvement came in administrative efficiency:

Before Lightning Bolt After Lightning Bolt
Schedule Creation Manual, time-intensive process 75% reduction in time required
Vacation Management Manual tracking and approval Automated with tiered request system
Schedule Publishing Monthly schedules only Bimonthly schedules with greater efficiency
Rotation Balancing Manual calculations Automated with reporting validation
Work-Life Balance Standard five-day week Optimized four-day week with fair shift distribution

Physician Satisfaction

The department experienced notable improvements in physician satisfaction:

  • Reduced burnout through four-day work weeks
  • Greater transparency in rotation and call shift distribution
  • Streamlined vacation requests with mobile access
  • Fairer distribution of responsibilities

The transparent reporting system makes it easy to see that rotations are balanced fairly, which gives physicians confidence that the system accommodates preferences as equitably as possible.

Adaptability for the Future

Perhaps most importantly, the department gained the ability to evolve with changing healthcare needs:

  • Easily modify rotations as practice patterns change
  • Quickly adapt to staffing changes
  • Test new scheduling approaches through simulation
  • Make data-driven decisions about resource allocation

Lessons Learned

The department’s journey yielded valuable insights:

1

Partner with experts:
Regular collaboration with Lightning Bolt consultants proved essential. Their schedule reviews after each generation significantly improved results and reduced administrative burden.

2

Embrace automation:
Transitioning from manual processes to Lightning Bolt’s centralized system transformed administrative workflows. Mobile access for vacation requests improved satisfaction for both providers and schedulers.

3

Think bigger picture:
Building schedules once every two months rather than monthly allowed the scheduling physician to tackle scheduling less frequently while maintaining quality.

4

Start with the end in mind:
By clearly defining their vision of a four-day work week, the department was able to successfully implement this significant change thanks to Lightning Bolt’s optimization capabilities.

The Path Forward

Today, the radiology department operates more efficiently than ever. Physicians enjoy better work-life balance with their four-day schedule, administrative time has been significantly reduced, and the entire department benefits from the transparency and fairness built into their scheduling process.

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How Better Radiology Schedules Helped Grow Service Lines https://www.lightning-bolt.com/case-study/radiology-scheduling-service-lines/ Wed, 25 Jun 2025 18:37:53 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=26966 Background A 60-physician radiology group affiliated with a state’s largest health system covers multiple locations across various subspecialties. It also includes six APPs and offers a full range of imaging services for patients of all ages. Challenge The radiology group was using another automated scheduling solution to create a standard monthly schedule. However, they were...

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Background

A 60-physician radiology group affiliated with a state’s largest health system covers multiple locations across various subspecialties. It also includes six APPs and offers a full range of imaging services for patients of all ages.

Challenge

The radiology group was using another automated scheduling solution to create a standard monthly schedule. However, they were still manually building complex vacation and holiday schedules before automating on-call shifts.

When a new Lead Scheduling Physician assumed the task of building the monthly schedule, it quickly became clear how time-consuming and inefficient the process was—especially when accounting for holidays, vacations, provider preferences, multiple locations, and varied shift types. Frustrated with the inefficiency, the physician sought a new solution that could optimize and auto-generate schedules with reduced manual input to streamline the process from start to finish.

Implementation

The health system is extensive and includes about 20 hospitals, 300 physician practice sites, and two clinically integrated networks with over 4,500 providers. The radiology department wasn’t the only department that needed to find a solution capable of managing enterprise-level scheduling complexities. As long-time users of PerfectServe’s clinical communication platform, the health system evaluated Lightning Bolt for its potential to streamline scheduling and integrate with communication workflows.

After deciding on Lightning Bolt’s healthcare scheduling software, the organization initiated a rapid enterprise-wide solution deployment. Using a ‘rip and replace’ approach, implementation teams rolled the solution out to over 2,100 providers in just three months.

Dedicated technical consultants supported each department to ensure proper implementation and user training. The radiology department’s Lead Scheduling Physician and others collaborated with the Lightning Bolt team to optimize schedules, improve workflows, and continue refining processes to save time and enhance work-life balance for providers.

Results

1

Intelligent Optimization

The radiology department uses credit hours—a unique tactic for assigning compensation to a particular type of shift—to track shifts worked, ensure accurate compensation, and distribute workloads evenly among providers. Before Lightning Bolt, it was difficult to confirm whether shift loads were balanced, potentially affecting the accuracy of provider compensation.

The department also schedules “gap credits” to track non-clinical shifts for activities like attending conferences or serving on executive committees. These required credits must be carefully scheduled to avoid impacting patient care while being distributed fairly. Managing these complexities requires a system that tracks both scheduling and payroll reporting to ensure transparency and equity.

Despite these complexities, Lightning Bolt auto-generates nearly all of the department’s schedule, equalizing credit hours across the year while maintaining accurate payroll. The Lead Scheduling Physician is then able to easily schedule any remaining tasks— medical school interviews, new hires, and administrative duties—around the optimized schedule.

2

Beneficial Time Savings
Lightning Bolt has significantly streamlined the process of creating the regular monthly call schedule. By automatically building schedules around providers’ time off, it has transformed what was once a time-intensive task into a much more manageable and efficient workflow.

The result is a smoother, more flexible scheduling process that meets both provider preferences and organizational needs.

3

Supporting Strategic Growth in Interventional Radiology
The group aimed to expand its interventional radiology service line, requiring a 50% increase in daily staffing—from two to three providers. They leveraged Lightning Bolt’s algorithm to gradually adjust assignments: starting with half-day interventional shifts, then full-day shifts, and ultimately five-day-per-week interventional coverage.

This incremental approach allowed the group to scale their service line strategically without overburdening providers, effectively matching staffing levels to work demands. By aligning resources with patient needs, the group achieved greater efficiency and reduced waste.

“Lightning Bolt has allowed for incremental growth in our service lines. Interventional Radiology used to do two days reading and two days doing interventions. Now we have a full schedule five days a week [of interventions], and the Lightning Bolt algorithm helped us do this.”

—Lead Scheduling Physician

4

Easier Shift Swaps, Trades, and Requests
In Lightning Bolt, providers are scheduled in specific seats to read images during their shifts and can now request certain seats for an added layer of autonomy.

Providers can also submit shift swaps and time-off requests. Some requests are automatically applied based on pre-set guidelines, while others require approval before being added to the schedule.

5

Streamlined Shift Prioritization
Updating shift priorities within Lightning Bolt is a game-changer for the group. For example, the mammography assignment designates one primary physician and three backups—A, B, and C—ranked by priority. This structure is mirrored across multiple hospital locations to ensure fair and efficient backup coverage.

6

Mobile App Increases Schedule Access and Vacation Visibility
Providers now have real-time access to their schedules in Lightning Bolt’s mobile app, which can be shared via link. Techs have access to a view-only version to ensure they contact the correct providers.

The system also integrates vacation schedules seamlessly, offering clear visibility into time-off requests and approved time off. This transparency helps reduce scheduling conflicts and ensures providers can easily access important information.

7

Enhanced Communication for Better Care Coordination
Lightning Bolt integrates with PerfectServe to improve communication and care coordination. The system supports messaging, escalations, and workflows for specific procedures, with messaging groups for peds call, stroke, lumbar punctures, general questions, and angio. The system uses Lightning Bolt assignments to determine the correct contact to ensure messages reach the right person.

This integration reduces communication bottlenecks by evenly distributing call responsibilities among team members, alleviating the burden on individual providers. Another integrated workflow using PACS and PowerScribe automates the delivery of radiology reports for stroke and trauma cases, enabling faster clinical response and improving patient outcomes.

8

Detailed Insights With Reports
The radiology department uses Lightning Bolt reports to ensure credit hours and gap credits are accurate. These reports include paid hours and quarterly compensation reports and help validate payroll to increase pay transparency. The Lead Scheduling Physician exports shift credit reports for accountant review and payroll verification.

Reports can also be run when the schedule is published to confirm fairness and re-run throughout the year to assess the impact of swaps and changes on shift distribution. Additional reports, like after-hours reports, track and compensate clinicians for on-call coverage, ensuring shifts are equitably distributed.

Conclusion

In just three months, the radiology group overhauled its scheduling protocols, streamlining nearly the entire process. With Lightning Bolt now managing complexities like gap credits, time off, and shift swaps, the team has reclaimed valuable time and improved overall efficiency.

The Lead Scheduling Physician’s team plans to explore additional opportunities for efficiency gains and leverage Lightning Bolt’s integration with PerfectServe’s clinical communication platform to automate alerting for significant imaging findings. The entire care team is highly satisfied with the improvements, and with more potential to unlock greater functionality in the future, this project highlights how optimized scheduling can directly contribute to better outcomes.

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Creating Equitable Residency Schedules that Meet ACGME Standards https://www.lightning-bolt.com/case-study/creating-equitable-residency-schedules-that-meet-acgme-standards/ Tue, 04 Mar 2025 17:01:26 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=27002 Background A medical center in Southern California founded a training program in 2018 for residents across multiple specialties. As a part of this program, residents provide care to patients in continuity clinics at a neighboring organization for a week at a time. Though this enhances the learning experience for residents, it adds complexity to the...

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Background

A medical center in Southern California founded a training program in 2018 for residents across multiple specialties. As a part of this program, residents provide care to patients in continuity clinics at a neighboring organization for a week at a time. Though this enhances the learning experience for residents, it adds complexity to the schedule.

Challenge

The medical director and program schedule team manually created four-week rotation schedules for 19 residents and 16 medical assistants while both trying to accommodate resident preferences and also comply with ACGME requirements. This Excel-based process often led to inconsistent shifts, unbalanced workloads, and scheduling challenges when last-minute changes were needed.

In addition to rotation and call shifts, the continuity clinic shifts proved challenging to manage. Ideally, three residents would be scheduled for each continuity clinic shift with a preceptor, but this wasn’t easy to achieve with the manual workflow and often left only one resident assigned per shift.

With new ACGME elective guidelines in place, the director aimed to switch from four-week to two-week rotations to enhance resident learning. He knew this rotation change would be difficult to build within Excel and would be all the more time-consuming. Facing these challenges, he determined that the residency program needed an automated scheduling tool to implement these changes more effectively.

Solution

The medical director needed an automated physician scheduling solution to create fair and optimized schedules that align with ACGME requirements. By implementing PerfectServe’s Lightning Bolt Scheduling, the director successfully transitioned to two-week rotations, ensuring compliance with ACGME guidelines while improving resident utilization. This automation has lightened the director’s workload and enhanced the residency experience for residents.

Results

1

Automation & Optimization
Previously, the director managed multiple Excel spreadsheets to build the Annual Block, Director Rotation, continuity clinic shift, and Daily schedules—each on a different timeline. This approach created a fragmented, non-transparent process that made it difficult to see residents’ full schedules beyond continuity clinic shifts.

With Lightning Bolt, all rotations are now scheduled in advance with real-time visibility, allowing faculty to see each resident’s full schedule. Automated rules keep the schedule accurate and adaptable, making Lightning Bolt the single source of truth for the entire team.

2

Improved Staff Utilization
Scheduling used to be a time-intensive, manual task, particularly for continuity clinic shifts, where availability was often limited to just a single resident per shift. While the team was optimistic about automation, they worried that the complex requirements of their schedule might be too intricate for any software to manage.

With Lightning Bolt’s algorithm and support from a dedicated consultant, three to six residents are now consistently scheduled per continuity clinic shift, leading to more balanced workloads that have a positive impact on both patient and resident experiences.

3

Time Savings
Before Lightning Bolt, the program director’s assistant spent most of her time managing resident requests and keeping everything in line with ACGME requirements. She was “overworked and always scrambling.” Now, scheduling time has been reduced by 18 hours each month, freeing her up for other essential tasks and duties.

As with any residency, new residents join the program every year. Previously, candidate interviews were scheduled in somewhat of an ad hoc fashion that caused confusion. Now, Lightning Bolt integrates interview times into the schedule in advance, saving time and allowing both residents and faculty to prepare more effectively.

4

Rotation Adjustments for Graduation Credit Management
Because ACGME increased the required number of electives, the previous four-week rotation schedule needed to change for residents to graduate on time. The director wanted the elective rotation schedule to be conducive to an efficient and comfortable learning experience for residents, and a two-week schedule was simply going to be a better fit.

Lightning Bolt enabled this transition by creating balanced schedules that align with the new parameters. This approach ensures residents receive equitable schedules with shifts that fulfill all graduation requirements.

5

Provider Preferences and Accommodation
Lightning Bolt accommodates unexpected changes in resident availability (e.g., maternity leave) and enables quick schedule adjustments within minutes. This flexibility keeps schedules balanced and up to date, offering residents greater peace of mind.

The auto-generation feature even helps to reincorporate residents who are returning from leave in a way that doesn’t overburden them. The director expressed notable appreciation for Lightning Bolt’s ability to account for these sudden changes in a resident’s ability to work.

6

Generating Reports
Before Lightning Bolt, tracking shift equalization among residents was nearly impossible, and manual scheduling made it too time-consuming to optimize.

Now, Lightning Bolt’s detailed reports provide clear visibility into shift distribution, allowing the director to track shifts worked, clinic balance, and resident hours. These reports also help ensure residents meet accreditation requirements as they advance in their training.

Future Plans and Growth

A key benefit of Lightning Bolt is its scalability across teams of any size. When the residency program expanded from six to eight residents, the system seamlessly integrated them into rotations. As needs change, the team can collaborate with their technical consultant to refine the system even further.

Coordinating a residency program involves scheduling more than just residents. The director plans to use Lightning Bolt to schedule additional roles, such as pairing preceptors with residents on continuity clinic shifts. Over time, Lightning Bolt will become the single source of scheduling truth for not just the entire team, but the entire organization.

Conclusion

Scheduling technology can simplify the management of complex accreditation and organizational requirements for residency programs. With Lightning Bolt, this program can seamlessly adjust rotations to meet evolving needs and preferences while staying aligned with organizational standards.

The newfound capabilities of schedule optimization have also made issues with continuity clinic shift allocation a thing of the past—Lightning Bolt now ensures an adequate number of residents are always available in continuity clinics. From happier schedulers and providers to improved shift equity and patient care continuity, Lightning Bolt has changed scheduling workflows for the better.

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How to Improve OR Room Utilization with Scheduling Software https://www.lightning-bolt.com/case-study/gastroenterology-scheduling-software-use-case/ Fri, 21 Feb 2025 22:08:05 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=26982 Background A Massachusetts-based gastroenterology department within a children’s hospital employs over 300 clinicians, including 70 endoscopists. The department specializes in pediatric GI, liver, and nutritional care while simultaneously advancing research. Challenge “As the department grew over the years, it became more and more difficult to track [provider requests and preferences],” the clinic supervisor said. “Ultimately,...

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Background

A Massachusetts-based gastroenterology department within a children’s hospital employs over 300 clinicians, including 70 endoscopists. The department specializes in pediatric GI, liver, and nutritional care while simultaneously advancing research.

Challenge

“As the department grew over the years, it became more and more difficult to track [provider requests and preferences],” the clinic supervisor said. “Ultimately, it was dependent on the admin manager and the medical director to keep track of and remember all the preferences. Also, due to the nature of manual entering, copying, and pasting in Excel, human error was unavoidable.”

The ambulatory clinic supervisor and administrative manager oversaw inpatient service, clinic, and procedure schedules to evenly distribute physician workloads. However, frequent errors arose from the lack of a centralized system to track provider assignments.

The inpatient service schedule was planned on whiteboards and sticky notes, a process that took weeks to complete for a schedule that covered a 12-month period. Clinic and procedure schedules, created using various EHR templates, were similarly time-consuming and had to be cross-checked to avoid double bookings.

OR and call schedules added further complexity. Realtime updates were difficult, leading to unused OR time when shifts were missed or left unscheduled—a lost revenue opportunity. Call schedules were built manually in spreadsheets and required review by the interim department director, who had limited time to meticulously check them.

These difficulties compounded into a list of common frustrations for the gastro team:

  • Outdated schedules that were printed and reprinted multiple times
  • Errors in time-off requests
  • Double-booked shifts
  • Frequently rescheduled patient appointments
  • Providers being contacted at the wrong time

As an added challenge, schedule information also had to be manually entered into the department’s paging software. These updates took a minimum of eight hours a month.

It was time to find a tech-enabled solution to ease the scheduling process by ensuring balance, accuracy, transparency, and access.

Solution

The clinic supervisor and administrative manager found PerfectServe’s Lightning Bolt Scheduling because it was already being used by other departments within the hospital. After consulting with some of these interdepartmental colleagues, the gastro team learned that they had great success with Lightning Bolt’s optimization and schedule auto-generation capabilities.

A huge selling point was the ability to connect with a technical consultant—a dedicated point of contact for the duration of their relationship. After the final decision was made, Lightning Bolt was fully implemented within two months.

Results

1

Time Savings
With Lightning Bolt, tracking provider preferences and vacation requests became a seamless process. The group saved hours for every scheduling cycle and eliminated wasted time fixing errors and other missing details. For instance, building the backup attending schedule used to take a minimum of four hours, but now it’s complete in just a few minutes—a 98% time savings.

“It took weeks to create the schedule pre-Lightning Bolt versus a matter of minutes post-Lightning Bolt. I was able to generate eight months of schedule in less than 20 minutes,” the clinic supervisor said. “The time saved on being able to generate the schedule based on an algorithm and data that exists in Lightning Bolt is invaluable. I could not imagine putting together the schedule for the 70+ providers we have now, manually.”

2

Error Elimination
Having preferences and requests built into Lightning Bolt also helped to reduce scheduling errors. And because these components are stored within the system, its rule-based algorithm automatically references them when schedules are built.

For the gastro department, neither the clinic supervisor nor the interim director needs to waste time double- or triple-checking the schedule—it’s always correct and up to date. Schedulers can also review, adjust, and confirm changes within the Lightning Bolt application as needed to maintain the proper level of human oversight.

3

Resource Utilization
In the past, when a provider requested a schedule change that then left the OR unoccupied, nobody filled the vacant slot. Lightning Bolt was able to address this problem in a few ways:

  1. First, Lightning Bolt builds a schedule where all available shifts are staffed appropriately, ensuring sufficient coverage to support patient access.
  2. Second, the department opted to use a Lightning Bolt feature that allows clinicians to see unused OR rooms. Now, if an OR room is empty during a shift, an NP can go in and assign that room to herself. It’s also set up as an auto-approve process in Lightning Bolt, so once the NP updates the schedule, the change is immediately available to all other users.

Schedulers now want to duplicate this workflow for clinic room space to increase patient access and limit the number of appointments that have to be rescheduled.

4

Tallies and Tally Targets
Before Lightning Bolt, tracking shift allotments and ensuring equitable schedules was a challenge, especially with the gastroenterology department’s rapid growth and varying schedule rotations. Some schedules were planned monthly, while others spanned six months to a year, making it difficult to assess fairness and accuracy.

With Lightning Bolt’s Tallies feature, administrators can compile schedule data and set shift targets for individual providers to build fairness in at the ground level when generating schedules. The scheduling team now uses Tallies to ensure goals are met and to create tailored reports for NP and MD on-call blocks, procedure room utilization, and backup shifts. These improvements enable the team to align all schedules—procedure, service, and clinic—at the start of the year.

5

Powerful Integrations
Before Lightning Bolt, schedules had to be migrated to the paging system by hand, which took about eight hours per month and caused constant provider frustration and communication delays.

“We used to get complaints frequently about contacting the wrong person or being contacted incorrectly because the [schedule changes] weren’t reflected in [the paging system],” one scheduler said.

Now that Lightning Bolt is the scheduling source of truth, the integration with the paging system requires virtually zero oversight, and there are no manual inputs required from schedulers. This also eliminates errors that could arise from transcribing the schedule by hand. The on-call schedule is automatically pulled into the paging system, meaning clinicians are now confident that they’re reaching out to the right person when they initiate communication.

Want to learn more about Lightning Bolt’s full suite of integrations? Check out our integrations catalog.

“We found that, in order for Lightning Bolt to be most useful, it should be as comprehensive as possible. We wanted to include all possible assignments for the provider, which we slowly added over time. We have also greatly expanded what we use Lightning Bolt for over the years to include all inpatient schedules, daily and weekly backup schedules, weekend triage assignments, and more.

Conclusion

The gastroenterology department’s transformation with Lightning Bolt highlights the power of technology to solve complex operational challenges. By automating scheduling, reducing errors, and improving resource utilization, the department can dedicate more of its focus to patient care.

Streamlined workflows have eased administrative burdens, enhanced communication, and allowed clinicians to work more efficiently. As the department grows, Lightning Bolt’s flexibility and scalability make it an essential tool for maintaining provider wellness and operational excellence.

“I was able to generate eight months of schedule in less than 20 minutes.”

– Clinical Supervisor

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How to Simplify Psychiatry Residency Schedules https://www.lightning-bolt.com/case-study/automated-provider-scheduling-psychiatry-how-to/ Fri, 21 Feb 2025 22:01:08 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=26951 “Our clinical mission can’t be our focus if we’re focused on all these operational logistical pieces. We need tools that will free up mind space and time to pursue and grow our clinical mission.” —Nadia Alamo, Project Manager Background The Department of Psychiatry at UNC Chapel Hill is the second largest department within the School...

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“Our clinical mission can’t be our focus if we’re focused on all these operational logistical pieces. We need tools that will free up mind space and time to pursue and grow our clinical mission.”

—Nadia Alamo, Project Manager

Background

The Department of Psychiatry at UNC Chapel Hill is the second largest department within the School of Medicine. As a critical mental healthcare provider for North Carolina’s 11 million residents, the department manages a network of over 200 providers, including attendings, residents, and fellows, across inpatient, outpatient, and specialized treatment programs.

Key Results

Challenges

The scope of operations continues to expand rapidly, as Project Manager, Nadia Alamo explained:
“I’ve been with the department for four years, and we’ve hired 20 new MDs every year since I’ve started, which is unheard of. We used to hire about four per year. We’re growing at an astronomical rate.”

1

Fragmented Schedule Management
Previously, the department struggled with decentralized scheduling. Faculty schedules were managed by 25 different administrators using various tools ranging from legacy software to spreadsheets. Three chief residents were also tasked with creating the residency program schedules. This created numerous operational challenges:

  • Multiple schedule versions existing simultaneously
  • Inconsistent publishing timelines
  • No centralized system for vacation tracking
  • Limited visibility across units

2

Complex Provider Allocation
Nadia also noted the department’s culture of encouraging diverse clinical engagement created unique scheduling challenges:

“Nobody does just one thing—we encourage passion projects. Any one person might do 20% inpatient, 20% acute telehealth, 30% at the youth behavioral hospital, and then maybe 10% in the esketamine clinic. So that one person has five different schedules.”

 
This complexity led to time-consuming manual negotiations between units for shared provider time.

3

Knowledge Management Gaps
The department discovered critical gaps in institutional knowledge, particularly around resident scheduling. Nadia explained why this is a major concern:

“We didn’t realize that we don’t have anyone in our department with historical
knowledge of our resident schedules. That information lives with the current chiefs,
and when they leave at the end of the year, they take that information with them.”

 
While the outgoing chief residents make concerted efforts to transfer scheduling knowledge to their successors, the sheer complexity of the schedules combined with the hectic period of graduation and resident onboarding makes complete knowledge transfer challenging. The timing is particularly difficult, as chiefs must balance wrapping up their own responsibilities while attempting to document and pass on years of accumulated scheduling expertise.

Solution & Implementation

The department selected Lightning Bolt for its ability to solve intricate scheduling puzzles through combinatorial optimization. Unlike manual scheduling or simpler automated systems that might get stuck with partial solutions, Lightning Bolt’s optimization engine successfully incorporates all preferences and requirements to create the best possible schedule without gaps.

The department took a strategic approach to implementation, focusing on three key areas:

Distributed Expertise Model

  1. Training schedule administrators as subject matter experts with standardized operations across all schedulers
  2. Giving administrators decision-making power about schedules for their location to avoid delays or confusion
  3. Building an institutional knowledge base

Defined Shift Priorities

  1. Top Priority: 24/7 attending on-call coverage
  2. Second Priority: Complex multi-provider schedules (assignments requiring coordination of multiple providers’ availabilities and specialties across different units)
  3. Third Priority: Simple, straightforward assignments

Custom Visibility Solutions

  1. 41 tailored schedule views so only critical, role-dependent aspects of the schedule are visible to each user
  2. Role-based access controls
  3. Real-time update capabilities

With guidance from their Lightning Bolt technical consultant, the department implemented a structured change management approach. Hands-on training and consistent support helped schedule administrators trust the platform’s ability to manage complex scheduling while remaining flexible to individual needs.

The implementation team focused heavily on stakeholder education and anxiety management. As Nadia notes:

“A lot of what change management is, in my opinion, is anxiety management. People [don’t always trust] that [an automated scheduling tool] will help them the way their supervisor will help them get the schedule that they want.”

Results

Operational Transformation
The implementation replaced fragmented processes with streamlined, automated solutions. The most significant operational improvements centered around standardization and centralization:

  • Consolidated publishing dates (May 1 and November 1)
  • Single source of truth for all schedules
  • Automated and balanced provider allocation
  • Integrated vacation request management

Efficiency Metrics
Administrative efficiency has seen measurable improvements across all key scheduling processes. In addition to reducing schedule creation time by 88%, the department has documented other significant time savings and process improvements:

Before & After

Schedule Swaps

Publishing Cycles

Source of Truth

Coordination

15
mins

Continuous & inconsistent

Multiple documents

Manual negotiations

30
mins

2x
annually

Single system

Automated resolutions

Strategic Impact

By dramatically reducing the administrative burden associated with scheduling, the department can focus on expansion and improvement of clinical services. This newfound operational efficiency has helped them better support several major initiatives:

  • Launching a 54-bed children’s hospital
  • Implementing a virtual intensive outpatient program
  • Expanding their internal wellness program
  • Supporting rapid departmental growth

Lessons Learned

The department’s implementation experience yielded several valuable insights for other organizations considering similar scheduling transformations:

1

Partner Closely with Technical Consultants:
The department established a practice of documenting needed rule changes immediately and maintaining regular consultant communication to ensure optimal system configuration.

2

Automation with Flexibility:
While Lightning Bolt’s automation handles the complex task of schedule generation, the platform maintains the flexibility needed for human refinement when required. The department learned to appreciate this balance, using the system’s robust automation while preserving administrators’ ability to make manual adjustments for unique, one-off situations.

3

Distribute Scheduling Authority:
Empower individual schedule managers with the training and authority to handle their team’s specific scheduling needs, creating a more efficient and scalable system.

4

Establish Clear Guidelines:
One crucial learning was the importance of distinguishing between rules (fixed requirements) and preferences (flexible requests) within the system. The team developed clear guidelines to help schedule managers make consistent decisions about which scheduling requirements warranted rule status versus preference status in Lightning Bolt.

Conclusion

Lightning Bolt has transformed scheduling operations at UNC Chapel Hill’s Department of Psychiatry from a fragmented, time-intensive process to a streamlined, automated system. As the department continues its rapid growth, the platform provides the scalability and efficiency needed to support its expanding clinical mission. Nadia sums up the impact:

“Our clinical mission can’t be our focus if we’re focused on all these operational logistical pieces. We need tools that will free up mind space and time to pursue and grow our clinical mission.”

Looking ahead, the department plans to leverage more advanced reporting capabilities, expand to include additional provider types, and find new ways to optimize schedule automation even further.

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Supporting Residency with Optimized Scheduling Software https://www.lightning-bolt.com/case-study/residency-schedule-internal-residency-program/ Fri, 14 Feb 2025 17:51:42 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=21502 Executive Summary The Internal Medicine residency program at an academic medical center in the Southeast uses Lightning Bolt Scheduling to create yearly and monthly schedules for 130 residents. Five chiefs oversee the complex 4+1 schedule to ensure vacation requests and new interns are accommodated. Lightning Bolt’s auto-generation feature simplifies academic medical center scheduling, while the...

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Executive Summary

The Internal Medicine residency program at an academic medical center in the Southeast uses Lightning Bolt Scheduling to create yearly and monthly schedules for 130 residents. Five chiefs oversee the complex 4+1 schedule to ensure vacation requests and new interns are accommodated.

Lightning Bolt’s auto-generation feature simplifies academic medical center scheduling, while the reporting capabilities help verify graduation requirements and maintain schedule balance. The residency team values Lightning Bolt’s user-friendly interface, historical data preservation, and strong partnership with the Lightning Bolt team.

Background

Prior to implementing Lightning Bolt’s rule-based, automated scheduling solution, chiefs relied on Excel, making scheduling a time-intensive process that required multiple versions and extensive revisions. The complexity was compounded by the program’s size, structure, and the need to integrate residents from other programs into the rotation.

Solution and Setup

The academic medical center implemented Lightning Bolt to streamline scheduling and enhance efficiency for its Internal Medicine residency. The software enables chiefs to create:

  • A yearly master rotation/block schedule that maps the residents’ structure for the year, including vacation and elective blocks.
  • A monthly “daily” schedule with specific daily assignments and times, which is released a few weeks prior to the start of each month.

Like most residency programs, chiefs collect vacation requests from residents and new interns before creating the yearly block schedule. With Lightning Bolt, chiefs enter these requests in advance, and the auto-generation feature incorporates them into the schedule, ensuring each resident receives their approved vacation.

Benefits of the 4+1 Scheduling Model

The program’s 4+1 scheduling model—which gives residents four weeks of wards and electives followed by one week in clinic—offers several advantages:

  • Enhanced Continuity of Care:
    Standardized clinic time promotes consistent patient care, while focused ambulatory training improves residents’ outpatient skills.
  • Improved Well-Being:
    Predictable clinic weeks provide residents with mental and physical breaks, allowing them to attend to personal appointments and tasks while getting more rest.
  • Optimized Schedules:
    Lightning Bolt supports the 4+1 model by ensuring residents’ schedules are optimized for diverse clinical experiences and a healthy work-life balance.

Accommodating Program Complexities

Lightning Bolt tackles scheduling complexity in a number of other ways for the program:

Flexibility for Departments with Diverse Scheduling Needs
Lightning Bolt’s advanced scheduling capabilities accommodate the unique requirements of departments with different schedule types, such as Internal Medicine’s 4+1 schedule and Family Medicine’s monthly block schedule. Internal Medicine residents begin new rotations on Mondays and end on Sundays, while Family Medicine residents align with the calendar month. Merging these schedule types manually would be time-consuming and error-prone, but Lightning Bolt simplifies the process by using sophisticated rules and customizable views. This ensures seamless integration of varying schedule lengths, reducing administrative burden and delivering equitable, efficient schedules for all departments.

Coordinating Cross-Department Coverage
The Internal Medicine residency program also uses Lightning Bolt to coordinate cross-department coverage. Residents from other specialties—such as Family Medicine, Med-Peds, Anesthesia, and OBGY —have medicine rotation requirements (often wards and ICU), meaning Internal Medicine needs their availability to complete schedules and avoid conflicts before scheduling their own residents, who have more flexibility.

Internal Medicine receives Family Medicine’s schedule and sees a Family Medicine resident rotating in the ICU in January and March. To prevent overstaffing, Internal Medicine schedules one less of their own residents in the ICU during those months, assigning them to other rotations instead.

Results

Lightning Bolt is now essential to the daily, monthly, and yearly operations of this academic medical center’s Internal Medicine residency. Though Excel is a fading memory, each time a new chief resident takes over scheduling duties, they are confronted with how complex the process must have been without Lightning Bolt.

Key benefits include:

1

Less Time Spent Scheduling
The auto-generation feature significantly reduces scheduling time, making it manageable despite the program’s complexity and large number of residents.

2

Efficiency Through Auto-Generation
The system auto-generates schedules based on predefined rules, minimizing manual adjustments. New workflows and requirements can easily be incorporated as circumstances evolve, both for the residency program and the medical center at large. As one example, Lightning Bolt allows the Internal Medicine residency program to blend the master schedule and monthly schedule, ensuring residents meet their training requirements and have adequate work-life balance.

3

Custom Tally Targets
The program uses Lightning Bolt’s tally targets for each resident year (PGY1, PGY2, PGY3) to appropriately allocate shifts in accordance with ACGME guidelines. Chiefs establish the number of weeks a resident needs to work a certain assignment, and Lightning Bolt’s rules ensure they work the required amount. For example, if a resident has a target of 10 electives, Lightning Bolt will assign them an elective 10 weeks out of the year. Results can easily be tracked with reporting functions, after which remaining target rotations can quickly be assigned to residents. Chief residents say this is the “most beloved Lightning Bolt feature” because it eliminates the headache of doing it manually

4

White Glove Customer Service
The program has been highly satisfied with Lightning Bolt’s responsive service team. Lightning Bolt treats each customer as an opportunity to create an ongoing partnership aimed at achieving peak optimization, which gives providers more time to do what matters most—care for patients.

5

Advanced Reporting
Lightning Bolt’s reporting features help chiefs track resident progress, monitor shift allocation, and ensure graduation requirements are met. For example, the Med-Peds residency, which partners with Internal Medicine, uses historical scheduling data (up to four years) to track residents’ progress throughout their time in the program. Since Med-Peds follows a 28-day rotation model, Internal Medicine uses Lightning Bolt reports to efficiently backfill the remaining days when a Med-Peds resident completes their rotation.

6

Mobile App Drives Higher Adoption & Satisfaction
Residents use the Lightning Bolt mobile app to view their schedules and request changes when they’re on the go, which increases flexibility, transparency, and overall resident satisfaction. This also saves chiefs from having to manually intake requests, make changes to the schedule, and then distribute a new version. Change Logs in Lightning Bolt provide visibility into how the schedule has changed over time.

7

Schedule Sharing with Public Links
The program can easily share schedules with other departments and residents using view-only public links. Users who receive these links don’t have to be logged in to Lightning Bolt to see schedules.

Conclusion

Implementing Lightning Bolt has greatly enhanced scheduling efficiency and resident satisfaction for this academic medical center’s Internal Medicine residency program. The software’s auto-generation, reporting, and mobile features simplify the creation of balanced, accurate schedules, while the consistency it provides ensures smoother transitions year over year. With support from a knowledgeable consultant team, the program benefits from preserved scheduling expertise and greater peace of mind—valuable assets in a field where reliability and clinician support are paramount.

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How Integrating Communication and Scheduling Workflows Enhanced Patient Care https://www.lightning-bolt.com/case-study/provider-scheduling-workflows-enhance-care/ Thu, 15 Aug 2024 17:25:47 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=21645 Background Beebe Healthcare is a multidisciplinary, multi-location health system providing care to patients in and around Sussex County, DE. Hospitalists at Beebe Healthcare’s Margaret H. Rollins Lewes Campus were using Excel and Microsoft Teams to build schedules for 27 physicians and 6 APPs. Dr. Kristie Zangari, administrator Lauren Phillips, and Acute Medicine Program Manager and...

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Background

Beebe Healthcare is a multidisciplinary, multi-location health system providing care to patients in and around Sussex County, DE. Hospitalists at Beebe Healthcare’s Margaret H. Rollins Lewes Campus were using Excel and Microsoft Teams to build schedules for 27 physicians and 6 APPs. Dr. Kristie Zangari, administrator Lauren Phillips, and Acute Medicine Program Manager and RN Kerri Wiggins were charged with building and managing the schedules.

Challenges

Before using PerfectServe’s Lightning Bolt Scheduling, Dr. Zangari had to type out each provider’s name while building a shift or copy a previous schedule before manually adjusting names and shifts to create the best possible schedule.

This process was fraught with obstacles, including trying to keep up with changes and time-off requests via word of mouth, email, or text message. When requests were granted, Dr. Zangari had to email providers individually to update them. This process had to be done with each request, no matter when the original schedule had been built, meaning multiple versions of the schedule existed at any given time.

Kerri kept the master schedule on a public computer drive so teams could see the schedule easily, though it changed often—sometimes daily. All updates had to be individually made inside the PerfectServe Clinical Collaboration schedule as well.

Despite Dr. Zangari’s best efforts, manually managing requests, editing Excel sheets, and distributing the most up-to-date version of the schedule became too difficult—there was just too much room for error.

Solution and Implementation

Several years before these difficulties started piling up, Beebe Healthcare implemented PerfectServe’s Clinical Collaboration solution to improve enterprise care team communication. They discussed Lightning Bolt during the initial sales process, but it wasn’t until Dr. Zangari and the hospitalist group expressed a desire to update their scheduling system that Lightning Bolt officially came into the picture.

Lightning Bolt’s seamless integration with PerfectServe is a major benefit. The tight connection ensures that the group’s communication workflows are always driven by real-time schedules.

Once the group elected to move forward with Lightning Bolt, deployment was efficient—the solution was up and running in just a few weeks. But even for the most intuitive software, learning all of the tips and tricks takes a bit of time. A dedicated Technical Consultant was with the team during implementation and remains a main contact point today for any support or needs. Through implementation and training, the assigned technical consultant gave the scheduling team small tasks to acclimate them to the system and to help them practice all the ways they were likely to use it moving forward. The consultant even left them with a test schedule to play around with so they could learn more about how the system would benefit the group.

Results

Time Savings
With Lightning Bolt, Dr. Zangari has abandoned the manual process of the past to take advantage of advanced schedule automation. Now that she no longer uses Excel to create schedules, Dr. Zangari estimates a time savings of 50%.

The previous process could take a few hours per day spread across multiple weeks, but she estimates that auto-generation has reduced schedule development time by 50-75%. Because Lightning Bolt automatically pulls approved requests onto the schedule, Dr. Zangari no longer has to manually enter shifts and vacations once they’re approved, which previously took up a significant portion of her time building the schedule.

Additionally, thanks to a public, easily accessible link, the hospitalist and NP schedules can both be shared in real time.

Auto-Generation
Outside of time savings, auto-generation boasts many other benefits. Lightning Bolt can also equalize nurse practitioner shifts, including weekend rotations, ED rotations, academic service providers’ FTE requirements, and nocturnist shifts.

Other examples of auto-generation in play include:

  • Putting weekend work for NPs on a rotation (for example, every other weekend)
  • Spacing out nocturnist shifts
  • Having a minimum and maximum number of ER shifts per person in a given 14-day pay period
  • Blocking time for academic service rotation to support a new residency program

Because Lightning Bolt builds these rules into the schedule automatically, Dr. Zangari knows that her group’s requirements are always being met. It also ensures that providers are working the most equitable schedule possible to reduce provider burnout.

“I anticipated that, being a hospitalist group, [the schedule] would be really difficult to reflect with rules. Somehow, [the Technical Consultant] worked his magic and made it fit with what we needed.”

—Kerri Wiggins, RN

Centralized Requests
Before Lightning Bolt, providers would request time off or shift swaps via email, text, or face-to-face conversation. Kerri had to keep track of these requests by hand, and if they were approved, she then had to email each provider to confirm.

Thanks to detailed training, providers can now enter their own requests in the Lightning Bolt app. The scheduling team can quickly approve or deny each request from the same place, after which the affected provider receives a notification. No more scrambling to keep track of requests, and no more closing the loop by email each time a request is granted.

A Single Source of Truth
Beebe Healthcare uses its Admits, Consults, and Triage schedules to determine which provider receives daytime admissions, consults, and transfers. The same is true for nighttime workflows, except there are two nocturnist assignments available. The integration between PerfectServe and Lightning Bolt is key here, and so is Lightning Bolt’s role as the single source of truth for all schedules.

One example of this workflow is residents being paired with attendings. Residents are the first point of contact for patients, which gives them muchneeded practice and experience. However, if a situation arises where a patient needs urgent care from a more experienced provider, they can be escalated to the right attending at the right time.

Beebe relies heavily on the accuracy of schedules, especially Codes/Alerts and Rounding schedules. Providers working these shifts receive an instantaneous PerfectServe message for all stroke alerts, Code Blues, and rapid response alerts, so having an up-to-date schedule can drastically reduce confusion and expedite patient care.

Before they integrated PerfectServe and Lightning Bolt, Dr. Zangari said it wasn’t unusual to experience two to three communication errors per week when schedules had to be updated manually due to last minute changes, shift swaps, and other factors. This meant patient care could be delayed, and consults and other requests could mistakenly go to the wrong provider.

Today, PerfectServe automatically pulls the up-to-date schedule from Lightning Bolt, meaning calls and messages always reach the correct on-call or working provider. Because Lightning Bolt is Beebe Healthcare’s sole scheduling system, it also means no more dual entry—schedules no longer have to be created in one place and ported over to another to ensure continuity.

As the previous section outlined, Lightning Bolt has vastly improved the user experience for administrators and providers alike. For administrators, the process of building schedules and managing requests is much simpler. For providers, it’s much easier to request time off or a shift swap, and the instant alerts when requests have been processed are also helpful.

Lightning Bolt’s intuitive desktop and mobile applications have made a world of difference as well. Administrators can manage schedules at their desks or on the go, and providers can check their schedules, request changes, and otherwise stay in the know regardless of where they’re located.

Advanced Reporting and Analytics
Before automation was in place, Beebe Healthcare had no surefire way to know if their shifts were fairly distributed while meeting the organization’s requirements. Lauren Phillips, who often assists with scheduling, had to manually tally shifts and keep track of each provider’s workload as closely as possible.

Today, Lightning Bolt automates this process with its Reports feature to keep track of overall shifts worked. Beebe creates this type of shift report for the emergency room, the nocturnists, backup shifts, nurse practitioners, and the total shifts worked to ensure equalization.

Excellent Customer Service
Before Lightning Bolt, the team at Beebe Health had no support to lean on for their scheduling process. Now equipped with their dedicated technical consultant, the entire team found training and implementation to be smoother and easier than expected.

Today, they have full access to customer support and the option to schedule time with their technical consultant if they need additional training or troubleshooting.

“The post go-live support has been phenomenal. It’s fast, efficient, and correct.”

—Kerri Wiggins, RN

Conclusion

Finding and implementing an advanced scheduling solution can seem like a tall order when you’re starting from Excel. But for health systems of any size, the benefits of deploying a solution that both automates and optimizes the scheduling process are abundant: significant time savings, more satisfied providers and administrators, and—if you integrate your scheduling and communication systems—far fewer communication mishaps that lead to delays in patient care.

This was all true for Beebe Healthcare. After implementing Lightning Bolt as the single source of truth for scheduling operations and integrating it with PerfectServe’s Clinical Collaboration solution, they found themselves with better schedules, happier providers and administrators, and greatly improved communication workflows that accelerated speed to care.

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How To Rapidly Deploy a Scheduling Solution Across a Large Health System https://www.lightning-bolt.com/case-study/rapidly-deploy-scheduling-solution-across-large-health-system/ Thu, 07 Mar 2024 16:48:30 +0000 https://www.lightning-bolt.com/?post_type=case-study&p=21396 Story Highlights Background St. Luke’s Health System is a non-profit hospital network founded in 1902 that serves southern Idaho, eastern Oregon, and northern Nevada. The Idaho-based system was established as a multi-location health system in 2006 and today encompasses eight medical centers, over 370 clinics and facilities, and many other laboratory locations. St. Luke’s has...

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Story Highlights
  • St. Luke’s Health System had just three months to replace their current scheduling solution, which was being discontinued. They were also expanding rapidly, with the number of providers on their roster growing every day. They needed a quick implementation with a scheduling solution that could easily accommodate their expected growth.
  • The PerfectServe Lightning Bolt Scheduling solution team took a “rapid enterprise deployment approach” when they brought St. Luke’s live on their scheduling platform across all 11 locations.
  • As part of the rollout, the implementation team identified and trained super users who could then train their St. Luke’s colleagues on the ins and outs of Lightning Bolt.
  • With Lightning Bolt, St. Luke’s found a source of scheduling truth that optimized schedules across their health system, improved patient care, and gave them access to helpful analytics and shift analyses.

Background

St. Luke’s Health System is a non-profit hospital network founded in 1902 that serves southern Idaho, eastern Oregon, and northern Nevada. The Idaho-based system was established as a multi-location health system in 2006 and today encompasses eight medical centers, over 370 clinics and facilities, and many other laboratory locations. St. Luke’s has more than 2,100 providers and just over 1,000 beds.

Challenges

St. Luke’s was using a scheduling vendor whose product was being discontinued over a short period of time. But even before this development, they felt the product was lacking. It didn’t offer organized schedule views, meaning it was difficult to sort schedules by department, group, etc. Providers also found that the solution didn’t make it easy to find relevant contact information for their colleagues. The time had come for a new, automated system that could do more than just host on-call schedules.

As a multi-site health system, St. Luke’s needed a solution capable of optimizing schedules across locations that could also be implemented quickly. The ideal solution would be user-friendly and easy to learn for providers in their short turnaround time of just three months, and it needed to be more than a one-to-one replacement for the previous on-call scheduling solution—it needed more functionality. And because St. Luke’s was growing at a rapid pace—the number of providers in the system grew from 1,100 to nearly 2,500 in the span of a few months—they also wanted a solution that could scale easily to match growth.

A few groups within the St. Luke’s system had already transitioned to Lightning Bolt for on-call scheduling and had experienced great results with quick and easy implementations. Because of this, St. Luke’s elected to make Lightning Bolt its sole source of truth for scheduling, with plans to use the solution not only for on-call scheduling, but also for provider shifts across the health system and across shift types.

The Lightning Bolt team designed a “rapid enterprise deployment approach” that allowed for successful training and deployment within the health system’s aggressive timeline.

The Implementation Process

Easing the Transition

Finding and implementing a new solution can be a daunting process, especially when you’re evaluating a new vendor. Too often, this means a drawn-out implementation, a steep learning curve, and all of the complexities that come with building a new vendor relationship. The PerfectServe team knows a thing or two about implementations, so they worked with their counterparts at St. Luke’s to design a “rapid enterprise deployment approach” that allowed for successful training and deployment that met the health system’s aggressive timeline.

This approach is designed to expedite implementation while ensuring all users still get sufficient Lightning Bolt training. The subject matter expert (SME) team worked to onboard 1,100 on-call providers on May 1, 2021, using Lightning Bolt to create on-call schedules. Just a few months later, St. Luke’s finished onboarding the rest of their 2,468 total providers. At that point, they were using Lightning Bolt to schedule all providers and shift types.

Empowering Users Across the Enterprise

There were a few factors that contributed to a successful three-month implementation. First, the Lightning Bolt team identified and trained super users, who then served as trainers for their colleagues. These super users were key to the rapid deployment schedule, and they took the unique step of supplementing the Lightning Bolt team’s efforts by holding their own office hours so providers and other care team staff could come directly to them with questions. Though Lightning Bolt offers around-the clock support, this extra layer of internal support from super users allowed St. Luke’s to reduce the number of IT tickets submitted to Lightning Bolt while giving them plenty of opportunities to identify potential glitches in the system.

Tools to Encourage Adoption

Because high adoption and utilization are necessary for a successful implementation, Lightning Bolt follows a process to ensure both metrics stay on track. For example, the implementation team works with customers to monitor which practices are still calling the practice manager to make schedule updates. This highlights users who likely aren’t comfortable using the technology yet.

Lightning Bolt also offers login reports to help customers identify the users who may need more training and support. This data offers insight into which users are interacting with the full range of Lightning Bolt’s functionality, such as making real-time changes to schedules. The report—which can be pulled on both the mobile and desktop applications with help from the Lightning Bolt team—can be used as a barometer for practice managers and operations leaders as they gauge the progress made throughout implementation. The scheduling solution St. Luke’s used previously did not offer a mobile app, and it lacked Lightning Bolt’s analytics capabilities, so the new setup is more intuitive for users and offers more granular insights about how to encourage adoption.

As Lightning Bolt was implemented across the St. Luke’s enterprise, dedicated consultants were assigned to the most complex departments to work through issues that arose and address any additional training needs. St. Luke’s also has its own team of SMEs who collaborate with the Lightning Bolt team to support smaller groups when needed. Today, Lightning Bolt holds biweekly check-in meetings with the main analyst on the St. Luke’s SME team to ensure everything is running smoothly.

Strong Partnership from the Start

Lightning Bolt was able to import all scheduling information from the previous vendor to jump start the change in schedule management. They also formed close relationships with a variety of clinical users across the St. Luke’s system, which had a dual purpose. First, these users could give the Lightning Bolt team valuable real-time feedback about the implementation, including big wins and areas that needed improvement. Second, this became a valuable conduit for best practice sharing, whereby Lightning Bolt consultants could advise the St. Luke’s team to make sure the solution was optimized for the unique needs of every system location. With dedicated training teams in place, a successful implementation completed, and 24/7/365 support from the Lightning Bolt team, St. Luke’s was off to a strong start.

Results

With Lightning Bolt implemented and a strong partnership established between vendor and client, St. Luke’s quickly started to see real-world results from the project:

Schedule Clarity: A Source of Truth

St. Luke’s now has one configurable source of truth for all on-call schedules and continues to actively optimize its use—a critical improvement for the health system. Each location has a customized list view of all providers in each location, and they’re organized coherently by department and specialty. This view includes fields for other assignment information, such as provider preferences on communication sequence like their preference to be contacted by pager or a messaging app.

Key Integrations Enhance Scheduling Workflows

With any clinical software solution, the ability to integrate with other technologies—especially existing IT, clinical, and telecom systems—often leads to more efficient workflows and better information sharing. Lightning Bolt supports a wide range of integrations, several of which are on display at St. Luke’s:

  • Credentialing: St. Luke’s uses the credentialing system HealthStream, which is integrated with Lightning Bolt to automatically sync provider information in real time, including when a new phone is used.
  • Provider Compensation: The provider compensation team uses Lightning Bolt to analyze all working shifts to ensure providers are accurately paid for the work they complete. By taking on-call data from Lightning Bolt’s up-to- date schedules, the compensation team can verify that provider compensation is accurate.
Improved Patient Care Times

Like almost every healthcare organization, St. Luke’s is always on the lookout for ways to improve its speed to care metrics. With Lightning Bolt, greater shift transparency was directly correlated with more timely patient care.

  • St. Luke’s hosts a custom intranet page so anyone who engages with the schedule can access shift information from anywhere at any time. This schedule is updated in real time, so there’s no guesswork about provider location, who’s on call, or which provider is the next in line to contact if the first-call provider doesn’t respond. Fewer communication obstacles means patient care can proceed much more efficiently.

Group-Specific Schedule Optimization

Lightning Bolt’s rule-based, infinitely customizable schedule automation capabilities came in handy across a number of groups within the St. Luke’s system. Different specialties often have very different day-to-day operations, and the Lightning Bolt team was able to work closely with their St. Luke’s counterparts to build group-specific rules that yielded optimized schedules at every location. Two examples highlight how this flexibility plays out in real life:

Pulmonology

The St. Luke’s Pulmonology group schedules 18-20 providers across 14 shifts in a seven-day rotation pattern. Within Lightning Bolt, there are rules that auto-schedule the providers on that rotation based on what their schedule for the previous few weeks looked like. The rotation is broken into 10 weeks of working shifts and four weeks of vacation. In addition to this rotation, the providers are on call across four different locations every day. Again, Lightning Bolt has rules for the group that auto-schedule these on-call shifts based on which shift in the rotation they’re working on a given day. Together, these rules allow Lightning Bolt to weave together various requirements to support Pulmonology’s weekly rotation of shifts and its 24-hour call obligations.

Clinic Hospitalists

The St. Luke’s Clinic Hospitalists group schedules roughly 60 providers made up of Nights, Full-Time, and Part-Time providers. For their schedule, they split providers into two teams: Team A and Team B. These teams work seven days on and seven days off at different times, and they get slotted in with their colleagues according to their team assignment. The group utilizes Lightning Bolt’s customizable rules to auto-generate their schedule in five layers, with some manual entry beyond layer 2: Nights, Backbone, Full-Time, Part-Time, and Open. Each layer has different providers, assignments, and rules that get added to the schedule until the entire schedule is complete. The Open layer is the final layer—it adds a placeholder tag (labeled “Open”) on all shifts that are left unfilled. These tags give providers an easy point of reference for open shifts they can request to work.

These two examples are not exhaustive. The Lightning Bolt team helped St. Luke’s optimize schedules for many groups, from cardiology to urology to wound care. In each case, the rules are built to support the unique workflows of the group. That’s the power of a rule-based scheduling solution powered by combinatorial optimization!

Advanced Reporting and Analytics

St. Luke’s was also able to take advantage of the data in the Lightning Bolt platform to dive deeper into schedule analytics. For example, the St. Luke’s team can use Lightning Bolt’s analytics tools to manage license counts and generate reports to track which departments have not published a schedule in Lightning Bolt yet.

Other analytics features include the ability to generate department-specific reports. In one case, Pulmonary Care uses department reports to split up inpatient and clinic shifts to ensure accurate provider compensation. Reports generated can ensure each provider is accurately compensated based on the shift worked, down to the department, specialty, and shift date and time.

Conclusion

For operations leaders and other health system decision makers, the prospect of using technology to improve cumbersome processes is tantalizing. But too often, new technology means a lengthy implementation, a steep learning curve, and the task of building a trusting relationship with a new vendor. Some health systems end up asking themselves if making the switch to a new vendor is actually worth the pain of replacing the old one.

With over 20 years of experience implementing scheduling technology, the Lightning Bolt team is all too familiar with these concerns. Especially during times of quick change—such as unexpectedly having to move from one solution to another in just three months—process improvements need to come from a partner with the right level of expertise who is flexible enough to meet the specific needs of your organization. The complexities of ensuring all users are trained, rules are built, integrations are properly connected, and organizational requirements are met can only be managed with careful planning and a high-functioning customer-vendor relationship.

St. Luke’s was in a time crunch, but they also wanted to level up their scheduling game. They found a proper match with Lightning Bolt’s rule- based solution and its team of collaborative, customer-first scheduling experts. Even though new chapters are still being added to the St. Luke’s-Lightning Bolt story, the common themes will always be cutting edge technology, a close partnership, and innovative thinking that lead to better outcomes for patients, providers, and everyone in between.

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