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Area of Science:

  • Healthcare Management
  • Organizational Behavior
  • Sociology of Work

Background:

  • Healthcare organizations face dynamic work demands and employee nonwork needs.
  • Existing scheduling practices may not adequately address these fluctuating requirements.
  • Reactive adjustments to posted work schedules, termed 'work schedule patching,' are common but often informal.

Purpose of the Study:

  • To develop a typology of work schedule patching strategies.
  • To explore the justifications and implementation variations of these strategies.
  • To investigate the relationship between scheduling adjustments and patient outcomes.

Main Methods:

  • Qualitative analysis of data from eight healthcare facilities.
  • Identification and categorization of work schedule patching narratives.
  • Exploratory statistical analysis linking scheduling practices to pressure ulcer incidence.

Main Results:

  • Three primary narratives for schedule patching were identified: share-the-pain, work-life-needs, and reverse-status-rotation.
  • These approaches varied in their level of formalization and improvisation.
  • An exploratory finding suggested a correlation between improvised work-life scheduling and lower rates of pressure ulcers.

Conclusions:

  • Work schedule patching is a prevalent phenomenon in healthcare, driven by both employer and employee demands.
  • Understanding the different patching narratives can inform more effective scheduling practices.
  • Further research is warranted to confirm the link between flexible scheduling and improved patient safety outcomes.