Responding to daily volume surges in real time in an academic setting: the "Ad Hoc" shift

Staffing shortages and increased radiology study volumes have led to higher workloads and increased rates of burnout among pediatric radiologists. These conditions are exacerbated by daily fluctuations in study volumes which can occur due to a plethora of reasons and can often be unpredictable. Current solutions involve increasing staffing numbers and offsetting certain specialized studies to other subspecialties. However, these solutions can be costly and impractical. Therefore, we devised a dynamic, flexible two-hour shift called the Ad Hoc shift in which a designated pediatric radiologist dubbed as the "maestro" assesses the body division workflow in real-time and decides whether to recruit additional radiologists during high study volumes. In this paper, we discuss the protocol of the proposed Ad Hoc shift, along with preliminary results from our institution after a year of implementation. Additionally, we discuss its advantages and address some considerations that may arise during the implementation process.