Q&A: Staff schedules
Q: I am looking to find out how other facilities structure their staff schedules. Are CDI staff exempt or nonexempt? Remote, onsite, hybrid? Anyone working 12- or 10-hour days? Flex schedule?
Response #1: Our staff are exempt. We work hybrid—three days onsite and two days from home. We alternate days onsite and offsite. Our per diem staff, however, are all remote. We mostly work Monday-Friday (occasionally weekend coverage depending on the circumstances at the facility); however, we allow flexibility for personal schedules by allowing staff to switch days (for example, Monday for a Saturday) if the CDI specialist would rather switch than take PTO.
We do not work 10-12-hour shifts. We did try that many years ago, but it didn’t work for us. By that I mean our team said it was too much to be in the record all that time, overall productivity was lower than when we had eight-hour shifts, and the literature does note that extended shifts can be mentally taxing.
Response #2: Our CDI staff are exempt. They used to be onsite but have switched to hybrid—40% onsite and 60% remote. They have a scheduling system that allows them a rotation to have an entire week at home once per month. They work eight-hour days, Monday through Friday, but are allowed a lot of flexibility. If they leave, they may work in the evening to complete the work.
Response #3: Our CDI staff are exempt, fully remote, and work flexible schedules. We have a couple of staff who by choice work weekends with two days off during the week. We have “preferred” business hours (7 a.m. to 5 p.m.) and we ask the staff to work the majority of their hours within that timeframe, so they can respond to providers during business hours. I am very forgiving about staff flexing time during the day to attend appointments though.
If staff flex some hours from one day to another (for example, they work four hours on Saturday and work a half day during the week), it has to be within the same pay week because we calculate productivity based on the work week.
I do have some part-time staff (0.8 FTE, four eight-hour days). I have mixed results with this group, and I am unsure if there is enough of a return for the institution to continue the positions if the staff leave.
Response #4: Our CDI specialists are all scheduled for 40 hours per week and are paid hourly. The default schedule is Monday through Friday, but we offer a lot of flexibility. There are some who like to work a few hours on Sunday to be off a half day on Friday, for example. Since the first part of the week is the busiest (due to the weekend), that works just fine for us. They often work late a day before they need to clock out for an appointment, etc. They appreciate the flexibility very much.
They are all 100% remote, but we chat through Microsoft Teams and meet via Zoom every other week. Productivity is monitored monthly. It has not been a problem, but if someone was not at or above 95% productivity, our policy is to develop a performance improvement plan which may include having them return to the HIM office to work until productivity improves.
Response #5: Our CDI staff are salaried employees, and they work remotely and report in-person once a month for a team meeting. We work eight hours a day but have the flexibility to start anywhere between 7:30 a.m. and 8:30 a.m.. They also rotate working on a Sunday for weekend coverage which allows them to have Friday off the following week. There are circumstances where they may choose another day they would like off that week—say for an appointment or a day trip out of town.
Response #6: Our CDI team works remotely with eight-hour shifts, Monday-Friday, and they cover rotating weekends (usually one to two weekends per calendar year). The start and stop times are flexible, and staff members may complete their hours between 5:30 a.m. to 6:30 p.m. The CDI leaders prioritize flexibility and work-life balance for the staff, which promotes job satisfaction.
Response #7: We are mostly remote. They come onsite once per month as a team for education sessions. They are also required to have CDI-provider partnership meetings with an assigned service line, either monthly or quarterly, depending on the service line. The sessions can be onsite or virtual depending on the service line department head’s request.
We are also exempt, Monday through Friday. I allow a flexible schedule. They are required to get their work done within the business day.
Response #8: Our team is exempt, and the frontline CDI team is fully remote with the exception of our CDI specialist level II team members who have been promoted to that position and spend at least two days a week onsite at their assigned facility being hands-on with assistance to and education of the physicians on CDI processes and queries, system defined consensus statements and diagnosis definitions, and in whatever way they can make connection and get buy-in from our physician partners. Some assigned to the smaller facilities also attend facility length of stay meetings as the providers attend in-person and it’s a good way to bring forward their queries waiting for response on those cases of interest.
We all are expected to work up to eight hours or more as needed for personal completion of daily workflow metrics. The daily hours worked are of their choosing between 6 a.m. and 6 p.m., Monday through Friday. They can flex out of work during the day for up to two hours and cover missed work if needed for their workflow metrics that same week as able. They are asked to request a day of PTO for needs that would be over two hours in a day.
We keep a shared PTO calendar for the region that all the team members can view and be aware of who is off on a particular day. The time off is noted after an email request for PTO to the regional supervisor and those approvals are entered by the supervisor on that shared PTO calendar for view.
Response #9: We are a team of 40 and we work Monday-Friday while allowing flexibility to trade a weekday for a weekend day when a person requests it to avoid PTO usage. Otherwise, there is no weekend coverage. Our staff is exempt, and our department is closed on the six hospital-observed holidays. We work eight-hour days allowing flexibility to leave for appointments. The entire team works remotely four days a week and comes onsite one day a week. We hold two huddles a week and one lunch-and-learn and one team meeting a month. They are mostly done remotely, but quarterly or every other month, we meet in-person for the team meeting. We train staff onsite for the first two weeks (Monday-Thursday and Fridays are remote).
Response #10: Our staff are exempt. In an effort to be flexible, we allow them to work any eight consecutive hours between the hours of 6 a.m. and 6 p.m. Our team works primarily remotely, but the job code is not listed as remote in the job description. Remote ability is a privilege based on their performance. We do still rotate through the team to come onsite for provider education, as well, but given the large size of our team, each employee may only have to be on campus once every other month. We do not routinely allow longer hours but do make exceptions in special circumstances. Staff are granted permission to break up their day (for example, 7-11 a.m., then 2-6 p.m.) to attend appointments, kid’s events, etc. They are also allowed to work on a Saturday or Sunday to make up for a weekday they want to take off without using their PTO. Overall, we make every effort to allow flexibility as long as staff are meeting their goals.
Editor’s note: This question was answered by members of the ACDIS CDI Leadership Council and originally appeared in the CDI Leadership Insider, the monthly council-only publication. For the purposes of this article, all Council member answers have been deidentified.