Systematic review: What is the impact of self‐scheduling on the patient, nurse and organization?

Abstract

Aim To systematically review and evaluate the literature on the impact of self‐scheduling on patient, nurse and organization‐related outcomes. Design A systematic review. Data sources PubMed, Embase, Web of Science, Cinahl, Scopus, Google Scholar, ERIC and Cochrane Library were screened until October 2019 (week 40) for peer‐reviewed, empirical articles, written in English, Dutch or French. Review methods Two reviewers screened title and abstract using predetermined eligibility criteria and one reviewer screened the full texts of relevant hits. Quality was assessed with the Mixed Methods Appraisal Tool. Results Studies (N = 23) were retained and classified into explanatory and descriptive studies. The articles reported on a range of outcomes: patient‐ and nurse‐reported quality of care, job satisfaction, satisfaction with scheduling, work/life balance, planning involvement, interaction with colleagues, health and well‐being, psychosocial factors, professional development, nurse manager's scheduling time, general working conditions, turnover, temporary employment agency use and absenteeism, recruitment and retention. Conclusion The evidence base is limited. Several studies confirmed the positive impact of self‐scheduling on the nurse and the organization. However, other studies found negative outcomes or no change. These outcomes should be interpreted in the light of contextual factors and the implementation process, which was often not without difficulties. Future research should use a multimethod longitudinal design, bear in mind the possibilities of quantitative research (e.g. for studying psychosocial factors) and employ a theoretical framework. Impact This review informs about the inconsistent evidence on the association between self‐scheduling and patient, nurse and organization‐related outcomes and includes enablers and barriers to a successful implementation. These outcomes are influenced by the implementation process and the sustainability of the self‐scheduling system, which are still major challenges for healthcare management. This demonstrates the urgent need for further research.

The effect of self-scheduling on organizational justice and work attitudes through leader-member exchange: A cross-sectional study using propensity scores

“…On the surface, self-scheduling looks like the ideal method to give employees the control over their own working hours whilst also meeting the needs of the organization. However, self-scheduling appears to have positive effects on various work attitudes in some organizations and not in others ( Wynendaele et al, 2020 ).…”

“…Finally, additional covariates on individual level were selected based on pre-existing expert knowledge and literature review ( Wynendaele et al, 2020 ) on the most important confounders: age, gender, degree, experience in healthcare, experience in the nursing home, work regime, marital status and locus of control. The latter was measured via the I-E Scale (internal-external scale) developed by ( Rotter, 1966 ).…”

“…These negative findings are now further reinforced. A possible explanation can be that self-scheduling is a complex intervention that expects from each employee an increased responsibility in the rostering process which necessitates good communication skills, a certain degree of assertiveness to negotiate with colleagues and an understanding of the rostering problem ( Wynendaele et al, 2020 ). Making so many decisions each month can become overwhelming due to the many potential (approximately equally good) outcomes that may result from each decision ( Toffler, 1970 ).…”

“…This in contrast with fixed scheduling, or traditional cyclical scheduling, where nurses work the same schedule for an extended period of time and the responsibility of drawing up this schedule lies with the head nurse. Literature already discussed advantages and disadvantages of selfscheduling ( Koning, 2014 ;Wynendaele et al, 2020 ). Regarding the nurse outcomes, research showed a higher satisfaction with scheduling , more influence on work-time ( Garde et al, 2011 ;Nabe-Nielsen et al, 2012 ;Nabe-Nielsen et al, 2011a ) and positive effects on work/life balance ( Albertsen et al, 2014 ;Nabe-Nielsen et al, 2011b ;Pryce et al, 2006 ).…”

Differences in work attitudes when nurses get their ideal roster based on their shift preferences

“…This can be interesting when a company wishes to switch to, for example, selfscheduling, where the "final roster" is a compromise between the "nurse's 'ideal roster" and the "imposed roster". This means that employees will almost never receive 100% their ideal schedule as they need to switch shifts among colleagues to meet staffing needs, have to comply to the rules, regulations and guidelines of the organization and, in addition, the monthly recurring process can be seen as a cumbersome procedure (Silvestro & Silvestro, 2000;Wynendaele, Gemmel, Pattyn, Myny, & Trybou, 2020).…”