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Customer SuccessHow to Simplify Psychiatry Residency Schedules
Organization
UNC School of Medicine
Department of Psychiatry
Challenge
Managing 200+ provider, resident, and faculty schedules across multiple clinical settings
Implemented Solution
Lightning Bolt Scheduling
TABLE OF CONTENTS
“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
∞ to 2x
Reduced schedule publishing from continuous to two times annually
20+
Supported schedules for 20+ new physicians annually
88%
Decrease in time spent creating schedules
1
Source of scheduling truth for all
41
Custom schedule views implemented
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
- Training schedule administrators as subject matter experts with standardized operations across all schedulers
- Giving administrators decision-making power about schedules for their location to avoid delays or confusion
- Building an institutional knowledge base
Defined Shift Priorities
- Top Priority: 24/7 attending on-call coverage
- Second Priority: Complex multi-provider schedules (assignments requiring coordination of multiple providers’ availabilities and specialties across different units)
- Third Priority: Simple, straightforward assignments
Custom Visibility Solutions
- 41 tailored schedule views so only critical, role-dependent aspects of the schedule are visible to each user
- Role-based access controls
- 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.