Algorithmic Scheduling Raises Questions of Transparency, Accountability, and the Future of Employment Conditions in Healthcare

Abstract

Algorithmic management is gradually replacing, totally or partially, the work of human managers in organizations seeking to maximize efficiencies across a range of economic sectors and occupations. The actual concept of algorithmic management has only recently been applied to healthcare research, although antecedents and elements of it have been percolating through healthcare for several decades. In this chapter, we synthesize findings from an exploratory iterative literature review of available evidence regarding the application of algorithmic management in healthcare, with a focus on algorithmic scheduling. Algorithmic scheduling replaces the manual creation of schedules, most often using hard and soft constraints to value competing priorities in schedule creation. We discuss several transparency and accountability-related implications regarding staffing decisions and assess whether research on the application of algorithmic scheduling in healthcare incorporates considerations about its implications for health workers’ employment and working conditions, work environment, health and well-being, or ethics. We find that algorithmic scheduling has global interest and that increased transparency about this type of scheduling decisions may present an opportunity to increase fairness in scheduling. Conversely, black box scheduling may obscure accountability for staffing decisions, for example by burying questions about staff/patient ratios within the operation of the scheduling technology. Algorithmic scheduling may also contribute to a worsening of job quality for health workers, especially if the process is not transparent and insufficient consideration is given to its impact on health workers’ employment and working conditions, work environment, or health and well-being.

Ähnliche Arbeiten