Shift swap
A shift swap is an exchange of assigned shifts or call between two clinicians, usually approved by a scheduler so that coverage and rules still hold.
A shift swap, or trade, is an agreement between two people to exchange assignments: one physician takes a colleague's Saturday call and gives up a Wednesday night in return. Related moves are a give, where one person hands a shift to a colleague without taking one back, and a take or pickup, where someone claims an open or offered shift. In many groups, a scheduler or administrator approves the change before it becomes final.
Approval exists for a reason. A swap can put someone on a line they are not credentialed or eligible for, break a rest rule, or push a resident past ACGME limits. For hourly, non-exempt staff, it can create overtime: the Fair Labor Standards Act requires at least time and a half for hours over 40 in a workweek, or, where a hospital uses the 8 and 80 system by prior agreement, over 8 hours in a day or 80 hours in a 14-day period. Physicians are exempt from those overtime rules.
Pitfalls: swaps arranged by text message that never reach the official schedule, so the operator pages the wrong physician; swaps approved without updating the fairness counters, so year-end totals no longer match who worked; and one-way gives that slowly move weekends and holidays onto the same few people.
Common questions
Should shift swaps need approval?
Usually, yes. An approval step checks that the person taking the shift is eligible for that line, that rest and hour rules still hold, and, for hourly staff, that the change does not create unplanned overtime. It also makes sure the published schedule, the paging list and the fairness counters all show who is actually working.
Do swaps count toward call fairness?
They should. The counters need to reflect who actually worked each night, weekend and holiday, not who was first assigned. A physician who gives away two holidays has worked two fewer holidays, even if the original schedule was balanced. Recording swaps also shows when the same people keep giving away the least popular shifts.
How do swaps affect overtime for hourly staff?
Under the Fair Labor Standards Act, non-exempt employees earn at least time and a half for hours over 40 in a workweek. Hospitals may instead use the 8 and 80 system, with a prior agreement: overtime after 8 hours in a day or 80 hours in a fixed 14-day period. A swap that moves a shift into another week or period can change who is owed overtime.
How Momentum handles it
In Momentum, gives, takes and swaps are requested from the web or the mobile app and approved by an administrator, and the counters are kept up to date with each swap.