Boston Children’s signs a multi-year deal with Chiefly after automating its block schedule
The Boston Combined Residency Program, with 188 residents across two hospital systems, faced escalating scheduling complexity under new ACGME requirements and outdated tools that risked missed deadlines. Partnering with Chiefly, the program generated a fully compliant block schedule within a week.
“We are extremely pleased with our engagement with Chiefly. They have found solutions that have positively contributed to a reduction in scheduling burden and have helped us automate tedious tasks. We hope to accelerate the scheduling process for the benefit of our Chief Residents and our entire Scheduling Team!”
Ted Sectish, Program Director
Executive Summary
With 188 pediatric residents across two hospital systems (Boston Children's Hospital and Boston Medical Center), the Boston Combined Residency Program (BCRP) operates one of the most complex training programs in the country. New ACGME requirements made an already challenging block scheduling process even more demanding, given BCRP's tight staffing margins, these changes left little room for error.
In January, it became clear that their existing scheduling tools (spreadsheets and a legacy platform) couldn't support the level of complexity, putting the team at risk of missing critical deadlines for the upcoming academic year.
Boston Children's partnered with Chiefly, and within a week they helped the program generate an initial, fully compliant block schedule. In doing so, the team also reimagined how scheduling was done entirely. Instead of manually building and troubleshooting schedules, the chief residents and program leaders became advisors to the process, leveraging Chiefly's automation to explore scenarios, enforce ACGME rules, and focus on meaningful decisions rather than clerical tasks.
Results:
BCRP delivered a 100% ACGME-compliant block schedule on time, cutting months of manual work down to days and saving over 3,600+ hours in just eight months, worth $224k to $274k (10x to 12x ROI). Chiefs regained ~15% of their year for education and patient care, schedulers avoided the annual late-night scramble, leadership gained real-time ACGME compliance visibility, and residents benefited from more equitable, predictable schedules with institutional knowledge preserved in the platform.
"If we didn't have Chiefly, the schedules either would not have been done or wouldn't have gone out on time; it would've been pretty catastrophic."
Jeffery Edwards (Chief Resident)
"One of my biggest goals is to reduce the scheduling burden of our Chief Residents and our administrative staff. Chiefly is helping us achieve this goal!"
Ted Sectish (Program Director)
Challenge: Complex Scheduling Across Two Health Systems
BCRP's scheduling challenge was truly high-stakes and multifaceted. At the same time, the program was also transitioning to an X+Y model and managing a wide set of combined tracks (Pediatrics/Neurology, Med-Peds, Pediatrics/Anesthesia, Pediatrics/Genetics, Triple Board, Accelerated Research Pathway, and Integrated Research Pathway) - each introducing additional rules and staffing nuances that compounded the challenge.
With no single system managing this complexity, the burden fell on oversight from the PD, the scheduling APD, 6 chiefs, and 3 full-time scheduling administrators, relying on heroic manual effort and tacit knowledge year-to-year to produce a viable schedule. We received feedback from each of these individuals to better understand 1) a breakdown of the time spent on this process, and 2) the impact of manual scheduling without Chiefly:
3,643 Estimated Hours Spent on Block Scheduling (Just from Jan to Aug)
- Chief Resident Perspective
"I'm sure at least 15% of my year could have been spent on this project alone if I'd taken it on myself."
Sidney Hilker (Chief Resident)"I don't think I realized how much time and energy I spent as a chief doing schedules. It really did take away from the other things I wanted to do with the job."
Margaret Irwin (Chief Resident) - Scheduling Manager Perspective
"Every March and April for the past six years, I'd be up till 11pm Monday to Friday. No matter how early you start, it just does not get done in time."
Jess Angerman (Scheduling Manager)
Other Impacts of Manual Scheduling (Before Chiefly)
- Fragmented institutional knowledge: Critical scheduling rules and workarounds existed only in scattered spreadsheets and depended heavily on the scheduling manager's institutional knowledge.
"If we were to lose our lead scheduler, the BCRP would be okay if we had Chiefly. And it would truly not be okay if it happened at a time of year where we were making block schedules if we didn't [have Chiefly]."
Sidney Hilker (Chief Resident) - Leaders acting as schedulers instead of educators: Manual scheduling forced chiefs and APDs to spend hundreds of hours as “doers” - buried in administrative tasks, rather than serving as advisors on program design and focusing on the educational mission.
- Lack of flexibility: The program needed year-round flexibility: the ability to adapt schedules as resident circumstances changed, balance demanding rotations equitably, and support wellness in real time.
- Compliance exposure: The program needed year-round flexibility: the ability to adapt schedules as resident circumstances changed, balance demanding rotations equitably, and support wellness in real time.
Intervention: Implementing Chiefly
Within days, chiefs and schedulers were onboarded and building off of pre-loaded staffing and ACGME requirements. The team started to see their roles shift from being in the minutiae of changes schedules to weighing in as advisors on how to create the best possible educational experience for residents.
Chiefly gave the team more confidence that they were meeting ACGME and staffing requirements, while experimenting real-time with their scenario planning tool to test different scenarios. Here were some initial reactions from the team:
Sidney Hilker (Chief Resident)"It was one week between setting the rules and running a schedule to sending out a draft."
Jess Angerman (Scheduling Manager)"It was an absolute pleasure working with you all, truly night and day from what we experienced earlier in the year. I just wish we had found you sooner and been able to reap the benefits of your wonderful platform."
Margaret Irwin (Chief Resident)"10/10 would recommend and have recommended!"
Jeffery Edwards (Chief Resident)
Results: Time Recovered, Risk Reduced, and Quality Increased
Chiefly transformed BCRP's scheduling from a manual, person-dependent process into a scalable tool that adapts to evolving ACGME requirements. Here are the tangible results from January to August 2024:
- 3,643 hours saved across chiefs, schedulers, APD, and PD, worth $224k in estimated salary + benefits or $274k in clinical-equivalent value
"Based on the amount of information we gave you guys, it did not take nearly as long as I thought it would to have all of our rules in place and be able to output a solution."
Jess Angerman (Scheduling Manager)
- Chiefs reclaimed an estimated ~15% of their year for leadership, teaching, DEI efforts, and acting-attending roles.
"I found it to be such a pleasure to work with [Chiefly]. You have a great understanding of how residencies work and the challenges they face… you worked with us so gracefully, so I was super grateful for that. And I think there's just so much potential in what you've created."
Sidney Hilker (Chief Resident) - Schedulers avoided the annual March to April late-night scramble with weeks of rework compressed into days.
"[Working with Chiefly] made changes so much faster than I could have done in Excel. Mollie and I were looking at it and we were like, wow! We did not expect it to output something as far along as that was."
Jess Angerman (Scheduling Manager) - Leadership gained ACGME compliance and staffing confidence with transparent audit trails and the ability to scenario-plan changes in real time.
"Your team is so willing to support, change, and pivot in real time saying, ‘well, that's not going to work, what are we going to do?' That responsiveness is incredible and the reason we were able to produce block schedules that were so thoughtful and not prone to error. I think your ability to work with the customer is exceptional and truly not something that exists in the market."
Margaret Irwin (Chief Resident) - Residents benefited from more equitable, predictable schedules with the ability to assess fairness and introduce more flexibility year-round.
"We were able to focus more on evenly distributing things… those are things that we have never really focused too much time on in the past."
Jess Angerman (Scheduling Manager)"The residency really prioritizes the ability to have flexibility and to actually cater to every individual need, which you only can do if you have a robust enough software."
Sidney Hilker (Chief Resident) - Maintained institutional knowledge - Chiefly's intuitive onboarding, interface, and knowledge of GME made it such that future chiefs and schedulers won't have to relearn the scheduling puzzle from scratch each year. What once depended on one or two individuals is now captured in a transparent, repeatable system.
" I found [Chiefly] actually very intuitive."
Jeffrey Edwards (Chief Resident)"Other [scheduling] softwares…[are] just a little bit more clunky…the platform that you guys have created is really easy and user friendly to use, even for someone like me who's not the most high tech individual."
Margaret Irwin (Chief Resident)
Next Steps: Time Recovered, Risk Reduced, and Quality Increased
Boston Children's now has a sustainable scheduling tool and has committed to partnering with Chiefly for the next two years. The program will continue using Chiefly to:
- Year-Round Value: Chiefly isn't just for building the annual schedule. BCRP expects to use it year-round to handle parental leaves, swaps, PTO requests, and fairness adjustments, keeping schedules compliant and transparent without reverting to spreadsheets.
- Automate and streamline block scheduling: reducing months of work to days.
- Ensure ACGME compliance and experiment in real time with audit-ready dashboards that are being built.
- Improve fairness and wellness by empowering the scheduling team to make quick overrides throughout the year.
- Protect institutional knowledge so turnover no longer forces each chief class to relearn the scheduling puzzle from scratch each year.
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