Customer case study · Trident Anesthesia
How Trident Anesthesia stopped building call by hand.
Twenty-five physicians. Two hospitals, six surgery centers. One partner who used to spend his nights and weekends on the call schedule and another building the daily schedule. The call-scheduling doctor has not touched the spreadsheet since November 2025.
Before
One partner. Every month. His nights and weekends.
Trident Anesthesia is a twenty-five-physician group covering two hospitals and six surgery centers across a region. Before Nice Schedule, one of the partners — Dr. Feller — built the monthly call schedule with paper and a spreadsheet.
That job is not a Saturday afternoon. It is nights and weekends. The reason is, figuring out a fair call schedule is truly a hard problem. And if it wasn't hard enough, the data is messy. Email requests, last minute changes, and special cases all add complexity.
The rules are specific: contract-employee minimums, post-call cardiac coverage, weekend pairings the group avoids. A spreadsheet can hold them as long as one person keeps them in their head. The risk is what happens to the schedule when that person stops being available — or wants a weekend back.
The work, before any schedule was generated
Rule capture, then the solver.
The first weeks were not about software. They were about getting the rules out of one partner’s head and onto paper. We sat down with Dr. Feller and walked through every situation the spreadsheet had been quietly handling for years: which sites need which credentials, which partner pairings get avoided on weekends, what post-call rest looks leading up to a cardiac case, how contract employees’ committed shifts get allocated before partners absorb the rest.
Then we imported the prior months’ schedules so fairness accounting could start from history, not from zero. Then we encoded the rules into the solver as constraints. Then — only then — we generated the first draft schedule.
Contract minimums protected first
Contract employees get their committed shifts first. Partners absorb the remainder. Encoded as a hard constraint — the solver assigns contracts before anything else.
Post-call cardiac recovery
Cardiac call comes with specific post-call rest requirements distinct from the rest of the schedule. Modeled separately, enforced before any cardiac assignment lands.
Weekend partner pairings
Specific partner combinations the group prefers to avoid on weekends. The solver knows which pairs to keep apart and finds combinations that work.
Year-long vacation glide path
Vacation distribution is solved across the whole year. No physician hits December with an unrealistic number of target shifts because the system didn't properly account for vacation.
After
Six months of published schedules. The partner has not touched the spreadsheet.
Since November 2025, every monthly Trident call schedule has been built through our solver and delivered to the group. The April 2026 schedule above is one of them. Now an entirely new doc has taken over the process. The published version goes out to the group without a partner spending a weekend on it.
What changed, mechanically, is that the rules now live in the solver instead of in one person's head. What changed for Trident is that a partner’s weekends came back.
On top of the process being automated, there is now a very user-friendly system of record. One that makes the daily scheduling process much smoother too.
What it does not solve
The honest part.
For Trident, we have not automated solving the daily schedule, yet. The daily schedule is finalized the night before, a lot of consideration goes into it.
We have added many features that makes the process a breeze. Instead of consolidating vacation, coverage requirements and capabilities manually, the system does it automatically.
Now the scheduling doc just paints coverage where coverage is needed.
But when we solve daily schedule automation, it will be done with the same attention to fairness and rules that we apply to the call schedule.
What we built it on
If you want to see the pieces in more depth.
What anesthesia call scheduling actually requires
Post-call rest, site coverage, partner pairings, fairness history — the rules every group has and most tools can’t model. The pillar page.
The AI-plus-solver walkthrough we published for free
The do-it-yourself version of the same approach. ChatGPT plus OR-Tools CP-SAT. Walks through how a constraint solver gets built and what it actually does.
How we compare to QGenda and Amion
An honest side-by-side. Where each tool is the right answer for an anesthesia group, where it isn’t.
Your group
If a partner in your group is doing Dr. Feller’s job today, send us their hardest rule.
The thing that makes the schedule take a weekend instead of an hour. We read every one and reply within one business day. We only take on two new groups per month, so the rule-capture work is done properly.