A separate evening shift lets your day clinicians leave at the time their schedule says. Weekend and evening shift coverage covers how to design, price and post that shift.
This post covers what comes next. The clinician who works the evening shift closes the clinic, and that clinician is often a locum or a part-time clinician who's never seen your morning. Closing has tasks the day shift doesn't do, and fewer people are around to answer questions.
What's Different About After-Hours Urgent Care Staffing
The evening clinician starts in the middle of the day. They take over occupied rooms, a waiting room and results that are still out. Shift handoffs with rotating locums covers how to schedule and run that handoff.
The people who answer questions have gone home. The clinic manager, the billing team and your IT support usually work office hours. A question that takes one minute to answer at 2 p.m. may have nobody to answer it at 8 p.m.
The shift ends without a handoff. Nobody arrives to take over the open items. Whatever isn't finished or written down waits until morning, when a different clinician arrives.
Write an After-Hours Contact List
Put on one page who can be reached after office hours, and how.
- The medical director, or whoever covers for them, with a mobile number and the hours they'll answer
- The manager on call for staffing and building problems
- EMR or IT support for a locked account, with the after-hours number if it's different from the daytime one
- The alarm company and the building contact
- Any outside service the clinic depends on in the evening
Call each number once, in the evening, before you rely on the list. A support line that sends evening calls to voicemail won't help a locum who's locked out of the EMR.
List What Changes at Your Clinic After Hours
Some services stop before the clinic closes. A locum can't know which ones unless you tell them. Go through your own day and write down:
- Whether X-ray is staffed until closing, and what happens when it isn't
- When the last specimen pickup is, and where specimens collected after it go
- Which offices you normally call or refer to are closed in the evening
- Which staff roles leave before closing
For each one, write what your clinic does in that case. The clinical parts of those answers are your medical director's decisions. The evening clinician needs them in writing before the shift.
Set a Last Check-In Time for the After-Hours Shift
Your posted closing time and the time you stop accepting patients may not be the same. Decide the rule and write it down: the last check-in time, who at the front desk applies it, and what staff say to a patient who arrives after it.
Without a written rule, the decision goes to whoever is standing at the door. A locum on their second shift shouldn't have to make it.
The rule also sets the real end of the shift. If patients checked in at the last minute keep the clinician past the posted end time, say in the shift description how that time is paid. A clinician with a day job elsewhere needs to know when they'll actually leave.
Closing Tasks for the After-Hours Urgent Care Shift
Write the closing routine as a checklist with an owner for each line. The items below are examples to adapt.
The clinician
- Complete and sign charts to your clinic's standard, or note which are still open
- List results that are still out and callbacks that are still owed
- Confirm that prescriptions written during the shift went through
Support staff
- Secure medications and supplies as your policy requires
- Shut down or restock equipment for the morning
- Close out the front desk
- Update the phone message or door sign if tomorrow's hours are different
Lockup
- Decide who sets the alarm and locks the doors
- Decide whether anyone may be alone in the building at closing
- Tell the locum their part before the shift
A locum shouldn't learn at closing time that they're expected to set the alarm.
Leave a Closing Note for the Morning Clinician
An evening shift has no incoming clinician to brief, so the briefing has to be written. Use the same sheet you use for a daytime handoff: what's open, what it's waiting on, and who owns it now.
Give every open item an owner who'll be in the building tomorrow. The evening clinician may not work at your clinic again for a week, so "I'll follow up" isn't a plan. Add anything that broke or ran out during the shift.
Say where the note goes. A sheet left at one workstation gets missed if the morning clinician sits at another.
Offer After-Hours Shifts to the Same Clinicians
A clinician learns your closing routine once. After they've closed your clinic a few times, they need the day's handoff and nothing else.
Offer recurring evenings to a small group instead of posting each one as a single shift. A clinician with a daytime job can commit to every Tuesday and Thursday more easily than to scattered dates. Building an urgent care float pool covers how to recruit and credential that group.
Ask each new evening clinician one question after their first closing shift: what did you have to guess? Add the answer to the checklist.
Rediworks is a self-service marketplace for urgent care locum shifts. You post the clinician type, dates, hours and rate for your evening shifts yourself. Sign up to post shifts.