A busy urgent care needs everyone on the floor working to the same standard, whether they've been there five years or arrived this morning. A locum clinician has the training. What they don't have yet is your clinic's context: where things are, how your EMR is set up, who to ask.
A quality assurance checklist for locum shifts closes that gap from the clinic's side. It writes down what a ready shift looks like at your clinic, checks it before the first patient, and records what happened so the next shift goes better.
This checklist covers operations: readiness, flow and feedback. Review of clinical care is your medical director's job and runs through whatever chart review process your clinic already has. The checklist's only clinical instruction is that locum clinicians go through that same process, on the same terms as permanent staff.
What a Locum Quality Checklist Should Measure
A quality program built for permanent staff measures people over months. A locum may work one shift this month and three next month, so a locum quality checklist has to produce something useful after a single shift.
Three things can be measured in that window:
- Readiness. Did the clinician have access, orientation and the information they needed before the first patient?
- Flow. Did the shift run at something close to the clinic's normal pace, and if it didn't, what slowed it?
- Friction. What did the clinician and the staff around them report afterward?
Most of what the checklist catches turns out to be the clinic's to fix. A locum who can't log in or can't find the supply room isn't showing you a quality problem with the locum.
Stage One: The Pre-Shift Quality Checklist
Complete this before the clinician sees a patient. The clinic manager or whoever leads the floor that day owns it.
Paperwork on file
- Everything your credentialing process requires for this clinician's role is complete and current. The list differs by role: what you hold for a physician isn't what you hold for an MA.
- Any qualification specific to this shift has been confirmed. A shift that includes occupational health visits is one example, covered in DOT physicals, drug screens and workers' comp with locums.
Access
- EMR login tested by the clinician, not only issued
- Access to any other system the role uses: medication dispensing, lab ordering, imaging
- Door codes, badge and parking
Orientation
- Walk-through of the clinic, including where emergency equipment is kept
- Walk-through of the X-ray and lab setup: what's on site today and who runs it
- Your clinic's documentation expectations and where its written policies are kept
- Who's who on this shift, and who to call when something is unclear
- How a transfer is arranged at your clinic and who makes the call
Expectations
- What the shift includes, matched against what the shift description said
- Anything the clinician has said they don't do, written down before the shift begins
If your clinic doesn't have an orientation routine to hang this stage on, start with what operators get wrong about locum orientation.
Stage Two: Quality Checks During the Locum Shift
The point of checking during the shift is to catch a problem while someone can still fix it. It isn't surveillance. The floor lead looks at two things.
Flow against your own baseline
- Time from rooming to being seen
- Time from being seen to leaving
- The length of the waiting room queue compared with a normal shift at that hour
Compare against your clinic's own numbers for the same shift type. A locum running slower than your usual pace is most often slowed by the EMR or by not knowing where something is, and both can be fixed on the spot by someone who knows the system. A run of complicated visits will slow anyone.
Signals from the people around them
- Questions the clinician has asked more than once, which point to a hole in orientation
- Patient complaints or requests to speak with a manager
- Staff reporting that they're unsure what the locum needs from them
One check-in partway through the shift is enough: ask what's getting in the way and fix what you can.
Stage Three: The Post-Shift Quality Review
Do this within a day, while everyone remembers. Ten minutes is plenty.
From the clinic's records
- Did the shift start on time and end on time?
- Was documentation finished by the end of the shift, or left open?
- Were there patient complaints tied to the shift?
- Is anything from the shift waiting on someone, such as a lab result due back tomorrow, and does it have an owner on permanent staff?
From the locum clinician
- What slowed you down?
- What would you have wanted to know before you started?
- What was different from what the shift description led you to expect?
From the staff who worked alongside them
- Was anything harder than usual, and why?
The clinician's answers are the most useful part of the review. If three different locums say the same lab ordering screen cost them time, that's a problem with the clinic's setup, and you'd never see it without asking.
Turning the Quality Checklist Into Decisions
A checklist that records observations and triggers nothing is a log. Decide in advance what each signal leads to, and write it down before the first locum shift.
| Signal | Compare against | Response |
|---|---|---|
| A pre-shift item is incomplete | Your checklist | Resolve it before the first patient, or escalate to whoever can |
| Flow is well off the usual pace | Your clinic's baseline for that shift type | Floor lead checks in and offers help with the EMR or the layout |
| Documentation left open at shift end | Your clinic's documentation policy | Follow up with the clinician the next day |
| A patient complaint | Your existing complaint process | Handle it the way you would for permanent staff |
| The same friction reported by several locums | Previous post-shift reviews | Fix the orientation material or the workflow |
The thresholds are yours to set. Base them on what your permanent staff do on the same kind of shift. A bar that's set higher for locums than for everyone else is measuring unfamiliarity with the building.
What to Do With the Quality Checklist Results
Decide who you invite back. Over several shifts, the reviews show which locum clinicians fit your clinic. Offering them shifts again builds a small group who already know your EMR and your staff, and each of their shifts needs less of stage one.
Fix orientation. Repeated friction at the same point is an orientation gap. Update the walk-through or the written material, and the next locum doesn't hit it.
Compare like with like. A Saturday afternoon and a Tuesday morning are different shifts. Keep results by shift type, day of week and season so a locum who worked your hardest shift isn't measured against your quietest.
Share the standard up front. Put what your clinic expects in the shift description. If you use a staffing agency, give your recruiter the same list. Clinicians choosing among shifts can tell which clinics have thought about what the day will involve.
The One-Page Locum Quality Checklist
Before the shift
- Required paperwork on file and current for this role
- EMR and system logins tested
- Clinic and diagnostic walk-through done
- Contacts and shift expectations confirmed
During the shift
- One check-in on flow against your baseline
- Questions, complaints and staff concerns noted
After the shift
- Open items assigned to permanent staff
- Ten-minute debrief with the clinician
- Notes filed where the next shift's floor lead can find them
Start with this version and add to it as you learn what your clinic's reviews keep turning up.
Rediworks is a self-service marketplace for urgent care shifts. You post the shift with the clinician type, dates and shift details. Sign up to post shifts.