US: HCA nurses tell WIRED its AI scheduling tool overrode their shift requests and scheduled them on requested days off; one delayed a medical appointment

The tool. According to WIRED, HCA has rolled out Timpani, an AI scheduling tool co-developed with Palantir, at roughly 130 of its 190 locations since 2023. It uses algorithmic forecasts of patient volumes and staffing needs to build nursing schedules automatically. HCA's innovation executive wrote in July that the efficiency comes from AI generating stronger initial schedules. Nurses told WIRED that managers formerly scheduled by hand, that appeals now go to a central team in Nashville and that shift swaps succeed about half the time.

The nurses' accounts. Amber Retzloff, a Florida critical care nurse and union leader, said that over the past four months she requested 50 specific 12-hour shifts and that over half the time the software assigned her different ones, often back-to-back days that left her mentally drained. She also described shifts where she was the only senior nurse and had to delay care for the sickest patients to guide junior colleagues. Lee Barker, a nurse and union leader at an HCA psychiatric centre in Missouri, said essentially every nurse there had been assigned to work on a requested day off, and that Barker delayed a long-planned doctor's appointment for a chronic condition after struggling to trade such a day. Five nurses at other locations described similar problems.

HCA's position. An HCA spokesperson said nursing leaders, not Timpani, make final scheduling decisions and that claims the tool is designed to reduce staffing at the expense of patient care misrepresent it. HCA says Timpani schedules nurses on 1 percent of requested days off on average. Palantir has said that customers are responsible for the data, policies and decision-making.

Limits. The accounts come from interviews with nurses who are union leaders; WIRED does not report checking their schedules. Patient effects are the nurses' concerns and are not counted here.

According to the nurses interviewed by WIRED, the AI scheduling tool repeatedly assigned a Florida nurse shifts she had not requested, often back-to-back days that left her mentally drained, and assigned a Missouri nurse to work on a requested day off, leading Barker to delay a doctor's appointment for a chronic condition. HCA says managers make final decisions.

According to WIRED, the union of about 500 nurses at the Missouri psychiatric centre filed a grievance over the software that is likely headed to arbitration, and National Nurses United says HCA rejected its requests for information about the tool. HCA says it continues to improve Timpani based on nurses' feedback.