Some HCA Healthcare nurses say Timpani, an AI-enabled scheduling tool built on Palantir software, ignores their shift preferences and leaves units short on experienced staff, Wired reported Oct. 2.
Wired interviewed six nurses who work at Nashville, Tenn.-based HCA Healthcare, including two who are leaders at National Nurses United, the nation’s largest nurses union. NNU represents about 10,000 of HCA’s roughly 100,000 nurses. It has previously organized protests against health systems’ use of Palantir’s technology.
Timpani is built on Palantir Foundry, a platform for storing and analyzing data across an organization’s operations. It uses algorithmic forecasts of patient volumes and staffing needs to automatically build nursing schedules. HCA has rolled it out at roughly 130 of its locations since 2023, according to Wired.
Michael Schlosser, MD, HCA’s executive vice president, chief clinical officer and chief transformation officer, wrote in July that Timpani has cut the hours managers spend on scheduling each month, reduced reliance on contract nurses and improved retention.
Nurses told Wired the tool often ignores their requests to space out shifts, work nights and weekends or take specific days off. They also said it schedules too few nurses, or too few experienced nurses, particularly on Sundays.
Amber Retzloff, RN, a critical care nurse in Florida and NNU leader, requested 50 specific 12-hour shifts over four months. Timpani assigned her different shifts more than half the time, she told forcing her to delay care for the sickest patients while she guided newer nurses through milder cases.
“We are overriding clinical judgment and the human-to-human piece of healthcare with an app,” she said.
HCA says Timpani schedules nurses on an average of 1% of their requested days off. Lee Barker, RN, an NNU leader at an HCA psychiatric center in Missouri, told Wired that being scheduled on those days was previously unheard of at the facility. Now nearly every nurse there has been. The center’s union of about 500 nurses filed a grievance over the software, and the matter is likely headed to arbitration.
Nurses also told Wired that local managers could initially edit Timpani’s schedules, but they now have to flag problem shifts to a centralized team at HCA’s Nashville headquarters.
An HCA Healthcare spokesperson told Becker’s the health system schedules hundreds of thousands of shifts a month and millions a year. Its data show nurses are scheduled according to their preferences 98% of the time, the spokesperson said.
“Labor union statements, some of which have come from nurses that have not yet used the tool, claiming Timpani is designed to reduce staffing at the expense of patient care misrepresent both its purpose and how it works,” the spokesperson said.
HCA said Timpani was developed with input from nurses and nurse leaders. The tool builds an initial schedule from anticipated patient needs, staffing requirements, skills and experience, and employee preferences. Nursing leaders then review the schedules and adjust them as patient needs and circumstances change.
“Our nurses and nurse leaders, not technology, make staffing and scheduling decisions,” the spokesperson said.
According to HCA, Timpani has cut the time nurse leaders spend building schedules to as little as two hours a month. The health system said it continues to use nurses’ feedback to improve the tool.
A Palantir spokesperson told Becker’s there “continues to be deep misunderstandings” about how the company’s software works in healthcare. “Palantir’s software does not make decisions for hospitals or healthcare workers,” the spokesperson said. “Palantir’s software simply helps integrate customers’ data sets and presents them in a unified manner — all so that healthcare workers can make better-informed decisions.”
The company added that its work in hospitals has helped reduce sepsis deaths and place patients into beds faster.
HCA spans 189 hospitals and approximately 2,600 ambulatory care sites across 19 states and the United Kingdom.
