Timpani was meant to make nursing schedules easier. HCA Healthcare rolled out the AI scheduling tool at roughly 130 of its 190 locations starting in 2023, promising a faster way to match staffing with patient demand. Nurses say the system has delivered something else: scheduling errors, exhaustion, and more work fixing schedules that should have worked in the first place.
Amber Retzloff, a critical care nurse and union leader, requested 50 specific 12-hour shifts across four months. Timpani assigned her different shifts, often on back-to-back days, despite her stated preferences. Her hospital adopted the tool nearly two years ago, and she says, “No one is happy with Timpani.”
Retzloff’s view matches complaints from five nurses at other HCA locations. They say Timpani ignores requests to space out shifts, work nights or weekends, and take specific days off, leaving nurses to spend more time trading assignments or appealing schedules.
Automation Is Rewriting the Shift
Timpani uses algorithmic forecasts of patient volumes and staffing needs to build nursing schedules automatically. It was built on Palantir Foundry, a software platform for storing and analyzing data, and HCA’s top innovation executive, Michael Schlosser, said at its 2023 launch that the system would save time and money.
Instead, nurses allege that the tool has potentially harmed patients by creating care teams that are understaffed, imbalanced, and exhausted. They say Timpani routinely schedules too few nurses or too few experienced veterans for a shift, with Sundays posing a particular problem.
Retzloff recalls recent shifts where all four of her colleagues were junior nurses. She had to delay care for the sickest patients, a result she blames on a scheduling process that gives too much authority to software and too little weight to clinical judgment.
“We are overriding clinical judgment and the human-to-human piece of health care with an app,” Retzloff said. She also accused HCA of “letting AI dictate,” a concise description of what happens when a scheduling tool treats staffing as a puzzle instead of a clinical operation.
Before Timpani, managers handled schedules manually and consulted nurses before overriding their requests. Nurses now report making alternative arrangements on shorter notice and facing more temporary reassignments.
Red Days, Missed Appointments, and Missing Answers
HCA says Timpani schedules nurses for 1 percent of their requested days off, known as red days. Lee Barker, an HCA nurse in Missouri, says nurses were assigned to work on days they were supposed to have off less than a year after Timpani’s introduction, and he delayed a doctor’s appointment because trading an assigned red day proved difficult.
Some colleagues are calling out and using paid or unpaid time to skip assignments. Nurses risk termination if they do that more than a few times annually, adding another pressure point to a system they say already creates unstable schedules.
Complaints have pushed HCA management to make minor updates, but nurses say the underlying problems persist. The National Nurses United union, which represents about 10,000 HCA nurses, says HCA has rejected its requests for information about Timpani.
HCA spokesperson Harlow Sumerford said nursing leaders, not Timpani, make final scheduling decisions. HCA’s goal, Sumerford said, is to place caregivers with the right skills and experience on each shift while considering scheduling preferences.
That explanation leaves a basic question hanging: if leaders make the final decisions, why are nurses spending so much time correcting the tool’s decisions? A system can support human judgment, but it cannot escape responsibility when its recommendations repeatedly shape the final schedule.
A former HCA data science manager, Angelique Russell, sued HCA in July, alleging the company fired her in retaliation for raising concerns about Timpani. Russell accused HCA of deleting data used by the tool to create schedules, which prevented auditing and may have violated healthcare laws.
That allegation raises the stakes beyond frustrating shift swaps. If scheduling data cannot be reviewed, nurses, unions, and managers lose a way to determine why assignments were made and whether the system produced unsafe staffing patterns.
HCA wanted automation to save time and money. Nurses say it has shifted the labor elsewhere—to appeals, emergency trades, missed appointments, temporary reassignments, and delayed patient care. The software may build the schedule, but humans are still left cleaning up its mistakes.
Based on
