Covering a sick call: open shift first, backup last
Updated October 13, 2026 · 8 min read
In Capillary's Coverage tab, a call-out on a published shift, or a shift no one is on yet, goes to everyone in the shift's group whose rest, other shifts, time off and own rules allow it. They can take it now, at a premium that rises on a timer up to a cap, or, with bids on, bid the premium they would take it for. At the deadline the scheduler chooses cover from a ranked list, backup first.
Coverage settings: every switch starts off
Changes to open-shift offers, the premiums and the deadline apply to shifts offered after the change.
| Setting | What it does | Default |
|---|---|---|
| Offer open shifts with a rising premium | Posts each call-out, and each unfilled shift a scheduler offers, as an open shift and emails everyone who can work it. Lets the department publish a schedule with open shifts. | Off |
| Let people bid their price | People can bid the premium they would take an offered shift for. The lowest bid gets it when the premium reaches it. | Off |
| Starting premium, rises by, every, up to | The premium ladder | 100 dollars, rising 75 dollars every 120 minutes, up to 600 dollars |
| Deadline: hours before the start | When the scheduler is asked to choose cover | 4 hours |
| Day and night backup, with each person's rules | Splits backup into day and night and turns on personal rules | Off |
| Fairness ledger | Shows backup days, call-ins, covers and credits for the last 12 months | Off |
A premium is extra pay for the shift, on top of usual pay. Capillary records it for the department's payroll and does not pay it. Each offer's premium is timed to reach its cap at the deadline, in the set steps: offered early, it holds at the starting premium; offered late, it starts partway up. So the most any offer pays is the cap. To keep the premium flat, set "Rises by" to 0.
How a call-out is covered
- 1
Report it
A clinician picks one of their own upcoming shifts under "I can't work". A scheduler picks anyone's shift under "Report a call-out". Either can add a note, such as Sick, that only schedulers can read. The shift must be published and not yet started.
- 2
Offer the open shift
With open-shift offers on, the shift appears on the Trades and Coverage tabs with its premium. Everyone in its staff group who can work it gets an email with the current premium, when it next rises, and the cap. The first person to take it gets it, with no approval step.
- 3
Let the premium rise
The premium goes up by the set amount at each interval until it reaches the cap. Whatever it shows when someone takes the shift is recorded. With bids on, when the premium reaches the lowest bid, that person gets the shift at that premium.
- 4
Reach the deadline
Schedulers get an email asking them to choose cover. For a physician shift, the physician on backup for that shift gets a heads-up. The open shift stays up until someone takes it or the scheduler assigns it. A call-out reported after the deadline goes straight to this step.
- 5
Choose cover
At any point, the scheduler can open Choose cover. It lists everyone in the shift's group, ranked, with the reason for each. Assigning someone updates the published schedule. The person who called out, the person covering and the schedulers each get an email.
Someone can take the open shift only if:
- They are in the shift's staff group: physician, APP or nurse.
- They have no approved time off that day.
- They have no overlapping shift, here or at another site.
- They keep the department's minimum rest before and after the shift, counting published shifts at another site.
- With day and night backup on, their own rules allow it.
Without open-shift offers, there is no open shift. The scheduler chooses cover from the same ranked list. Reporting a call-out also cancels any trade under way for that shift.
Offer a shift no one is on yet
With open-shift offers on, a scheduler can publish a month that still has open shifts. Each one is then listed in the Coverage tab under "Offer an open shift". Offering it works like a call-out: the same people get the email, with the same premium, deadline and backup step.
Bids: pick your premium
With bids on, anyone who can take an offered shift can instead bid the premium they would take it for. A bid is one of the premiums still to come on the ladder, shown with the time the premium reaches it.
- When the premium reaches the lowest bid, that person gets the shift at once, at that premium, after the same checks as taking it. No approval is needed.
- If two people bid the same premium, whoever has covered fewer shifts in the last 12 months gets it, then the earlier bid. Changing a bid counts from the change.
- A bid at the top premium wins at the deadline, before the scheduler is asked to choose cover.
- Before a bid's time, someone can take the shift now, which closes every bid on it, and a scheduler can accept any bid at once, or assign someone.
- If the person with the lowest bid can no longer work the shift, for example after a new shift leaves them too little rest, their bid is set aside with the reason, they get an email, and the next-lowest bid wins when the premium reaches it.
- A bid can be changed or withdrawn until its time. Schedulers see every bid; each clinician sees only their own.
- Emails: a receipt when you bid, with the time your bid would win; one when it wins; one if it is set aside; and one to the others who bid when the shift is filled.
Backup roster and each person's rules
The scheduler fills the backup roster for each month in the Coverage tab. By default it holds one backup per day for any shift.
With day and night backup on, each day gets a day backup for day and evening shifts and a night backup for nights. Each shift counts as day, evening or night by the department's own shift times, if it set them, or by Capillary's rule: a shift that covers at least half of the night, 22:30 to 06:30, with the sleepiest hours counting most, is a night, such as 19:00 to 07:00 or 19:00 to 03:00. Other shifts go by start time: day 05:00 to 12:59, evening 13:00 to 20:59, night 21:00 to 04:59. A physician who has said they won't be backup for nights is marked "no nights" in the night backup list.
The same switch adds "Your coverage rules" to each clinician's Coverage tab.
- Extra shifts I would pick up: which of day, evening and night shifts they are offered.
- I can be backup for: which kinds they cover when the scheduler calls them in.
- Notice I need, in hours. Blank means any notice.
- Most per month: the most call-outs they will cover in one month. Blank means no limit.
- Not the day after a night shift: no shift that starts within 24 hours of a night shift ending, here or at another site.
Offers follow these rules. A scheduler can still assign someone outside them, after a confirmation that repeats the reason. The form starts with every shift kind ticked and "Not the day after a night shift" ticked. The rules apply only once the clinician saves them. For how groups run backup call, see jeopardy call.
Worked example: a Saturday evening call-out
Example with sample names and one department's own settings. The premium starts at 150 dollars and rises by 50 dollars every 60 minutes, up to 400 dollars. The deadline comes 4 hours before the start. Minimum rest is 11 hours. The department uses day and night backup.
At 06:30 on Saturday 14 November 2026, Kai Ito calls out of the 15:00 to 23:00 evening shift.
| Time | Premium | What happens |
|---|---|---|
| 06:30 | 150 dollars | Call-out reported. Physicians who can work the shift get an email. |
| 07:00 | 200 dollars | First rise. Five steps reach the cap at the 11:00 deadline, so the steps run from 06:00. |
| 08:00 | 250 dollars | Second rise |
| 09:00 | 300 dollars | Third rise |
| 10:00 | 350 dollars | Fourth rise |
| 11:00 | 400 dollars | Deadline, 4 hours before 15:00, and the cap. Schedulers get an email. The day backup gets a heads-up. The premium stays at 400 dollars. |
Ines Duarte worked Friday's night shift, which ended at 07:00 on Saturday. She gets no offer, because a 15:00 start leaves her 8 hours off, under the department's 11.
No one takes the shift by 11:00. The scheduler opens Choose cover.
| Physician | What the list shows | Scheduler's options |
|---|---|---|
| Sam Ahmed, on day backup | Fits: free, rested and inside their rules | Assign |
| Lee Brooks | Fits: free, rested and inside their rules | Assign |
| Nina Cho | Nina Cho needs at least 12 hours' notice. | Assign anyway, after confirming |
| Ines Duarte | Ines Duarte would have less than 11 hours of rest around Night shift on Nov 13. | None. She can't be assigned. |
Physicians on backup who fit come first, then others who fit, then people outside their own rules, then people who can't be assigned. Within each group, the people called in from backup least often come first.
Assigning Sam Ahmed calls him in from backup. A backup call-in records no premium. Assigning Lee Brooks instead records the 400 dollars showing at 11:00.
The fairness ledger
With the ledger on, the Coverage tab shows each person's last 12 months: backup days, times called in from backup, shifts covered, nights covered, covers under 12 hours' notice, premiums recorded and credits.
Credits are 1 per backup day and 3 per shift covered, with 2 more for a night and 2 more under 12 hours' notice. Schedulers see every row. Each clinician sees only their own.
What it does not do yet
- The backup roster lists physicians only. A nurse or APP call-out reaches its own group as an open shift (with open-shift offers on) and on the scheduler's cover list. No one gets a backup heads-up for it.
- Capillary records premiums for payroll. It does not pay them.
- Capillary does not split an open shift between two people.
- Bids are steps on the department's premium ladder. There is no other price to name.
- If the scheduler has changed a shift in an unpublished draft, a call-out for it has to wait for the next publish.
- Personal rules apply only with day and night backup on.
- Offers and alerts go by email to clinicians who have joined the department. There are no text messages or phone calls.
Try it
The demo shows a full sample month for a fictional department. It needs no account. To cover call-outs, sign in or create an account, publish a month, then turn on the features you want in the Coverage tab.
Common questions
- Does the scheduler have to approve whoever takes a call-out?
- No. The first person who can work the shift gets it, or the lowest bid once the premium reaches it, even if your department requires approval for trades.
- Who can see why someone called out?
- Only schedulers. The note on a call-out, such as Sick, is hidden from everyone else.
- Is a won bid binding?
- Yes. When your bid wins, you are on the published schedule at once, with no approval step, and you get an email. Change or withdraw your bid before its time if your plans change; after that, report a call-out.
- What if two people bid the same premium?
- Whoever has covered fewer shifts in the last 12 months gets the shift. If that ties too, the earlier bid wins.
- Can I stop getting offer emails?
- Yes. In My account, under "Email me about", uncheck "Open shifts offered: call-outs and unfilled shifts". Open shifts still show on your Coverage tab.
- Can a nurse's call-out go to a physician?
- No. Offers and the cover list stay inside the shift's group: RNs for nurse shifts, NPs and PAs for APP shifts, MDs and DOs for physician shifts.
Build your ED schedule with rest checked on every save.
Capillary checks role, overlapping shifts and rest, including shifts at other sites, before anything is published or traded.