HCA nurses have described schedule changes and staffing concerns involving Timpani, while Rayus schedulers reported errors in a separate Foundry-based appointment workflow. The systems handle different jobs: Timpani uses forecasts of patient volume and staffing needs to build nurse schedules; Rayus’s tool transfers details from doctors’ orders into appointment fields.
| Organization and system | Task | Reported concern |
| HCA Healthcare’s Timpani | Builds nurse schedules using forecasts of patient volume and staffing needs | Nurses described changed shift assignments, requested days off being scheduled as workdays, staffing concerns and difficult appeals. |
| Rayus Radiology’s Foundry-based workflow | Transfers details from doctors’ orders into appointment scheduling fields | Schedulers reported wrong-patient links, tests that did not match orders and inaccurate patient details. |
What HCA nurses report about Timpani
Amber Retzloff, an HCA nurse, said that over four months Timpani assigned her to different shifts than she had requested for more than half of 50 requested 12-hour shifts. She also described a shift where she was the only senior nurse among four junior colleagues, and said she had to delay care for the sickest patients while guiding them.
Lee Barker, another HCA nurse, said assignments to requested days off—known at HCA as “red days”—had become routine at her facility. Barker described delaying a long-planned medical appointment after a red-day assignment proved difficult to trade. Retzloff and Barker estimated that successful shift swaps happened about half the time. Nurses also described appeals moving from some local managers to a centralized HCA team in Nashville.
HCA says nursing leaders make the final scheduling decisions and that Timpani assigns nurses to requested days off an average of 1% of the time. The company says it is improving the system using staff feedback.
How Timpani works, and what HCA reports
HCA co-developed Timpani with Palantir. Launched in 2023, the nurse-scheduling system runs on Palantir Foundry and uses forecasts of patient volume and staffing requirements to generate schedules. HCA’s July 2026 paper said Timpani was live at more than 130 hospitals and supported over 1,200 nursing departments.
The same paper said departments typically spend 8–15 hours a month building schedules, while Timpani brings the work to 2–3 hours per cycle. HCA also reported that more than 98% of shifts include a mix of skills and experience, and fewer than 2% are staffed entirely by beginners. The company said departments using Timpani reported a 6% decline in turnover and reduced use of contract labor.
Rayus’s separate appointment workflow
Rayus Radiology uses a different Foundry-based tool to transfer information from doctors’ orders into appointment scheduling fields. Schedulers reported cases where the workflow linked an order to the wrong patient profile, entered a test that did not match the order, or produced inaccurate patient details.
Rayus disputes the broad characterization of these problems. The company says its technology supports rather than replaces human judgment and oversight.
