Personnel Schedules for Advanced Deployment Systems Jonathan D. Washko, BS-EMSA Director of Deployment – REMSA President – Washko & Associates, LLC Partner

Personnel Personnel Schedules for Schedules for Advanced Advanced Deployment Deployment SystemsSystems

Jonathan D. Washko, BS-EMSAJonathan D. Washko, BS-EMSADirector of Deployment – REMSADirector of Deployment – REMSAPresident – Washko & Associates, LLCPresident – Washko & Associates, LLCPartner – Stout Solutions & FirstWatchPartner – Stout Solutions & FirstWatch

““Developing schedule patterns Developing schedule patterns that mirror demand is an art as that mirror demand is an art as

much as a science. Equally much as a science. Equally challenging is creating a real-challenging is creating a real-

world work schedule that takes world work schedule that takes into account what employees into account what employees

really value”really value”

Session OverviewSession Overview

Homeostasis & The EMS Success Triad Scheduling Components & Steps for

Advanced Deployment Systems Building a Triad Balanced Schedule Pitfalls & Tips / Tricks Summary / Review / Questions

Homeostasis & The EMS Success TriadHomeostasis & The EMS Success Triad

The Constant Balancing of 3 Key Elements Patient Care Employee Well-Being Financial Success (however you define it)

Pat

ient Car

e

Employee Wellbeing

Econ

omic S

tability

SuccessTriad


Patient Care Response Times Clinical Performance Customer Service

Pat

ient Car

eSuccess

Triad


Employee Well-Being Retention Health / Safety / Welfare Satisfaction Schedules Work Environments Compensation Recruitment Family P

atie

nt Car

e

Employee Wellbeing

SuccessTriad


Financial Success A/R Billing Practices EMS Delivery Model & System Design Operational Efficiency & Effectiveness Employee Compensation Safety & Risk Management Systems Engineering Profitability Subsidy Needs

Pat

ient Car

e

Employee Wellbeing

Econ

omic S

tability

SuccessTriad

Scheduling Components & Steps for Scheduling Components & Steps for Advanced Deployment SystemsAdvanced Deployment Systems

Step 1: Have Good, Clean Data – Crap In / Crap Out Theory Step 2: Perform a Temporal Demand Analysis

The Science The Art (someday may be science)

Step 3: The Schedule Build…A Matter of Supply, Demand & Playing Tetris Playing it Old School Zoll’s Resource Planner (formerly ISERA Deployment Planner)

This isn’t a plug….it’s the only software of its kind in existence today

Step 4: The Shift Bid Step 5: Building the Bridge Step 6: Schedule / Production Fulfillment Step 7 (Optional): Purchase Order Unit Hours Step 8: Repeat as Necessary


Step 1: Have Good, Clean Data – Crap In / Crap Out Theory Clean and accurate data is important Bad data or incorrectly filtered data can KILL (how) Decide what is “system” coverage and what is “out of

system” coverage then filter your data to this definition Look for anomalies that can skew your results

e.g. – MCIs, HazMats, Large Multi Unit Responses Decide what type of responses are in and what are out


Step 2: Perform a Temporal Demand Analysis The Science

Mathematical models that drive your demand prediction curves

Stoutian Theory Based Advanced Statistics Based

Task Time Adjustments Discussed first day here at the conference

The Art (someday may be science) A Unit Hour Buffer based on numerous variables

Performance requirement, system efficiency, service area size & makeup, seasonality, system effectiveness, etc.

This is typically a S.W.A.G.


Step 3: The Schedule Build…A Matter of Supply, Demand & Playing Tetris Playing it Old School

Graphs, colored pencils & time Microsoft Excel Templates

Zoll’s Resource Planner (formerly ISERA Deployment Planner) This isn’t a plug….it’s the only software of its kind in existence

today Allows you to easily build a complex schedule that meets your

predetermined demand curves and patterns Allows for different variables to adjust scheduling based on

Demand, Costs, FTEs, Resource Availability, Lost Unit Hours and others

This is NOT schedule fulfillment software…it’s schedule building software…there’s a HUGE difference!

If we have time, I will demo it at the end of the session Start of Shift and End of Shift Lost Unit Hours


Step 4: The Shift Bid The Shift Bid is used to migrate the schedule into the

workforce Can have one of the largest impacts on employee well-

being of all HPEMS concepts MUST be balanced, fair & accurate Typically seniority based Multiple ways to do this

Individual bid on paper Buddy bid using the college signup approach Hybrid models (combination of the two) REMSA’s going on-line successes

HEADCOUNT / HEADCOUNT / HEADCOUNT!!!!!!!!!!! Only bid out shifts you have headcount to fill, otherwise

your weekend and night shifts will look like Swiss cheese


Step 5: Building the Bridge A transitional “bridge” schedule from an old schedule to

the new schedule MUST be built This is MANDATORY This allows any gaps between the two schedules to be

“repaired” It’s like building a bridge…if one side of a bridge is

being built while the other side is also being built…when then they meet in the middle they must match PERFECTLY

Failure to do this will be disastrous! Did I mention that this is MANDATORY?


Step 6: Schedule / Production Fulfillment This is the true “Production Factory” of your HPEMS

system Most medium to large size HPEMS systems have

scheduling departments Many new software programs are available that help

make this process highly efficient and effective Zoll’s Crew Scheduler, eCore’s Net Scheduler Pro, ADP’s

Scheduling Suite and others Most important step in production fulfillment is

understanding the SIGNIFICANT impacts of unfilled or overfilled production schedules on the Success Triad

Unfilled = adverse patient & employee effects Overfilled = adverse financial effects Properly filled = balance & harmony


Step 7 (Optional): Purchase Order Unit Hours P.O.U.H. are used in larger HPEMS systems to adjust

their temporal unit hour supply up or down based on seasonal volumetric variances, compliance variances or other system problems

Essentially, they add or remove shifts (unit hours) on a weekly or daily basis based on predicted volume changes, response time performance issues, hospital delay problems, etc.

Must have a solid PRN / Part Time employee pool and/or flexible FT employee pool in order to successfully achieve this level of dynamic scheduling

This is a solid approach for aggressive deployment models to meet their financial needs while also balancing the needs of the rest of the Triad


Step 8: Repeat as Necessary Most HPEMS systems perform a new scheduling cycle

(all these steps) every 6 months or so This allows the HPEMS system to adjust their unit hour

supply with any changes in demand curves including seasonality and growth

Based on the culture of your organization, this process may be sacred or loathed, but it is a necessary evil of Production Model EMS systems

Many things can be done to help employees manage their way through this process with positive outcomes and happy personnel…

Building a Triad Balanced ScheduleBuilding a Triad Balanced Schedule

The Constant Balancing of 3 Key Elements Patient Care Employee Well-Being Financial Success (however you define it)

Pat

ient Car

e

Employee Wellbeing

Econ

omic S

tability

SuccessTriad

Building a Triad Balanced Building a Triad Balanced ScheduleSchedule

A Look at the Triad & Schedules… Patient Care

Demand patterns must be met May cause some less desirable shifts to be required

Financial Success / Stability Revenue, costs & profit (or your budget) typically will

dictate unit hour availability UHU, your ability to perform in an efficient and effective

manner and your deployment plan aggressiveness also dictate the number of unit hours needed to be successfully balanced

Employee Well-being Difficult to balance here with other competing interests

but there are ways…

Building a Triad Balanced ScheduleBuilding a Triad Balanced Schedule Employee Well-being

Difficult to balance here with other competing interests but there are ways…

The Shift Bid Committee Group of employees of various stake holder groups that

come together and drive the entire scheduling process from start to implementation

They typically survey the workforce to see what kind of shifts, work weeks, patterns, etc. their peers want

They do it all (with help from management content experts where needed)

They help with the demand analysis, they build the schedule and they do the actual shift bid

No Good ‘Ole Boy Stuff The bid is the way the bid is, don’t change it! The empowerment of quality is based on the quality of

empowerment

Building a Triad Balanced ScheduleBuilding a Triad Balanced Schedule Employee Well-being

Difficult to balance here with other competing interests but there are ways…

Go on-line! Technology has allowed this process to become a live and

dynamic process which improves employee satisfaction At REMSA, we use a single bid process where employees

submit a paper bid (as a backup), however, on bid day the process is performed live on the internet

Each employee is assigned a bid time based on seniority Employees then see the bid as it unfolds live and we allow

changes from their submitted paper bid when their turn arrives

When the employee picks a shift it is theirs and they know immediately

They also immediately know who their partner will be

Pitfalls, Tips & TricksPitfalls, Tips & Tricks Pitfalls

Bad data and/or bad demand analysis = bad schedule Bidding out more shifts then you have headcount to fill Not building a bridge / transitional schedule Not taking into account ALL employee stakeholder

group needs

Tips & Tricks Do a supply to demand graph of the new schedule to

ensure it matches With today’s software tools, excess UH waste can be

minimized to +/- 3% or so Use a Shift Bid Committee and properly empower them Consider creating multiple schedules and having

employees pick the one they like best

Summary / Review / QuestionsSummary / Review / Questions

Contact Information for Jonathan Washko REMSA

Phone: 775-858-5700 x140 Email: [email protected] Website: www.remsa-cf.com

Washko & Associates, LLC. Phone: 804-347-3337 / 775-626-4459 Email: [email protected] Website: www.washkoassoc.com

mailto:[email protected]

http://www.remsa-cf.com/

mailto:[email protected]

http://www.washkoassoc.com/

Documents

Personnel Schedules for Advanced Deployment Systems Jonathan D. Washko, BS-EMSA Director of Deployment – REMSA President – Washko & Associates, LLC Partner