Issue link: https://industrialengineer.epubxp.com/i/777540
February 2017 | ISE Magazine 31 In order to analyze the hourly call volume demand for ambulances, a de- mand analysis was built to measure hourly demand for each hour of the day each day of the week using the 90th per- centile and averages. As noted in Figure 2, the call volume, represented by the blue vertical bars, was temporal in nature, as indicated by peaks and valleys; whereas the staffing curve shown by the red line was static in nature. Figure 2 is an accurate reflection of the current state, at that time, of opera- tions for each day of the week. During peak hours of the day the EMS system did not have enough ambulances on duty to manage high peak volumes, and during nonpeak hours (midnight to 6 a.m.) the system had too many ambu- lances on duty for the actual call volume. This led to excessive costs. These structural inefficiencies directly contrib- uted to prolonged emergency response times, suboptimal levels of service, crew fatigue and revenue loss as emergency calls were given to the local competitor. The process map in Figure 3 shows that under the current call-taking/call- assignment process required by state zoning rules, nearly 50 percent of the process steps are nonvalue-added. Thus, when calls were given to local competi- tors due to service level inadequacies, the current process was riddled with delays, waste and reworks, which added layers of inefficiencies between the sup- plier and consumer. The takeaway is that if the system was optimized and staffed properly, then the nonvalue-added steps in red on Figure 3 would become nonfactors as fewer calls would be given away to the competitor. Improve/implement Once the KPIs were measured and the FIGURE 2 Supply doesn't meet demand This hourly call volume demand analysis revealed that Navicent Health's EMS staffing levels did not match the volume of calls. FIGURE 3 A broken process The current process included a number of nonvalue-added steps, shown in red. Incident occurs Call 911 Call received by EMS If yes, call dispatched Crew responds Crew arrives Patient treated Patient transported Arrive at destination Transfer of care Crew back in service Crew returns to zone If no, transfer to other EMS service Call received Call dispatched Crew responds Call patched to zone provider Truck available? MCCG or MGA zone? Detailed process map