Personnel
Schedules for
Advanced
Deployment
Systems
Jonathan D. Washko, BS-EMSA
Director of Deployment – REMSA
President – Washko & Associates, LLC
Partner – Stout Solutions & FirstWatch
“Developing schedule patterns
that mirror demand is an art as
much as a science. Equally
challenging is creating a realworld work schedule that takes
into account what employees
really value”
Session 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 Triad
 The Constant Balancing of 3 Key Elements
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Patient Care
Employee Well-Being
Financial Success (however you define it)
Success
Triad
Employee Wellbeing
Homeostasis & The EMS Success Triad
 Patient Care
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Response Times
Clinical Performance
Customer Service
Success
Triad
Homeostasis & The EMS Success Triad
 Employee Well-Being
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Retention
Health / Safety / Welfare
Satisfaction
Schedules
Work Environments
Compensation
Recruitment
Family
Success
Triad
Employee Wellbeing
Homeostasis & The EMS Success Triad
 Financial Success
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A/R Billing Practices
EMS Delivery Model & System Design
Operational Efficiency & Effectiveness
Employee Compensation
Safety & Risk Management
Systems Engineering
Profitability
Subsidy Needs
Success
Triad
Employee Wellbeing
Scheduling Components & Steps for
Advanced Deployment Systems
 Step 1: Have Good, Clean Data – Crap In / Crap Out Theory
 Step 2: Perform a Temporal Demand Analysis
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The Science
The Art (someday may be science)
 Step 3: The Schedule Build…A Matter of Supply, Demand &
Playing Tetris
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Playing it Old School
Zoll’s Resource Planner (formerly ISERA Deployment Planner)
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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
Scheduling Components & Steps for
Advanced Deployment Systems
 Step 1: Have Good, Clean Data – Crap In / Crap
Out Theory
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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
Scheduling Components & Steps for
Advanced Deployment Systems
 Step 2: Perform a Temporal Demand Analysis
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The Science
 Mathematical models that drive your demand prediction
curves
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Stoutian Theory Based
Advanced Statistics Based
Task Time Adjustments
 Discussed first day here at the conference
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The Art (someday may be science)
 A Unit Hour Buffer based on numerous variables
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Performance requirement, system efficiency, service area
size & makeup, seasonality, system effectiveness, etc.
This is typically a S.W.A.G.
Scheduling Components & Steps for
Advanced Deployment Systems
 Step 3: The Schedule Build…A Matter of Supply, Demand &
Playing Tetris
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Playing it Old School
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Zoll’s Resource Planner (formerly ISERA Deployment Planner)
 This isn’t a plug….it’s the only software of its kind in existence
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Graphs, colored pencils & time
Microsoft Excel Templates
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
Scheduling Components & Steps for
Advanced Deployment Systems
 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 wellbeing 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
Scheduling Components & Steps for
Advanced Deployment Systems
 Step 5: Building the Bridge
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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?
Scheduling Components & Steps for
Advanced Deployment Systems
 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
Scheduling Components & Steps for
Advanced Deployment Systems
 Step 7 (Optional): Purchase Order Unit Hours
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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
Scheduling Components & Steps for
Advanced Deployment Systems
 Step 8: Repeat as Necessary
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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 Schedule
 The Constant Balancing of 3 Key Elements



Patient Care
Employee Well-Being
Financial Success (however you define it)
Success
Triad
Employee Wellbeing
Building a Triad Balanced Schedule
 A Look at the Triad & Schedules…
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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 Schedule
 Employee Well-being
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Difficult to balance here with other competing interests
but there are ways…
 The Shift Bid Committee
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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
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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 Schedule
 Employee Well-being
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Difficult to balance here with other competing interests
but there are ways…
 Go on-line!
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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 & Tricks
 Pitfalls
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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
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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 / Questions
 Contact Information for Jonathan Washko
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REMSA
 Phone: 775-858-5700 x140
 Email: jwashko@remsa-cf.com
 Website: www.remsa-cf.com
Washko & Associates, LLC.
 Phone: 804-347-3337 / 775-626-4459
 Email: jw@washkoassoc.com
 Website: www.washkoassoc.com