personnel schedules for advanced deployment systems jonathan d. washko, bs-emsa director of...
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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
Homeostasis & The EMS Success TriadHomeostasis & The EMS Success Triad
Patient Care Response Times Clinical Performance Customer Service
Pat
ient Car
eSuccess
Triad
Homeostasis & The EMS Success TriadHomeostasis & The EMS Success Triad
Employee Well-Being Retention Health / Safety / Welfare Satisfaction Schedules Work Environments Compensation Recruitment Family P
atie
nt Car
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Employee Wellbeing
SuccessTriad
Homeostasis & The EMS Success TriadHomeostasis & The EMS Success Triad
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
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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
Scheduling Components & Steps for Scheduling Components & Steps for Advanced Deployment SystemsAdvanced Deployment Systems
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
Scheduling Components & Steps for Scheduling Components & Steps for Advanced Deployment SystemsAdvanced Deployment Systems
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.
Scheduling Components & Steps for Scheduling Components & Steps for Advanced Deployment SystemsAdvanced Deployment Systems
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
Scheduling Components & Steps for Scheduling Components & Steps for Advanced Deployment SystemsAdvanced 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 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
Scheduling Components & Steps for Scheduling Components & Steps for Advanced Deployment SystemsAdvanced Deployment Systems
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?
Scheduling Components & Steps for Scheduling Components & Steps for Advanced Deployment SystemsAdvanced 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 Scheduling Components & Steps for Advanced Deployment SystemsAdvanced Deployment Systems
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
Scheduling Components & Steps for Scheduling Components & Steps for Advanced Deployment SystemsAdvanced Deployment Systems
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