Don’t Let the Inmates Run the Asylum

1. Don’t Let the Inmates Run the Asylum Laura Terry Director of Administration Professional Ambulance Service Cambridge, MA 617.682.1839 lterry@proems.com www.proems.com

2. About Pro EMS • 9-1-1 for the city of Cambridge, MA & Paramedic intercept to 8 towns • Sixteen ambulances with 50 field providers • Annually, we respond to over 26,000 calls, including over 20,000 emergencies, transporting nearly 20,000 patients • Our paramedics and EMTs work in a tiered system utilizing predominantly ALS supported by BLS ambulances • Use of automatic vehicle location (AVL) / global positioning system (GPS), computer aided dispatch (CAD), electronic patient care reporting (ePCR)

3. The City of Cambridge • Population • Broad ethnic and linguistic diversity • 100,000 + residents • 300,000 daytime • Geography • 6.25 square miles • 6th highest population density in the country • Over 6.5 miles of riverfront • 100+ hi-rise structures

4. Intercept Towns • Collective of eight towns • Population • 150,000 + residents • Geography • 200 square miles

5. The Problems Needed to Do a Better Job Tracking Man Hours Needed to Do a Better Job Tracking Time and Attendance Needed a better handle on Payroll

6. Our Solution Our Solution Has Been RescueNet CrewScheduler Let’s Take a Look…

7. Getting a Handle on Man Hours Needed Better Management and Metrics for Man Hours and Payroll to Better Manage Weekly Man Hours Total (<5% over scheduled hours) Weekly Payroll Dollars (dramatic swings in overall payroll was unexplained) Causes Us to Give a Fresh Look at Operations, Procedures, and Schedules

8. Weekly Hours Report

9. Actual Hrs vs. Scheduled Hrs

10. Weekly Payroll Dollars by Dept.

11. Weekly Hours Report

12. Total Payroll

13. Getting a Handle on Man Hours Caused us to implement new system for cleaning and restocking Looked at man hours – Every FTE required 2 hours OT in cleaning and restocking. Let’s face it…not their preferred way to make 2 hours OT. Not doing a great job.

14. Getting a Handle on Man Hours Hired two (2) Support Services Technicians. One SST on duty from 0800 – 2000 every day. SSTs handle all washing and cleaning of vehicles and restock used equipment

15. Getting a Handle on Man Hours Crews now come in and go right out. Only need to check medications. When they return at night - park the vehicle and punch out. No washing. No restocking.

16. Getting a Handle on Man Hours Resulted in savings of over 80 hours/week of field personnel overtime ($30/hr) replaced by 88 hours/week of straight time for SSTs ($17.00/hr) $45,000/per year savings Ambulances checked and clean Field staff loves it

17. Others Areas of Focus • Paramedic Program – Instructor Hours • Community CPR • NEOP • Internal Training

18. Tracking and Reducing Tardiness Field Providers Late for Shifts Nearly 10% of the Time Crews Getting Stuck on Late Calls Bad for Morale of People Coming in On Time We Needed to Fix This Problem

19. Tracking and Reducing Tardiness Supervisor is Paged Every Time Someone is Late Supervisors Provide Immediate Feedback and Corrective Action Coming to Work on Time becomes a Measureable Element for the Field Provider’s Performance Review

20. Tracking and reducing tardiness…

21. Tracking and reducing tardiness…

22. Tracking and Reducing Using Technology to Fix and Control Problem Late Punch Out Percentage (Target<5%) Late Punch In Percentage (Target <5%) Supervisor is paged every time someone punches in late. Immediate action taken to work problem. *1 minute past is late

23. Top 10 Late Punch-In Excuses, # 10 “1 minute late? Bite my ass,that’s some f***ing bulls**t.”

24. Top 10 Late Punch-In Excuses, # 9 “Tequila and a midget.”

25. Top 10 Late Punch-In Excuses, # 8 “Yeah bitch. 15 minutes.Now that’s late.”

26. Top 10 Late Punch-In Excuses, # 7 “Traffic, construction….general mayhem. Sorry.”

27. Top 10 Late Punch-In Excuses, # 6 “Buttload of Nyquil = Don’t Hear Alarm”

28. Top 10 Late Punch-In Excuses, # 5 “It’s a matter of perspective.”

29. Top 10 Late Punch-In Excuses, # 4 “I’m “That” Guy”

30. Top 10 Late Punch-In Excuses, # 3 “I couldn’t find my pants.”

31. Top 10 Late Punch-In Excuses, # 2 “10” of white fury f’d up my civic.”

32. Top 10 Late Punch-In Excuses, # 1 “Vaheing: Definition;- To forget a schedule change completely and thus be 43 minutes late.”

33. Results – Overall • Drives us to constantly look for better ways to do things • Drives us to constantly look for better technology • Involves employees in the process

34. What’s Next For Pro EMS? • Never Stop – Continuous Quality Improvement • Regularly work with Zoll Data Systems as an Alpha and Beta Site • Working with other EMS providers to assist them with their technology needs and systems.

35. Thank You! WWW.PROEMS.COM lterry@PROEMS.COM 617.682.1839